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CN 34-1304/R ISSN 1674-3679

2023 Vol. 27, No. 12

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Original Articles
Analysis of HIV testing conducted by MSM civil society organizations in 17 cities, 2019-2021
CAO Zhaobing, JIANG Zhen, ZHAO Tianming, QIU Yanchao, LIU Lihua, JIA Ce, WU Zunyou
2023, 27(12): 1365-1370. doi: 10.16462/j.cnki.zhjbkz.2023.12.001
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  Objective  To understand the status of HIV testing in men who have sex with men (MSM) civil society organizations.  Methods  An online questionnaire survey was conducted on MSM civil society organizations in 17 cities of the 13th Five Year Key Project sub-project 3, including basic information and HIV testing status of the civil society organizations. Descriptive statistical analysis and chi-square test were used.  Results  A total of 20 MSM civil society organizations were surveyed, of which 14 (70%) were registered with the industry and commerce or civil affairs departments. There was a decreasing trend in the rate of positive initial screening and confirmed HIV diagnosis in 20 civil society organizations from 2019-2021, with a cumulative total of 156 119 tests in civil society, 132 072 tests in registered civil society organizations, and 24 047 tests in unregistered civil society organizations. The HIV prevalence rate of MSM population tested by registered civil society organizations was 2.06%, which was lower than that of unregistered civil society organizations at 2.95% (χ2=74.00, P<0.001). The referral confirmation rate of the initial screening positive population in registered civil society organizations was 89.9%, higher than 83.51% in unregistered civil society organizations (χ2=27.36, P<0.001). Registered civil society organizations were tested both online and offline, while unregistered civil society organizations were predominantly online, with online testing accounting for 78.87% (χ2=6 874.98, P<0.001). In addition, the HIV prevalence of MSM population tested in 2021 by registered civil society organizations at the time of analysis by year was 1.73%, which was lower than that of unregistered civil society organizations at 2.63% (χ2=4.61, P=0.032).  Conclusions  HIV testing workloads carried out by civil society organizations are high. HIV testing pathways differ between registered and unregistered civil society organizations. Overall registered civil society organizations have better testing results than unregistered civil society organizations. The referral confirmation rate of the initial screening positive population in both types of civil society organizations needs to be improved.
Analysis on the use of addictive substances and its influencing factors among men who have sex with men in Yunnan
ZHANG Liqiong, LUO Jian, LI Shu, ZHANG Yanjiao, DENG Shuangfen, LI Jixiang, ZHANG Cunmin
2023, 27(12): 1371-1376. doi: 10.16462/j.cnki.zhjbkz.2023.12.002
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  Objective  To investigateand analyze the use of addictive substances and its influencing factors in men who have sex with men (MSM) in Yunnan.  Methods  The MSM in Yunnan were recruited from social organization of MSM. The inclusion criteria were male, age aboved 18 years, having had sex with men or male homosexuality. Demographic information, sexual behavior, use of addictive substances, HIV related knowledge and detection status were collected, analyzed and compared. Multiple logistic regression was used to analyze the factors correlated with addictive substances in MSM.  Results  A total of 2 411 MSM were investigated in the study. The overall prevalence rates of addictive substances use were 15.06% (363/2 411) in the lifetime and 10.24%(247/2 411) in the last six months, of whom 85.02%(210/247) were rush poppers users. Factors associated with addictive substances use included: border states (cities) (OR=1.79, 95% CI: 1.33-2.44), 18~25 years old group [compared to 18~25 years old group, 25-35 years old group (OR=0.49, 95% CI: 0.34-0.72); aboved 35 years old group (OR=0.47, 95% CI: 0.34-0.64)], educated above high school (OR=1.65, 95% CI: 1.29-2.11), the primary sex role is inserted(OR=1.65, 95% CI: 1.24 - 2.21), having multiple sexual parters in the past six months (OR=2.29, 95% CI: 1.72-3.06), low condom use [compared to low condom use, high condom use (OR=0.59, 95% CI: 0.46-0.75)] and poor knowledge about AIDS [compared to poor knowledge about AIDS, high knowledge about AIDS (OR=0.52, 95% CI: 0.35-0.76)].  Conclusions  Publicity and education on addictive substances and HIV/AIDS among MSM population in Yunnan should be strengthened, especially in border states and cities. In addition, it is necessary to strengthen the monitoring and supervision of addictive substance use represented by Rush poppers in this population and the monitoring of the prevalence of sexually transmitted diseases such as HIV, so as to reduce the use of addictive substances and the harm of sexually transmitted diseases.
Late HIV diagnosis and its correlates among newly reported Chinese and Burmese HIV/AIDS cases in Dehong Dai and Jingpo Autonomous Prefecture from 2014 to 2021
ZHOU Qunbo, YANG Yuecheng, XIANG Lifen, YE Runhua, TANG Renhai, WANG Jibao, YANG Shijiang, HE Na, DING Yingying, DUAN Song
2023, 27(12): 1377-1383. doi: 10.16462/j.cnki.zhjbkz.2023.12.003
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  Objective  To investigate the proportions and correlates of late HIV diagnosis among newly reported Chinese and Burmese HIV/AIDS cases in Dehong Dai and Jingpo Autonomous Prefecture, between 2014 and 2021.  Methods  Data were derived from China "Comprehensive AIDS Prevention and Control Information System", all newly reported HIV/AIDS cases in Dehong Prefecture from 2014 to 2021 were included. Logistic regression models were used to explore the correlates of late diagnosis.  Results  Among 2 586 and 4 788 newly reported Chinese and Burmese HIV/AIDS cases, 763 cases (29.5%) and 707 cases (14.8%) were late diagnosis, respectively. In multivariable regression models, male gender, aged over 30 years, illiteracy, heterosexual transmission, and cases reported by medical institutions were positively associated with late HIV diagnosis among Chinese HIV/AIDS cases (all P<0.05), whereas aged over 30 years, illiteracy, and cases reported by medical institutions were positively associated with late HIV diagnosis among Burmese HIV/AIDS cases (all P<0.05).  Conclusions  Dehong Prefecture should continue to strengthen the awareness of HIV/AIDS prevention, treatment and testing among various types of population and promote the active testing among hidden populations to reduce late HIV diagnosis.
AIDS sentinel surveillance of commercial sex workers in Liuzhou City, 2019-2022
XIE Changping, HE Zhiyan, YANG Yanzhen, QI Guangzi, TAN Shounan
2023, 27(12): 1384-1390. doi: 10.16462/j.cnki.zhjbkz.2023.12.004
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  Objective   To analyze the AIDS sentinel surveillance results of the commercial sex workers in Liuzhou from 2019 to 2022, to understand the factors influencing HIV infection in this population, and to provide a scientific basis for the HIV prevention and control of the commercial sex workers.   Methods   A random sampling method was used to survey the commercial sex workers in Liuzhou from 2019 to 2022, and the results of the questionnaires and laboratory tests were collated.   Results   The average knowledge rate of HIV-related knowledge was 98.88% and the HIV-positive rate was 1.31%. Age, marital status, education level, receipt of HIV prevention services in the last year, and condom use in the last month of commercial sex were independent influencing factors for HIV positivity in commercial sex workers (all P < 0.05). Multifactorial logistic regression analysis showed that those aged ≥50 years had a higher risk of HIV infection compared to those aged < 30 years (OR=28.151, 95% CI: 2.665-298.453, P=0.006); those who received HIV prevention services in the last year had a lower risk of HIV infection (OR=0.124, 95% CI: 0.041-0.375, P < 0.001).   Conclusions   The HIV prevalence rate among commercial sex workers in Liuzhou, Guangxi is low, but the quality of HIV prevention services for older commercial sex workers should still be improved. Inovative forms of prevention and control interventions should be introduced to further strengthen HIV-focused interventions for commercial sex workers.
Characteristics of MSM with heterosexual behavior and analysis on related factors of their HIV infection in Fuzhou from 2016 to 2021
ZHANG Hong, CHEN Jianhui, XUE Honghong, XU Shaoyi, HE Dingsheng, LIN Chunzhong
2023, 27(12): 1391-1397. doi: 10.16462/j.cnki.zhjbkz.2023.12.005
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  Objective   To understand the characteristics of MSM with heterosexual behavior and related factors of their HIV infection in Fuzhou, and to provide reference basis for effective intervention measures.   Methods   From 2016 to 2021, MSM aged 15 and over who had oral or anal sex with men in the last year were recruited. MSM who had sex with the female in the past 6 months were selected, and their sociolect-demographic, behavioral characteristics and HIV infection status were analyzed.   Results   13 829 MSM were investigated, of which the respondents with heterosexual behavior from 2016 to 2021 was 156, 207, 314, 352, 338 and 241 respectively. Multivariate logistic regression analysis of heterosexual behavior showed that >25 age group (OR=1.298, 95% CI: 1.091-1.544), married/cohabiting (OR=9.283, 95% CI: 8.025-10.739), education level of high school or technical secondary school (OR=1.259, 95% CI: 1.021-1.552), heterosexuality (OR=37.311, 95% CI: 25.204-53.126), bisexuality (OR= 7.266, 95% CI: 6.325-8.347), undetermined sexual orientation (OR=4.394, 95% CI: 3.001-6.433), finding male sex partners through places (OR=1.370, 95% CI: 1.080-1.738) were risk factors (all P < 0.05); MSM who lived in Fuzhou for 1-2 years (OR=0.733, 95% CI: 0.553-0.971), MSM who lived in Fuzhou for more than two years (OR=0.809, 95% CI: 0.670-0.977), non-drug users (OR=0.459, 95% CI: 0.228-0.924) were protective factors (all P < 0.05). The HIV antibody positive rate of MSM with heterosexual behavior was 4.17% (67/1 608). The HIV antibody positive rate of MSM showed a downward trend (trend χ2 =6.959, P=0.008). The results of multivariate logistic regression analysis showed that undetermined sexual orientation (OR=3.133, 95% CI: 1.112-8.826) was risk factors; education level of high school or technical secondary school (OR=0.469, 95% CI: 0.247-0.889), education level of junior college or below (OR=0.330, 95% CI: 0.178-0.613), never having anal sex or using condom every time (OR=0.184, 95% CI: 0.063-0.539), sometimes using condom (OR=0.304, 95% CI: 0.103-0.897), non-drug users (OR=0.228, 95% CI: 0.059-0.883) were protective factors (all P < 0.05).   Conclusions   The proportion of insisting condom use among MSM with heterosexual behavior is low. The intervention of MSM with heterosexual behavior should be strengthened to enhance the utilization rate of condoms and reduce the risk of AIDS spreading to women.
Effect of rapid progression on immune reconstitution after highly active anti-retroviral therapy in HIV/AIDS men who have sex with men
QIN Chuan, MENG Xinmei, ZHANG Peng, HU Jiaguang, LI Minji, HUANG Xiaohong, WEI Hongwei
2023, 27(12): 1398-1402. doi: 10.16462/j.cnki.zhjbkz.2023.12.006
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  Objective   To explore the effect of rapid disease progression on immune reconstitution after highly active anti-retroviral therapy (HAART) in HIV/AIDS MSM.   Methods   A total of 108 HIV/AIDS MSM were divided into rapid progression group (n=68) and non-rapid progression group (n=40). The recovery of immune reconstitution related indexes in two groups after HAART 24 months were statistically analyzed.   Results   During the progress of HAART, CD4+T cell (CD4) count and CD4/CD8+T cell (CD8) ratio in both groups gradually increased, and CD4/CD8 ratio in rapid progression group was lower than that in non-rapid progression group (0.62±0.29 vs. 0.84±0.33, F=4.244, P=0.042) after 24 months of HAART initiation. The baseline CD8 count in rapid progression group (933±430) was lower than that in non-rapid progression group (1 248±476) (t=3.515, P=0.001), and then CD8 count in both groups gradually decreased to a similar level (F=0.110, P=0.741), with smaller decline in rapid progression group than in non-rapid progression group.   Conclusion   For HIV/AIDS MSM, the rapid disease progression will have a negative effect on immune reconstitution of HAART.
Spatial clustering of HIV/AIDS among out-of-school adolescents in Chengdu from 2010 to 2021
SHI Yaying, ZHU Yanfeng, LUO Lin, DAI Zhen, LIU Fang, HE Qinying
2023, 27(12): 1403-1407. doi: 10.16462/j.cnki.zhjbkz.2023.12.007
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  Objective   To analyze the characteristics and trends of spatial aggregation of HIV among out-of-school adolescents in Chengdu from 2010 to 2021, providing a reference basis for regionalized prevention and resource adjustment in the future.   Methods   Newly reported HIV/AIDS cases among out-of-school adolescents in Chengdu between 2010 and 2021 were screened from the China Disease Control and Prevention Information System for descriptive analysis. Spatial autocorrelation and clustering were analyzed using ArcGIS 10.6 software. Spatiotemporal scanning was conducted using SaTScan.   Results   The average annual growth rate was 15.97% from 2010 to 2015, while the average annual reduction rate was -7.97% from 2015 to 2021. The epidemic of out-of-school adolescents affected 334 towns or streets from 2010 to 2021, exhibiting spatial aggregation that was concentrated in the central area of Chengdu, and gradually spreading to the surrounding area over time. The distribution of hotspots for heterosexual and homosexual transmission differed. Spatiotemporal scanning analysis revealed that the clustering areas were primainly located in 37 streets within the central area of Chengdu during the period of 2012-2017.   Conclusions   The number of HIV cases among out-of-school adolescents in Chengdu displays a trend of initial increase followed by a decrease from 2010-2021. The spatial distribution exhibits distinct unevenness, with more serious epidemics concentrated in the central area of Chengdu. Therefore, it is crucial to strengthen publicity and intervention efforts for out-of-school adolescents in the hot distribution areas of heterosexual and homosexual transmission.
A qualitative study on perception and influencing factors of high-risk sexual behaviors among men who have sex with men using geosocial networking apps
ZHANG Weijie, GUO Zhihui, XIN Yuting, XIE Ting, TENG Yi, GUO Yichen, WANG Bingyi, PENG Xin, LIANG Bingyu, BIAN Junye, LI Xinyi, SUN Yinghui, ZOU Huachun
2023, 27(12): 1408-1412. doi: 10.16462/j.cnki.zhjbkz.2023.12.008
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  Objective  To investigate perception and influencing factors of high-risk sexual behaviors among men who have sex with men (MSM) using geosocial networking apps specific to MSM (gay apps) and to provide evidence for developing targeted interventional strategies.  Methods  In collaboration with local community-based organizations in seven cities of mainland China, MSM who had used gay apps for more than one year were recruited for one-on-one semi-structured interviews.The interview transcripts were analyzed by NVivo 12.0.  Results  A total of 21 MSM were recruited, with a median age of 27(24, 31) years.Perception of high-risk sexual behaviors among MSM using gay apps is mainly unprotected sex.Factors that increased the occurrence of high-risk sexual behaviors included: personal factors: alcohol and recreational drug use, and different roles in sex; factors relevant to sex partners: regular relationship with a sex partner, and the appearance and occupation of sexual partners; social factors: social circles and holidays.Factors that reduced the occurrence of high-risk sexual behaviors included offline health education, web-based health knowledge promotion, and peer's high-risk sexual experiences.  Conclusions  MSM who used gay apps have insufficient perceptions of high-risk sexual behaviors and factors influencing high-risk sexual behaviors are complex.In the future, health dissemination and education jointly provided by offline institutions and online platform are needed to guide this population to form a spectrum of correct and complete perception of high-risk sexual behaviors, raise awareness of HIV prevention, and reduce the occurrence of high-risk sexual behaviors.
Cluster analysis based on glycometabolism-related factors for males and females with normal fasting plasma glucose and the risk of type 2 diabetes mellitus
MA Rui, CHEN Yichao, XIE Hankun, LIU Yu, FAN Yao, TANG Wei, SHEN Chong
2023, 27(12): 1413-1420. doi: 10.16462/j.cnki.zhjbkz.2023.12.009
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  Objective  We did cluster analysis in male and female populations with normal fasting plasma glucose based on factors related to glycemic metabolism, and evaluated the association between cluster allocation and the risk of type 2 diabetes mellitus (T2DM).  Methods  The study population consisted of baseline participants with fasting plasma glucose < 6.1 mmol/L from a prospective cohort in Jurong City.Hierarchical K-means clustering was conducted separately for 2 857 males and 4 398 females.Cluster variables included age, fasting plasma glucose, the homeostasis model assessment 2 estimates of β-cell function and insulin resistance, triglyceride, upper neck circumference, waist-to-height ratio, and physical activity index.The Kaplan-Meier curve for cumulative hazard was used to estimate the incidence of T2DM in male and female clusters.Cox proportional hazard regression model was applied to assess the association between cluster allocation and T2DM risk.  Results  The male and female populations were classified into 5 distinctive clusters, respectively, with various phenotypic characteristics and different incidence of T2DM.Male cluster 1 had the lowest body mass index (BMI) but the highest age, and cluster 2 had the highest level of physical activity.Male cluster 3 had the highest BMI and the lowest level of physical activity.Cluster 4 was characterized by high insulin resistance and compensatory β-cell secretion, while cluster 5 exhibited a phenotype of young age and severe dyslipidemia.Female cluster 1, 2, and 4 were similar to those of males.Female cluster 3 had the lowest age, while cluster 5 presented features of the lowest physical activity, obesity, and dyslipidemia.Compared with male cluster 1, the risk of T2DM in cluster 3 and 4 increased by 1.28 times and 0.87 times respectively (all P < 0.05).After adjusting for covariates, the HR (95% CI) were 1.651(0.927-2.939) and 1.516(0.779-2.950) with no statistical significance (allP>0.05).Compared to female cluster 1, cluster 3 had a lower risk of developing T2DM, with an adjusted HR (95% CI) of 0.380(0.205-0.704).Cluster 5 had a higher risk of T2DM than cluster 1(P < 0.05), but the association was not significant after adjusting for covariates (HR=1.172, 95% CI: 0.717-1.916).  Conclusions  Our findings indicate that heterogeneity of physiological metabolism exists among individuals with normal fasting plasma glucose before the diagnosis of T2DM.The clustering phenotypic characteristics also present certain gender differences.Cluster analysis for non-diabetic populations based on glycometabolism-related factors could aid in the improvement of early detection and screening for high-risk subgroups, as well as precise intervention to effectively reduce the risk of diabetes and complications.
Prospective cohort study on the association of body mass index level and its dynamic changes on risks of incident comorbidity among hypertension, diabetes and dyslipidemia
ZHOU Jie, WU Yanli, WANG Yiying, YU Lisha, ZHANG Ji, YU Yangwen, LI Xuejiao, LONG Mengya, LIU Tao
2023, 27(12): 1421-1429. doi: 10.16462/j.cnki.zhjbkz.2023.12.010
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  Objective  To investigate body mass index (BMI) level and its dynamic changes and the risk of comorbidity of hypertension, diabetes and dyslipidemia, and provide the reference for prevention and control of chronic disease comorbidity.  Methods  The data used in the study were from the natural cohort of Guizhou province established in 2010.In order to obtain the cohort, stratified random cluster sampling method was employed to investigate a total of 9 280 people from 48 towns in 12 counties (cities, districts).A follow-up survey was completed from 2016 to 2020.The subjects with baseline hypertension, diabetes, dyslipidemia comorbidities and with incomplete data during follow-up were excluded.A total of 4 688 patients were ultimately included into this study.Cox proportional hazard regression model was used to analyze the relationship between BMI values, different change values of BMI and changes in BMI (maintaining normal BMI, continuing overweight and obesity, changing from the normal BMI to the overweight and obesity, changing from the overweight and obesity to the normal BMI) and hypertension, diabetes, dyslipidemia comorbidity.Risk ratio (HR) and 95%CI were calculated.  Results  Among the groups distinguished by region, gender, age, ethnic group, education level, smoking, drinking and dietary score, differences in comorbidity of hypertension, diabetes and dyslipidemia were significant statistically (all P < 0.05).The risk of comorbidity increased with the increase of BMI value (HR=1.046, 95% CI: 1.031-1.061).Moreover, the risk of comorbidity among the groups of overweight (HR=1.293, 95% CI: 1.124-1.487) and obesity (HR=2.130, 95% CI: 1.706-2.658) was higher than that among the groups having normal BMIs.The risk for the group with BMIs lowered by 1.0 kg/m2 or less to undergo comorbidity was decreased by 21.3%, whereas the risk for the group with BMI increased by 5.0 kg/m2 or more to undergo comorbidity was increased by 42.9%(HR=1.429, 95% CI: 1.108-1.845).For the patients who kept overweight (HR=2.301, 95% CI: 1.962-2.697) and the patients who had normal BMI but became overweight (HR=1.698, 95% CI: 1.451-1.987), the risks of comorbidity were increased 2.301 times and 1.698 times, respectively, compared with those with normal BMI.  Conclusions  BMI level and its dynamic changes are closely related with comorbidity of hypertension, diabetes and dyslipidemia.Controlling and reducing BMI to normal level is a necessary and effective method to prevent comorbidity of the three diseases.
Quality of life among chronic obstructive pulmonary disease patients aged 40 years and above and its associated factors in Shandong Province
DONG Qiuyue, GAO Congcong, LIU Cairui, ZHANG Bingyin, LU Zilong, JIA Cunxian, GUO Xiaolei
2023, 27(12): 1430-1434. doi: 10.16462/j.cnki.zhjbkz.2023.12.011
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  Objective  To understand the quality of life of chronic obstructive pulmonary disease (COPD) patients aged 40 years and above in Shandong Province, and to explore the factors related to quality of life, so as to provide scientific and reasonable suggestions for better improving quality of life of patients with COPD and reducing the burden of COPD.  Methods  Utilizing the data of COPD in Chinese residents in 2019 from Shandong Province.SAS 9.4 was used to sort and analyze the data.Single factor analysis was carried out by χ2 test while possible related factors were analyzed by multinomial logistic regression analysis.  Results  Among 559 COPD patients aged 40 years and above in Shandong Province in 2019, 75.0% had mild impact on quality of life, 16.6% had moderate impact, and 8.4% had severe and extremely severe impact.The analysis results showed that, In model 1(COPD has a moderate impact on patients'quality of life compared with a mild impact), BMI≥28.0 kg/m2(OR=3.11, 95% CI: 1.34-7.23), smoking (OR=1.83, 95% CI: 1.12-2.97), cooking use of clean fuels (OR=0.37, 95% CI: 0.24-0.56) and COPD moderate effects on patients'quality of life (all P < 0.05);In model 2(patients with severe or higher impact of COPD on quality of life compared with those with mild impact), clean fuels were used for cooking (OR=0.47, 95% CI: 0.31-0.71) and COPD severity was severe or higher (OR=15.19, 95% CI: 5.75-40.15) was associated with severe and above impact on quality of life in COPD patients (all P < 0.05).  Conclusion  s Preventing exacerbations, using clean fuel in cooking, reducing their BMI and keeping a good figure were all associated with the high quality of life in COPD patients.
An exploratory study on the change of aging degree and inflection point age of residents in some communities in Jiangxi Province
YANG Shanlan, TU Jiaxin, ZHANG Langlang, WU Lei, HUANG Helang
2023, 27(12): 1435-1441. doi: 10.16462/j.cnki.zhjbkz.2023.12.012
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  Objective  To explore the characteristics of aging changes in the population, reveal the inflection point age in the whole life cycle, clarify the nonlinear process of aging development, and provide targeted intervention periods for the active health of the population.  Methods  Using multistage stratified cluster sampling, 5 106 valid subjects were selected. The physiological-psychological-social three dimensional human aging scale (PPSHAS) scale was used to measure the degree of aging. Score of the aging degree was fitted by the LOESS smoothing curve; The age of aging inflection point was analyzed by ROC curve, and its predictive value on aging degree was verified by logistic regression model and the C index.  Results  Significant differences were found in the scores of aging degree among different age groups (all P < 0.05), and it increased in a wave-like manner with age. According to the WHO′s analysis of aging inflection points for four groups (young, middle-aged, older, and elderly), the inflection point ages of aging were found to be 26.0, 38.0, 47.0, 57.1, 61.6, 68.5, 76.9, and 83.8 years, respectively (all P < 0.05). After adjusting for confounding factors, the inflection point age remained a valuable predictor of changes in the aging degree, with good model consistency (Hosmer Lemeshow test P>0.05).  Conclusions  The aging process of the human body is uniform, and the four groups of people have aging inflection points. This study is of positive significance to deeply understand aging, grasp aging laws, and do a targeted anti-aging work.
A study on the correlation between residents' health literacy and knowledge of disease prevention and control
MI Fenfang, XU Ningjun, ZHANG Hongxia, HAN Jin, RONG Chao, QIAN Min, YUAN Fang, LIN Min
2023, 27(12): 1442-1446. doi: 10.16462/j.cnki.zhjbkz.2023.12.013
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  Objective  To investigate the health literacy (HL) status among residents and its correlation with their knowledge level of disease prevention and control, so as to provide scientific suggestions for improving their knowledge and ability of disease prevention and control.  Methods  The residents′ HL and their knowledge level of disease prevention and control were investigated through an online questionnaire. A linear regression model was used to analyze the impact of HL on the knowledge level of disease prevention and control.  Results  The percentage of residents reaching the standard was 27.1% in HL score. Female residents exhibited significantly higher HL scores (50.1±13.6) compared with their male counterparts (45.0±17.5, P < 0.05). The percentage of residents reaching the standard was 17.4%, 26.0% and 16.0% in comprehensive knowledge of disease prevention and control, knowledge of infectious disease and chronic disease, respectively. Basic knowledge and concepts, as well as healthy lifestyle and behaviors in HL, had the most significant impact on the knowledge level of disease prevention and control (β=0.34, 95% CI: 0.30-0.37 and β=0.40, 95% CI: 0.35-0.44, respectively).  Conclusions  The percentage of residents reaching the standard was relatively low in HL score. The residents′ HL had a significant impact on their knowledge level of disease prevention and control. Therefore, it is suggested to enhance residents′ HL to improve their knowledge and ability of disease prevention and control.
Associations between down-regulated expression of m6A methyltransferases and systemic lupus erythematosus
WU Jun, LI Shangjie, ZHANG Jie, YE Dongqing, WANG Xiaojun
2023, 27(12): 1447-1454. doi: 10.16462/j.cnki.zhjbkz.2023.12.014
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  Objective  To investigate the correlation between N6-methyladenosine(m6A) methyltransferase and systemic lupus erythematosus(SLE).  Methods  Real-time quantitative polymerase chain reaction (RT-qPCR) and western blot (WB) were utilized to verify the expression of m6A methyltransferases in SLE, and further analyzed the associations of the expression of m6A methyltransferases with clinical characteristics and treatment of SLE. Jurkat cell lines with silencing and overexpressing METTL3 were generated for the functional investigation of T cells, flow cytometry analyzed the apoptosis and RT-qPCR detected the cytokines interleukin-2 (IL-2) and tumor necrosis factor-alpha (TNF-α) secretion.  Results  The expression levels of m6A methyltransferases were stably down-regulated in patients with SLE, among which METTLE was stably down-regulated in T cells of patients with SLE, as well as closely correlated with antibodies (anti-dsDNA and anti-SSB/La) and low complements (all P < 0.05). Functional experiments found that down-regulated expression of METTL3 inhibited the apoptosis of Jurkat cells, as well as triggered the expression of IL-2 and TNF-α.  Conclusion  The expression levels of m6A methyltransferases were decreased in patients with SLE, and METTL3, the core m6A methylation enzyme, may be related to T cell apoptosis and inflammatory responses. Further studies are needed to find out the important role of methyltransferase-dependent m6A modification in the prevention and treatment of SLE.
Associations between m6A related-mRNA IFIT5 and systemic lupus erythematosus
WU Jun, LI Shangjie, ZHANG Jie, YE Dongqing, NI Jindong
2023, 27(12): 1455-1460. doi: 10.16462/j.cnki.zhjbkz.2023.12.015
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  Objective  N6-methyladenosine (m6A) methylation involved in immuno-inflammatory responses via the regulation of mRNA expression and function is reported, but its limit is in systemic lupus erythematosus (SLE). Therefore, this study will initially explore the associations of m6A-related mRNA expression with SLE.  Methods  Real-time quantitative polymerase chain reaction and western blot were used to validate the expression levels of m6A-related IFIT5in T cells of patients with SLE. Following that, the correlations between IFIT5and clinical characteristics, laboratory parameters and treatment of patients with SLE were analyzed. Further functional experiments were conducted to establish the Jurkat cell lines with silencing IFIT5 for exploration of the alteration of T cells and immune inflammatory cytokines (TNF-α, IL-2, and IL-6).  Results  Compared with normal controls, m6A modification of highly expressed IFIT5 in SLE patients was significantly enhanced. The expression levels of IFIT5 were steadily up-regulated in the T cells of patients with SLE, and were closely associated with the degree of disease activity in patients with SLE. Cell experiments showed that silencing IFIT5 significantly inhibited T cell proliferation and accelerated apoptosis, as well as triggered tumor necrosis factor-alpha (TNF-α) secretion and induced the expression levels of interleukin-2 (IL-2) and interleukin-6 (IL-6).  Conclusion  The high expression level of IFIT5is related to m6A modification, it is also up-regulated in the T cells of patients with SLE, which participate in the immune inflammatory responses of Jurkat cells, and the specific mechanism deserves further study.
Undergraduate Education
Comparative analysis of undergraduate education models and their implications in preventive medicine between China and the United States from the perspective of competency-based education
FAN Guanhua, SHAO Ruitai, LI Liping
2023, 27(12): 1461-1466. doi: 10.16462/j.cnki.zhjbkz.2023.12.016
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Abstract:
From the perspective of competency development, a comparative analysis of the undergraduate education models in preventive medicine between China and the United States has been conducted, with the aim of identifying the shortcomings in China′s preventive medicine education and proposing reform suggestions. Research has shown that the problems China′s preventive medicine education must face include an overall insufficient quantity, an incomplete education and training system, and an emphasis on theory over practice, problems that became more prominent in the context of emerging infectious disease outbreaks. An in-depth analysis of the undergraduate curriculum systems in preventive medicine in both China and the United States was conducted, delving into the relationship between public health education and talent development directions. Based on this, suggestions were made for the construction of China′s public health talent training system.
Reviews
Prevalence of anxiety among people living with HIV/AIDS in China: a Meta-analysis
ZHANG Wenxin, FAN Song, CHEN Run, WANG Ruolan, REN Ningjun, LI Yuansheng, LI Ailing
2023, 27(12): 1467-1474. doi: 10.16462/j.cnki.zhjbkz.2023.12.017
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Abstract:
  Objective  To systematically evaluate the prevalence of anxiety among HIV/AIDS patients in China.  Methods  Cross-sectional studies on the anxiety of HIV/AIDS patients in China were searched from the establishment of the database to March 2022. After literature screening and quality evaluation, a meta-analysis was carried out by R 4.4.1 software.  Results  A total of 65 articles were included, with 31 303 subjects. The prevalence of anxiety among HIV/AIDS patients in China was 33.04% (95% CI: 29.73%-36.36%). The results of subgroup analysis showed that there were statistically significant differences in anxiety among HIV/AIDS patients in different regions, evaluation scales, infection routes and study population (all P < 0.05). At the same time, social/family/friends support (OR=0.739 4, 95% CI: 0.683 9-0.799 5, P < 0.01) was a protective factor for anxiety symptoms in HIV/AIDS patients.  Conclusions  The prevalence of anxiety among HIV/AIDS patients is high in China. It is suggested that the early evaluation and intervention of mental health status of HIV/AIDS patients should be strengthened to improve the anxiety state of patients with HIV/AIDS.
The detection rate of depression during childbearing process among Chinese women: a Meta-analysis
YANG Zhongting, WEN Xuan, YE Qingyun, DENG Chunyan, DU Xingmei, CHEN Ying, DENG Rui, HUANG Yuan
2023, 27(12): 1475-1479. doi: 10.16462/j.cnki.zhjbkz.2023.12.018
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Abstract:
  Objective  To synthesize the detection rates of perinatal depression previously reported among Chinese women for each stage of the process from the first trimester of pregnancy to six months after labor, and to provide evidence for the development and implementation of prevention and treatment measures for perinatal depression.  Methods  Studies on the detection rates of depression among Chinese women at all stages of childbearing process, which had been published before September 5th, 2021, were searched through PubMed, CNKI, Wanfang, and VIP databases systematically. According to the heterogeneity test results, the detection rates of depression at different stages of childbearing process were pooled by a random effects model by using software Stata 15.1. The subgroup analyses were conducted to detect the differences in detection rates of perinatal depression. The sensitivity analyses and publication bias tests were performed.  Results  A total of 77 articles were included, with 249 310 women. The pooled detection rate of depression during childbearing process was 17.84% (95% CI: 16.06-19.61). The antepartum depression detection rate was 20.23% (95% CI: 17.60-22.86), which was higher than the postpartum depression detection rate of 14.50% (95% CI: 12.53-16.48). The highest detection rate was 24.48% (95% CI: 17.89-31.06) in the first trimester of pregnancy, followed by those in the second trimester (20.63%, 95% CI: 15.30-25.95), the third trimester (17.76%, 95% CI: 14.91-20.60), forty-two days after labor (16.95%, 95% CI: 13.88-20.02), one hundred days after labor (7.69%, 95% CI: 4.46-10.93), and six months after labor (2.37%, 95% CI: 1.62-3.12). The results of subgroup analyses showed that the survey years, research designs, survey areas, depression detection tools, positive cutoff points, sample sizes and levels of study quality didn′t affect the heterogeneity of the original study results.  Conclusions  The pooled detection rates of perinatal depression among Chinese women show a decrease trend from the first trimester of pregnancy to six months after labor. The early screening and prompt intervention to identify and treat depression should be provided. Some unmeasured or unreported factors in the existing studies may lead to the heterogeneity of the original study results. The study design should be optimized and the study quality should be improved in the future.
Research and progress of miRNA as potential biomarkers for pneumoconiosis
DU Miaomiao, WANG Jia, LI Wenwen, MU Min, ZHU Fenglin, YE Dongqing
2023, 27(12): 1480-1485. doi: 10.16462/j.cnki.zhjbkz.2023.12.019
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Abstract:
Pneumoconiosis is one of the most common occupational diseases in China, which has a very complex pathogenesis and lacks effective treatment in clinical practice. MicroRNAs (miRNAs) are a class of non-coding single-stranded RNA molecules that participate in the regulation of post-transcriptional translation by binding to target genes and inhibiting mRNA translation or promoting mRNA degradation. Previous studies have shown that miRNA is closely related to the occurrence and development of pneumoconiosis, which considered to be an important candidate biomarker for early screening and diagnosis for pneumoconiosis. This artide summarizes the current status of miRNA in pneumoconiosis, aiming to provide new ideas and methods for the study of pathogenesis, early warning, diagnosis and treatment of pneumoconiosis.
Short Reports
Qualitative study on influencing factors of HIV infection and health service utilization among China-Myanmar cross-border couples in Dehong Prefecture: Based on provider-demander perspectives
HE Shuxian, ZHOU Qunbo, LI Lin, YANG Yuecheng, XIANG Lifen, XU Cuiping, SHI Naili, YE Runhua, DING Yingying, DUAN Song, HE Na
2023, 27(12): 1486-1489. doi: 10.16462/j.cnki.zhjbkz.2023.12.020
Abstract(195) HTML (66) PDF(21)
Abstract:
  Objective  To investigate the status and influencing factors of HIV infection and health service utilization among the China-Myanmar cross-border couples in Dehong Prefecture.  Methods  Upon the theoretic frame of Andersen′s behavioral model, focus group interviews were conducted on professionals of local health service institutions (health service providers) in Dehong Prefecture, and one-to-one in depth interviews were conducted on the China-Myanmar cross-border couples (health service demanders). Thematic analysis was conducted on the interview texts.  Results  Forty participants were interviewed, including 7 health service providers and 33 health service demanders. Among the demanders, 13 were female with an average age of (38.61±5.74) years old, and 20 were male with an average age of (39.30±5.90) years old. Cross-border couples in Dehong were satisfied with Chinese medical insurance policy, received better social support, and had a higher level of health belief, which also influenced their utilization of health services. Meanwhile, the factors influencing HIV infection among the China-Myanmar cross-border couples include poor knowledge of AIDS, lack of tracing and testing management, etc.  Conclusions  Dehong Prefecture has well achieved goals in the management of China-Myanmar cross-border couples. The fairness of cross-border couples in obtaining local health services is relatively high. Multi-departmental cooperation should be strengthened to solve the difficulties in the management of identity identification, premarital examination and source tracing in a multi-dimensional way, and strengthen the guarantee of health service for cross-border couples.
Investigation of the status of HIV testing is available in sexually transmitted diseases related clinics in some areas in China
WANG Haixue, HU Jingkun, XU Jie
2023, 27(12): 1490-1494. doi: 10.16462/j.cnki.zhjbkz.2023.12.021
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Abstract:
  Objective  To understand the current status of HIV testing in sexually transmitted diseases (STD) related clinics in some Chinese areas in recent years, and to provide reference for improving the efficiency of HIV testing.  Methods  Purposive sampling method was used to investigate the outpatient clinicians of STD related clinics in 9 medical institutions in Beijing, Ningbo, Liuzhou, Yibin and Kunming. Personal in-depth interview was used to investigate the status of HIV testing.  Results  A total of 18 outpatient clinicians in STD related clinics were interviewed. Most of them had bachelor′s degree (77.78%). Most of their professional titles were deputy chief physicians (55.56%). The proportion of HIV testing and the proportion of HIV-positive rate varied greatly between different regions and different medical institutions. There were some problems in the provision of HIV testing in STD related clinics, such as the lack of technical guidance documents, the weak awareness of clinicians and the low cooperation of patients.  Conclusions  Technical guidance documents should be formulated to standardize the HIV testing as soon as possible. At the same time, training should be strengthened to improve the awareness of clinicians in providing HIV testing. We should strengthen the propaganda to raise awareness of the necessity of HIV testing and the acceptance of HIV testing in patients.

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