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CN 34-1304/R ISSN 1674-3679

2023 Vol. 27, No. 5

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Public Health and Environmental Governance
Key points of public health management of living environment
LIU Quanhong, WANG Bin, WANG Dongming, MA Jixuan, ZHOU Min, GUO Yanjun, CHEN Weihong, WU Tangchun
2023, 27(5): 497-502. doi: 10.16462/j.cnki.zhjbkz.2023.05.001
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The increasing concentration of the population and the growing demands of human life, coupled with the relatively lagging implementation of environmental improvement and control measures, have led to a certain degree of deterioration in the living environment, seriously affecting the physical and mental health of residents. With the promotion and implementation of the ecological civilization concept and policy documents such as the "Healthy China 2030" planning outline, the living environment of Chinese residents has been significantly improved, but still faces problems such as unbalanced, insufficient, incomplete, and unsustainable governance. Based on the layout of China's new development pattern and ecological civilization construction in the new era, this paper reviews the key issues in living environment management from the perspectives of rural waste collection and disposal, standardized treatment of domestic sewage, toilet revolution, and kitchen revolution, urban air pollution control, waste sorting, and sewage treatment, and puts forward corresponding management points to provide a reference for formulating relevant policies, improving the quality of life of the people, promoting people's well-being, and ensuring public health.
The occurrence of water pollution and its adverse health effects and future countermeasures in China
ZENG Qiang, WU Tangchun
2023, 27(5): 503-507. doi: 10.16462/j.cnki.zhjbkz.2023.05.002
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Water pollution has been a global environmental issue, which seriously affects the economic and social development and the people's life and health. With the full implementation of the Action Plan for Water Pollution Prevention and Control, the prevention and control of water pollution in China has undergone significant changes, but there are still some gaps with the people's growing demand for water quality safety and health protection. In this paper, we analyze the various water quality changes in China from 2012 to 2021, and the results showed that the overall water quality has an increasing trend in China. We summarized the main health hazards of water chemical, biological, and physical pollution. Among them, the chemical pollution has been the main feature of water pollution in China. The adverse health outcomes including carcinogenesis, teratogenesis, and endemic diseases resulting from the water chemical pollution are prominent, whereas water-borne communicable diseases resulting from the water biological pollution still need to be vigilant. Based on these, we further put forward the countermeasures in terms of the management system, pollution control, and research need. These corresponding countermeasures include improvement of the laws and regulations on water environment, promotion of the precise prevention and control of water pollution, and enhancement of researches on water pollution and health risks, which will provide the references for the formulation of water pollution control policies and boost the construction of "Healthy China".
Characteristics of indoor and outdoor environmental from health benefit and promotion perspective
ZHANG Biao, WANG Jie, ZHANG Yuanyuan, ZHANG Xiaomin, WU Tangchun
2023, 27(5): 508-515. doi: 10.16462/j.cnki.zhjbkz.2023.05.003
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The environment is closely related to human health. Healthy China Action (2019-2030) points out that a good environment is the guarantee of human health. In order to further protect and promote the health of residents in China, this article proposes to summarize the characteristics and health effects of indoor and outdoor environmental factors, such as "green space""blue space""soundscape", sunlight exposure and indoor clean air, suitable temperature and humidity, and healthy lighting. Also, the relevant improvement measures and recommendations are put forward to increase awareness of environment and health, and to advocate a green lifestyle and promote the residents health.
Investigation and research on the awareness and application of environmental health risk assessment and mortality burden monitoring system
LIAO Qijing, GE Xiaoting, BAO Yu, HE Junxiu, HU Sihan, JING Tao, QIN Jian, YANG Xiaobo
2023, 27(5): 516-521. doi: 10.16462/j.cnki.zhjbkz.2023.05.004
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  Objective   To examine the current status and key challenges of employing environmental health risk assessment and mortality burden monitoring systems in China and to explore potential optimization strategies.   Methods   Technicians responsible for environmental health risk assessment and mortality burden monitoring from environmental monitoring departments and CDCs in Liaoning, Shanghai, Hubei, Guangxi, and Shanxi were chosen as subjects through stratified and convenience sampling. They completed self-administered electronic questionnaires. Of 217 returned questionnaires, 211 were deemed valid after removing invalid ones.   Results   Among the 211 respondents, 98.58% of participants acknowledged the significance of environment-related health risk assessments, 57.35% of participants were familiar with environmental health risk assessment standards or guidelines, and 97.52% of participants considered these guidelines or standards instructive, with no statistically significant difference between units at each level (χ2=2.420, P=0.299). Only 19.91% of participants applied environmental health risk assessment models in their actual work, with a higher percentage at provincial units (27.78%) compared to municipal (14.89%) and county units (20.55%). The awareness rate of China's environment-related mortality burden monitoring system was only 8.06%, and 92.42% of participants believed it necessary to conduct environment-related mortality burden monitoring. The respondents considered air (90.00%) and domestic and heavy mentals (83.40%) respectively the most critical environmental media and target substances to monitor the environment-related mortality burden. The most commonly used indicators to assess the burden of environment-related mortality were mortality rate, case fatality rate, and potential years of life lost.   Conclusions   China's environmental health risk assessment and mortality burden monitoring systems face low awareness and recognition, particularly regarding dissemination and practical application. A range of robust measures is needed to expedite the development of China's environmental health risk assessment system and mortality burden monitoring system to safeguard public health.
Original Articles
Effects and interactions of short-term exposure to O3 and meteorological factors on the number of deaths in Ningbo City
ZHANG Li, ZHANG Xiaofei, SHI Guoxiu, LYU Kang, DOU Qian, LI Yonghong, YAO Xiaoyuan, ZHENG Shan
2023, 27(5): 522-527. doi: 10.16462/j.cnki.zhjbkz.2023.05.005
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  Objective   To explore the impact and interactions of short-term exposure to O3 and meteorological factors on the number of deaths in Ningbo City.   Methods   Using cause of death, meteorological, and environmental monitoring data from Ningbo City, Zhejiang Province, a distributed lag nonlinear model (DLNM) was employed to analyze the effects and interactions of short-term exposure to O3 and meteorological factors on the number of deaths.   Results   Low temperature, low temperature-humidity index (THI), and low wind chill index (WCI) increased the risk of death from all causes, respiratory diseases, and circulatory diseases. Short-term exposure to O3 has a significant effect on the risk of all-cause mortality, respiratory and circulatory mortality (all P < 0.05), with the maximum effect observed at cumulative lag of 06, 07 and 06 days, which were 1.008(95% CI: 1.004-1.011), 1.015(95% CI: 1.007-1.022) and 1.009(95% CI: 1.004-1.014), respectively. Short-term exposure of O3 and high temperature, high THI, and high WCI showed a significant synergistic enhancement effect on the risk of all-cause mortality, respiratory and circulatory diseases, with the most pronounced effect observed in individuals aged ≥65 years.   Conclusions   Short-term exposure to O3 and meteorological factors in Ningbo has a certain impact on the number of deaths, with significant interactions observed. The population aged ≥65 years may represent a potential high-risk group.
Effects of atmospheric particulate matter on the prevalence of cardiovascular diseases in adult residents and effect modification of vegetation coverage
CHU Yifan, SHI Hengyuan, LIU Chao, LIU Chengrong, DONG Yilin, ZHANG Peiyao, JIA Xianjie, WU Xuesen, GAO Huaiquan
2023, 27(5): 528-533. doi: 10.16462/j.cnki.zhjbkz.2023.05.006
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  Objective   To evaluate the effects of atmospheric particulate matter on the prevalence of cardiovascular diseases in adult residents and effect modification of vegetation coverage.  Methods  A total of 4 000 adult residents were selected in Bengbu City in 2015. The basic information was obtained through a questionnaire survey and residents' physical examination. The concentration of atmospheric particulate matter (PM) in the 1 km buffer zone where the participants' homes were located was obtained through satellite retrieval technology. Logistic regression was used to analyze the association between PM and CVD. Stratified analyzes were performed to explore the potential confounding effect of age, sex, BMI, and the vegetation cover rate.  Results  Among the 3 190 subjects included, 1 080 were CVD patients. There were statistical differences in the prevalence of CVD among submicrometer particles (PM1), fine particulate matter (PM2.5), and inhalable particles (PM10) groups (all P < 0.05). There were statistically differences in the prevalence of CVD among normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), soil adjusted vegetation index (SAVI) (all P < 0.05). Logistic regression showed that after adjusting covariates, the risk of the PM2.5-high concentration group was 1.352 times that of the low concentration group (OR=1.352, 95% CI: 1.078-1.696). There was no statistically significant difference between the adjusted models of PM1 and PM10 (all P > 0.05). Stratified analysis showed that the interaction between PM2.5 and vegetation coverage was statistically significant (all P < 0.05). And the association between PM2.5 and the risk of cardiovascular disease was stronger when the vegetation coverage was at a lower level compared to higher level.  Conclusions  The more serious the atmospheric PM pollution, the higher the risk of CVD could be. Vegetation cover may moderate the association between PM pollution and CVD.
Interaction between polycyclic aromatic hydrocarbons exposure and alcohol consumption: effects on mental health status in non-smokers
TAN Lina, LIU Shaohui, JING Jiajun, HU Qiuhua, PENG Yang, ZHANG Li'e, MA Xiaoli, HHUANG Haifeng, ZOU Yunfeng, WANG Mingjun
2023, 27(5): 534-539. doi: 10.16462/j.cnki.zhjbkz.2023.05.007
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  Objective  To explore the effects of polycyclic aromatic hydrocarbons (PAHs) exposure and its interaction with alcohol consumption on the mental health of non-smokers.  Methods  A questionnaire survey and mental health assessment were conducted among 513 non-active smokers in a large enterprise in Guangxi. The general mental health questionnaire was used to evaluate the mental health status of the subjects. Urinary hydroxypolycyclic aromatic hydrocarbons (OH-PAHs) levels were employed as an indicator of internal exposure to PAHs. Logistic regression model and generalized linear model were employed to analyze effects of PAHs exposure and its interaction with alcohol consumption on mental health status.  Results  The average age of the subjects in this study was (39.60±6.60) years old. 44.2% of the subjects were drinkers, with most being unmarried, male, and exposed to secondhand smoke (P < 0.05). Logistic regression analysis showed that the increase of urine concentration of 1-hydroxynaphthalene (1-OHNAP) and total hydroxynaphthalene (∑OHNAPs) was associated with the risk of poor mental health (OR=1.23, 95% CI: 1.01-1.49; OR=1.10, 95% CI: 1.00-1.21; all P < 0.05). Interaction analysis showed that compared with non-drinking and low level OH-PAHs group, the concentration of 1-OHNAP, 2-hydroxynaphthalene (2-OHNAP), ∑OHNAPs and total hydroxypolycyclic aromatic hydrocarbons (∑OHPAHs) in urine and alcohol consumption increased the risk of poor meatal health in middle-aged and older adults (OR=3.91, 95% CI: 1.01-15.11; OR=3.69, 95% CI: 1.05-12.98; OR=1.96, 95% CI: 1.01-3.80; OR=1.73, 95% CI: 1.06-2.93; all Pint < 0.05).  Conclusions  PAHs exposure is a risk factor for poor mental health in non-smoking populations, and alcohol consumption can exacerbate the risk of poor mental health in middle-aged and elderly non-smokers exposed to PAHs.
A cross-sectional study of the association between low-carbohydrate diet and fasting hyperglycemia
ZHU Yu, LI Haowei, ZHOU Zhihao, CAO Chengsong, XIE Shaoyu, CAO Hongjuan, ZHANG Junqing, ZHOU Yu, LI Xiude, HUANG Yong, ZHANG Zhuang, YANG Wanshu
2023, 27(5): 540-545. doi: 10.16462/j.cnki.zhjbkz.2023.05.008
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  Objective  We developed a low-carbohydrate diet (LCD) score and estimated its association with fasting hyperglycemia.  Methods  Data from a population-based cross-sectional study in Lu'an City, Anhui Province was used to calculate overall LCD, plant LCD, and animal LCD score, based on the percentage of energy from total carbohydrate, total and subtypes of fat, and total and subtypes of protein. Hyperglycemia was defined as fasting glucose ≥ 6.1 mmol/L. Multivariate logistic regression was used to estimate ORs and 95% CIs.  Results  Of the 2 574 participants included in this study, 232 (9.01%) had hyperglycemia. When comparing the highest with the lowest tertile, the multivariable-adjusted ORs of hyperglycemia were 0.69(0.49-0.99) for overall LCD score, 0.61(0.43-0.87) for plant LCD score, and 0.68(0.47-0.98) for animal LCD score. The isocaloric substitution of 5% energy from saturated fat for carbohydrate was associated with lower odds of hyperglycemia (OR=0.50, 95% CI: 0.28-0.90), while increasing monounsaturated fat in place of carbohydrate was associated with increased odds of hyperglycemia (OR=1.69, 95% CI: 1.06-2.68).  Conclusions  Greater adherence to overall LCD, plant LCD, and animal LCD score was associated with lower odds of hyperglycemia. An appropriate reduction in carbohydrate intake, and increase in saturated fat intake might yield a lower risk of hyperglycemia.
Analysis of diabetes prevalence and related factors among older adults in rural Yunnan Province: a structure equation modelling approach
LI Xiao, SHEN Jingrong, LIU Yingnan, CUI Wenlong, ZUO Chunmei, HE Lianju, CAI Le
2023, 27(5): 546-550. doi: 10.16462/j.cnki.zhjbkz.2023.05.009
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  Objective  This study aims to analyze the prevalence of diabetes and its associated influencing factors among older adults in rural Yunnan Province.  Methods  A stratified randomized method was used to select 4 833 older adults aged ≥60 years in rural Yunnan Province. Each participant underwent a questionnaire survey and health examination. The associated influencing factors were analyzed using structural equation modelling (SEM).  Results  The prevalence of diabetes among older adults in rural Yunnan Province was 10.2%. The results of SEM indicated that body fat distribution (obesity and central obesity) and physical inactivity had both direct and indirect effect on diabetes, with the path coefficients of 0.134 and 0.041, respectively. Hypertension and family history of diabetes had direct effect on diabetes, with path coefficient of 0.054 and 0.097, respectively. Gender, smoking, residential pattern and socioeconomic status (SES) had only indirect effect on diabetes, with path coefficients of 0.045, 0.005, -0.007 and -0.049, respectively.  Conclusions  The main factors influencing diabetes prevalence include body fat distribution, physical inactivity, hypertension, family history of diabetes, and smoking. Promoting healthy lifestyle education among older adults with low SEP is beneficial for diabetes prevention and control.
Casual analysis between serum total bilirubin and diabetic nephropathy
XIA Miao, WANG Minzhen, ZHAO Zengyi, XING Yuwei, ZHAO Weili, YANG Hongyan, LIU Zanchao
2023, 27(5): 551-556. doi: 10.16462/j.cnki.zhjbkz.2023.05.010
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  Objective  To explore the causal relationship between serum total bilirubin(TBIL) and diabetic nephropathy (DN) using a regression discontinuity design (RDD) approach.  Methods  We analyzed data from 4 173 participants with type 2 diabetes mellitus (T2DM) at the Second Hospital of Shijiazhuang City. The prevalence of DN was assessed, and significant influencing factors were selected through logistic regression analysis. A risk prediction model was established, and individual DN risk was calculated. RDD was performed using TBIL as the grouping variable and individual DN risk as the outcome variable.  Results  Of the 4 173 patients with T2DM, 507 had DN (12.15%). The DN risk prediction model identified hyperlipidemia, smoking, drinking, diet control, physical exercise, hypoglycemic drugs, diabetes course, blood urea nitrogen, systolic blood pressure and TBIL as predictive factors. The area under the curve (AUC) for the model was 0.758(95% CI: 0.736-0.779). TBIL was found to be an protective factor for DN(OR=0.967, 95% CI: 0.948-0.987); at TBIL=8 μmol/L, the risk of DN significantly decreased by 5.02%(P=0.004).  Conclusions  TBIL is a protective factor for DN, and when TBIL=8 μmol/L, the risk of developing DN sharply declines.
Comorbidity patterns and conditions among 84 724 cerebral infarction patients in Gansu Province
HE Yongmei, CHEN Sixuan, YAO Jinwen, GAO Xin, CHEN Yongcong
2023, 27(5): 557-561. doi: 10.16462/j.cnki.zhjbkz.2023.05.011
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  Objective  The aim of this study is to investigate the comorbidity conditions and patterns among discharged cerebral infarction patients in Gansu Province, providing a basis for the prevention and treatment of comorbidities related to cerebral infarction.  Methods  A total of 84 724 patients with cerebral infarction from 14 public hospitals in Gansu Province were enrolled between January 1, 2020, and December 31, 2020. Basic demographic characteristics and comorbidities history were descriptively analyzed, and the comorbidity models were examined using UpSet graph.  Results  Of the 84 724 cerebral infarction patients, 54.06% were male. The average age of patients was (67.65±10.83) years, with the majority of patients (65.51%) aged between 60 and 80 years. The prevalence of comorbidity was 80.23%, with 59.32% of patients presenting with one or two chronic diseases and 20.91% with more than two. Hypertension was the most common comorbid chronic disease (53.69%). The most prevalent singular comorbidity model was cerebral infarction and hypertension (17.40%), the most common binary model was cerebral infarction, hypertension, and heart disease (7.04%), and the most frequent ternary comorbidity model was cerebral infarction, hypertension, heart disease, and chronic lung disease (1.77%).  Conclusions  The prevalence of comorbidity among cerebral infarction patients in Gansu Province was relatively high, with hypertension being the most common comorbidity. Health-relevant departments should focus on strengthening the management of chronic diseases associated with cerebral infarction.
Construction of midlife crisis scores and its relationship with cognition and depression
YIN Ping, XIE Jinzhao, LIAO Jing, GU Jing
2023, 27(5): 562-568. doi: 10.16462/j.cnki.zhjbkz.2023.05.012
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  Objective  To construct a comprehensive measurement of midlife crisis in the Chinese population, compare the differences in midlife crisis across different years, examine its relationship with socio-demographic characteristics, and explore the association between midlife crisis and cognition and depression.  Methods  Using data from the China Health and Retirement Longitudinal Survey (CHARLS) in 2011 and 2018, based on the literature and expert consultations, a comprehensive assessment for midlife crisis was constructed from five dimensions: economic, caregiving, work status, health, and social relationship. A total score of 10 was assigned, with a higher score indicating a more severe midlife crisis. Multiple linear regressions were used to analyze the differences and sociodemographic factors influencing midlife crisis across different years, and to explore the association between midlife crisis and cognition and depression.  Results  A total of 8 554 middle-aged adults aged 45-60 years were included. After adjusting for sociodemographic variables, the total score for midlife crisis was higher in 2018 than in 2011. In terms of the five dimensions, the economic crisis and caregiving crisis in 2018 were higher, while the work crisis, health crisis, and social relationship crisis were relatively lower (all P < 0.05). Older individuals, women, and rural residents experienced greater work and health crises, while those with higher levels of education experienced greater economic crisis. Middle-aged individuals with lower consumption levels and larger family sizes experienced greater care crisis (all P < 0.05). The midlife crisis was negatively correlated with cognitive function and positively correlated with depression (all P < 0.05).  Conclusions  The midlife crisis situation differs among different generations, and it is related to cognitive function and depression. In the future, attention should be paid to midlife crisis and interventions should be strengthened for high-risk groups.
Influencing factors of adherence to follow-up among patients with chronic HBV infection based on health belief model
PAN Deng, XIE Jinzhao, GU Jing, HAO Yuantao
2023, 27(5): 569-573. doi: 10.16462/j.cnki.zhjbkz.2023.05.013
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  Objective  To explore the factors influencing the adherence to follow-up among patients with chronic HBV infection using the health belief model (HBM) and provide a basis for the effective management of patients with chronic HBV infection.  Methods  A questionnaire survey and on-site medical examination were conducted among patients with chronic HBV infection in the demonstration areas of major infectious diseases in Guangdong Province during the 13th Five-Year Plan period. Data on basic characteristics, HBM-related variables, and adherence to follow-up were collected. Logistic regression was used to analyze the factors influencing adherence to follow-up among patients with chronic HBV infection.  Results  33.8% of patients with chronic HBV infection had poor adherence to follow-up. The results of multivariate logistic regression (stepwise) suggested that among the HBM-related variables, perceived barriers (OR=1.494, P < 0.001) was a risk factor for poor adherence, while perceived susceptibility (OR=0.796, P < 0.001), cues to action (OR=0.701, P < 0.001) and self-efficacy (OR=0.674, P < 0.001) were protective factors for poor adherence. Stratification of participants by HBV DNA also revealed that perceived barriers was a risk factor for poor adherence, while cues to action and self-efficacy were protective factors for poor adherence.  Conclusions  Perceived susceptibility, perceived barriers, cues to action, and self-efficacy all influence adherence to follow-up among patients with chronic HBV infection. Future interventions can be designed to improve adherence to follow-up by focusing on reducing perceived barriers and improving self-efficacy.
Etiology characteristics and their time series prediction of hand, foot and mouth disease in Dali
LIU Qing, LIU Lu, ZHANG Tai, DUAN Feiyun, CHEN Xiaoming
2023, 27(5): 574-580. doi: 10.16462/j.cnki.zhjbkz.2023.05.014
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  Objective   To understand the etiological characteristics of hand, foot and mouth disease (HFMD) in Dali, to use the seasonal autoregressive integrated moving average (SARIMA) models to explore the infection trend of pathogens and to provide a basis for the pathogen monitoring and prevention and control of HFMD in this region.   Methods   The etiological test results of HFMD in Dali from 2013 to 2021 were collected, which descriptive methods were used to predict the etiological characteristics of HFMD and SARIMA models.   Results   A total of 2 793 positive pathogens (60.27%) were detected in Dali, including 1 157 coxsackievirus A16(CA16) (41.42%), 669 enterovirus 71 (EV71) (23.95%), and 967 other enteroviruses (EV) (34.62%) between 2013 and 2021. Male-to-female positive ratio was 1.44∶1. The highest ratio was 1-3 years old (71.07%). Autumn had the highest positive rate (66.87%). CA16 composition ratio was the highest (52.89%). EV71 were the dominant epidemic strains in 2013-2014 and 2017, CA16 were the dominant epidemic strains in 2015-2016 and 2019, and other EV strains were the dominant epidemic strains in 2018 and 2021. The positive rates of different counties were significantly ($\chi$2=220.63, P < 0.001), which the highest rate was in Eryuan county (75.92%) and the lowest rate was in Nanjian county (40.87%). The prevalence of HFMD pathogens is obviously seasonal, which using SARIMA (1, 1, 0) (0, 1, 1)12 can well predict the infection trend of each pathogen.   Conclusions   The pathogens of HFMD coexist in Dali, with CA16 and other EV as the dominant strains, the key population is preschool children, originated in summer and autumn, Eryuan, Binchuan and Heqing Counties are at high incidence. The SARIMA(1, 1, 0)(0, 1, 1)12 model can more accurately predict the changing trend of HFMD pathogens.
Analysis of HIV self-testing and related factors in club drug abusers among men who have sex with men in Qingdao
Huang GH, Zhu LM, SONG Xin, FU Yong, GE Lin, LI Peilong, LI Dongmin
2023, 27(5): 581-586. doi: 10.16462/j.cnki.zhjbkz.2023.05.015
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  Objective   To analyze HIV self-testing and related factors in club drug abusers among men who have sex with men in Qingdao and provide a reference for promoting HIV self-testing among this population.   Methods   From April to July 2022, club drug abusers among MSM who being HIV-negative or with unknown HIV status were recruited by a community organization. A face-to-face questionnaire was conducted to investigate their demographic characteristics, sexual behaviors, club drug abuse and HIV self-testing status. The $\chi$2 test and multivariate logistic regression were used to analyze the related factors associated with HIV self-testing.   Results   A total of 569 participants were included in this study, with 67.84% (386/569) received HIV self-testing in the past 6 months. Among them, 65.80% (254/386) received HIV self-testing one time, 32.90% (127/386) self-tested twice and 1.30% (5/386) self-tested three times. HIV self-testing reagent sources were 80.57% (311/386) from MSM social organizations, 36.01% (139/386) from internet purchases, and 14.25% (55/386) from peer offerings. Multivariate logistic regression analysis showed that the frequency of HIV testing at facility-based sites once and ≥2 times in the past 6 months (OR=30.318, 95% CI: 8.181-112.360; OR=5.487, 95% CI: 1.663-18.101), having unprotected anal sex in the past 6 months (OR=2.437, 95% CI: 1.310-4.533), engaging in group sex in the past 6 months (OR=1.807, 95% CI: 1.113-2.932) and having mixed-use of club drugs in the past 6 months (OR=1.582, 95% CI: 1.004-2.493) were positively associated with HIV self-testing in the past 6 months. Being married (OR=0.595, 95% CI: 0.367-0.967) and receptive sexual role (OR=0.529, 95% CI: 0.311-0.902) were negatively associated with HIV self-testing in the past 6 months.   Conclusions   HIV self-testing rates were high in club drug abusers among MSM in Qingdao but low among those who were married, had receptive sexual roles, did not receive facility-based HIV testing, and did mixed-use club drug. HIV self-testing promotion should be strengthened for this population with low self-testing rates to improve utilization of HIV self-testing services.
Short Reports
Association of lncRNA MALAT1 and GAS5 polymorphisms with genetic susceptibility to hepatocellular carcinoma
WEI Meirong, WANG Xiaofeng, LUO Bing
2023, 27(5): 587-592. doi: 10.16462/j.cnki.zhjbkz.2023.05.016
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  Objective   This study aims to investigate the relationship between long non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) and growth arrest specific transcript 5 (GAS5) gene polymorphisms and hepatocellular carcinoma (HCC) susceptibility.   Methods   Cancer tissues from 225 HCC patients and peripheral venous blood samples from 220 healthy individuals were collected.DNA was extracted from these samples, constituting the case and control groups in this case-control study. At the same time, the single nucleotide polymorphism (SNP) of MALAT1 rs11227209 and GAS5 rs55829688 were detected using the Taq-Man MGB allele typing kit, and the results were analyzed by SPSS 17.0.   Results   The genotype frequencies(CC, CG, GG)of MALAT1 rs11227209 were 46.2%, 42.7%, and 11.1% in the case group and 50.0%, 42.7%, and 7.3% in the control group. Comparisons between homozygous mutant genotype CC and dominant model CG+GG genotype group, as well as homozygous wild genotype GG and recessive model CC+CG genotype group, revealed no statistically significant differences in genotype distribution ($\chi$2=0.636, P=0.425; $\chi$2=1.933, P=0.164). The genotype frequency (TT, TC, CC) of GAS5 rs55829688 were 45.3%, 43.6%, and 11.1% in the case group and 57.7%, 38.2%, and 4.1% in the control group. The distribution of CC genotype was higher in the case group (OR=3.459, 95% CI: 1.546-7.738, P=0.003). The frequency of C Allele was significantly higher in the case group compared to the control group (OR=1.624, 95% CI: 1.208-2.184, P=0.001). Allele C was a risk gene, increasing the risk of HCC in carriers (OR=1.647, 95% CI: 1.132-2.395, P=0.009). Genetic susceptibility stratification analysis showed that female patients carrying GAS5 rs55829688 CT+TT genotype could reduce the risk of HCC (OR=0.161, 95% CI: 0.045-0.580, P=0.005), as could individuals aged ≥50 years with the CT+TT genotype (OR=0.232, 95% CI: 0.074-0.728, P=0.012).   Conclusions   The SNP at rs55829688 of GAS5 is associated with increased HCC risk, particularly for individuals with CC genotype.Age, gender and the SNP of GAS5 rs55829688 may jointly impact the risk of HCC. No association was found between SNP at MALAT1 rs11227209 and HCC risk.
Analysis of the association between ambient temperature and foodborne diseases in Anhui Province, 2016-2019
ZHU Jiansheng, MENG Can, XU Lizi, ZHAO Yunxia, LIN Chao, SU Hong
2023, 27(5): 593-597. doi: 10.16462/j.cnki.zhjbkz.2023.05.017
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  Objective   To examine the effect of ambient temperature on foodborne diseases in Anhui Province, identify lag effects, and pinpoint vulnerable populations.   Methods   Foodborne disease surveillance data and meteorological data from all Cities in Anhui Province from 2016 to 2019 were collected. A generalized linear model based on quasi-Poisson regression was used to analyze the potential association between mean temperature and foodborne diseases in each city. Meta-analysis was then applied to pool the estimated city-specific effects.   Results   Between 2016 and 2019, 348 958 cases of foodborne diseases were reported in Anhui Province, with an annual incidence rate of 0.13%. Mean ambient temperature exhibited a linear effect on foodborne diseases incidence and revealed a delayed effect. In single lag effect, the maximum effect occurred at lag0 with a corresponding RR of 1.009 6 (95% CI: 1.004 7-1.019 0), indicating that a 1 ℃ temperature increase would raise the risk of foodborne diseases by 1.009 6-time on the current day. As the lag day lengthened, the effect diminished gradually, becoming statistically insignificant on the third lag day. For cumulative lag effects, the maximum effect was at lag05 1.019 9(95% CI: 1.012 6-1.027 2). Subgroup analysis showed that individuals less than 65 years old were more susceptible than those aged 65 or older.   Conclusions   Ambient temperature can increase the risk of foodborne disease, with a lag effect observed. Prevention program on foodborne disease should be focusing on susceptible individuals.
A correlation analysis between epidemiological characteristics of pediatric intussusception and meteorological factors in Wuhu
CHU Zhenjie, LIU Jie, SUI Bangzhi, ZHU Qinghua, XIA Yu, DUAN Guangqi
2023, 27(5): 598-604. doi: 10.16462/j.cnki.zhjbkz.2023.05.018
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Abstract:
  Objective   This study aims to elucidate the epidemiological characteristics of pediatric intussusception over the past six years and its association with meteorological factors in Wuhu, with a view to enhancing our understanding of the condition and providing a theoretical foundation for the development of predictive models.   Methods   A retrospective analysis was performed on the statistical and clinical features of pediatric intussusception cases treated at the First Affiliated Hospital of Wannan Medical College between April 2014 and December 2019. Seasonal patterns were assessed using the circular distribution method and Q-type clustering in systematic clustering. The Poisson regression was used to analyze the correlations between intussusception incidence and six meteorological factors.   Results   A total of 1 026 intussusception cases were collected, including 986 primary intussusceptions. The male-to-female ratio was 1.87∶1, with 52.02% of patients being no more than two years old. The predominant clinical symptoms were abdominal pain or crying (69.57%, 686/986), vomiting (62.98%, 621/986), and bloody stool (22.41%, 221/986). Circular distribution analysis (Z=7.62, P < 0.001) and clustering analysis revealed distinct peaks in intussusception incidence from May to June, indicating seasonality. Poisson regression analysis demonstrated positive correlations between monthly intussusception incidence and total monthly sunshine (β=0.004, P=0.005), and negative correlations with monthly average wind speed (β=-0.433, P=0.016), monthly average air pressure (β=-0.064, P < 0.001), and monthly average air temperature (β=-0.066, P < 0.001). No significant associations were found with monthly precipitation and monthly average relative humidity (all P>0.05).   Conclusions   In Wuhu, intussusception exhibits seasonal occurrence patterns and is influenced by climate factors. Months characterized by abundant sunshine, low wind speed, average air pressure, and moderate temperature are associated with higher incidence rates.
Analysis of anti-HBs positive influencing factors in patients with chronic kidney disease based on Bayesian network model
LU Xiaoxiao, YAO Tian, WU Yuanting, CAO Na, WANG Jianmin, LIU Hongting, FENG Yongliang, WANG Suping
2023, 27(5): 605-610. doi: 10.16462/j.cnki.zhjbkz.2023.05.019
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Abstract:
  Objective   To evaluate the positive rate of anti-HBs in patients with chronic kidney disease (CKD), and to explore influencing factors of the positive rate of anti-HBs and the network relationship among them.   Methods   A total of 623 CKD patients who were aged 18 to 70 years and treated in two hospitals between April and July 2019 were selected as the research subjects. General demographic characteristics, disease progression and the information related to hepatitis B of CKD patients were obtained through questionnaire survey and medical records. Quantification of HBsAg, anti-HBs and anti-HBc were detected. The influencing factors of anti-HBs positive in CKD patients and the network relationship among the influencing factors were performed by χ2 test, unconditional logistic regression and Bayesian network model.   Results   The history of hepatitis B vaccination rate in CKD patients was 14.13% (88/623), and the positive rate of anti-HBs was 32.58% (203/623). After controlling the confounding factors, the positive rate of anti-HBs in CKD patients with history of hepatitis B vaccination and family history was higher than those without such histories, with the OR(95% CI) of 1.71 (95% CI: 1.07-2.72) and 2.63 (95% CI :1.03-6.73), respectively. The results of Bayesian network model showed that history of hepatitis B vaccination and family history of hepatitis B virus were directly correlated with anti-HBs, while age and education level were indirectly correlated with anti-HBs through history of hepatitis B vaccination.   Conclusions   The positive rate of anti-HBs in CKD patients was low, and the hepatitis B vaccination was poor. It is necessary to strengthen the health education of CKD patients, actively carry out the detection of hepatitis B serum markers, early hepatitis B vaccination, especially the elderly, those with low education background, and no family history of hepatitis B virus.
Analysis on the factors influencing adolescents smoking behavior in Jiangsu Province using a structural equation model
FAN Jiannan, QU Chen, SHEN Xiaobing
2023, 27(5): 611-615. doi: 10.16462/j.cnki.zhjbkz.2023.05.020
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Abstract:
  Objective   To identify the factors influencing adolescent smoking behavior in Jiangsu Province by a Structural Equation Model (SEM) model, providing a reference for tobacco control initiatives..   Methods   Probability Proportionate to Size Sampling (PPS) was used to distribute questionnaires to adolescents, and the SEM model was conducted for data analysis.   Results   A total of 6 104 students were surveyed, revealing a 2.65% smoking rate among junior high school students in Jiangsu Province. Logistic analysis showed that the risk factors for student smoking as males (OR=1.623), having friends who smoke (OR=7.827), use cigarettes given by friends (OR=7.219), enjoying smoking (OR=3.120), potential predisposition to smoking (OR=2.854), having teachers who smoke (OR=2.068), exposure to indoor secondhand smoke (OR=2.196), the belief that quitting smoking is difficult (OR=2.010), and a lack of awareness about the harms of secondhand smoke (OR=1.738) (all P<0.05). The results of the SEM demonstrated a direct effect of tobacco susceptibility on smoking behavior (0.270), an indirect effect of smoking environment (0.236). And a total effect of tobacco access (0.719), with a direct effect of 0.580 and an indirect effect of 0.139. The model exhibited a good fit.   Conclusions   Tobacco susceptibility, access to tobacco, and the smoking environment are the primary factors influencing adolescent smoking behavior. Interventions addressing both individual and environmental aspects can effectively reduce youth smoking rates.
Comparative analysis of epidemiological characteristics and prevention measures of COVID-19 in Nanjing and Yangzhou
WANG Lei, ZHANG Lei, WU Jie, XU Jianguo, WANG Jinsong
2023, 27(5): 616-620. doi: 10.16462/j.cnki.zhjbkz.2023.05.021
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Abstract:
  Objective   To analyze and compare the epidemiological characteristics and prevention measures of COVID-19 in Nanjing and Yangzhou.   Methods   Confirmed COVID-19 cases data were extracted from the official websites of the Health Commissions of Nanjing and Yangzhou. Epidemiological characteristics and prevention measures of COVID-19 were analyzed and compared by using SPSS21.0 software.   Results   From July 20 to August 26, 2021, Nanjing reported 235 confirmed COVID-19 cases, while Yangzhou reported 570 cases. Significant differences were observed between Nanjing and Yangzhou in terms of age (χ 2=65.292, P < 0.001), place of residence (χ 2=696.964, P < 0.001), detection method (χ 2=159.880, P<0.001), exposure pathway (χ 2=52.359, P<0.001) and clinical classification (χ 2=70.124, P<0.001). However, there was no significant difference in sex between Nanjing and Yangzhou.Nanjing conducted seven rounds of large-scale nucleic acid testing, totaling over 40 million samples, whileYangzhou completed seven rounds of large-scale nucleic acid testing and multiple rounds of testing for targeted population, totaling nearly 25 million samples.   Conclusions   Differences were observed between Nanjing and Yangzhou in transmission patterns across outbreaks and the population characteristics of confirmed cases. The spread of COVID-19 in Yangzhou, primarily through communities, is more extensive and difficult to prevent compared to Nanjing's airport transmission chains.

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