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CN 34-1304/R ISSN 1674-3679

2023 Vol. 27, No. 2

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Literature Review
Epidemiological researches driven by big data in healthcare: opportunities and challenges
FU Qi, MAO Chen
2023, 27(2): 125-126. doi: 10.16462/j.cnki.zhjbkz.2023.02.001
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This article reviews the formation and development of the national strategies of big data in healthcare, explores the opportunities and challenges in the era of big data in healthcare with the perspective of epidemiological research, and brings up new ideas for future epidemiological researches driven by big data in healthcare.
Original Articles
Meta-analysis of SARS-CoV-2 reinfection rate in the world
MA Yi-rui, DENG Jie, LIANG Wan-nian, LIU Min, LIU Jue
2023, 27(2): 127-135. doi: 10.16462/j.cnki.zhjbkz.2023.02.002
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  Objective  We aimed to review the data available to explore prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection in the real world.  Methods  We searched observational cohort studies and case-control studies that described the SARS-CoV-2 reinfections in PubMed, Embase, Web of Science, CNKI and WanFang Data from inception to 11 Dec 2022. Studies, data extracted and quality assessed were selected according to strict inclusion exclusion criteria. All analyses were using Stata version 16.0.  Results  A total of 24 studies were included, involving 78 635 cases of SARS-CoV-2 reinfection and 6 616 869 cases of SARS-CoV-2 primary infection. In cases after the primary SARS-CoV-2 infection, the pooled prevalence of reinfection was 2.06% (95% CI: 1.73%-2.40%). Compared with other age groups, the secondary infection rate was higher in those aged 40- < 50 years 2.97% (95% CI: -1.20%-7.14%) and 50- < 60 years 2.32% (95% CI: -0.74%-5.38%). In vaccination status group, the pooled prevalence was 5.47% (95% CI: 1.99%-8.95%) in unvaccinated cases, 1.85% (95% CI: 1.63%-2.08%) for those received partial COVID-19 vaccination, and 1.11%(95% CI: 0.34%-1.89%) for those received fully vaccination. In addition, the pooled prevalence of SARS-CoV-2 reinfection was 6.02%(95% CI: 5.67%-6.37%) in the health care workers.  Conclusions  There is a risk of SARS-CoV-2 reinfection, but the results of this global real-world meta-analysis showed that the rate of reinfection is not high. It is recommended to scientifically understand the risk of SARS-CoV-2 reinfection, strengthen public health education, maintain healthy habits, and reduce the risk of SARS-CoV-2 reinfection.
Analysis of the characteristics of imported COVID-19 cases in mainland China
JIANG Zhi-hao, ZONG Hui-ying, NING Pei-shan, CHENG Pei-xia, RAO Zhen-zhen, HU Guo-qing
2023, 27(2): 136-141. doi: 10.16462/j.cnki.zhjbkz.2023.02.003
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  Objective  This study aimed to examine the epidemic characteristics of the COVID-19 imported cases entering mainland China from March 4, 2020 to October 31, 2021, so as to provide the reference for the prevention and control of imported epidemic at present.  Methods  Data were collected from the Daily Summary on the COVID-19 epidemic issued by the national/provincial health commission official website from March 4, 2020 to October 31, 2021, including "number of imported cases and existing imported cases and source country/territory and destination province for imported cases. Joinpoint regression was used to examine the time trends in the number of imported cases over time.  Results  From March 4, 2020 to November 3, 2021, the number of monthly newly imported cases and existing confirmed cases changed as a "W" shape. The imported cases came from 152 counties and territories in total, mainly from Myanmar, United States, Philippines and Russia (accounting for 27.6% of all imported cases). The number of imported cases mainly entered Shanghai, Guangdong, Yunnan, Sichuan, and Fujian, explaining 70.59% of total imported cases.  Conclusions  The great fluctuating change of imported cases in the mainland of China may be related to the change of global COVID-19 epidemic and domestic prevention and control policies. Considering the imbalanced distribution of source country/territory and destination province of imported cases, the government should take targeted measures in important source countries/territories and destination provinces. Each province and municipality should modify its policy for preventing the imported epidemic dynamically according to the latest characteristic of source country/territory and virus mutation.
Comparative study on epidemiological characteristics and public health interventions of COVID-19 among China, South Korea, the United States and France based on the poisson regression model
ZHANG Yu-qin, CHEN Shi-rui, WANG Xin-ran, LIN Xiao, CHEN Xiu-yuan, HAO Yuan-tao
2023, 27(2): 142-147. doi: 10.16462/j.cnki.zhjbkz.2023.02.004
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  Objective  To analyze the trend of COVID-19 epidemic and to comparatively evaluate effects of economic policies, containment and closure policies and health system policies in China, South Korea, the United States (US) and France.  Methods  Daily confirmed COVID-19 cases and daily comprehensive policy index, specific indicators in mainland China, South Korea, US and France were collected. Considering the lag effect of policy effects, poisson regression model was established to estimate the daily real-time regeneration (Rt), and the log-log model with variable coefficient was used to compare the prevention and control effects of policies and measures in different countries.  Results  Containment and closure policies and health system policies were negatively correlated with Rt, and the cumulative lag effect weakens with the increase of lag time. Economic policies were negatively correlated with Rt only in US and France. The effect of American and French policies on Rt was weaker than that of China and South Korea.   Conclusion   Containment and closure policies and health system policies have a great effect on reducing Rt and controlling the epidemic, the timely and powerful comprehensive blockade measures at the early stage of the epidemic have better effects than mitigation measures.
Comparison of the transmission of COVID-19 between Hebei and Heilongjiang in early 2021
JIAO Hai-yan, LIAO Ying, WANG Lei
2023, 27(2): 148-156. doi: 10.16462/j.cnki.zhjbkz.2023.02.005
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  Objective  To compare the diversity of transmission of COVID-19 in Hebei and Heilongjiang Province in early 2021, and to provide theoretical support for the formulation of prevention and control strategies for COVID-19.  Methods  A dynamical model with staged control strategies was constructed based on the number of existing asymptomatic cases, the number of existing confirmed cases and the cumulative number of removed cases in Hebei and Heilongjiang at the beginning of 2021. Parameters of the model were estimated by the nonlinear least square method. Sensitivity analysis was used to explore the impact of key parameters on the peak number and peak time of existing confirmed cases in the two regions. We respectively analyzed the influence of the change for the number of initial contacts, the probability of initial contacts, the relative infectivity correction factor of the latent and the composition ratio of the symptomatic infection on the number of existing asymptomatic cases, the number of existing confirmed cases and the number of cumulative cases in the two regions.  Results  The model fitting results of the two regions were good. Compared the results of Hebei with those of Heilongjiang, there was a larger proportion of asymptomatic infected persons. When the number of initial contacts, the probability of initial contacts, the relative infectivity correction factor of the latent and the composition ratio of the symptomatic infection separately decreased by 10%, the average decrease for the peak number of existing asymptomatic and existing confirmed cases, and the cumulative removed cases in Heilongjiang were more than those in Hebei.  Conclusions  In early 2021, the transmissions of COVID-19 in Hebei and Heilongjiang were significantly different. In particular, the impact of control measures on the development of the epidemic is different in different areas.
Molecular epidemiological analysis of COVID-19 imported cases in Ruili from July to November, 2021
ZHENG Xue-dong, ZHAO Xiao-nan, WU Yan-peng, CHEN Zhi-yuan, WANG Yan, YU Hong-jie, FU Xiao-qing, ZHAO Shi-wen
2023, 27(2): 157-163. doi: 10.16462/j.cnki.zhjbkz.2023.02.006
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  Objective  To analyze the epidemiological and genomic characteristics of COVID-19 cases imported by land in Ruili, and to provide reference for border epidemic prevention and control in Yunnan Province.  Methods  We collected information about SARS-CoV-2 infected individuals from overseas land in Ruili, Yunnan from July to November, 2021. The epidemiological characteristics were statistically analyzed. The second-generation sequencing platform of Illumina was used to conduct high-throughput sequencing on the selected 40 positive samples and to analyze their genotyping and variation characteristics.  Results  During the study period, Ruili City reported 796 COVID-19 cases from abroad.The median age of COVID-19 cases was 28.5 years (Interquantile range 10; range 1-85). The gender ratio between men and women was 4.61∶1; Most of these infected individuals engaged in business services, accounting for 49.75% (396/796); 95.60% of COVID-19 cases were mild and moderate cases. The sequencing results of 34 cases can be divided into three clades according to Nextstrain typing method, including 24 cases belong to 21A(Delta) clade, 9 cases belong to 21I(Delta) clade and 1 case belongs to 20I(Alpha V1) clade.  Conclusions  The virus genotypes of the cases in this study were mainly divided into three branches and there were some differences among them, most of which were Delta mutants.We should continue to implement border control measures and continue to monitor the virus mutation of imported cases, so as to evaluate the threat of the mutant strain to the current situation of epidemic prevention and control in Yunnan Province.
Protection probability against SARS-CoV-2 Omicron variant BA.1, BA.2 and BA.5 in asymptomatic infection caused by prototype strain
ZHENG Nan, CHEN Xin-hua, LU Wan-ying, YU Hong-jie
2023, 27(2): 164-168. doi: 10.16462/j.cnki.zhjbkz.2023.02.007
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  Objective  To estimate the protection probability against SARS-CoV-2 variant Omicron strains BA.1, BA.2 and BA.5 infection, symptomatic infection and severe disease outcomes in asymptomatic individuals infected with SARS-CoV-2 prototype strain previously.  Methods  Our previous study had shown that the dynamic change of neutralizing antibodies in asymptomatic individuals infected with the SARS-CoV-2 prototype strain. Based on our previous study, a peer-reviewed predictive model on the basis of logistic model was used to estimate the protection probability of asymptomatic individuals against Omicron strains BA.1, BA.2 and BA.5. We estimate the protection probability against infection, symptomatic infection and severe disease outcomes on 28, 51 and 261 days after confirmation.  Results  The protection probability against reinfection of Omicron variant strains BA.1, BA.2, and BA.5 on 28 days after confirmation were 30% (95% CI: 16%-52%), 23% (95% CI: 15%-36%) and 8% (95% CI: 4%-16%) respectively, while decreased to 9% (95% CI: 3%-21%), 6% (95% CI: 3%-12%) and 2% (95% CI: 1%-4%) on 261 days after confirmation. The protection probability against symptomatic infection of Omicron strains BA.1, BA.2, and BA.5 were 51% (95% CI: 28%-80%), 42% (95% CI: 26%-67%) and 16% (95% CI: 7%-40%) respectively on 28 days after confirmation, while decreased to 16% (95% CI: 7%-35%), 12% (95% CI: 7%-22%) and 3% (95% CI: 1%-8%) on 261 days after confirmation. The protection probability against severe disease of Omicron strains BA.1, BA.2, and BA.5 were 91% (95% CI: 72%-98%), 88% (95% CI: 70%-97%) and 66% (95% CI: 35%-90%) respectively on 28 days after confirmation, while decreased to 60% (95% CI: 35%-86%), 51% (95% CI: 32%-75%) and 22% (95% CI: 10%-50%) on 261 days after confirmation.  Conclusions  Neutralizing antibodies induced in asymptomatic individuals infected with prototype strain could provide higher protection against Omicron strain BA.5 than Omicron strains BA.1 and BA.2. Among the three clinical outcomes, the protective probability against severe disease outcome was better, followed by symptomatic infection, and the protective probability against infection was poor.
Disease burden of tuberculosis in China and three South Asia countries along the Belt and Road, 1990-2019
ZHAO Fei, PEI Hang, YAO Yuan-yuan, LIU Xing-rong
2023, 27(2): 169-175. doi: 10.16462/j.cnki.zhjbkz.2023.02.008
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  Objective  The study aiming at analyzing the disease burden of tuberculosis in China, Bangladesh, India and Pakistan along the "Belt and Road" from 1990 to 2019, and to provide scientific evidence for tuberculosis prevention and control and international cooperation in the field of tuberculosis in China and other countries along the "Belt and Road".  Methods  Based on data from the Global Burden of Disease Study 2019 (GBD 2019), we used the incidence rate, the mortality rate and the disability-adjusted life years (DALYs) to describe the disease burden of tuberculosis from 1990 to 2019. And we applied the average annual percent change (AAPC) to analyze the trend of disease burden in tuberculosis.  Results  From 1990 to 2019, the age-standardized incidence rate (ASIR), the age-standardized mortality rate (ASMR) and the age-standardized DALY rate (ASDR) of tuberculosis in four countries decreased between 42.85% and 90.23%. The AAPC ranged from -7.77% to -1.90% and the trend was statistically significant (all P < 0.05). In 2019, Pakistan had the highest ASIR, ASMR and ASDR of tuberculosis among the four countries. Except in Pakistan, the ASIR, ASMR and ASDR of tuberculosis in males were higher than those in females. The incidence, mortality and DALY rates of tuberculosis increased with age in the four countries.  Conclusions  Although the disease burden of tuberculosis in the four countries showed an overall downward trend from 1990 to 2019, it was still far from the target of WHO strategy to stop tuberculosis. The ASIR of tuberculosis in the three South Asian countries, such as India, is generally higher than that in China; Therefore, tuberculosis prevention and control should be considered as a priority area of international health cooperation in the construction of the "Belt and Road".
Spatial-temporal analysis and prediction model for the incidence of influenza from 2004 to 2018 in China
LIU Yun-guang, HUANG Qian, ZHANG Le, WANG Chao-cai, LIU Yan
2023, 27(2): 176-183. doi: 10.16462/j.cnki.zhjbkz.2023.02.009
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  Objective  To analyze the spatial and temporal characteristics of influenza and predict incidence from 2004 to 2018 in China, and to provide data refence for influenza prevention and control.  Methods  Data about the incidence of influenza in China from 2004 to 2018 was collected. Arcgis, Geoda and SaTScan software were used to visualize and classify the incidence of influenza by mapping, spatial autocorrelation and spatial-temporal scanning analysis respectively. The autoregressive integrated moving average model (ARIMA), exponentialsmoothing (ETS), trigonometric seasonality, Box-Cox transformation (TBATS) and neural network autoregression (NNAR) models were used to predict the 1-, 2- and 5- year incidence and compare the accuracy respectively.  Results  The incidence of influenza increased year by year from 2004 to 2018, and the incidence in Beijing, East China and South China were significantly higher than the national average. There was basically no global correlation but local aggregation of influenza in China. The Beijing and Tianjin City showed a high-high or low-high aggregation for a long time, and Fujian and Jiangxi Province showed a high-high aggregation from 2014 to 2016. From 2014 to 2018 and spatial correlation analysis were basically consistent, I and II aggregation areas with Fujian and Beijing as aggregation centers respectively. The best forecasting models for 1-, 2- and 5 years were NNAR, ETS and ARIMA models, respectively.  Conclusions  The incidence of influenza increased year by year from 2004 to 2018, and Beijing, East and South China became high incidence areas for influenza. Each area can develop appropriate preventive and control measures according to the spatial and temporal characteristics of influenza.
Transmission modes and influencing factors of Streptococcus pneumoniae among preschool children in Foshan
YU Hai-feng, DENG Wen-jun, LI Ping-yuan, ZHANG Jing-feng, ZHOU Jun-li, YAO Zhen-jiang, YE Xiao-hua
2023, 27(2): 184-190. doi: 10.16462/j.cnki.zhjbkz.2023.02.010
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  Objective  To urderstand the transmission mode and influencing factors of Streptococcus pneumoniae (S. pneumoniae) in preschool children, and to provide an important scientific basis for revealing the transmission pattern and controlling the transmission.  Methods  Stratified cluster sampling method was used to select 2 031 healthy children from seven kindergartens in Shunde District, Foshan City. Nasal swabs were taken and tested for S. pneumoniae. The random-effect model was used to explore the clustering of S. pneumoniae carriage in children, and homology analysis of molecular types was used to reveal the transmission mode. Both χ2 test and random-effect logistic regression were used to analyze the effects of multiple influencing factors.  Results  The nasal carriage rate of S. pneumoniae in children was 21.8%. Random-effect model indicated that there was a class-level clustering effect of S. pneumoniae carriage in children (Z=4.34, P < 0.001). The within-class homology rates of strains in seven kindergartens were 60.9%, 79.2%, 76.0%, 80.0%, 82.8%, 75.9% and 33.3%, respectively. The between-class homology rates were 90.6%, 91.7%, 88.0%, 82.9%, 63.8%, 93.1% and 76.2%, respectively. The analysis of influencing factors showed that non-household registration (OR=1.36, 95% CI: 1.04-1.79, P=0.027), rural area (OR=1.60, 95% CI: 1.09-2.35, P=0.017) and nasal carrying Moraxella catarrhalis (OR=1.91, 95% CI: 1.49-2.45, P < 0.001) were risk factors for S. pneumoniae carriage, while grade (OR=0.66, 95% CI: 0.52-0.83, P < 0.001) and nasal Staphylococcus aureus carriage (OR=0.41, 95% CI: 0.31-0.55, P < 0.001) were protective factors.  Conclusions  There is a high risk of S. pneumoniae transmission among children within and between classes. Grade, household registration, area and nasal carriage of other bacteria are important influencing factors for S. pneumoniae carriage in preschool children.
Investigation on the incidence and health-seeking behavior of diarrhea among children aged under 5 years in Suzhou
SHEN Si, DAI Zi-rui, CHEN Li-ling, SHAO Xue-jun, ZHANG Jun, ZHANG Tao, XUE Jian, ZHAO Gen-ming
2023, 27(2): 191-194. doi: 10.16462/j.cnki.zhjbkz.2023.02.011
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  Objective  This paper aims to investigate the incidence and health-seeking behavior of diarrhea among children under 5 years old in Suzhou City, and to inform the development of relevant health policies.  Methods  A repeated cross-sectional survey design and a stratified random sampling method was conducted to investigate the occurrence and health-seeking practices of childhood diarrhea in the past 1 month.  Results  The occurrence rate of diarrhea among children under 5 years old in Suzhou last month was 3.39%, with an average of 0.41 episodes of diarrhea per child per year. The consultation rate was 72.50%. The peak rate of diarrhea was 5.97% among children aged 6-12 months (χ2 =126.52, P < 0.001). The different consultation rates of childhood diarrhea in different seasons were not statistically significant, and the health-seeking pattern was relatively fixed. The primary reason for children not seeking medical care was that parents did not think the disease was serious, and they preferred self-treatment through self-medication.  Conclusions  Attention should be paid to diarrhea among children under 5 years old in Suzhou City, especially among younger infants. Relevant education of parents should be strengthened, medical and health care should be further improved, and surveillance of childhood diarrhea should be enhanced.
Regional distribution of depression symptoms in Chinese elder and relationship with cardiovascular and cerebrovascular diseases
ZHANG Zi-wei, HUA Yu-meng, CHEN Yang-yang, LIU Ai-ping
2023, 27(2): 195-200. doi: 10.16462/j.cnki.zhjbkz.2023.02.012
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  Objective  To explore the regional distribution of depressive symptoms and the relationship with cardiovascular and cerebrovascular diseases in the elderly over 60 years old in China.  Methods  Based on China Health Retirement Longitudinal Study (CHARLS) in 2018, 3 778 elderly people aged 60 and above were enrolled. The Spearman correlation was adopted to analyze the urban-rural differences between regional economic development and depressive symptoms and cardiovascular and cerebrovascular diseases among the elderly. The logistic regression analysis was used to analyze the relationship between cardiovascular and cerebrovascular diseases and depressive symptoms in the elderly in different regions.  Results  The prevalence of depressive symptoms in the elderly in China was 45.9%. The per capita GDP was negatively correlated with the prevalence of depression symptoms in the elderly (rs=-0.651, P < 0.001). The per capita GDP level in urban and rural areas was negatively correlated with the prevalence of depression symptoms (rs city=-0.850, P < 0.05; rs country=-0.810, P < 0.05). The level of per capita GDP in rural areas was negatively correlated with the prevalence of cardiovascular and cerebrovascular diseases (rs country=-0.876, P < 0.05). The risk of depression symptoms in patients with cardiovascular and cerebrovascular diseases was 1.876 times than that in the elderly without cardiovascular and cerebrovascular diseases (OR=1.876, 95% CI: 1.561-2.255, P < 0.05).  Conclusions  The low level of regional economic development and cardiovascular and cerebrovascular diseases pose a double burden on the mental health of the elderly. Therefore, developing regional economy plays an important role in promoting the physical and mental health of the elderly, and more attention should be paid to the mental health of the elderly patients with cardiovascular and cerebrovascular diseases.
Diversity trend of sex differences in disability-free life expectancy among older adults in China from 2020 to 2050
GUO Shuai, LUO Ya-nan, ZHENG Xiao-ying
2023, 27(2): 201-208. doi: 10.16462/j.cnki.zhjbkz.2023.02.013
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  Objective  To analyze the trends in health expectancy and its gender differences among older adults in China from 2020 to 2050, and to provide evidence and clues for the relationship between longevity and health and its sex differences in the future.  Methods  Based on the 2010 Census, and the National Sample Surveys on Disability in 1987 and 2006, population-development environment model (PDE) and epidemiological methods (EPI) were used to predict mortality and disability rates. The Sullivan method was used to estimate age-sex-specific disability-free life expectancy (DFLE) and life expectancy with disability (LwD) for the population 50 years and older between 2020 and 2050.  Results  Life expectancy (LE) among older adults continues to increase. The rise in LE was primarily driven by the increase in LwD for women, while for men, the contribution of the increase in DFLE was higher. Expansion of morbidity was found in women under 75 years old and men under 65 years of age and was less pronounced in men. Women aged 80 years and older will spend more than half of their remaining life with disability, which is larger than men. Women had a higher DFLE presented than men, the absolute sex gaps in DFLE presented narrow over time but remain relatively stable among the oldest-old. By contrast, as for the relative terms, the DFLE was lower in women than in men, and the sex gaps will narrow after 2040 and become more pronounced among the oldest-old.  Conclusions  The functional status of older adults in China will deteriorate in the future. The relative sex differences in DFLE will narrow after 2040 under the scenario of the high proportions of LE with disability. It should establish a comprehensive long-term care system as soon as possible, and pay more attention to the functional ability of women female oldest old.
Association between regional economic development and cancer incidence and mortality in China
CAO Wei, LI Feng, LIANG Yu-qing, YU Da
2023, 27(2): 209-215. doi: 10.16462/j.cnki.zhjbkz.2023.02.014
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  Objective  To examine the association between gross domestic product (GDP) per capita and the cancer burden across different regions.  Methods  We used data from the 2018 China Cancer Registry Annual Report and 2016 China Statistical Yearbook. A stratified random sampling method was conducted and a total of 55 regions were included. Linear correlation, restricted cubic splines (RCS), and multiple linear regressions were performed to fit the associations between regional GDP per capita and cancer incidence (mortality) rates. Subgroup analyses were conducted for the three most common cancers in males (lung, stomach, and liver cancers) and females (breast, lung, and colorectal cancers), separately.  Results  Regional GDP per capita was positively correlated with the age-standardized incidence and mortality rates (ASIR: r=0.61, ASMR: r=0.49; P < 0.001) of all-site cancers. RCS fitting showed that in regions with a higher GDP per capita, the rising trends of cancer incidence and mortality slowed down. Multivariable regression models found that in regions with a higher GDP per capita, ASIR (β=12.08/105, 95% CI: 7.57-16.59/105) and ASMR (β=5.56/105, 95% CI: 2.70-8.42/105) of all-site cancers were higher; Among males, the ASIR (β=3.63/105, 95% CI: 1.87-5.40/105) and ASMR (β=3.47/105, 95% CI: 2.00-4.93/105) of lung cancer increased, while the ASIR of liver cancer decreased (β=-1.47/105, 95% CI: -2.78--0.16/105); Among females, the ASIR and ASMR of breast cancer, lung cancer, and colorectal cancer were significantly higher.  Conclusions  Economic development is one of the significant factors related to the heavy cancer burden in China. The formulation and implementation of targeted cancer prevention and control strategies could refer to each region's economic development and cancer profile.
Multi-omics data integration molecular subtyping of lower-grade gliomas based on MOVICS clustering ensemble
ZHAO Xin, WEI Yi-fang, LI Ling-mei, SHI Guo-jing, FANG Rui-ling, CAO Hong-yan
2023, 27(2): 216-223. doi: 10.16462/j.cnki.zhjbkz.2023.02.015
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  Objective  To investigate the application of multi-omics integration and visualization in cancer subtyping (MOVICS) clustering ensemble method in multi-omics data integration for lower-grade gliomas (LGG) subtyping, and high risk LGG group identification, and further screen potential biomarkers and important pathways.  Methods  The MOVICS method was used to integrate the subtyping results of 10 integration methods based on the LGG multi-omics data, to obtain a robust molecular subtyping of LGG patients. Cox regression analysis was carried out to evaluate the mortality risk of different patients. Differentially expressed mRNA (DEmRNAs), miRNA (DEmiRNAs) and differential methylation genes (DMGs) analyses were conducted between different subtypes. Overlapping genes among the three omics data types were used for GO term and KEGG pathway enrichment analysis. Additional analysis was conducted to identify hub genes and further evaluate their influence on patients survival outcome. Finally, pathway activity analysis between different subtypes was performed.  Results  LGG patients were divided into three subtypes. Patients in subtype 3 were 2.794 times more likely to die than patients in subtype 1. A total of 1 569 DEmRNAs, 140 DEmiRNAs and 337 DMGs were screened, the combined analysis genes yielded 119 genes which are regulated by mRNA, miRNA and DNA methylation and enriched 26 GO items and 7 KEGG pathways with statistical differences. Survival analysis showed that DNAJB14 and MTUS1 were significantly associated with survival outcome. Pathway activity analysis indicated that activities of Androgen, EGFR, Trail and VEGF showed significant difference between subtypes.  Conclusions  MOVICS classified LGG patients into three subtypes with distinct survival outcomes. Potential biomarkers, hub genes and important pathways were identified, which provided novel insights into the underlying differences between subtypes in molecular levels. These molecular signatures could offer new opportunities for individualized treatment and prevention of LGG patients.
Combined effects of psychosocial factors and traffic environment on pedestrians' distraction
NING Pei-shan, HU Guo-qing
2023, 27(2): 224-230. doi: 10.16462/j.cnki.zhjbkz.2023.02.016
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  Objective  The combined influences of psychosocial factors and traffic environment on three types of pedestrian's distraction (including mobile phone use, chatting with other pedestrians, and eating/drinking/smoking) were examined based on the integrated behavioral model.  Methods  Multi-stage random sampling was used to select 20 road intersections in Changsha City as research sites. Video-taping and questionnaire surveys were used to collect data on distraction, psychosocial factors, and traffic environment. Based on the integrated behavioral model, we developed the questionnaire from the perspective of psychosocial factors including pedestrian's attitudes, subjective norms, personal agency, and distraction habits towards different types of distraction. A structural equation model was used to test the combined effect of psychosocial factors and traffic environment on pedestrians' distraction.  Results  A total of 1 974 pedestrians participated in the questionnaire survey, collecting 1 741 valid questionnaires (600 for mobile phone use, 660 for chatting with other pedestrians, and 481 for eating/drinking/smoking). The individual attitudes, subjective norms, personal agency, intention, distraction habits, and traffic environment accounted for 22%, 18%, and 23% of the variation of pedestrian's distraction in mobile phone use, chatting with other pedestrians, and eating/drinking/smoking, respectively. Personal agency, subjective norms, and attitudes were the main explanatory factors of mobile phone use, with indirect effects of 0.126, 0.110 and 0.102 (P < 0.05), respectively. Distraction habits was the major explanatory factor for chatting with other pedestrians and eating/drinking/smoking, with total effects of 0.158 and 0.250 (P < 0.05), respectively. The influence of traffic environment on the three types of distraction among pedestrians was not statistically significant.  Conclusions  Psychosocial factors and traffic environment jointly affected the incidence of three types of pedestrian's distraction, but the major explanatory factors differed across types of distraction. In the future, education, legislation, and engineering interventions should be integrated to address the major explanatory factors of distraction.
Review
Advances and challenges in intranasal vaccines development for respiratory infectious diseases
HUANG Xing-cheng, ZHUANG Chun-lan, LIU Xiao-hui, HU Xiao-wen, WU Ting
2023, 27(2): 231-237. doi: 10.16462/j.cnki.zhjbkz.2023.02.017
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The great challenge to prevent transmission makes widespread of respiratory infectious diseases easily occur. Intranasal immunization is considered to be a promising route of vaccination to prevent it. Different from parenteral vaccines, intranasal vaccines can induce mucosal immune in respiratory tracts in addition to systemic immune, which provide the first line of defense against respiratory pathogen infection and further prevent transmission. Safe and effective intranasal spray flu vaccines have been licensed. Since the outbreak of COVID-19, intranasal administration has been applied in different vaccine platforms. This article has reviewed the progress of intranasal vaccines for respiratory infectious diseases that have been licensed or are under evaluation in the clinical trials, meanwhile discusses its unique advantages and challenges faced.
Short Reports
Comparative analysis on seroprevalence of hepatitis B in 2010 and 2020 in Jiangsu Province
JIANG Jie, QIAN Jiao, ZHU Li-guo, YAO Min-fang, ZHU Tao, XU Jian-fang, CAO Min-quan, PENG Hong, ZHU Feng-cai, ZHAI Xiang-jun
2023, 27(2): 238-243. doi: 10.16462/j.cnki.zhjbkz.2023.02.018
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Abstract:
  Objective  To describe the characteristics of epidemic change of hepatitis B and to analyze the effect of comprehensive prevention and control measures for hepatitis B in Jiangsu Province.  Methods  According to the method of a cross-sectional survey, two large-scale seroepidemiological surveys of hepatitis B were carried out in 2010 and 2020 in Zhangjiagang City, Danyang City and Taixing City.  Results  A total of 148 196 and 100 989 people were investigated in 2010 and 2020, respectively. Age-standardHBsAgprevalence was 7.36% in 2010 and 5.33% in 2020, with a decrease by 28.55%. The HBsAg standard positive rates in Zhangjiagang City, Danyang City and Taixing City demonstration areas in 2020 were 2.92%, 5.25% and 7.14%, respectively, which were significantly lower than the HBsAg levels in 2010. According to the comparison of different age groups, the HBsAg positive rate decreased from 2020 to 2010 in all age groups, especially in the 20-35 age group. In the 2020 survey, the HBsAg positive rate was 4.88% in the population with a history of hepatitis B vaccination, which was significantly lower than that in the unvaccinated population (P < 0.001). The overall positive rate of anti-HBs was 45.55% in the 2020 survey, which was highest in infants aged 1- < 5 years, and decreased significantly in adolescents aged 5- < 20 years.  Conclusion  Through the implementation of the comprehensive prevention and control strategy for hepatitis B, the prevention and control of hepatitis B in the Jiangsu Province has achieved remarkable results, but the adult hepatitis B vaccination still needs to be strengthened.
Epidemiological characteristics of hepatitis C in Kashgar, Xinjiang during 2005-2019
ATIGULI Saimaiti, XIE Chun-mei, HAIRENGULI Maimait, HEI Fa-xin
2023, 27(2): 244-248. doi: 10.16462/j.cnki.zhjbkz.2023.02.019
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Abstract:
  Objective  We aims to analyze the epidemiological characteristics of viral hepatitis C in Kashgar, Xinjiang Province from 2005 to 2019, so as to provide scientific evidence for the hepatitis C prevention and treatment strategies.  Methods  Descriptive epidemiological methods were used to statistically analyze the epidemiological characteristics of hepatitis C cases reported in Kashgar, Xinjiang from 2005-2019 in National Notifiable Disease Report System (NNDRS).  Results  During 2005-2019, the incidence of hepatitis C showed an increasing trend, with an average annual increase rate of 11.5%. The incidence rate increased rapidly from 2005 to 2013, and did not fluctuate significantly from 2013 to 2019. Since 2015, the number of reported hepatitis C cases in Kashgar ranked first in Xinjiang Province. The main epidemic characteristics included unbalanced regional distribution, predominantly female, occurring mainly in the age of 40~ < 75 years old, and the main occupation was farmers.  Conclusions  The situation of hepatitis C epidemic in Kashgar, Xinjiang is relatively serious. People aged 40~ < 75, women, and rural residents are the key populations of hepatitis C infection. An epidemiological investigation should be carried out on these populations as soon as possible to find out the risk factors, and take effective preventive and therapeutic measures to curb the hepatitis C epidemic in these population.

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