中华疾病控制杂志

The association between hypertension disorders in pregnancy and the neurodevelopment of infants: a birth cohort study

WANG Xing, WU Wenjing, LIN Qingmei, HAO Yuantao, CAI Li

2024, 28(5): 497-502. doi: 10.16462/j.cnki.zhjbkz.2024.05.001

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Objective To investigate the association between hypertension disorders in pregnancy (HDP) and the neurodevelopment of infants. Methods The study utilized birth cohort data from the Foshan maternal and child health information system to select a sample of 17 812 pairs of maternals who received antenatal care at a women and children hospital and their offsprings born at the same facility. The neurodevelopment of the infants was assessed using the Neuropsychological Examination Scale for Chinese Children (NESCC) at various intervals throughout the study. Maternals who were exposed to HDP during gestation were categorized as the exposure group, with the control group selected using a 1:1 propensity score matching method. A total of 1 414 pairs of mothers and children were included in the study. The study employed generalized estimation equations to examine the association between HDP and the neurodevelopmental outcomes of infants. Results The study found that infants exposed to HDP exhibited lower development quotients in total and individual neurodevelopmental domains at 3, 6, 8 and 12 months compared to infants without HDP exposure (all P < 0.05). Even after confounding factors were controlled, HDP exposure remained a significant risk factor for the neurodevelopment of infants, with the partial regression coefficient (β) and (95% CI) of -5.72 (-6.80--4.63). Specifically, HDP exposure was negatively associated with gross motor, fine motor, adaptability, language, and social behavior development, with a partial regression coefficients (β) and 95% CI of -5.35 (-6.86--3.84), -5.64 (-6.92--4.35), -5.88 (-7.26--4.49), -5.80 (-7.10--4.50) and -5.91(-7.11--4.72), respectively. Conclusions HDP has been identified as a risk factor for the neurodevelopment of infants, exhibiting negative associations with the development of gross motor, fine motor, adaptability, language and social behavior

Study on the load level, composition distribution and correlation of organophosphorus flame retardants in pregnant women and newborns in Chongqing

SONG Yu, ZHOU Niya, WANG Xiaogang, YANG Huifang, CAO Jia

2024, 28(5): 503-509. doi: 10.16462/j.cnki.zhjbkz.2024.05.002

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Objective To evaluate the organophosphate flame retardants (OPFRs) loads of pregnant women and newborns in Chongqing and its relationship, components and correlation. Methods Date were drawn from The Preconception Reproductive Health and Birth Outcome Cohort (PREBIC), and a total of 221 healthy pregnant women-newborns pairs who delivered in Chongqing Maternal and Child Health Hospital from November 2020-November 2021 were included in the final analysis. The levels of 8 mOPFRs in serum were detected by liquid chromatography/mass spectrometry. The Spearman rank correlation analysis was used to analyze the association of 8 mOPFRs exposure levels in peripheral venous blood of pregnant women and umbilical cord blood of newborns. Results The detection rate of total mOPFRs(∑mOPFRs) in peripheral venous blood of pregnant women was 84.6%, and the detection rate of each mOPFRs ranged from 12.7% to 76.9%; the detection rate of ∑mOPFRs in umbilical cord blood of newborns was 93.2%, and the detection rate of each mOPFRs ranged from 1.8% to 91.0%. di-o-tolyl phosphate(DoCP) & di-o-tolyl phosphate(DpCP) and bis(2-ethylhexyl)phthalate(BEHP) in peripheral venous blood of pregnant women were correlated with the concentrations in umbilical cord blood of newborns (r=0.29 and 0.22, P < 0.05). Conclusions A variety of mOPFRs were detected in peripheral venous blood of pregnant women and umbilical cord blood of newborns in Chongqing, and there was a correlation between the levels of mOPFRs in pregnant women and newborns.

Association between traditional bullying victimization and suicide-related psychological behaviors among adolescents and the moderating role of sleep quality

YE Juan, ZHANG Yuling, WANG Shaojie, LI Yuan, WANG Gengfu

2024, 28(5): 510-515. doi: 10.16462/j.cnki.zhjbkz.2024.05.003

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Objective To analyze the association between adolescents′ traditional peer victimization and suicide-related psychological behaviors, and explore the role of adolescents′ sleep quality in this association, so as to provide scientific basis for the prevention of adolescents′ suicide-related psychological behaviors. Methods In October 2020, a total of 5 724 middle school students in Xuancheng city, Hefei city and Huaibei city of Anhui province were selected by using a stratified random cluster sampling method. The Olweus bullying victimization questionnaire, Pittsburgh Sleep Quality Index scale and self-designed psychological behavior questionnaire were used. Chi-square test was used to compare the detection rates of traditional peer victimization and suicide-related psychological behaviors among adolescents with different demographic characteristics. Logistic regression was used to analyze the association between peer traditional bullying and suicide-related psychological behaviors, and the moderating role of sleep quality on the above association was explored by using logistic regression stratified by sleep disorders. Results Multivariate logistic regression analysis showed that peer victimization and sleep quality were positively correlated with four suicide-related psychological behaviors (OR=3.38-4.01, all P < 0.001). The sleep quality of adolescents had a moderating effect on the exposure to traditional peer victimization and four suicide-related psychological behaviors (OR=0.48-0.64, all P < 0.001). Conclusions There is a positive correlation between adolescents′ exposure to peer traditional victimization and suicide-related psychological behaviors, and sleep quality plays a moderating role between adolescents′ exposure to peer traditional victimization and suicide-related psychological behaviors.

Analysis of minor injuries cases in Jiangsu Province from 2015 to 2021

SHI Zhan, HUANG Xiaoping, ZHANG Xiaoyan, DU Wencong

2024, 28(5): 516-522. doi: 10.16462/j.cnki.zhjbkz.2024.05.004

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Objective To investigate the occurrence and characteristics of minor injury cases in Jiangsu Province from 2015 to 2021, providing basis for developing strategies and measures for preventing Injury among minors. Methods All the first diagnosed injury cases of minors aged 0-17 years reported by outpatient and emergency departments of injury surveillance sentinel hospitals in Jiangsu province from 2015 to 2021 were collected and analyzed. The content includes general information of patients, basic information and clinical information of injury cases, and information of the reporting persons.We used the composition ratio to describe the distribution characteristics of injuries. And rank sum test were used to compare the differences in the severity of minor injuries between different categories. Results A total of 98 954 cases of minor injuries were collected from 12 sentinel hospitals in 5 monitoring points in Jiangsu Province from 2015 to 2021, with 60 380 were males(61.02%). The ratio of male to female was 1.57∶1. Most injuries were caused by animal bite, drop and blunt, respectively accounted for 35.38%, 32.00% and 10.81%. August to October of each year is the peak season for minor injuries. The distribution of injuries caused by different reasons were varied in different months. Injuries in different age groups were mainly occurred at home, accounting for 78.13% (0- < 4 years old), 68.00% (4- < 7 years old), 52.98% (7- < 13 years old), and 36.27% (13-17 years old). The proportion of minor injuries aged 7 and above occurred in schools and public places were increased to those aged 7 and below, with 84.96% and 15.04% respectively. The main activity of injury was leisure, accounting for 66.88%. Conclusions Most minor injuries in Jiangsu Province were male, mainly caused by animal bite and occurred at home in summer and autumn.Safety education and protection should be carried out.

Analysis of vitamin A level and its influencing factors among students in monitoring area of nutritional health status of students in 2021

SUN Wenxin, XU Peipei, GAN Qian, XU Juan, YANG Titi, CAO Wei, WANG Hongliang, LUO Ruihe, PAN Hui, WANG Zhifang, FU Yimeng, ZHANG Qian

2024, 28(5): 523-529. doi: 10.16462/j.cnki.zhjbkz.2024.05.005

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Objective To analyze the vitamin A levels and influencing factors among students in the monitoring areas of the Nutritional Improvement Program for Rural Compulsory Education Students in 2021. Methods Serum vitamin A concentration 0.2-0.3 μg/mL is defined as marginal vitamin A deficiency, < 0.2 μg/mL is defined as vitamin A deficiency, > 0.3 μg/mL is defined as vitamin A insufficient. In the monitoring area of the Nutritional Improvement Program, questionnaire surveys, physical examinations, and laboratory tests were conducted on primary and secondary school students aged 6-17 and their vitamin A levels and influencing factors were analyzed. Results Totally 45 702 primary and secondary school students were included in this study. The average of serum vitamin A level was 0.37 (0.31-0.44) μg/mL, the marginal deficiency rate was 18.3%, and the deficiency rate was 1.0%. Differences in vitamin A nutritional status were observed across different genders, ages, and school locations. Logistic regression model revealed that students aged 6- < 9 years (OR=3.892, 95% CI: 3.303-4.587, P < 0.001), whose schools are located in rural areas (OR=1.148, 95% CI: 1.072-1.229, P < 0.001), parents working outside (OR=1.234, 95% CI: 1.153-1.321, P < 0.001) and students with lower maternal education levels (OR=1.169, 95% CI: 1.046-1.306, P=0.006), students who could not guarantee to drink milk every day (OR=1.155, 95% CI: 1.075-1.240, P < 0.001) and consume less than 4 kinds of vegetables per day (OR=1.081, 95% CI: 1.006-1.163, P=0.034) have an increased risk of vitamin A deficiency. Conclusions The prevalence of marginal vitamin A deficiency among students in monitoring areas in 2021 was still high, especially among younger children. Maternal education level, intake of milk and vegetables are potential influencing factors of vitamin A deficiency, which need to be paid attention to by all sectors of society.

Analysis of iodine nutritional status monitoring results for children aged 8-10 in Luzhou from 2018 to 2022

GOU Zhao, YANG Peiji, LI Jinsong, WU Douqiong, MA Ling

2024, 28(5): 530-534. doi: 10.16462/j.cnki.zhjbkz.2024.05.006

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Objective To explore the iodine nutritional status of children aged 8-10 in Luzhou from 2018 to 2022, and to provide a basis for evaluating the effectiveness of iodine deficiency disorders prevention and adjusting iodine supplementation strategies. Methods A stratified cluster random sampling was adopted from 2018 to 2022, randomly selecting 7 000 children aged 8 to 10 from seven counties (districts) in Luzhou City. Urine samples and frequently consumed salt samples were collected and tested according to relevant standards. Excel 2019 and SPSS 25.0 were used for descriptive analysis to calculate indicators such as the median urinary iodine, median salt iodine, iodized salt coverage rate, iodized salt qualification rate, and the consumption rate of qualified iodized salt. The iodine nutrition status of Luzhou residents was evaluated through methods such as the Kruskal-Wallis H test and chi-square test. Results The median of urinary iodine was 184.1(124.7, 255.0) μg/L. There was a statistically significant difference in urinary iodine concentration among children in different years and counties (districts) (P < 0.001). The difference in it among children aged 8, 9 and 10 years old was also statistically significant (χ² =12.251, P=0.002). The urinary iodine concentration of boys was higher than that of girls (Z=-4.433, P < 0.001). The median salt iodine of 7 000 salt samples was 26.6(24.5, 28.8) mg/kg, the coverage rate of iodized salt was 99.27%, the qualified rate of iodized salt was 94.88%, and the edible rate of qualified iodized salt was 94.19%. The differences in salt iodine content, coverage rate of iodized salt, and edible rate of qualified iodized salt were statistically significant in different years and counties (districts) (all P < 0.05). Conclusions From 2018 to 2022, the overall iodine nutrition of children aged 8-10 is suitable in Luzhou, and the consumption of iodized salt is good, meeting the elimination standards for iodine deficiency disorders. However, there is still a certain proportion of children with iodine malnutrition. In the future, efforts should continue to be made to monitor iodine nutritional status and promote the publicity and education of reasonable iodine nutrition.

Associations of sedentary behaviour and physical activity with mental health problems and testosterone levels among male college students in Chongqing, China

WAN Mei, WANG Lihong, LING Xi, CHEN Qing, SUN Lei, YANG Huan, LIU Jinyi, AO Lin, CAO Jia, ZOU Peng

2024, 28(5): 535-539. doi: 10.16462/j.cnki.zhjbkz.2024.05.007

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Objective To investigate the associations of sedentary behaviour and physical activity (PA) with mental health problems and testosterone levels in male college students from Chongqing, China. Methods A total of 582 college students from the Male Reproductive Health in Chongqing College Students (MARHCS) cohort study in 2015 were included. Participants completed a questionnaire assessing demographics, sedentary behaviour, PA and mental health information. Physical activity was classified into quartiles based on scores on the physical activity rating scale-3, resulting in the following groups: Q1, Q2, Q3, and Q4. Serum testosterone and cortisol levels were measured by chemiluminescent enzyme immunoassay. Logistic and linear regressions model were used to analyze associations of sedentary behaviour and PA with mental health problems and serum testosterone and cortisol levels. Results The rates of depression, anxiety, and stress symptoms were 6.70%, 12.71%, and 6.70% among 582 male college students, respectively. Compare to sedentary behavior < 6 participants, participants in the sedentary behaviour > 10 hours group had higher risk of depression symptoms (OR=6.66, 95% CI: 2.16-20.49, P=0.001) and lower testosterone levels (-13.22%, 95% CI: -19.56%--6.37%, P < 0.001). Participants in the PA Q4 group had lower risk of depression symptoms (OR=0.34, 95% CI: 0.13-0.87, P=0.025) and higher testosterone levels (8.02%, 95% CI: 1.37%-15.10%, P=0.017) than participants in the PA Q1 group. Further analyses found that there were no associations of sedentary behaviour with depression, anxiety and stress symptoms, testosterone and cortisol levels and testosterone/cortisol ratio among college students with high PA level (all P > 0.05). Conclusions Sedentary behavior is a risk factor of depression symptoms and decreased testosterone level in college students. PA is a protective factor of depression symptoms and associated with increased testosterone levels. PA may protect the adverse effects induced by sedentary behaviour.

Investigation on the level of knowledge-attitude-practice and driving factors of vaccination of influenza among young and middle-aged population

ZHOU Sijia, CHEN Ziying, JIANG Xin, LIU Wen, MA Yuhang, WANG Kai, HU Jianli, PENG Zhihang

2024, 28(5): 540-546. doi: 10.16462/j.cnki.zhjbkz.2024.05.008

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Objective To understand the knowledge, attitude and practice level of influenza vaccine among young and middle-aged groups, as well as their vaccination status and intention, and to explore related influencing factors to help promote vaccination. Methods From May to August 2023, 4 895 permanent residents in Nanchang, Changsha, and Kunming were selected by multi-stage random sampling to complete a questionnaire survey. Multivariate logistic regression was used to analyze the influencing and driving factors of KAP level of influenza vaccine. Results The knowledge and attitude towards influenza vaccine among young and middle-aged people were average, and the level of vaccination was relatively low. In addition, there were statistically significant differences (P < 0.05) in the KAP level among gender, education level, occupation, annual income, whether suffering from underlying diseases, smoking, and alcohol consumption. The results of multivariate analysis showed that partial occupation (all P < 0.05), having underlying diseases (OR=1.309, 95% CI: 1.073-1.597, P=0.008), good cognition (OR=1.574, 95% CI: 1.322-1.874, P < 0.001), and good attitudes (OR=2.379, 95% CI: 1.616-3.502, P < 0.001) were promoting factors of vaccination. Severe influenza season conditions, fear of infection affecting family and colleagues, free or discounted vaccines, and vaccination recommendation from government and health authorities were the main factors contributing to the change in vaccination intentions among the young and middle-aged population. Conclusions The KAP level of influenza vaccine in young and middle-aged people is low, so the popularization of influenza vaccine related knowledge should be strengthened. Vaccine uptake can be promoted through various measures, including the implementing preferential vaccination policies at different levels and phases, improving incentives for grassroots vaccination service personnel, and encouraging clinical doctors to prescribe vaccines.

Association of greenness exposure and particulate matter exposure with ischemic stroke patients mortality in a cohort study

LIU Chengrong, LIU Chao, ZHANG Yingying, ZHAO Ke, ZHANG Peiyao, ZHANG Bingyin, LU Zilong, GUO Xiaolei, XUE Fuzhong, JIA Xianjie

2024, 28(5): 547-553. doi: 10.16462/j.cnki.zhjbkz.2024.05.009

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Objective The interaction between greenness exposure and mortality from ischemic stroke (IS) was assessed based on satellite remote sensing data (NDVI). Methods Individual cases suffering from IS from 2013-2019 were collected in five counties in Shandong to construct a cohort of IS patients. NDVI summer exposure values and annual average exposure concentrations of PM_2.5 and PM₁₀ were matched according to the residential address of each patient. Cox proportional risk models were used to explore the association between long-term greenfield exposure and combined exposure to PM_2.5 and PM₁₀ and their interactions with ischemic stroke death, and the analyses were stratified by sex, age, and residence. Restricted cubic spline functions were used to assess the dose-response relationship between greenfield exposure, PM_2.5 and PM₁₀ and the risk of death in IS patients, respectively. Results The cohort included 59 084 individuals and 4 726 (8.00%) deaths due to IS. The results of the model′s analysis showed that NDVI was negatively associated with the risk of death in patients with IS when assessing the combined exposure of NDVI with PM_2.5 and PM₁₀. The interaction results showed that the IS mortality hazard ratio (HR) for each 0.1-unit increase in NDVI was 0.74 (95% CI: 0.67-0.82), each 10 μg/m³ increase in PM_2.5 was 0.94 (95% CI: 0.88-1.00), and the interaction term was 1.04 (95% CI: 1.02-1.07). Age, sex, and residence were effect modifiers influencing the association of combined exposure to NDVI with PM_2.5 and PM₁₀ and its interaction with death in IS patients. NDVI was nonlinearly associated with IS death, and PM_2.5 and PM₁₀ were associated with IS death in a "U" and "J" pattern, respectively. Conclusions Greenness exposure may reduce the risk of death from IS, while the risk of death from the disease may be further reduced by practicing good greenness planning and by reducing exposure concentrations of PM_2.5 and PM₁₀.

Association of long-term nitrogen dioxide exposure with death in ischemic stroke patients and effect modification of greenness

ZHAO Ke, HU Yang, ZHANG Peiyao, LIU Chao, LIU Chengrong, SHI Chunxiang, WEI Jing, ZHANG Bingyin, LU Zilong, GUO Xiaolei, XUE Fuzhong, JIA Xianjie, MI Jing

2024, 28(5): 554-560. doi: 10.16462/j.cnki.zhjbkz.2024.05.010

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Objective This study aimed to investigate the association between long-term nitrogen dioxide (NO₂) exposure and the risk of death in ischemic stroke (ischemic stroke, IS) patients, as well as the modification of greenness on this association. Methods We conducted a longitudinal study on IS cases in 4 districts/counties in the northwest region of Shandong Province with relatively high NO₂ concentrations from 2013 to 2019. Participants were followed up until December 31, 2019, or the date of death. A time-dependent Cox proportional risk model was used to assess the hazard ratio (HR) and its 95% CI for stroke-related death in IS patients per IQR increase in NO₂. The exposure-response relationship between long-term NO₂ exposure and the risk of IS patient mortality was fitted using a restricted cubic spline function. We then explored the effect modification role of greenness exposure by incorporating an interaction term between NO₂ and normalized difference vegetation index (NDVI) levels. Finally, we conducted a series of sensitivity analyses and subgroup analyses based on different genders, age groups, and urban/rural areas. Results A total of 46 252 IS patients were included in the study and the annual mean concentration of NO₂ in the 4 districts/counties from 2013 to 2019 was (43.30±1.32) μg/m³. The results showed that the HR of death in IS patients were 1.22 (1.15-1.29) for each IQR increase in NO₂. The exposure-response relationship showed a non-linear relationship between long-term NO₂ exposure and the risk of IS patient mortality. The results of the interaction were found to be statistically significant (P_nolinear=0.005) with HRs of 1.23 (1.17-1.30), 1.21 (1.15-1.28), and 1.19 (1.12-1.26) for each IQR of NO₂ rise in patients with IS at the low, middle, and high levels of exposure to the greenness, respectively. Interaction effects between long-term NO₂ exposure and greenness exposure was found across different gender and age groups, as well as in rural areas (all P < 0.05). Conclusions Long-term exposure to NO₂ is considered a risk factor for mortality in IS patients, while greenness may potentially mitigate this detrimental effect.

The causal association between ischemic stroke and the risk of membranous nephropathy based on two-sample Mendelian randomization

LIU Yimin, ZHANG Li′e, PENG Yang, LI Zhenning, ZOU Yunfeng

2024, 28(5): 561-565. doi: 10.16462/j.cnki.zhjbkz.2024.05.011

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Objective To investigate the causal relationship between ischemic stroke and incidence of membranous nephropathy using a Two-sample Mendelian randomization (MR) method. Methods Single nucleotide polymorphisms (SNPs), which were independent of each other and closely associated with ischemic stroke were identified from a Genome-Wide Association analysis. The identified SNPs were used as instrumental variables. Odds ratios were obtained from the MR analyses on the causal association between ischemic stroke and membranous nephropathy using the inverse variance weighted analysis, weighted median method, and MR-Egger method. Results A total of 17 SNPs that were associated with ischemic stroke were identified in this study. The inverse variance weighted analysis showed that ischemic stroke was associated with higher risk of membranous nephropathy (OR=1.61, 95% CI: 1.11-2.33, P=0.01). Results of the sensitivity analysis were consistent with those of the main analysis, confirming the robustness of this study. No heterogeneity among SNPs was observed in this study. Conclusions From a genetic perspective, the present study suggested an association between ischaemic stroke and elevated risk of membranous nephropathy. Strengthening screening and prevention of membranous nephropathy among patients diagnosed with ischemic stroke is of great clinical and public health significance.

Study on the relationship between insulin resistance and cardiovascular disease risk based on a coal mining population in Northern Shaanxi

DU Yuanzhen, Tao Xinrong, ZOU Yuanjie, DING Yu, MU Min, CHEN Qianwei

2024, 28(5): 566-573. doi: 10.16462/j.cnki.zhjbkz.2024.05.012

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Objective To investigate the relationship between insulin resistance (IR) and cardiovascular disease (CVD) risk in a population of miners. Methods The data were collected from a cross-sectional study of a group of coal miners in Northern Shaanxi Province between 2020 and 2023. TyG/TyG-BMI was developed to indicate insulin resistance in the body based on TG and FPG levels, while the Prediction for ASCVD Risk (PAR) was created to assess the risk of cardiovascular disease using factors including sex, age, waist circumference, blood pressure, cholesterol levels, smoking habits, medical history, and geographic location. BMI group: underweight group with BMI < 18.5 kg/m², normal group with BMI ≤ 24.0 kg/m², overweight group with BMI < 28.0 kg/m² and obesity group with BMI≥28.0 kg/m². The TyG and TyG-BMI variables were divided into three groups (T₁, T₂, and T₃) according to their tertiles, with the T₁ group serving as the reference group. To explore the association between insulin resistance and the risk of cardiovascular disease, a logistic regression model was employed. Results Totally 4 359 subjects were included. After adjusting for covariates, each unit increases in the TyG increased high PAR by 27.6%(OR=1.276, 95% CI: 1.193-1.365).The high PAR in the group with the TyG in T₃ was 3.013 times of that in the group T₁ (OR=3.013, 95% CI: 2.341-3.879). Sensitivity analysis and the subgroup analysis confirmed the stability of the association between the TyG and the PAR. In the general population, for every unit increase in the TyG as a continuous variable, the high PAR increased by 29.1%(OR=1.291, 95% CI: 1.171-1.422). As a categorical variable, the risk for high PAR in the T₃ group was 3.658 times of that in the T₁ group (OR=3.658, 95% CI: 2.550-5.247). In the hyperreconstituted population, for every unit increase in the TyG as a continuous variable, the risk for high PAR increase by 56.9% (OR=1.569, 95% CI: 1.402-1.756). As a categorical variable, the risk for high PAR in the T₃ group was 5.610 times of that in the T₁ group (OR=5.610, 95% CI: 3.753-8.386). In the obese population, for every unit increased in the TyG as a continuous variable, the high PAR increased by 47.5% (OR=1.475, 95% CI: 1.211-1.796). As a categorical variable, the risk for high PAR in the T₃ group was 4.147 times of that in the T₁ group (OR=4.147, 95% CI: 2.254-7.628). No statistically significant association existed between TyG and PAR in individuals with the obese population. Conclusions In coal mining populations, elevated levels of body insulin resistance strongly associates with an increased risk of developing cardiovascular disease. BMI may modulate this relationship. Early suppression of elevated levels of body insulin resistance, before the onset of overweight or obesity, may positively influence the prevention and control of atherosclerotic cardiovascular disease.

Using molecular transmission networks to analyze the epidemiological characteristics of HIV-1 CRF01_AE in Kunming

CHENG Peng, LIU Jiafa, WANG Jiali, YANG Cuixian, HE Baocui, ZHANG Mi, LI Jianjian, DONG Xingqi

2024, 28(5): 574-580. doi: 10.16462/j.cnki.zhjbkz.2024.05.013

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Objective To construct the molecular transmission network of the HIV-1 CRF01_AE strain in Kunming, to analyze its epidemiological characteristics, to observe its dynamic epidemiological trends, and to provide a scientific basis for the development of local epidemic prevention and control interventions. Methods A total of 253 newly infected patients with HIV-1 CRF01_AE in Kunming who received treatment at Yunnan Infectious Disease Hospital from 2015 to 2021 were selected as study subjects. Their gene sequences were successfully amplified using RT-nested PCR (reverse transcription nested polymerase chain reaction), and the sequences were compared and imported into HyPhy 2.2.4 software for the calculation of paired gene distances. GraphPad-Prism 8.0 software was used to determine the optimal gene distance threshold, and Cytoscope 3.7.2 software was used for network visualization. Network characterization was performed using the Network Analyzer and MCODE (Molecular Complex Detection) tools. Results At an optimal genetic distance threshold of 0.018, 118 of 253 study subjects (46.64%) entered the network analysis, forming a total of 38 molecular clusters with composition sizes ranging from 2 to 17 nodes. The network clusters were mainly heterosexual (51.78%) and homosexual (37.94%), and the age group was mainly distributed between 20 and 40 years old (77.47%). The total number of links for all nodes in the network was 226; the maximum number of links for a single node was 10. MCODE identified three important molecular clusters, types B, C and D. Type B consisted of 17 nodes and 19 link counts and was a homosexually propagating cluster in a low-growth state. Types C and D both consisted of 5 nodes and 10 link counts, were heterosexually propagating clusters, and were stationary. Conclusions The molecular clusters in the molecular transmission network of the HIV-1 CRF01_AE strain in Kunming have certain specificity and aggregation. Homosexual and heterosexual transmission populations have become the two major risk groups for HIV-1 CRF01_AE strain infection in Kunming, while cross-transmission occurs in both groups. It is worth noting that there is a large cluster of same-sex transmission in the transmission network with high transmission risk and activity, which needs to be monitored. Targeted interventions should be developed to prevent and control the "core population" in the cluster.

Research progress on the impact of COVID-19 infection during pregnancy on the health outcomes of pregnant women and their offspring

QIN Chenyuan, LIU Min, LIU Jue

2024, 28(5): 581-585. doi: 10.16462/j.cnki.zhjbkz.2024.05.014

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The impact of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection during pregnancy on the health outcomes of both mothers and offspring has been a major focus of international research during the COVID-19 pandemic. Pregnant women have long been recognized as a vulnerable group during infectious disease epidemics due to physiological changes in their immune, cardiovascular, and respiratory systems. Increasing evidence suggested that SARS-CoV-2 infection during pregnancy is associated with several adverse maternal outcomes, including complications during pregnancy, premature delivery, hospitalization or admission to the intensive care unit, and even death. Additionally, adverse outcomes for offspring include premature birth, stillbirth, low birth weight, being small for gestational age, and long-term neurobehavioral developmental abnormalities. This article reviews the adverse effects of SARS-CoV-2 infection during pregnancy on the short- and long-term health outcomes of pregnant women and their offspring. The aim is to provide scientific evidence for counseling on pregnancy risks related to COVID-19, as well as for obstetric and neonatal care.

Research progress on the association between daily step count and cardiovascular disease and its main metabolic risk factors

XIAO Yingcheng, CHEN Hao, ZHENG Pinpin, JIA Yingnan

2024, 28(5): 586-590. doi: 10.16462/j.cnki.zhjbkz.2024.05.015

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Cardiovascular disease has become the leading disease problem affecting health around the world. Studies have proved that adequate weekly physical activity can effectively reduce the morbidity and mortality of cardiovascular disease. Daily step count has become a hot topic in physical activity research worldwide. This paper systematically reviews the recent research progress on the relationship between daily step count and cardiovascular disease, as well as its main metabolic risk factors, and proposes a recommended range of daily step counts to promote cardiovascular health. It is expected to provide scientific evidence for developing effective prevention for cardiovascular disease and its main metabolic risk factors.

Application of microfluidic chips in the study of pneumoconiosis

TIAN Chang, SHAO Chaojie, LI Mengxue, ZHOU Lin, HUANG Hui, CHU Fengjen, MU Min, YE Dongqing

2024, 28(5): 591-595. doi: 10.16462/j.cnki.zhjbkz.2024.05.016

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Pneumoconiosis is a serious occupational disease that threats human health in physical and mental. Studying its mechanism is of great significance in the prevention, diagnosis, and treatment of pneumoconiosis. However, there are many technical difficulties in the traditional in-vivo and in-vitro research methods, which are unable to reproduce the three-dimensional lung tissue and the physical and biological microenvironment of the lung in-vivo, and it is difficult to conduct real-time dynamic observation of the physiological and biochemical processes, which restricts the research on the pathological mechanism of pneumoconiosis. Microfluidic chips, with their ability to manipulate cells, particles and solutions in time and space, provide new ideas for simulating the state of the lungs and reconstructing their physical and biological microenvironment. Starting from the interaction between dust particles and the lungs, this article reviews the deposition characteristics of dust particles in the lungs, the physiological and biochemical changes caused by dust particles on the lungs, and the research progress in the interaction between dust particles and pneumoconiosis using microfluidic chips.

A systematic review of the efficacy and safety of the immunomodulator thymic polypeptides as adjuvant treatment for severe pneumonia

JIANG Ziyun, ZHANG Yangyang, YANG Huilin, ZHOU Jianguo, LI Xun

2024, 28(5): 596-606. doi: 10.16462/j.cnki.zhjbkz.2024.05.017

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Abstract:
Objective To evaluate the effectiveness and safety for thymic polypeptides as adjunctive treatment of severe pneumonia and explore the rationality for application. Methods A systematic searching was conducted in six Chinese and English databases to identify randomized controlled trials on the use of thymic polypeptides for severe pneumonia. After screening, the included studies were subjected to quality assessment and data synthesis. Results A total of 28 randomized controlled trials involving 2 228 participants were included. Results showed that the thymic polypeptide group had lower mortality rate (RR=0.51, 95% CI: 0.32-0.83, P=0.006), higher effectiveness rate (RR=1.24, 95% CI: 1.19-1.30, P < 0.001), shorter ICU stay (MD=-3.03, 95% CI: -3.79--2.26, P < 0.001), shorter mechanical ventilation time (MD=-61.34, 95% CI: -65.55--57.12, P < 0.001), and better blood gas and inflammatory indicators compared to the control group, with no significant difference in adverse event rate (P > 0.05). Subgroup analyses revealed a trend for reduced ICU stay for patients over 60. The quality of evidence was generally low, with high heterogeneity in some indicators. Conclusions Based on the available evidence, thymic polypeptides show certain advantages as adjuvant treatment for severe pneumonia. However, there are limitations in the current evidence that do not justify the widespread use of them in China, There is a need for more RCTs to be conducted in the future, along with in-depth research into the safety and economic benefits of these medications.

Correlation between social activity participation and self-neglect in the elderly with depression

LIU Mengqing, CHEN Yue, YUAN Mengyuan, MA Shaodi, QIN Qirong, QU Guangbo, SUN Yehuan, LI Jie

2024, 28(5): 607-612. doi: 10.16462/j.cnki.zhjbkz.2024.05.018

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Abstract:
Objective To explore the association between social activity participation and self-neglect in the elderly with depression. Methods Using stratified cluster sampling method and data from the Healthy Aging Cohort Study in Ma′anshan, 648 elderly people with depression at baseline were selected as subjects. Multivariate logistic regression was used to analyze the correlation between social activity participation and self-neglect. Results The overall score of self-neglect in depressed elderly was (7.42±5.10). After adjusting for confounding factors, participation in physical activity was a protective factor for overall self-neglect (OR=0.521, 95% CI: 0.359~0.758, P < 0.01) and in 3 dimensions of personal hygiene self-neglect (OR=0.523, 95% CI: 0.332~0.822, P < 0.01), emotional self-neglect (OR=0.537, 95% CI: 0.364~0.793, P < 0.01), and social communication self-neglect (OR=0.486, 95% CI: 0.334~0.709, P < 0.001) in older adults. Participation in friendship and care interaction was a protective factor for the overall self-neglect of the elderly (OR=0.622, 95% CI: 0.423~0.916, P < 0.05), which was also related to personal hygiene self-neglect (OR=0.438, 95% CI: 0.268~0.717, P < 0.01), safety self-neglect (OR=0.236, 95% CI: 0.138~0.403, P < 0.001) and social communication self-neglect (OR=0.510, 95% CI: 0.345~0.755, P < 0.01). Conclusions Social activity participation has certain protective effects against self-neglect of the depressed elderly in Ma′anshan City. However, different social activity participation contents may have different influences.

Persistent carriage of Streptococcus pneumoniae and its influencing factors among children in kindergartens

YANG Shimin, DENG Wenjun, ZHANG Jingfeng, LI Pingyuan, ZHOU Junli, YAO Zhenjiang, YE Xiaohua

2024, 28(5): 613-620. doi: 10.16462/j.cnki.zhjbkz.2024.05.019

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Abstract:
Objective To explore the prevalence and influencing factors of persistent carriage of Streptococcus pneumoniae (S. pneumoniae) in kindergarten children. Methods A multi-stage stratified cluster sampling method was used in this study. Healthy children were sampled from six kindergartens in Shunde District, Foshan City. All children underwent three nasal swab samplings, followed by isolation and identification of S. pneumoniae. Univariate chi-square tests and multivariate logistic regression analysis models were used to analyze the factors influencing persistent carriage of S. pneumoniae in children. Given the non-independence and strong correlation of the number of positive cases within classes across three samples, this study has developed three separate multivariable logistic regression analysis models (namely, models 1 to 3). Apart from the variable "number of positive cases within the class", all three models maintain consistency in controlling for confounding factors and in the analytical methods used. A random forest model was applied to rank the importance of factors associated with persistent carriage of S. pneumoniae. Results The persistence carriage rate of S. pneumoniae in children was 6.6%. The results of the multivariable logistic regression analysis in model 1 indicated that a higher number of positive cases within a class was associated with an increased rate of persistent carriage of S. pneumoniae, showing a monotonic increasing trend. Compared to the group with 0 to < 4 positive cases, the odds ratios for other groups were 2.35 (95% CI: 1.12-4.90, P=0.023), 5.86 (95% CI: 2.75-12.49, P < 0.001), and 9.43 (95% CI: 4.68-19.02, P < 0.001), respectively. The rate of persistent carriage of S. pneumoniae decreased with increasing age. Compared to the group aged 0 to < 3 years, the odds ratios for other age groups were 0.38 (95% CI: 0.20-0.72, P=0.003), 0.29 (95% CI: 0.15-0.55, P < 0.001), and 0.29 (95% CI: 0.14-0.60, P=0.001), respectively. A history of allergic diseases within the past year was identified as a protective factor for the persistent carriage of S. pneumoniae, with an odds ratio of 0.44 (95% CI: 0.20-0.98, P=0.045). The findings from models 2 and 3 were consistent with those from model 1. Conclusions An increased number of positive cases within a class is a significant risk factor for the persistent carriage of S. pneumoniae among kindergarten children; whereas, an increase in age and a history of allergic diseases within the past year serve as protective factors against the persistent carriage of S. pneumoniae in this population.

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2024 Vol. 28, No. 5

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

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