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CN 34-1304/R ISSN 1674-3679

2022 Vol. 26, No. 9

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All for the People's Health—Our Ten Years
Progress and effects of women and children's health in China
LI Wen-xian, CAO Xiu-jing
2022, 26(9): 993-995. doi: 10.16462/j.cnki.zhjbkz.2022.09.001
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Abstract:
Great emphasis has been placed on women and children's health, as priority development area in China. Since the 18th National Congress of the Communist Party of China, women and children's health has stepped into a new historical period and made remarkable progress. In 2021, maternal mortality ratios have decreased to 16.1 cases per 100 000 and infant mortality rates and under-5 mortality rates have decreased to 5.0 cases per 1 000 and 7.1 cases per 1 000. Core indicators have reached a record low. Prevention and treatment on cervical and breast cancer, prevention of mother-to-child transmission of HIV, syphilis and hepatitis B, heath management for children, and prevention and treatment on birth defects have obtained positive achievements. China has made important contributions to the development of women and children's health in the world.
Literature Review
Epidemiologic features and scientific prevention and control of monkeypox
WU Yu, LIU Jue, LIU Min, LIANG Wan-nian
2022, 26(9): 996-999. doi: 10.16462/j.cnki.zhjbkz.2022.09.002
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Monkeypox is a rare, sporadic, acute infectious disease with smallpox-like clinical manifestations caused by monkeypox virus (MPXV). Since May 2022, more than 1 000 laboratory-confirmed cases of monkeypox have been reported worldwide. This is the first time in the world that multiple monkeypox cases and clustered cases have been reported in both non-endemic and endemic countries. The prevention and control of the epidemic presents new challenges. This study reviewed the research progress on the etiological characteristics, epidemic status, epidemiological characteristics, and prevention and control measures of monkeypox virus, in order to provide reference for scientific prevention and control.
Maternal and Child Health
The influencing factors in early pregnancy of term small for gestational age infant
LYU Tian-chen, QU Yi-min, ZHAN Yong-le, CHEN Yun-li, SHI Ying-jie, YUE He-xin, ZHAO Jian, JIANG Yu
2022, 26(9): 1000-1004. doi: 10.16462/j.cnki.zhjbkz.2022.09.003
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  Objective  To explore the influencing factors of term small for gestational age (SGA) infant, and to provide a scientific basis for preventing the SGA.  Methods  Questionnaire survey and Hospital Information System (HIS) were used to collect data, and logistic regression analysis model was used to analyze the influencing factors of SGA.  Results  The incidence of SGA was 6.6%. Non-first pregnancy and docosahexaenoic acid (DHA) supplementation during pregnancy were the protective factors of SGA, low BMI before pregnancy and umbilical cord entanglement during pregnancy were the risk factors of SGA (all P < 0.05).  Conclusion  Pregnant women should maintain a reasonable weight before and during pregnancy, supplement DHA during pregnancy, and prevent umbilical cord entanglement and other pregnancy complications to reduce the risk of SGA.
Analysis of influencing factors of eczema in preschoolers in China: a prospective cohort study in five provinces
YUE He-xin, QU Yi-min, ZHAN Yong-le, CHEN Yun-li, SHI Ying-jie, LYU Tian-chen, LIU Xuan, MENG Yao-han, JING Ao, GUI Lu-ting, LIU Rui-yi, QIN Dong-xu, WANG Jia-xu, ZHANG Yi-fang, JIANG Yu
2022, 26(9): 1005-1010. doi: 10.16462/j.cnki.zhjbkz.2022.09.004
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  Objective  To investigate the incidence of eczema in preschoolers in China, and to explore its risk factors.  Methods  In this study, 681 children in Chinese Pregnant Women Cohort Study and Offspring Follow-up were included. The demographic information of parents during pregnancy and home environmental factors were investigated by questionnaire. Logistic regression was applied to analyze the influencing factors of eczema in preschoolers.  Results  The incidence of eczema in preschoolers was 23.79%. Our result showed that the risk of eczema in preschoolers whose mothers were multiparae (OR=0.601, 95% CI: 0.398-0.908) is lower than primiparae. 3 to 5 year old children whose mothers (OR=2.191, 95% CI: 1.393-3.447) or fathers (OR=2.008, 95% CI: 1.244-3.239) have an allergic history are more likely to suffer from eczema. Compared with breast feeding, artificial feeding (OR=4.165, 95% CI: 1.450-11.963) and mixed feeding (OR=8.151, 95% CI: 5.165-12.866) were risk factors of infantile eczema. Faded, blackened or mildewed household floors, windowsills or walls also increase the risk of eczema in preschoolers (OR=2.051, 95% CI: 1.094-3.843). Compared to the lower frequency, higher frequency of intake of poultry was significantly associated with an increased risk of eczema (OR=1.145, 95% CI: 1.011-1.297).  Conclusions  Parity, parents' allergic history, feeding patterns, frequency of poultry intake during pregnancy and home environment are associated with eczema in preschoolers, and targeted health education should be strengthened to effectively prevent the occurrence of eczema in 3 to 5 year old children.
The influencing factors and perinatal outcomes of gestational diabetes
MENG Yao-han, QU Yi-min, ZHAN Yong-le, CHEN Yun-li, SHI Ying-jie, JING Ao, MA Liang-kun, JIANG Yu
2022, 26(9): 1011-1016. doi: 10.16462/j.cnki.zhjbkz.2022.09.005
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  Objective  To analyze the risk factors of gestational diabetes mellitus (GDM) and to explore the perinatal outcomes of GDM.  Methods  Data were derived from the Chinese Pregnant Women Cohort Study, and 3 874 pregnant women were included. According to the results of 75 g oral glucose tolerance test, 494 cases were in the GDM group, and 3 380 cases were in the non-GDM group. The clinical characteristics, perinatal outcomes and neonatal outcomes of mothers and infants in each group were recorded, and the data were compared by χ2 test, Wilcoxon rank sum test, Fisher exact probability method and univariate logistic regression analysis.  Results  The incidence of premature delivery and premature rupture of membranes of GDM were higher than those in the normal group, with statistically significant differences (all P < 0.05). The multivariate logistic regression showed that the risk of developing GDM increased with age. In addition, the southern region (OR=1.719, 95% CI: 1.401-2.109, P < 0.001), insufficient weight gain during pregnancy (OR=1.485, 95% CI: 1.164-1.893, P=0.001) and preconception overweight (OR=1.634, 95% CI: 1.241-2.151, P < 0.001) were independent risk factors of GDM.  Conclusion  Advanced age, southern region, overweight before pregnancy and insufficient weight gain during pregnancy are influencing factors of GDM. The related risk factors should be identified as soon as possible and actively intervened, in order to reduce the occurrence of adverse pregnancy outcomes and improve health status of mothers and infants.
Original Articles
The trajectory of depression in Chinese women from early to late pregnancy
YAN Pan-pan, LIU Xiao-yu, XU Ji-hong
2022, 26(9): 1017-1022. doi: 10.16462/j.cnki.zhjbkz.2022.09.006
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  Objective  To explore the developmental trajectory of depressive symptoms in Chinese women from early to late pregnancy.  Methods  From 21 August 2019 to 28 June 2020, 2 485 pregnant women from several hospitals in China were conducted the follow-up survey of depressive symptoms in early pregnancy (T1, < 13 weeks), mid pregnancy (T2, 20 to 28 weeks) and late pregnancy (T3, 32 to 36 weeks) through a self-administered maternal mental health online survey system using the self-administered basic information questionnaire and the Edinburgh postnatal depression scale. Besides, the data was analyzed using Mplus 8.3 for both latent variable growth curve model and growth mixture model.  Results  A total of 531 pregnant women completed the measurement at three time points during pregnancy. The detection rates of depression were 31.64% in early pregnancy, 23.92% in mid-pregnancy and 25.61% in late pregnancy. The results of the model showed an overall gradual decrease in depressive symptoms during pregnancy from early to late pregnancy, with three potential categories of normal remission group (C1, 67.42%), depression risk group (C2, 28.44%) and depression high risk group (C3, 4.14%). Among of them, the C1 group showed a gradual decrease from early to late pregnancy (xβ=-1.15, P < 0.001); the C2 group showed a steady increase (xβ=0.86, P < 0.001); and the C3 group showed a significant increase (xβ=1.57, P < 0.001).  Conclusion  Depressive symptoms during pregnancy show a linear trajectory of progressive decline from early to late pregnancy as a whole, and there are three potential categories with distinct group heterogeneity.
Association of dietary vitamin C intake during pregnancy with preeclampsia and its clinical subtypes
LI Jin-bo, LI Wang-jun, REN Qing-wen, GUO Meng-zhu, FENG Yong-liang, YANG Hai-lan, ZHANG Ya-wei, WANG Su-ping, WU Wei-wei
2022, 26(9): 1023-1029. doi: 10.16462/j.cnki.zhjbkz.2022.09.007
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  Objective  To investigate the relationship between dietary vitamin C intake during pregnancy and preeclampsia (PE) and its clinical subtypes.  Methods  Pregnant women who were delivered in the Department of Obstetrics and Gynecology of the First Hospital of Shanxi Medical University from March 1, 2012 to September 30, 2016 were selected as the research subjects. Among them, 861 PE pregnant women were used as the case group and 7 987 non-PE pregnant women were used as the control group. Information on demographic characteristics, disease history, family history and dietary intake during pregnancy were collected. Unconditional logistic regression was used to analyze the influence of dietary vitamin C intake during pregnancy on the risk of PE and its clinical subtypes.  Results  After adjusting for maternity age, educational level and other influencing factors, the dietary vitamin C intake of pregnant women reached Q3 level in the first trimester (OR=0.80, 95% CI: 0.64-0.99) and the third trimester (OR=0.78, 95% CI: 0.63-0.97) were negatively related with the risk of PE. After stratifying according to the pre-pregnancy BMI, the dietary vitamin C intake of pregnant women with pre-pregnancy BMI < 24.0 kg/m2 reached Q3 level in the first trimester (OR=0.73, 95% CI: 0.55-0.96), the second trimester (OR=0.71, 95% CI: 0.54-0.93) and the third trimester (OR=0.67, 95% CI: 0.51-0.88) were protective factors for PE. After further exploring the relationship between dietary vitamin C intake of pregnant women with different pre-pregnancy BMI and PE clinical subtypes, it was found that the dietary vitamin C intake of pregnant women with pre-pregnancy BMI < 24.0 kg/m2 Q3 level in the third trimester (OR=0.66, 95% CI: 0.47-0.93) reduced risk of late-onset preeclampsia (LOPE).  Conclusion  Dietary vitamin C intake of pregnant women with Pre-pregnancy BMI < 24.0 kg/m2 at Q3 level had reduced risk of PE, especially for LOPE.
Morbidity and influencing factors of congenital syphilis in newborns in Hubei of China, 2015-2020
XU Yang-huan, ZHANG Fan, DAI Guo-hong, LI De-hai, MA Yan-xia, ZHANG Ying, YAN Jiong
2022, 26(9): 1030-1036. doi: 10.16462/j.cnki.zhjbkz.2022.09.008
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  Objective  To investigate the epidemiological characteristics of pregnant women with syphilis and the prevalence of congenital syphilis in their children in Hubei Province, and to explore the related influencing factors of congenital syphilis.  Methods  Data of syphilitic pregnant women was collected from the national integrated prevention of mother-to-child transmission of HIV, syphilis, and HBV information management system from January 1, 2015, and December 31, 2020. The demographic characteristics, detection and treatment of syphilis, and the prevalence of congenital syphilis were analyzed. A multiple logistic regression model was used to analyze the influencing factors of congenital syphilis.  Results  The average age of 3 467 syphilis-infected pregnant women was (29.79±5.43) years old, and the rate of mother-to-child transmission was 3.17% (110 cases). About 73.35% (2 543 cases) had received antisyphilitic treatment, 49.21% (1 706 cases) had received standard treatment, and 74.82% (2 594 cases) of children exposed to syphilis received preventive treatment. Multivariate analysis showed that the parturition or postpartum period of syphilis was diagnosed (OR=1.879, 95% CI: 1.237-2.853), the status of syphilis infection of husband/sexual partner (OR=3.762, 95% CI: 1.473-9.608), non-treatment (OR=6.360, 95% CI: 3.316-12.199), nonstandard treatment (OR=4.714, 95% CI: 2.385-9.320), the last non-treponema pallidum antigen serologic test result≥1∶8 (OR=8.908, 95% CI: 1.840-43.131), preventive treatment for exposed children (OR=0.559, 95% CI: 0.369-0.846) and term birth (OR=0.496, 95% CI: 0.300-0.821) were independent factors affecting the prevalence of congenital syphilis (all P < 0.05).  Conclusions  The incidence of congenital syphilis was closely related to the diagnosis period of syphilitic pregnant women, the non-treponema pallidum antigen serologic test result at the last test during pregnancy, treatment condition, the gestational age of delivery, the status of syphilis infection of husband/sexual partner and preventive treatment condition of exposed children. Early diagnosis, standardized treatment and preventive treatment of exposed children were beneficial to reduce the occurrence of congenital syphilis.
The investigation of minerals in human breast milk across lactation stages in six representative areas of China
QIAN Chang-li, TIAN Fang, CHEN Rui-di, LI Na, MAO Ying-yi, LU Pan-ting, ZHAO Yan-rong, WANG Yu
2022, 26(9): 1037-1042. doi: 10.16462/j.cnki.zhjbkz.2022.09.009
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  Objective  The study aimed to investigate the representative mineral levels in breast milk at different lactation stages in China and to provide reference and guidance for future infant formula development.  Methods  A total of 690 healthy parturients at different lactation stages were recruited in Chengdu, Shanghai, Tianjin, Guangzhou, Changchun, and Lanzhou. Milk was collected from parturients at 0-5 d, 10-14 d, 40-45 d, 200-240 d, and 300-400 d after delivery. Determination of 12 minerals (K, Ca, Na, Mg, P, Fe, Cu, Zn, Se, Mn, Mo and Cr) in breast milk was conducted by inductively coupled plasma-mass spectrometry (ICP-MS).  Results  Across the 5 lactation periods, Zn dropped dramatically (about 90%) (all P < 0.05). Minerals including K, Na, Zn, Fe, Cu, and Se were significantly affected by lactation time and tended to decrease with the prolonging of lactation time (all P < 0.05), while being stable after 200 days. Ca and P were stable at the early stage and then decreased slightly at the middle-late lactation stage. The content of Mg stayed stable over the lactation period. Except for Ca, P, Cu, and Mg, other minerals showed no significant regional difference (all P > 0.05).  Conclusions  There were differences in the mineral content of breast milk at different lactation stages and different regions. Infant formula should consider the representative levels of mineral content in Chinese breast milk, and be developed according to the nutritional needs of infants at different lactation stages. Meanwhile, the mineral absorption and utilization ratio should be improved to make it more similar to breast milk, so as to meet the growth and development needs of infants without increasing the burden on their kidneys.
The relationship between stunting and underweight of infants with altitude in Tibet-based on propensity score matching method
SUOLANG Qu-zhen, LI Ya-jie, LUO Yang-cuo, NIMA Qu-cuo, CIREN Zhuo-ga, YANG Shu-juan
2022, 26(9): 1043-1049. doi: 10.16462/j.cnki.zhjbkz.2022.09.010
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  Objective  To investigate the incidence of stunting and underweight of infants in Tibet and its relationship with altitude.  Methods  Multi-stage stratified cluster sampling method was used to select infants aged 0-3 years for on-site physical examination and questionnaire survey of guardians. The propensity score matching method was used to balance the confounding factors between the two comparison groups. Univariate logistic regression was used to analyze the relationship between altitude with stunting and underweight.  Results  The incidence of stunting and underweight of infants in Tibet were 20.9% and 8.7%. After conducting 1∶1 propensity score matching method, 324 pair, 648 matched samples were obtained. The confounding factors were balanced between the comparison groups. After matching, compared with infants living at relative low altitude (< 4 000 meters), the OR and 95% CI of stunting and underweight of infants living at high altitude (≥4 000 meters) were 2.31(1.74-3.10) and 1.95(1.27-3.09), respectively. High altitude increased the risk of stunting regardless of gender, family income level and birth weight. while increased the risk of underweight in boy, infants with high family income level, normal birthweight and term production (all P < 0.05).  Conclusions  The growth and development of infants in Tibet is poor. Living at high altitude has a great impact on growth and development of infants.
Analysis of related factors of adverse birth outcomes of living newborns from 2016 to 2020 in Guiping County, Guangxi, China
ZHANG Xiang-ming, ZHAO Peng, CHEN Si-cheng, LI Kai-juan, CHEN Liu-ping, XIN Yan-jian, FENG Zhu-mei, SHI Meng-meng, ZHONG Yan-xu
2022, 26(9): 1050-1056. doi: 10.16462/j.cnki.zhjbkz.2022.09.011
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  Objective  To understand the changing of newborns' birth weight, the characteristics and the related factors of adverse birth outcomes in Guiping County, providing scientific evidence to promote newborns' health in the future.  Methods  The data of newborns were collected from Guiping People's hospital from January first, 2016 to December 31st, 2020. R 4.1.2 version software was used for data description and statistic testing, which included ggplot2, chi-square test, trend chi-square test, t-test, and logistic regression.  Results  There were 25 958 newborns included in the study, with a mean birth weight of (3 054±515) g. The incidence of low birth weight was 10.38%, while the incidence of macrosomia was 2.07%, and the incidence of preterm birth was 11.09%, respectively. Female infants, living in rural areas, and having a high-risk pregnancy were risk factors for low birth weight(OR=1.81, 95% CI: 1.61-2.04; OR=1.56, 95% CI: 1.27-1.90; OR=1.70, 95% CI: 1.44-2.00, respectively); while birth in winter, the second or third parity, and frequent obstetric examinations were protective factors for low birth weight (OR=0.77, 95% CI: 0.65-0.92; OR=0.55, 95% CI: 0.48-0.62; OR=0.50, 95% CI: 0.42-0.59; OR=0.78, 95% CI: 0.67-0.91, respectively). In addition, birth in winter, maternal age 20- < 35 years old and ≥35 years old, the second or third parity, and having high-risk pregnancy were risk factors for macrosomia (OR=1.59, 95% CI: 1.21-2.08; OR=2.94, 95% CI: 1.29-6.71; OR=3.16, 95% CI: 1.35-7.38; OR=1.74, 95% CI: 1.37-2.22; OR=1.73, 95% CI: 1.31-2.29; OR=3.53, 95% CI: 2.66-4.96, respectively). Besides, living in rural areas, paternal ethnicity are other ethnic minorities, having a high-risk pregnancy and multiple fetuses were risk factors for neonatal preterm birth (OR=1.18, 95% CI: 1.01-1.37; OR=1.53, 95% CI: 1.03-2.28; OR=10.20, 95% CI: 8.29-12.55; OR=7.05, 95% CI: 6.17-8.05, respectively), while female infants, the second or third parity, and the number of obstetric examinations were protective factors for preterm birth (OR=0.91, 95% CI: 0.83-0.99; OR= 0.86, 95% CI: 0.77-0.95; OR=0.87, 95% CI: 0.77-0.98; OR=0.37, 95% CI: 0.33-0.42, respectively).  Conclusions  The incidence of preterm birth has decreased during these five years. However, the incidence of low birth weight and macrosomia was still stable or even increasing. It is necessary to carry out high-quality studies to access the causality of related factors and intervention measures to promote newborn health in the future.
Prediction for the outpatient amount of childhood common respiratory diseases based on multivariate LSTM model with lag effect
QIN Jia-jie, CHEN Cong, GUAN Jing, LIU Wei
2022, 26(9): 1057-1064. doi: 10.16462/j.cnki.zhjbkz.2022.09.012
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  Objective  To construct the prediction model of the daily outpatient amount of childhood common respiratory diseases and analyze the trend of the outpatient amount in the future, which will provide data support for the scientific prevention and control of common respiratory diseases in children.  Methods  Based on the daily outpatient cases of a hospital and meteorological and air pollutant data from January 1, 2017 to December 31 2019, the distributed lag nonlinear model (DLNM) was used to analyze the influence and lag effect of average daily temperature and pollutant concentration on the daily outpatient amount in spring and autumn semesters.A multivariate long and short-term memory (LSTM) model was constructed to predict daily outpatient amounts in the spring and autumn semesters.  Results  The median average daily temperature in the spring and autumn semesters was selected for research, and we found that the impact of average daily temperature on the daily outpatient amount in the autumn semester lagged 7 days and lasted for about 10 days, while the effect on the spring semester was immediate and lasted for about 4 days.The multivariate LSTM model combined with the lag effect can predict daily outpatient amount in spring and autumn semesters well, the mean absolute percentage error (MAPE) on the test set was 4.59% and 4.77%, respectively.  Conclusion  The multivariate LSTM model combined with the lag effect can accurately predict the daily outpatient amount, which provides a scientific basis for the prevention and control of diseases.
Cluster analysis based on the characteristics of pertussis time series
CHEN Jia, SONG Qiu-yue, LI Fang, ZHANG Yan-qi, LIU Ling, YI Dong, WU Ya-zhou
2022, 26(9): 1065-1071. doi: 10.16462/j.cnki.zhjbkz.2022.09.013
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  Objective  The data on the incidence of pertussis in 25 provincial administrative regions in China were clustered using a time-series feature extraction method.Based on the clustering results, the different incidence patterns of pertussis in various regions are analyzed to provide a scientific basis for the unified planning and implementation of pertussis disease prevention and control in China.  Methods  The nine global features of pertussis time series from 25 provincial administrative regions in China were extracted, and the nine indicators were transformed into a feature matrix consisting of three principal components using principal component analysis for hierarchical clustering analysis.The optimal number of clusters was selected to classify the different incidence patterns of pertussis time series.  Results  The optimal cluster number of hierarchical clustering was three categories, i.e.corresponding to the three incidence patterns of pertussis: acyclic, seasonal and non-trend pattern (9 provincial administrative regions in total), acyclic, seasonal and trend pattern (10 provincial administrative regions in total) and cyclic, seasonal and trend pattern (6 provincial administrative regions in total).  Conclusion   The hierarchical clustering by time series feature extraction can well group similar patterns closely together and accurately delineate the incidence patterns of pertussis in 25 provincial administrative regions of China.The clustering results can provide a theoretical basis for relevant departments to formulate prevention and control measures for pertussis in different Provinces.
Correlation between depressive symptoms and health promotion behavior in the elderly—based on structural equation model
YU Ji-qin, WU Yong-jun, ZHANG Yue, HE Yu-zheng, CAI Yu-tong, ZHENG Jian-zhong, TONG Yan
2022, 26(9): 1072-1077. doi: 10.16462/j.cnki.zhjbkz.2022.09.014
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  Objective  To explore the relationship between depressive symptoms and health promotion behaviors in the elderly, and to provide a reference for improving psychological intervention measures for the elderly.  Methods  A random cluster sampling method was used to survey 1 949 elderly people in Ningxia Hui Autonomous Region from May 6-July 31, 2021.The Depression Screening Scale (patient health questionnaire, PHQ-9) and the Health Promotion Lifestyle Self-rating Scale (health-promoting lifestyle profile, HPLP-C) were used for evaluation, and the chi-square test and binary logistic regression model were used to explore the influencing factors of depressive symptoms and establish a structural equation model of depressive symptoms and health promotion behaviors.  Results  A total of 1 937 people completed the questionnaire, and 760(39.2%) people were found to have depressive symptoms.Binary logistic regression showed that older, female, and unhealthy seniors were more likely to have depressive symptoms (all P<0.05).In the structural equation model, there was a positive correlation between health responsibility (β=0.20) and depressive symptoms, while self-actualization (β=-0.15) and interpersonal relationships (β=-0.06) were negatively correlated with depressive symptoms.  Conclusions  There is a correlation between depressive symptoms and health promotion behaviors in the elderly, and the occurrence of depressive symptoms can be prevented by improving the healthy behaviors of the elderly.
Dietary fiber intake and gut microbiota in Chinese patients with type 2 diabetes: secondary data analyses of a randomized controlled trial
FU Jiong-xing, YAO Wei-yuan, XU Wang-hong
2022, 26(9): 1078-1084. doi: 10.16462/j.cnki.zhjbkz.2022.09.015
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  Objective  To evaluate associations of dietary fiber intake with gut microbiota in Chinese patients with type 2 diabetes (T2DM).  Methods  A cross-sectional study was conducted among 356 T2DM patients participating in a randomized controlled trial of health literacy and exercise interventions.Total energy and dietary fiber intake were calculated based on the 3-day 24-hour diet recall data and Chinese Food Composition Table.Bacterial 16S rDNA V4 region was sequenced, and Qiime2 was used to conduct bioinformatics analyses.MaAsLin method and generalized linear model were applied to identify differential taxa associated with dietary fiber intake.  Results  Dietary fiber intake was at a low level in our subjects, with a median intake (IQR) of 7.4(5.5, 9.7) g/day.Beta diversity of fecal microbiota based on the Jaccard distance matrix (PERMANOVA P=0.016) were significantly different between groups with a higher or a lower dietary fiber intake, but no significant association was observed between Alpha diversity and dietary fiber intake.Fusobacterium, Collinsella and Prevotella were more abundant in patients with a lower dietary fiber intake, while Streptococcus Luteciae, Fragilis and Bifidobacterium were enriched in patients taking higher dietary fiber.  Conclusions  Dietary fiber intake is associated with gut microbiota composition in diabetes patients, with several harmful bacteria abundant in patients taking lower dietary fiber, and Bifidobacterium enriched in those taking higher dietary fiber.Our results suggest potential regulating effect of usual dietary fiber intake on gut microbiota in diabetes patients.
Characteristics of new HIV infections among MSM population in 20 cities of China——a cohort study based on social network reservation platform for HIV test
DONG Ting-li, JIANG Zhen, CAO Zhao-bing, ZHANG De-chuan, ZHAO Tian-ming, XIE Zhen, MI Guo-dong, LIU Kang-mai, XU Jie, WU Zun-you
2022, 26(9): 1085-1090. doi: 10.16462/j.cnki.zhjbkz.2022.09.016
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  Objective  Describe the characteristics of new human immunodeficiency virus (HIV) infections in men who have sex with men (MSM) population and analyze the influencing factors of new HIV infection among MSM population.  Methods  From January 1, 2019 to December 30, 2020, cohort study of HIV new infections among MSM population was conducted by HIV testing reservation mechanism, which was established on social software in 20 cities of 6 provinces of China.Anonymous online questionnaires survey, repeated HIV testing and follow-up services, and HIV risk self-assessment were carried out.The X2-test, Mann-Whitney test and t-test were used to compare differences between new HIV infections and HIV-negative subjects among MSM population.Factors influencing new HIV infection of MSM population in 20 cities were analyzed by Cox proportional risk regression models.  Results  A total of 6 206 people who were HIV-negative initially and participated HIV test repeatedly were included in this study.17, 488 person-time HIV tests were conducted totally, of which 162 were positive converted from negative.The results of the multifactorial analysis showed that aging 18-<25 years old (HR=2.01, 95%CI: 1.11-3.64), local residence ≤12 months (HR=2.00, 95% CI: 1.25-3.19), having education level of junior secondary school or below (HR=1.91, 95%CI: 1.17-3.13), unknowing HIV infection status of sexual partner (HR=1.91, 95%CI: 1.35-2.69), not using condoms when having homosexual behavior (HR=2.33, 95%CI: 1.63-3.32), sex role was "0" only (HR=2.09, 95%CI: 2.19-5.80), and non-initial testing within this year (HR=1.63, 95%CI: 1.08-2.25) were risk factors for new HIV infection in MSM population.  Conclusions  The influencing factors of new HIV infection in the MSM population are complicated.Targeted intervention, prevention and control strategies based on web-based platforms and information technology are needed.
Epidemiological characteristics of measles and strategies for measles elimination from 2011 to 2020 in Anhui Province
ZHANG Ning, ZHOU Shu-jie, CHENG Xiao-dong, SU Yin, WANG Bin-bing
2022, 26(9): 1091-1096. doi: 10.16462/j.cnki.zhjbkz.2022.09.017
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Abstract:
  Objective  To analyze epidemiological characteristics of measles from 2011 to 2020 in Anhui Province and explore the strategies for measles elimination.  Methods  The epidemiological characteristics of measles in Anhui Province from 2011 to 2020 were analyzed by descriptive epidemiology.  Results  A total of 8 892 cases of measles were reported in Anhui province from 2011 to 2020, with an average annual incidence of 1.48/100 000, the overall trend is downward (X2trend=1 794.80, P<0.001).Measles cases were mainly concentrated from February to June, and there was no obvious seasonal clustering in the years with low incidence.The average annual incidence in northern Anhui, central Anhui and southern Anhui were 1.82/100 000, 1.12/100 000 and 1.24/100 000 respectively, with the difference being statistically significant (X2=44.95, P<0.001).About 90.25% of the total cases were people aged less than 2 years and over 15 years old, 56.94% of the cases had no history of receiving MCV vaccination, and 30.40% don't know if they've been vaccinated.There were 758 cases in which measles virus genotypes were available, including 737 cases with H1 genotype, 16 cases with vaccine strain A genotype, 2 cases with B3 genotype, and 3 cases with D8 genotype.A total of 5 public health emergencies and 76 outbreaks of measles were reported.  Conclusions  The incidence of measles in Anhui Province decreased from 2011 to 2020 and maintained low in recent years.We should increase MCV coverage and timely vaccination among age-eligible children, conduct MCV supplementary immunization activities if necessary, and enhance epidemiological and etiological surveillance of measles, in order to block the spread of measles effectively.
Short Reports
Effects of exposure to bisphenol A on estrogen homeostasis based on the biomonitoring method in pregnant women
WU Lin-ying, WANG Yi, XUAN Dong-liang, WANG Yuan-ping, TIAN Jing, YANG Zi-chen, HAN Ming-hui, WANG He-xing, PENG Qian, JIANG Qing-wu
2022, 26(9): 1097-1101. doi: 10.16462/j.cnki.zhjbkz.2022.09.018
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Abstract:
  Objective  To investigate the effect of bisphenol A (BPA) on estrogen homeostasis during pregnancy.  Methods  We selected 151 pregnant women in Jiading District, Shanghai, and a questionnaire survey and collection of urine samples were performed for them.The concentrations of BPA, estrone, 17β-estradiol, and estriol in their urine were determined by ultra-performance liquid chromatography-tandem quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) and corrected by the level of urinary creatinine.The corrected concentrations were transformed by a natural logarithm.After removing outliers, the relationship between urinary BPA and urinary estrogen was analyzed by multiple linear regression analysis.  Results  The positive rate of urinary BPA in urine samples of pregnant women was 99.34%.After the correction of the urinary creatinine level, the median urinary BPA concentration was 0.65 μg/g.Age, gestational week, total annual household income, second-hand smoke exposure and educational level did not affect urinary BPA level.Urinary estrogen levels were raised with the development of pregnancy.Multiple linear regression analysis showed that urinary BPA level was positively associated with estrone level (β=0.171, 95%CI: 0.006-0.336) and 17β-estradiol level (β=0.137, 95%CI: 0.000-0.274) in all pregnant women.There was a positive correlation between urinary BPA level and urinary estrone level in pregnant women during the third trimester (β=0.449, 95%CI: 0.014-0.884).  Conclusions  Pregnant women in Shanghai are generally exposed to BPA, and the exposure level of BPA during pregnancy may affect estrogen homeostasis.
Physical development and health status of children with autism spectrum disorder aged 2-5 years in Tangshan
CUI Li-hua, DU Wen-ran, YANG Xiao, LIU Chen, ZHAO Su-jun, MA Yi-ning, DONG Jing-yi, PANG Shu-lan, FENG Fu-min
2022, 26(9): 1102-1107. doi: 10.16462/j.cnki.zhjbkz.2022.09.019
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Abstract:
  Objective  To investigate the physical development, nutrition and health status of children with autism spectrum disorder (ASD) aged 2-5 years in Tangshan, so as to provide evidence for formulating intervention measures.  Methods  A total of 208 children with ASD aged 2-5 years from Tangshan Maternal and Child Health Hospital and special education institutions from March 2019 to June 2021 were recruited for questionnaire survey and physical measurement.Indexes of height for age Z score (HAZ), weight for age Z score (WAZ) and body mass index for age Z score (BAZ) were used to evaluate growth status according to WHO child growth standard.  Results  The distribution curves of HAZ, WAZ and BAZ in ASD children shifted to the left side extending beyond-2 and+2.The rates of stunting, wasting, underweight, overweight, obesity in ASD children were 4.3%, 6.3%, 1.4%, 4.8% and 4.3%, respectively.The wasting rate among different groups with feeding methods (X2=7.836, P=0.020), ASD severity (X2=13.011, P=0.001) and groups with whether gastrointestinal symptoms (X2=4.513, P=0.034) were different, which of the mixed feeding group and severe ASD groups and group with gastrointestinal symptoms were the highest.The monthly prevalence rate of children with ASD was 58.2% and the top three diseases were acute upper respiratory tract infections, influenza and gastroenteritis, accounting for 46.2%, 9.1% and 4.8% respectively.  Conclusions  The children with ASD show deviation of physical development and the high prevalence rate of common diseases in Tangshan.It is necessary to strengthen growth monitoring, nutrition intervention and disease prevention to them.
Relationship between marital adjustment and depression in infertile couples undergoing in vitro fertilization treatment for the first time based on the actor-partner interdependence model
WANG Jie-yu, TANG Wang-qin, WU Jing-mei, WANG Dan-ni, WANG Yin-shuang, CHEN Chang-e, LUO Gui-ying, CAO Yun-xia, HONG Jing-fang
2022, 26(9): 1108-1112. doi: 10.16462/j.cnki.zhjbkz.2022.09.020
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Abstract:
  Objective  To investigate the actor-partner effects of marital adjustment and depression on infertile couples who underwent in vitro fertilization (IVF)-assisted treatment for the first time.  Methods  A total of 374 infertile couples were investigated by general data questionnaire, hospital anxiety and depression scale (HADS) and the Locke Wollance marital adjustment test scale (LWMAT).The relationship between marital adjustment and depression was analyzed by the actor-partner interdependence model.  Results  Marital adjustment of husbands and wives predicted their own depression (β=-0.378, P<0.001;β=-0.223, P<0.001).The marital adjustment of husbands and wives also predicted their partners'depression (β=-0.331, P<0.001;β=-0.161, P<0.001).The actor-partner effects of marital adjustment and depression was similar tested by equality constraint.  Conclusions  There is a close relationship between the depression and marital adjustment of actor and partner among infertile couples, therefore they should be treated as a whole.The study has provided a theoretical basis for the later intervention program of couples as a unit.
Epidemiological analysis of AIDS among students in Liuzhou City from 1998 to 2020
LIANG Jia-jia, LIU Xue-mei, YANG Jun, YANG Miao-ying, XIE Chang-ping, WEI Tao, FENG Xian-xiang
2022, 26(9): 1113-1116. doi: 10.16462/j.cnki.zhjbkz.2022.09.021
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Abstract:
  Objective  To analyze the epidemiological characteristics of AIDS among students in Liuzhou city from 1998 to 2020, and to provide scientific evidence for formulating AIDS prevention and control strategies about students.  Methods  Descriptive epidemiological method was used to analyze the data of HIV infected and AIDS patients (HIV/AIDS) among students in Liuzhou from January 1, 1998 to December 31, 2020.  Results  There were 201 students with HIV/AIDS in Liuzhou city by the end of December 31, 2020.Among these patients, 127 were HIV infected (63.2%) and 74 were AIDS patients (36.8%).The epidemic of the number of new HIV/AIDS cases among students showed an overall upward trend.The number of AIDS patients was more than that of HIV infections before 2011, but the number of HIV infections gradually increased since 2011 and reached the peak in 2017.Before 2013, mother-to-child transmission was the main route of transmission.Heterosexual transmission and homosexual transmission increased rapidly since 1998.Among students with HIV/AIDS, there were 152 males (75.6%) and 49 females (24.4%), with a gender ratio of 3.1:1.0.Most of them were aged from 14 to 20(47.3%), and 64.2% were above high school.By the end of December 31, 2020, 13 deaths (6.5%) had been reported, there were statistically significant differences in fatality rates among different transmission routes and education levels (all P<0.05).  Conclusions  The number of HIV/AIDS among students in Liuzhou city is increasing rapidly, and homosexual transmission is the main way of transmission in recent five years.Comprehensive intervention measures should be strengthened to control the spread and prevalence of AIDS among students.

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