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CN 34-1304/R ISSN 1674-3679

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2024 Vol. 28, No. 10

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Original Articles
The impact of cognitive level about injury prevention on the incidence of accidental injuries children and adolescents in Shenzhen
ZHANG Wenyan, YU Xiaoxuan, DENG Xiao, DAI Wenjie, ZHAO Shaojuan
2024, 28(10): 1117-1123. doi: 10.16462/j.cnki.zhjbkz.2024.10.001
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  Objective  To assess cognitive level about injury prevention and the incidence of accidental injuries among children and adolescents in Shenzhen, as well as the relationship between the cognitive level and incidence of accidental injuries.  Methods  Using a multi-stage sampling approach, a total of 4 867 children and adolescents from the fourth grade and above were recruited as study subjects from four schools selected in Guanhu Street, Longhua District, Shenzhen. The chi-square test was used to compare the differences in the distribution of individual and family factors in the occurrence of unintentional injuries among children and adolescents, and a multifactorial logistic regression analysis model was used to analyse the factors influencing the incidence of unintentional injuries.  Results  Among these 4 867 participants, 2 479 (50.93%) and 2 388 (49.07%) had a low and high level of cognitive about injury prevention, respectively. 178 reported experiencing accidental injuries within the past 12 months and the incidence rate of accidental injuries was 3.66% (95% CI: 3.13%-4.18%). There was a significant difference in the incidence of unintentional injuries among children and adolescents at different levels of injury prevention awareness (P < 0.05). Multivariable logistic regression analysis model analysis showed that compared to those with high cognitive levels about injury prevention, those with low cognitive levels (OR=2.615, 95% CI: 1.833-3.731) had an increased risk of experiencing accidental injuries.  Conclusions  The incidence of accidental injuries among children and adolescents in Shenzhen is relatively low, and their level of cognitive awareness regarding injury prevention has an impact on the occurrence of accidental injuries. In the future, consideration may be given to implementing measures to raise the level of awareness of injury prevention among children and adolescents in order to reduce the incidence of unintentional injuries.
Influencing factors and interaction between main behavioral factors of road traffic injuries among middle school students
XU Lulu, HUANG Wen, HUANG Mingang, WANG Keying, CHEN Kangkang, CHEN Qifeng, FEI Fangrong, XU Laichao
2024, 28(10): 1124-1129. doi: 10.16462/j.cnki.zhjbkz.2024.10.002
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  Objective  To investigate the incidence and influencing factors for road traffic injuries (RTIs) among middle and high school students in Shaoxing, so as to provide a basis for the prevention of RTIs.  Methods  A total of 7 200 students were selected from 171 junior and senior high school classes in Shaoxing using a multi-stage stratified cluster sampling method. Logistic regression model and interaction model were used to analyze the interaction between risk factors and main behavioral factors of RTIs.  Results  The 1-year incidence of RTIs in middle and high school students was 15.44%. Males, high school students, walking/cycling to and from school, and walking time ≥20 min on the way to and from school were risk factors for RTIs in middle school students. With regard to behavioral factors, our study showed that using electronic devices (OR=1.54, 95% CI: 1.31-1.81, P<0.001), playing on the road ≥20 min (OR=2.37, 95% CI: 1.39-4.05, P < 0.001), and running the red light (OR=2.84, 95% CI: 1.62-5.00, P < 0.001) were associated with an increased risk of RTIs. Moreover, using electronic devices and playing on the road showed an additive interaction, with an OR of 3.91 (95% CI: 2.95-5.18, P < 0.05).  Conclusions  Higher rates of RTIs were reported among middle school students, with road risk behaviors being a significant modifiable influence. The use of electronic devices on the way to and from school and playing on the road have an additive effect on the occurrence of RTIs and should be highlighted.
Study on the effect of induced abortion on healthy life expectancy of rural women
LI Zixu, WANG Xiaoqiong, JIANG Feng, ZHANG Huanxiang, LI Runxin, WANG Yali, LIU Xiaotian, SONG Xiaoqin, LI Hui, WANG Chongjian
2024, 28(10): 1130-1136. doi: 10.16462/j.cnki.zhjbkz.2024.10.003
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  Objective  To investigate the effect of induced abortion on healthy life expectancy (HLE) and life expectancy (LE) of rural women.  Methods  Based on the baseline (2015-2017) and follow-up survey (2018-2022) of Henan Rural Cohort, the information of women induced abortion was obtained through questionnaire survey. The socioeconomic status (SES) of the subjects was evaluated based on their marital status, educational level and average monthly income, and health status was assessed according to whether they had chronic diseases. The multi-state life table method was used to calculate the HLE and LE of women in different age groups and different number of induced abortions.  Results  A total of 18 291 rural women were included in this study. There were 11 540 (63.09%), 3 889 (21.26%) and 2 862 (15.65%) women with 0, 1 and 2 or more induced abortions, respectively. The HLE and LE of women with 0 induced abortion at aged 40 were 22.65 and 43.69 years, respectively. Compared with 0 induced abortion, women with 1 induced abortion lost HLE and LE by 0.66 and 0.73 years, respectively, and women with 2 or more induced abortions lost HLE and LE by 1.42 and 1.66 years, respectively. The HLE of women with 0 induced abortion at aged 40 was 23.21 and 22.39 years in higher and lower SES, respectively. Compared with 0 induced abortion, the loss of HLE for women with 1 induced abortion was 0.69 and 0.64 years in higher and lower SES, respectively, and the loss of HLE for women with 2 or more induced abortions was 1.48 and 1.38 years, respectively.  Conclusions  HLE and LE were associated with induced abortion in rural women. As the number of induced abortions increased, HLE and LE showed a downward trend, suggesting that reproductive health education should be strengthened to prolong women′s HLE and LE.
The relationship between physical activity and cognitive function among the middle-aged and older adults in China: the moderating effect of diet
ZHAO Caifeng, DONG Weizhong, XU Shanshan, HU Liang
2024, 28(10): 1137-1142. doi: 10.16462/j.cnki.zhjbkz.2024.10.004
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  Objective  To investigate the relationship between physical activity and cognitive function among the middle-aged and older adults in China, as well as the impact of diet on this relationship. The findings will provide a basis for implementing comprehensive behavioral interventions.  Methods  Based on the China health and nutrition survey (CHNS), 3 584 subjects with a baseline age of 55 years and above were included. A linear mixed-effects model was used to examine the association between physical activity and cognitive function, and a stratified analysis was conducted to determine whether such association varies between different groups of diet.  Results  After adjusting for demographic factors, lifestyle factors, and chronic disease conditions, there was a significant association between overall physical activity and total cognitive function scores (β=0.050, 95% CI: 0.035-0.065). Stratified analyses showed that in the group with lower health level of diet, the overall level of physical activity was more strongly associated with the total cognitive function score (β=0.094, 95% CI: 0.054-0.133).  Conclusions  More attention should be paid to protecting cognitive function by increasing physical activity level for middle-aged and elderly Chinese, especially those with low dietary health level.
The relationship between annual health examination and death risk among older adults
WANG Jingyue, SUN Boran, HOU Huijie, XIAO Wenbo, LIU Yang, RUAN Zhanliang, WANG Yuan, LU Wenli
2024, 28(10): 1143-1148. doi: 10.16462/j.cnki.zhjbkz.2024.10.005
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  Objective  To describe the participation in the annual health examination and explore whether annual health examination was associated with the risk of death among Chinese older adults.  Methods  The study was conducted using data from 2014 to 2018 of the Chinese longitudinal healthy longevity survey (CLHLS). The individuals who were aged 65 and older, completed the investigation of annual health examination, and without abnormal death time were included. The elderly were divided into four age groups and there were 941, 1 745, 1 594, and 1 188 participants in the 65- < 75, 75- < 85, 85- < 95, and ≥95 years old group, respectively. Chi-square test was used to analyze the characteristics of the elderly who attended the annual health examination. Cox proportional hazard model was used to explore the association between annual health examination and death.  Results  A total of 5 468 individuals were included, and 3 188 (58.30%) older adults participated in annual health examination. The rate of annual physical examination was higher among the elderly who were male, younger, married, wealthy, lived in rural or nursing home, kept exercising, and had chronic diseases (P < 0.05). The death risk was lower in the elderly who participated in annual health examination, after adjusted for demographic, chronic disease, and health behaviors (HR=0.79, 95% CI: 0.72-0.86), especially for the older adults aged 75- < 85(HR=0.68, 95% CI: 0.55-0.85) and 85- < 95(HR=0.70, 95% CI: 0.60-0.82) years old.  Conclusions  The rate of annual health examination of the elderly is high, and the annual health examination is significantly related to lower risk of death among the elderly in China. The active participation in annual health examination among older people still needs to be encouraged in the future.
Causal association study of relative fat mass index and risk of all-cause death in middle-aged and elderly women with hypertension
YANG Wenyan, LI Jing, TIAN Jing, YAN Zhijia, YANG Hong, YAN Jingjing, WANG Yajing, ZHANG Yanbo
2024, 28(10): 1149-1155. doi: 10.16462/j.cnki.zhjbkz.2024.10.006
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  Objective  This study aims to investigate the causal correlation between the relative fat mass index (RFM) and the risk of all-cause mortality among middle-aged and elderly Chinese women with hypertension. Additionally, it seeks to compare the causal correlation between RFM and the risk of all-cause mortality with that of BMI and the risk of all-cause mortality.  Methods  Based on the China health and retirement longitudinal study (CHARLS) database, this study took 1 958 participants who met the inclusion and exclusion criteria as research subjects.the study plotted restricted cubic splines (RCS) to determine the cut-off value for RFM and subsequently grouped participants accordingly. Logistic regression models were constructed to analyze the correlation of RFM groups and BMI groups in relation to the risk of all-cause mortality. Furthermore, the average causal effects of them on the risk of all-cause mortality will would be calculated by employing double robust estimation.  Results  The Logistic regression models showed that compared with the 39.30≤RFM≤42.10 group, both the RFM>42.10 group and the RFM < 39.30 group would increase the risk of all-cause mortality in patients. In comparison with the normal BMI group, the thin group increased the risk of all-cause mortality, while the overweight and obese groups reduced the risk. The double robust estimation revealed that in comparison to the 39.30≤RFM≤42.10 group, both the RFM>42.10 group and the RFM < 39.30 group would increase the risk of all-cause mortality, with average treatment effect (ATE) values of 4% respectively (95% CI: 0.006-0.074) and 12% (95% CI: 0.077-0.163). However, the other groups didn′t demonstrate a causal correlation with the risk of all-cause mortality when comparing with the normal BMI group.  Conclusions  There is a causal correlation between RFM and all-cause mortality risk in middle-aged and elderly female with hypertension patients in China. Reasonable control of RFM may help reduce the risk of all-cause mortality in these patients.
Association between high-sensitivity C-reactive protein and 10-year risk of atherosclerotic cardiovascular disease among community-dwelling older adults aged 65 years and above in Shanghai
WEN Cai, SHEN Ying, YU Jianguo, GONG Aiqin, ZHANG Mei, JIN Yan, LI Yongmei, LI Jing, ZHAO Qi
2024, 28(10): 1156-1163. doi: 10.16462/j.cnki.zhjbkz.2024.10.007
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  Objective  To evaluate the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) in community-dwelling older adults aged ≥65 years and to examine the association between high-sensitivity C-reactive protein (hs-CRP) levels and ASCVD risk, along with related predictive factors.  Methods  Using data from the 2023 physical examination database for older adults in Zhongshan Street, Songjiang District, Shanghai, the 10-year ASCVD risk was assessed using the prediction for atherosclerotic cardiovascular disease risk in China (China-PAR) model. The association between hs-CRP levels and the 10-year ASCVD risk and its components was analyzed using a multivariate logistic regression model and a restricted cubic spline model.  Results  A total of 3 654 participants were enrolled, with a median age of 70.00 (interquartile range: 68.00-75.00) years. The median level of hs-CRP was 1.05 (interquartile range: 0.43-2.23) mg/L, with 48.25%, 35.14%, and 16.61% of participants exhibiting high, medium, and low levels, respectively. The average 10-year ASCVD risk among the study population was 10.39%. After adjusting for confounding factors using multivariable logistic regression, the risk of high 10-year ASCVD was 2.50 times (95% CI: 1.78-3.52) and 3.32 times (95% CI: 2.02-5.47) higher in the medium and high hs-CRP groups, respectively, compared to the low group. Restricted cubic spline models demonstrated a non-linear dose-response relationship between hs-CRP levels and 10-year ASCVD risk among older adults. Older age, increasing waist circumference, elevated total cholesterol, lower levels of high density lipoprotein cholesterol, smoking, and the use of antihypertensive medications were associated with higher hs-CRP levels (all P < 0.05).  Conclusions  Higher hs-CRP levels are significantly associated with increased 10-year ASCVD risk in older adults. Early screening of hs-CRP levels in high-risk populations may facilitate targeted interventions to reduce ASCVD risk.
A prospective cohort study on the prevalence and influencing factors of falls among community-dwelling older adults in Guangzhou City
SUN Siyu, YANG Wenhao, HUANG Tingyuan, YUAN Lexin, CHEN Jiamin, LIU Hui, LIN Weiquan, ZHU Wei
2024, 28(10): 1164-1169. doi: 10.16462/j.cnki.zhjbkz.2024.10.008
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  Objective  To understand the prevalence and influencing factors of falls among community-dwelling older adults in Guangzhou City, and to explore the synergistic patterns and influencing pathways among different factors.  Methods  The prospective cohort study method was used for a baseline survey of 4 950 community-dwelling older adults aged 65 years and above in Guangzhou City in 2021; the occurrence of falls and other health conditions among baseline older adults was followed up in 2022. Cox proportional hazards model was used to analyze the influencing factors of falls. Association rules and Bayesian network modeling were used to analyze the synergistic patterns and influence pathways of the influencing factors.  Results  A final valid sample of 3 393 older adults was included with a median follow-up of 1.53 years. The prevalence of falls was 25.49% (95% CI: 24.02%-26.96%). Cox proportional hazards model results showed that females (HR=1.246, 95% CI: 1.088-1.426), ≥75 years (HR=1.343, 95% CI: 1.133-1.592), insured (HR=1.440, 95% CI: 1.038-1.997), diabetes (HR=1.309, 95% CI: 1.143-1.498) and stroke (HR=1.914, 95% CI: 1.309-2.799) increased the risk of falls occurring in older adults; high school and above (HR=0.861, 95% CI: 0.750-0.987), daily exercise (HR=0.684, 95% CI: 0.580-0.807), and satisfaction with self-assessment of health status (HR=0.484, 95% CI: 0.278-0.841) reduced the risk of falls among older adults. The results of association rules showed that the most common collaboration mode was diabetes, females, and falls (support: 19.07%, confidence: 32.77%, lift: 1.29). The result of Bayesian Network model showed that exercise frequency, age, education, self-assessment of health status, gender, diabetes, and stroke were the important influencing factors of falls, and the area under the curve of the model was 0.612.  Conclusions  The prevalence of falls among community-dwelling older adults in Guangzhou City was high, and the influencing factors are complex. It is recommended to develop and implement comprehensive intervention measures for high-risk groups, including those who are physically inactive, elderly, female, and those with chronic diseases.
Association between sarcopenia and all-cause mortality: a study based on 2011-2020 CHARLS data
ZHU Feiyun, YANG Ying, PAN Mengshan, YIN Tongle, XU Jiamin, CHEN Rucheng, ZHENG Weijun
2024, 28(10): 1170-1175. doi: 10.16462/j.cnki.zhjbkz.2024.10.009
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  Objective  To explore the association between sarcopenia and all-cause mortality in adults aged 45 and older.  Methods  Data from the China health and retirement longitudinal study (CHARLS) from 2011-2020 were utilized. Sarcopenia was diagnosed according to the 2019 standards set by the Asian Working Group for Sarcopenia (AWGS). The logistic regression model was used to calculate the individual propensity score (PS), and then the inverse probability of treatment weighting (IPTW) method was employed to perform Cox proportional hazard regression model analysis.  Results  The study included 12 241 participants: 7 279 participants without sarcopenia, 3 036 with probable sarcopenia, and 1 926 with sarcopenia. After IPTW adjustment, participants with possible sarcopenia had a 46% increased risk of mortality (HR=1.46, 95% CI: 1.19-1.77) compared to those without sarcopenia, and participants with sarcopenia had a 99% increased risk (HR=1.99, 95% CI: 1.43-2.76).  Conclusions  This research underscores the significant impact of sarcopenia on the mortality risk within the Chinese population, highlighting that sarcopenia can significantly increase the risk of death in adults aged 45 and above.
Correlation between ambient temperature and mortality risk and burden of circulatory diseases in Hohhot
LI Huan, YANG Shengmei, YUE Xuanzhi, WU Duoduo, ZHANG Wenyu, JIA Xinrui, WEI Nana, KANG Weiwei, FAN Yaochun
2024, 28(10): 1176-1183. doi: 10.16462/j.cnki.zhjbkz.2024.10.010
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  Objective  To investigate the impact of extreme temperature weather on the risk of cardiovascular disease-related mortality among local residents in Hohhot City from 2014 to 2022, calculate the attributable risk, and provide a basis for the rational allocation of climate environmental health resources.  Methods  Using descriptive analysis methods, statistically describe and analyze the data of cardiovascular disease-related deaths (50 032 people) over 9 consecutive years in Hohhot City, along with meteorological data, and analyze the overall characteristics and trends of the residents′ mortality rates year by year. Quantitatively analyze the exposure-lag-response relationship between extreme temperatures and cardiovascular disease mortality using a distributed lag non-linear model, and further stratify the analysis by gender and age.  Results  There was a negative correlation between the number of daily deaths from circulatory diseases and the average daily temperature, indicating that the lower the temperature, the higher the number of deaths. Extreme low temperatures had a relatively rapid and longer-lasting impact on cardiovascular disease mortality. The exposure-lag-response relationship showed that for every 1 ℃ change in extreme temperature, the maximum cold effect on cardiovascular disease occurred at lag 3 days for the overall population as well as for males, females, individuals aged < 65, and those aged ≥65. The corresponding relative risk (RR) values were 1.027, 1.026, 1.033, 1.022, and 1.045, respectively. The heat effect had a significant impact at lag 7 and lag 5 days on the overall population and residents aged 65 and above, with RR values of 1.040 and 1.045, respectively. Both the cold effect and the heat effect had statistically significant impacts (P < 0.05) on cardiovascular diseases in the overall population with a cumulative lag of 21 days, with RR values of 1.131 and 1.145, respectively. During the study period, the specific mortality rate of cardiovascular diseases due to extreme temperatures in the overall population was 5.87%. Stratified analysis revealed a higher specific mortality rate among individuals aged 65 and above.  Conclusions  Extreme temperature weather can increase the risk of cardiovascular disease-related mortality among local residents, with a greater impact on individuals aged 65 and above. Residents of Hohhot City are more sensitive to the cold effect in terms of cardiovascular disease.
Epidemiological characteristics and spatial clustering analysis of acute hemorrhagic conjunctivitis in Shaanxi Province from 2011 to 2023
ZHANG Luqian, LI Xinxin, ZHANG Mengyan, WANG Shu, NIAN Yunpeng, NING Shaoqi
2024, 28(10): 1184-1189. doi: 10.16462/j.cnki.zhjbkz.2024.10.011
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  Objective  To investigate the trends and epidemiological characteristics of acute hemorrhagic conjunctivitis acute hemorrhagic conjunctivitis (AHC) in Shaanxi province from 2011 to 2023, with the goal of informing and developing targeted prevention and control strategies.  Methods  Data on AHC cases reported in Shaanxi Province from 2011 to 2023 were collected and processed for statistical analysis using Excel 2007 and SPSS 18.0. Regression analysis was conducted using Joinpoint 4.9.1.0, spatial clustering analysis with Geoda 1.6, and map visualization with SuperMap.  Results  A total of 14 273 AHC cases were reported in Shaanxi Province from 2011 to 2023, with an average annual incidence of 2.89/100 000. The overall incidence showed a significant declining trend (AAPC=-12.6%, t=-5.40, P < 0.01), with cases predominantly concentrated in Hanzhong Prefecture (41.84%) and Xianyang Prefecture (19.14%). Cases were reported across all counties and districts, with the highest incidences observed in 5 districts or countries, including Hantai District, Ningshan County, Mian County, Nanzheng District and Lueyang County. Farmers made up the majority of the occupational group, with a male-to-female ratio of 1.11 to 1.00. The highest incidence was found in the 35 to 70 years age group, with a peak during the summer and autumn seasons. Global spatial autocorrelation analysis revealed a significant spatial clustering between 2011-2018 and 2020-2023 (P < 0.01). Local spatial autocorrelation analysis identified a total of 78 "high-high" clusters, predominantly located in southern Shaanxi Province.  Conclusions  In Shaanxi Province, the incidence of AHC showed a notable decline from 2011 to 2021, with distinct regional clustering patterns. To prevent clustered outbreaks during AHC epidemic seasons, it is crucial to focus public education and surveillance efforts on specific population groups and key areas.
Epidemiological characteristics of tuberculosis patients receiving civil assistance in Guangxi Zhuang Autonomous Region
MO Wenxiu, LIANG Dabin, LIANG Xiaoyan, HUANG Minying, CUI Zhezhe
2024, 28(10): 1190-1195. doi: 10.16462/j.cnki.zhjbkz.2024.10.012
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  Objective  This study aims to analyze the epidemiological characteristics of tuberculosis (TB) patients who have received civil assistance in Guangxi Zhuang Autonomous Region, and to provide references for the assistance of TB.  Methods  The registered TB data of Guangxi from 2019 to 2022 were collected. The temporal, spatial, and population distribution characteristics of TB patients which receiving civil assistance were analyzed using descriptive epidemiological methods. The count data was represented by the composition ratio (%), and χ2, χ2-trend tests and Kruskal-Wallis H tests were employed to analyze rariations in rates.  Results  From 2019 to 2022, a total of 145 982 TB cases were reported in Guangxi Zhuang Autonomous Region, of which 18 891 cases (12.94%) received civil assistance. The registration rate of TB patients receiving civil assistance in Guangxi Zhuang Autonomous Region had decreased year by year (χ2trend=132.72, P < 0.001). Among the 2 464 tuberculosis patients who successfully escaped poverty in the period of 2019-2020, approximately 48.09% of them managed to achieve poverty alleviation within that same year through the implementation of various measures such as civil assistance. Among these patients receiving assistance, the number of male was higher than that of female. The average age of these cases was (53.4±17.3) years, and farmers accounted for 86.66%. The area with highest rate of registration for civil assistance was located in the western of Guangxi Zhuang Autonomous Region. In terms of therapeutic effect, the rate of successful treatment was 85.83% among these population, and sputum negative conversion rate had increased over the years (χ2trend=56.3, P < 0.001).  Conclusions  With the successful implementation of the poverty eradication campaign, the number of TB patients in need of civil assistance in Guangxi Zhuang Autonomous Region has been decreasing year by year. However, compared with other regions, the disease and economic burden of tuberculosis patients in western Guangxi Zhuang Autonomous Region is relatively heavy. The TB patients in rural areas were the priority population needing civil assistance. It is recommended to strengthen the multi-sectoral linkage of health, medical security, civil assistance and other departments, from financial support to humanistic care, to achieve accurate assistance.
Analysis of the impact of the COVID-19 on the prevalence of notifiable infectious diseases in Suzhou
ZHANG Longyao, LU Shanshan, GUAN Jinxing, CHEN Feng, ZHU Jie, SHI Qiufang, CHEN Liling
2024, 28(10): 1196-1203. doi: 10.16462/j.cnki.zhjbkz.2024.10.013
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  Objective  To understand the changes in the epidemiological characteristics of notifiable infectious diseases in Suzhou before and after the COVID-19 pandemic, and to explore the impact of comprehensive preventive and control measures on these diseases during the pandemic.  Methods  Based on China′s different stages of COVID-19 prevention and control strategies and the local epidemic situation in Suzhou, we divided the COVID-19 epidemic period from January 2020 to April 2023 into four distinct phases. This period was compared with the monthly average incidence levels of notifiable infectious disease from January 2012 to December 2019. Then we constructed intervention models to calculate the incidence rate ratios (IRR) for different modes of transmission of infectious diseases and predict the incidence levels of infectious diseases in the absence of comprehensive COVID-19 prevention and control measures.  Results  From January 2012 to April 2023, 22 notifiable infectious diseases were included in this study. Among them, hand, foot, and mouth disease had the highest number of cases, totaling 234 791 cases. By the different disease transmission route, gastrointestinal or enteroviral diseases had the highest number of cases (279 326). Gastrointestinal or enteroviral diseases, respiratory diseases, and sexually transmitted or bloodborne diseases all experienced a significant decrease in incidence over the four phases, with IRR consistently below 1. From the results of intervention model, gastrointestinal or enteroviral diseases were most affected, with IRR ranging from 0.12 (95% CI: 0.07-0.22) to 0.38 (95% CI: 0.31-0.47). Assuming there was no COVID-19 pandemic, gastrointestinal or enteroviral diseases were projected to peak in Phases Ⅰ and Ⅳ, while respiratory diseases showed an upward trend in incidence over the years. The predicted incidence trend of sexually transmitted or bloodborne diseases is similar to previous years, but with higher peaks.  Conclusions  During the COVID-19 pandemic in Suzhou, the incidence of notifiable infectious diseases significantly decreased. However, as prevention and control measures are gradually relaxed, there may be a rebound in infectious disease incidence, necessitating adjustments to control policies.
Epidemic characteristics and changing trends of road traffic injury patients in sentinel hospitals in Jiangsu Province from 2006 to 2022
WANG Rong, FAN Xikang, WU Xun, YANG Jie, ZHOU Jinyi, DU Wencong
2024, 28(10): 1204-1211. doi: 10.16462/j.cnki.zhjbkz.2024.10.014
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  Objective  To analyze the epidemiological characteristics and trends of road traffic injury cases in Jiangsu Province, providing scientific evidence for formulating road traffic injury prevention and control measures and strategies.  Methods  The data on road traffic injury cases were collected from sentinel hospitals in Jiangsu Province between 2006 and 2022. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of these cases. The ratios of different types of road traffic injury cases were calculated, and the χ2 test was used for group comparisons. Additionally, the temporal distribution was analyzed using the circular distribution method.  Results  Road traffic injury cases ranked second among the causes of injury occurrence (277 744 cases, 18.70%). The gender ratio of road traffic injury cases was 1.29∶1.00. From 2006 to 2022, the proportion of road traffic injury cases among all residents′ injuries in Jiangsu Province showed a downward trend (χ2trend=34 066.82, P < 0.001). Road traffic injuries have seasonal characteristics, with the peak period of road traffic injuries from April 15th to December 31st each year, and the peak day of occurrence being August 23rd each year. At the time of road traffic injuries, the cases were mainly driven by vehicles (73.2%). The degree of injury was mainly mild (72.2%). The main outcome was leaving the hospital after treatment (77.4%). Residents aged 65 and above have the most severe injuries after road traffic accidents (with 59.8% classified as moderate or severe injuries) and the highest number of observations/hospitalizations/transfers (32.5%). The main injury parts were the lower limbs (28.8%) and head (21.8%). The nature of the injury was mainly contusion/abrasion (66.2%).  Conclusions  Road traffic injuries are an important cause of medical visits for residents in Jiangsu Province, with interventions targeting the male population and those aged 65 and older. Meanwhile, protection of key body parts such as the lower limbs and head should be strengthened to reduce the severity of road traffic injuries.
Education Communication
Reform and practice of the comprehensive public health talents training system under the concept of "Great Health": a case study of Jilin University
ZHOU Liting, LI Juan, KOU Changgui, YE Lin, YU Xihe, REN Shuping, LIU Yawen
2024, 28(10): 1212-1216. doi: 10.16462/j.cnki.zhjbkz.2024.10.015
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The cultivation of public health talents is an important cornerstone for building a strong public health system, ensuring national public health security, and implementing the healthy China strategy under the concept of "Great Health". The School of Public Health at Jilin University has addressed three prominent issues in the field of public health and preventive medicine, including single knowledge structure for professionals, insufficient innovative spirit and practical ability, and narrow international perspective. Based on the talent cultivation concept of combining knowledge impartation with ability cultivation, integrating innovative spirit cultivation with practical ability training, and unifying professional quality formation with patriotism. With the help of education reform projects, curriculum development and international talent training programs, the "five modules, four platforms, and three ways" public health compound talent training model has been implemented. This reform not only improves the training quality of public health and preventive medicine professionals, but also has a positive impact on the overall improvement of public health education in China, and also provides new ideas for cultivating new public health talents.
Review
Epidemiology and research progress in prevention and control of mpox
YU Xiang, WEI Zhuohang, SANG Shenggang, ZHANG Rongguang
2024, 28(10): 1217-1222. doi: 10.16462/j.cnki.zhjbkz.2024.10.016
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Mpox, a zoonotic disease caused by mpox virus (MPXV), presents with fever, rash and enlargement of lymph nodes as the main clinical manifestations. Since 2022, the prevalence of mpox has increased rapidly, especially in non-endemic regions, making it one of the most pressing public health issues of global concern. As an emerging infectious disease, mpox is treated with either specific medicines or therapies. Therefore, moving forward with the prevention threshold and guarding against the risk of a recurrence are imperative for all countries to respond to the outbreak of mpox. In this article, we summarized the epidemic process, epidemiological characteristics, causes of outbreaks and prevention and control of mpox, aiming to provide a systematic perspective for the research on the transmission mechanism and prevention and emergency management of the worldwide epidemic.
Short Reports
A study on the relationship between the dietary inflammatory index and hypertension among residents of the Xinjiang region
WANG Min, DENG Lu, GUO Heng, QIAN Xin, TANG Wennu, DING Wenchang, MA Rulin
2024, 28(10): 1223-1228. doi: 10.16462/j.cnki.zhjbkz.2024.10.017
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Abstract:
  Objective  To explore the relationship between dietary inflammatory index(DII) and hypertension risk among Xinjiang Uygur Autonomous Region residents.  Methods  Using whole cluster sampling, adult residents of Shihezi and Tumushuk cities were selected for the study. General demographic information, dietary information, and physical examination of the study subjects were collected. The t-test, ANOVA, and Wilcoxon rank-sum test were used to analyze the dietary nutrient intake of the study population. A restricted cubic spline was used to analyze the dose-response relationship between DII and the risk of developing hypertension. The DII of the study subjects was divided into T1-T3, and the relationship between DII and the risk of hypertension was analyzed using logistic regression models.  Results  Except for carbohydrates, cholesterol, and vitamin E, intakes of other nutrients differed significantly between hypertensive populations and control (all P < 0.05). Restricted cubic spline results showed a nonlinear dose-response relationship for the strength of the association between successive changes in DII and the prevalence of hypertension. After adjusting for confounders, the risk of hypertension tended to increase with higher DII (Ptrend < 0.001). The risk of developing hypertension was 1.68 (95% CI: 1.12-2.51) and 2.95 (95% CI: 2.11-4.11) in the T2 and T3, respectively, compared with T1.  Conclusions  In Xinjiong Uyqur Autonomous Region, the hypertensive population had a higer DII score than the non-hypertensive population, and the higher the DII score, the higher the risk of hypertension.
Evaluation on the effectiveness of national demonstration areas for comprehensive prevention and control of non-communicable diseases in Shanghai Pudong New Area based on decomposition method of life expectancy
CHEN Hanyi, ZHANG Li, CHEN Yichen, XIAO Shaotan, ZHAO Genming
2024, 28(10): 1229-1234. doi: 10.16462/j.cnki.zhjbkz.2024.10.018
Abstract(31) HTML (10) PDF(4)
Abstract:
  Objective  To investigate change in life expectancy before and after the construction of National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases (referred to as "Demonstration Area"), as well as the effectiveness of control on main chronic diseases.  Methods  Data of all-cause of death in Pudong New Area from 2006 to 2021 were used. Gender- and age- specific contributions of four major chronic diseases were analyzed using decomposition method of life expectancy.  Results  The contributions of prevention and control on cancer and chronic respiratory diseases to the increase of life expectancy were 0.17, 0.51 and 0.25 years as well as 0.25, 0.32 and 0.16 years, during 2006-2012 (before the establishment of Demonstration Area), 2012-2018 (the initial construction period) and 2018-2021(the consolidation period), respectively. The contributions were higher than cardiovascular diseases (0.08、0.28、-0.13 years) and diabetes (0.03、-0.06、-0.05 years) at the same period. The middle-aged and elderly population made the most contribution. The contributions of prevention and control on cancer and chronic respiratory diseases among males had always been higher than those among females. Male contributed lower than female in 2012-2018 in terms of cardiovascular diseases. On the aspect of diabetes, male contributed negatively in all three periods and female turned to contribute negatively from 2012 to 2021.  Conclusions  Since the establishment of Demonstration Area in Shanghai Pudong New Area, the prevention and control on four major categories of chronic diseases contributed to the growth of life expectancy in varying ways. The decomposition method of life expectancy provides a new perspective of evaluation on the effectiveness of Demonstration Area in future.
Association between sex hormone levels and metabolic syndrome in a population of elderly men in Shanghai community
CHEN Yijun, WU Qiang, TANG Shuning, LIN Fangting, CHEN Xiuqin, GAO Junling, HUANG Limei, XIAO Qianyi
2024, 28(10): 1235-1240. doi: 10.16462/j.cnki.zhjbkz.2024.10.019
Abstract(38) HTML (10) PDF(2)
Abstract:
  Objective  To investigate the association between testosterone and estradiol levels and the components of metabolic syndrome (MetS) in elderly men aged ≥ 60 years in Shanghai communities.  Methods  This study included a total of 201 elderly men aged ≥ 60 from Shanghai communities. Information on age, lifestyle (including smoking, drinking, and physical activity), and medical history was gathered via a questionnaire survey. Physical measurements included height, weight, waist circumference, blood pressure (BP), fasting plasma glucose (FPG), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and testosterone. A multivariate logistic regression model was employed to analyze the association between sex hormone levels and MetS and its components.  Results  After adjusting for age, smoking, drinking, physical activity, and BMI, high testosterone levels were associated with a lower risk of MetS (OR=0.76, 95% CI: 0.61-0.95, P=0.016). The results showed that compared with the lowest level group, the risk of MetS in the highest level group was reduced by 66% (T3∶T1: OR=0.34, 95% CI: 0.13-0.90, P=0.030); Compared with the lowest level group, the risk of MetS in the highest level group was reduced by 68% (T3∶T1: OR=0.32, 95% CI: 0.11-0.88, P=0.027). The analysis of MetS components showed that among older men ≥ 60 years old, the high-level testosterone group had a low risk of hyperglycemia.  Conclusions  The serum testosterone and estradiol levels of elderly men in Shanghai community were negatively correlated with MetS risk, and testosterone was negatively correlated with the risk of hyperglycemia in MetS components.

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