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CN 34-1304/R ISSN 1674-3679

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2024, Volume 28,  Issue 3

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Original Articles
The trend of injury mortality rates among Chinese residents from 2004 to 2021
WANG Suxian, JIANG Shuai, ZHAO Yaojun, DUAN Yanran, MU Zihan, WANG Jing, TANG Yanyu
2024, 28(3): 249-255. doi: 10.16462/j.cnki.zhjbkz.2024.03.001
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  Objective  It could provide evidence for the formulation of injury prevention and control strategies by analyzing the trend of the injury mortality rate of Chinese residents from 2004 to 2021.  Methods  The injury data on age, gender and urban-rural status were extracted from the 《National Cause of Death Surveillance Dataset》 from 2004 to 2021. The Joinpoint regression model was used to calculate the annual percent change (APC) and average annual percent change (AAPC).  Results  The injury standardized mortality rate of Chinese residents decreased from 2004 to 2021 (AAPC=-4.43%, P < 0.001). The AAPC was 1.12% for non-accidental falls (P < 0.001). In contrast, the remaining four injury types showed a decreasing trend, corresponding to the AAPC was -5.44%, -4.16%, -5.87% and -3.24% respectively (P < 0.001). From age perspective, drowning, road traffic accidents, and non-accidental falls were the main causes of injury in the 0- < 15 years, 15- < 65 years, and ≥65 years subgroups, respectively. Contrary, the ≥65 years age group showed an increasing trend for non-accidental falls (AAPC=1.82%, P=0.033). From different populations perspective, the injury standardized mortality rate of road traffic accidents was higher in males than females. And the injury standardized mortality rate in rural areas was higher than in urban areas each year, among them, males in rural were the highest group.  Conclusions  The injury mortality rate showed a decreasing trend from 2004 to 2021 for Chinese residents. For injury prevention and control, targeted intervention measures should be taken for males, the ≥65 years age and rural residents as a focus group.
Analysis of mortality status and cause-eliminated life expectancy by region in China
TAO Mengmeng, TIAN Wei, LI Kunkun, CAO Wenjun
2024, 28(3): 256-261. doi: 10.16462/j.cnki.zhjbkz.2024.03.002
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  Objective  To analyze the incidence time trend of chronic kidney disease (CKD) in China from 1990 to 2019, evaluate its age, period and cohort effect, and predict the incidence of chronic kidney disease in China from 2020 to 2034, so as to provide reference for relevant prevention and treatment policies and measures of CKD.  Methods  Based on the data of the Global Burden of Disease Study 2019(GBD 2019), the Joinpoint regression model was used to analyze the trend change of chronic kidney disease in different genders, and the annual percentage change (APC) and the average annual percentage change (AAPC) were calculated. With the help of age-period-cohort model, the influence of age, period and cohort factors on the incidence of CKD in different sexes was analyzed. Bayesian age-period-cohort analysis was used to predict the incidence and number of CKD in different gender from 2020 to 2034.  Results  From 1990 to 2019, the standardized incidence rate of CKD in the entire population, as well as among men and women in China, demonstrated an overall upward trajectory (AAPC=0.30%, 0.30%, 0.29%, all P < 0.001). Notably, there was an irregular variation observed in women during the years 1993-1996 (APC=-0.54%, P=0.073), with females exhibiting a higher incidence rate than males. However, the incidence rate in males has escalated at a significantly higher pace than that in females in recent years. The fluctuations in chronic kidney disease incidence in China were influenced by age, period, and cohort factors (all P < 0.001). The overall risk of CKD increased with age, experiencing a notable rise after the age of 60. Furthermore, the incidence continued to rise post-1995, associated with birth cohorts before 2005, and demonstrated a decline after 2005. Projections for the period from 2020 to 2034 anticipate an upward trend in the standardized incidence rate and the number of cases of chronic kidney disease in China, with a more pronounced increase among males compared to females.  Conclusions  From 1990 to 2019, the incidence rate and the number of cases of CKD in China demonstrated a continuous upward trend. It is advisable to bolster preventive measures for the elderly and high-risk populations, particularly individuals with hypertension and diabetes. Moreover, careful consideration should be given to the nutritional intake and health assessments of infants and young children.
Study on the trend and forecast of the incidence of chronic kidney disease in China from 1990 to 2019
SUN Ke, NI Shuaihu, ZHENG Qingyong, LUO Xiaofeng
2024, 28(3): 262-268. doi: 10.16462/j.cnki.zhjbkz.2024.03.003
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  Objective  To explore the current status of population mortality in different regions and study the changing trends of various causes of death, providing reliable evidence for the rational utilization of health resources.  Methods  Compared the rank order of death causes in the eastern, central, and western regions in 2010, 2015, and 2020, compiled life expectancy tables and cause-eliminated life expectancy tables. Calculated mortality rate, standardized mortality rate, years of potential life lost rate and the seventh national population census data were used for standardization.  Results  The mortality rate in all regions showed a decreasing trend, and the standardized rate of mortality of western was the highest. The average annual increase in life expectancy was 0.32, 0.34 and 0.31 years. Cancer, cerebrovascular disease, heart disease, respiratory disease and injury were the top five causes of death in each region. Cancer was the leading cause of death in the eastern region, while the cerebrovascular disease is the leading cause in the central region. The rate of life lost due to heart disease showed an increasing trend in all regions, with the central region recording a heart disease of 49.50% in the age group above 85 in 2020. The rate of life lost due to respiratory system decreased annually, but showed an increasing trend with age and had the greatest impact on the lifespan in the western regions. The rate of life lost due to injuries showed an increasing trend in the age group above 75 years.  Conclusions  Life expectancy increased gradually in all regions, but the rate of life lost due to cardiovascular diseases continued to rise, and injuries also had an increasing impact on the lifespan of the elderly. Different diseases had varying impacts on the lifespan in different regions, and disease prevention and control strategies should be tailored to different ages and regions.
Influential factors of mild cognitive impairment in type 2 diabetes mellitus based on machine learning and logistic regression
ZHANG Hongmei, ZHANG Ning, SUN Yujiao, ZHANG Zhou
2024, 28(3): 269-276. doi: 10.16462/j.cnki.zhjbkz.2024.03.004
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  Objective  To analyze the risk factors of mild cognitive impairment in type 2 diabetes mellitus(T2DM) by using machine learning and Logistic regression, and to provide basis for relevant intervention.  Methods  The data of 1 284 T2DM patients in the Department of Endocrinology of Nanjing Gulou Hospital were collected. The data were divided into the training set (70%) and the testing set (30%). Logistic regression model, Random Forest and XGBoost were used to construct the models, and the results were explained by the model interpretability.  Results  The random forest model had the highest predictive performance, the AUC value of the training set was 1.0 while the testing one was 0.783 (95% CI: 0.660-0.894), the model screened 19 important variables for MCI in patients with T2DM, such as education time, age, insulin sensitivity index, peripheral neuropathy, glycosylated hemoglobin, abnormal bone metabolism.  Conclusions  The prediction performance of random forest model is the best, which can help medical staff accurately identify the risk factors of MCI in patients with T2DM, and help medical staff to apply early intervention.
Association between fasting blood glucose trajectories and new-onset cardiovascular diseases in the elderly health check-up population in Nanjing
CHEN Quan, DU Jinling, HONG Xin
2024, 28(3): 277-283. doi: 10.16462/j.cnki.zhjbkz.2024.03.005
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  Objective  To investigate the association between fasting blood glucose trajectory and the incidence of cardiovascular disease among the elderly population aged 65 years and above in Nanjing.  Methods  A total of 7 079 participants were included from the Nanjing elderly health checkup cohort who met the inclusion criteria. The trajectory of fasting plasma glucose(FPG) index (FPG was taken as its logarithm to make it obey normal distribution) was constructed by group-based trajectory model (GBTM) over the years from 2018 to 2020. And we followed up the incidence of cardiovascular disease in 2021. A Cox regression model was used to analyze the association between distinct trajectory groups and the incidence of cardiovascular disease.  Results  The FPG trajectory was finally divided into low-level group (5 635, 79.6%), medium-level group (1 201, 17.0%) and high-level group (243, 3.4%). A total of 70 cases of cardiovascular disease were newly reported during the follow-up period, with the low, medium, and high level groups accounting for 0.83%, 1.42%, and 2.47% of the new cases in the group, respectively. The incidence of cardiovascular disease increased with increasing FPG levels (trend χ2 =8.750, P=0.003), and the difference was statistically significant (χ2 =9.050, P=0.011). The Cox regression model showed that the risk of cardiovascular disease in the high-level group was 2.96 times higher than that in the low-level group (95% CI: 1.27-6.92).  Conclusions  Long-term high levels of FPG increase the risk of cardiovascular disease in the elderly, so timely intervention and early prevention are warranted.
Risk assessment of mild cognitive impairment in elderly patients with diabetes mellitus based on machine learning
ZHANG Haixin, ZHANG Yifang, XIE Zhilan, ZHANG Wenling, WANG Yuping, LI Jinlei
2024, 28(3): 284-289. doi: 10.16462/j.cnki.zhjbkz.2024.03.006
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  Objective  This study aims to develop a high-accuracy risk assessment model for identifying the risk of mild cognitive impairment (MCI) in elderly patients with diabetes mellitus using machine learning algorithms, providing insights for early identification and prevention of cognitive impairment in this population.  Methods  A total of 1 319 patients aged 60 and above with type 2 diabetes mellitus, who visited the Endocrinology Department of People′s Hospital of Penglai in Yantai City, Shandong Province, between October 2021 and May 2022, were enrolled as the study population. The demographic information, medical history, lifestyle factors, psychological health status, and physiological indicators were collected. The Montreal Cognitive Assessment (MoCA) scale was used to evaluate the cognitive function of patients. BP neural network model, random forest model, and XGBoost model were constructed using R version 4.1.3 software. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, F1 score, and the area under the curve (AUC) with 95% CI of models were calculated.  Results  The sensitivity values of the BP neural network model, random forest model, and XGBoost model were 57.79%, 77.89%, and 80.40%, respectively. The specificity values were 78.17%, 60.41%, and 61.42% for the respective models. The AUC values for the ROC curves were 0.746 (95% CI: 0.698-0.794), 0.755 (95% CI: 0.708-0.802), and 0.756 (95% CI: 0.709-0.803), respectively.  Conclusions  The XGBoost model and random forest model demonstrated good performance and showed potential for application in the field of MCI risk assessment among elderly patients with diabetes mellitus.
A cohort study of the effect of sleep duration on possible sarcopenia in rural middle-aged and elderly people in China
LIANG Bo, WEI Yue, PEI Lijun
2024, 28(3): 290-297. doi: 10.16462/j.cnki.zhjbkz.2024.03.007
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  Objective  To explore the effect of sleep duration on the risk of possible sarcopenia in rural middle-aged and elderly adults (≥45 years) in order to reduce the incidence of possible sarcopenia.  Methods  The cohort study was conducted base on the Chinese health and retirement longitudinal study (CHARLS). Possible sarcopenia was identified by measuring grip strength and five repetitions of sitting-up time. A total of 7 075 participants of middle-aged and elderly adults aged ≥45 years without possible sarcopenia in 2011 and 2013 were used as baseline data, and were followed up until 2015. Cox proportional risk model was used to explore the association between sleep duration and the risk of possible sarcopenia in rural middle-aged and elderly people.  Results  Compared to rural middle-aged and elderly adults with sleep duration of 8- < 9 hours, those with sleep duration less than 6 hours, 6- < 7 hours, 7- < 8 hours and more than 9 hours had an increased risk of possible sarcopenia by 22% (HR=1.22, 95% CI: 1.07-1.39, P=0.003), 17% (HR=1.17, 95% CI: 1.01-1.35, P=0.037), 18% (HR=1.18, 95% CI: 1.02-1.35, P=0.022) and 16% (HR=1.16, 95% CI: 1.02-1.33, P=0.028) respectively. Trend test showed that the risk of possible sarcopenia increased with the shortening of sleep time (< 9 h), and there was a dose-response relationship (P < 0.001). Among participants aged 45- < 60 years, compared with sleep duration of 8- < 9 hours, the risk of possible sarcopenia with sleep duration less than 6 hours, 6- < 7 hours and 7- < 8 hours was increased by 21% (HR=1.21, 95% CI: 1.01-1.46, P=0.041), 23% (HR=1.23, 95% CI: 1.02-1.48, P=0.033) and 30% (HR=1.30, 95% CI: 1.08-1.56, P=0.005), respectively. Compared with sleep duration of 8- < 9 hours, short sleep duration (< 6 h) was associated with a 27% increased risk of possible sarcopenia in females (HR=1.27, 95% CI: 1.06-1.52, P=0.010), and long sleep duration (≥9 h) was associated with a 21% increased risk of possible sarcopenia in males (HR=1.21, 95% CI: 1.01-1.46, P=0.045).  Conclusions  The shorter and longer sleep duration among rural middle-aged and elderly were associated with an increased risk of possible sarcopenia, and there existed age differences. Optimizing sleep duration may prevent the occurrence and development of sarcopenia.
Healthy life expectancy for rural older population based on mental health: multistate Markov modeling
WANG Chongjian, HU Ze, JIANG Feng, LIU Xiaotian, LI Runxin
2024, 28(3): 298-302. doi: 10.16462/j.cnki.zhjbkz.2024.03.008
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  Objective  This study aimed to estimate the life expectancy (LE) healthy life expectancy (HLE) indicators regarding depression and anxiety symptoms to quantify the impact of them on the health of the elderly population in order to provide recommendations for countermeasures to prolong HLE in rural areas.  Methods  Participants aged 60 and older from the baseline study and the follow-up study of the "Henan Rural Cohort Study" were used to evaluate LE and HLE indicators across age and gender. In the present study, the HLE indicators included depression-or anxiety-free life expectancy (DAFLE), depression-free life expectancy (DFLE) and anxiety-free life expectancy (AFLE).  Results  Based on the data from the baseline and the follow-up survey of "Henan rual cohort", the DAFLE, DFLE, AFLE was measured via multistate life tables. For those who were 60 years old, the DAFLE, DFLE and AFLE were 20.081 5, 20.230 1 and 20.435 2 years, accounting for 95.85%, 96.28% and 96.99% of LE, respectively. For men aged 60 years old, the DAFLE, DFLE and AFLE were 18.076 8, 18.012 8 and 18.166 5 years, accounting for 96.70%, 97.10% and 97.41% of LE, respectively. For women aged 60, the DAFLE, DFLE and AFLE were 22.811 6, 23.325 3 and 23.492 2 years, which accounted for 95.33%, 95.59% and 96.57%, respectively.  Conclusions  The ratio of HLE to LE were higher among men than women, which suggest that depression and anxiety effected the quality of life among elderly women more severely than among men.
Cataract surgery incidence and influencing factors in middle-aged and elderly Chinese: a prospective cohort study
JIN Xin, LIANG chen, GUO Shuai, ZHENG Xiaoying
2024, 28(3): 303-309. doi: 10.16462/j.cnki.zhjbkz.2024.03.009
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  Objective  The study aimed to explore the pattern of cataract surgery incidence and influencing factors among middle-aged and older people in China.  Methods  The study adopted a prospective cohort design. It was based on the tracking studies data of cataract surgery incidence in a cohort of 12 522 middle-aged and older people from the China Health and Retirement Longitudinal Study 2011-2018, and analysed the influencing factors of cataract surgery incidence using logistic regression.  Results  The 12 522 middle-aged and elderly Chinese population participated in four consecutive rounds of survey from 2011 to 2018, and the 7-year incidence of cataract surgery was 2.89%. The 7-year incidence of cataract surgery in the elderly population aged 60 years and older was 5.34%, which showed an increasing trend along with older age. Logistic regression results showed that the following factors were significantly associated with the increase of the incidence of cataract surgery: older age, being female, having poorer distant or near vision, having diabetes, having a lower level of education, and having a lower per capita weekly expenditure per household (OR=1.072, 95% CI: 1.071-1.074, P < 0.001; OR=1.141, 95% CI: 1.108-1.176, P=0.030; OR=1.587, 95% CI: 1.531-1.646, P < 0.001; OR=1.445, 95% CI: 1.394-1.499, P < 0.001; OR=1.474, 95% CI: 1.417-1.533, P < 0.001; OR=0.867, 95% CI: 0.840-0.895, P=0.002; OR=0.982, 95% CI: 0.966-0.997, P=0.019). A similar result was found in the analyses on the risk groups such as the population aged 60 years and older and the elderly with poor distant vision. However, socioeconomic factors were no longer the main influence on the occurrence of cataract surgery.  Conclusions  Individual demographic characteristics and the prevalence of chronic conditions significantly influence the incidence of cataract surgery. Health promotion programs aimed at eye care, advocated by relevant authorities, are instrumental in mitigating the impact of socio-economic factors on the accessibility of cataract surgery for the elderly. A holistic approach that considers both health status and eye health services is crucial for the effective implementation of programs designed to enhance the uptake of cataract surgery.
Analysis of the risk factors of coronary heart disease in population at high cardiovascular risk in Inner Mongolia
MIAO Yu, YAN Tao, ZHANG Ziying, GUO Shuyi, WANG Jingyu, YAN Jinli, XU Lei, WANG Ya, ZHANG Chunfa, ZHONG Wuzhi, ZHANG Nan, ZHANG Xingguang
2024, 28(3): 310-315. doi: 10.16462/j.cnki.zhjbkz.2024.03.010
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  Objective  To explore the related risk factors of coronary heart disease (CHD) in the population at high risk of cardiovascular disease in Inner Mongolia, and to provide scientific basis for the development of prevention and treatment strategies for CHD in Inner Mongolia.  Methods  This study was a prospective cohort study, the study population was selected by multi-stage stratified cluster sampling method. A survey was conducted in six cities in Inner Mongolia region from December 2015, and the follow-up survey was conducted once a year until December 2021. The baseline survey included general information, disease and treatment history, physical examination and laboratory tests. The follow-up survey included cardiovascular health status and clinical endpoint events. Cox regression model was used to analyze the risk factors of CHD.  Results  A total of 37 726 subjects were finally included in this study, multivariate Cox regression analysis showed that: increasing age (HR>1.00, P < 0.001), smoking (HR=1.20, P < 0.001), drinking (HR=1.41, P < 0.001), overweight or obesity (HR=1.19, P < 0.001), hypertension (HR=1.41, P < 0.001), diabetes (HR=1.22, P < 0.001) were dyslipidemia (HR=2.20, P < 0.001) were risk factors for CHD. In contrast, high education level (HR < 1.00, P < 0.001) and non-heavy physical labor type (HR < 1.00, P < 0.001) were protective factors for CHD.  Conclusions  In Inner Mongolia, increasing age, smoking, drinking, dyslipidemia, hypertension, diabetes, overweight or obesity are risk factors for CHD, high education level and non-heavy physical labor type are protective factors for CHD.
Trend analysis on dietary diversity and quality among urban residents with health examination in Beijing from 2008 to 2018
SHI Hongjing, CHEN Yuanyuan, LYU Jun, SUN Dianjianyi, MAN Sailimai, WANG Xiaona, LI Liming, WANG Bo, YU Canqing
2024, 28(3): 316-322. doi: 10.16462/j.cnki.zhjbkz.2024.03.011
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  Objective  To explore the long-term trend of dietary diversity and quality among Beijing urban residents with health examinations from 2008 to 2018.  Methods  The urban residents who completed physical examination questionnaires in a physical examination center in Beijing between 2008 and 2018 were selected. A semi-quantitative food frequency questionnaire was used to calculate the daily intakes of major food groups. The scores and index percentages of diet diversity score-9 classification (DDS9) and Chinese diet balance index (DBI_16) were standardized to the gender and age composition of urban residents aged 20 and above in Beijing from the 2010 national census data, and meta-regression analysis was used to explore the long-term trend.  Results  Among the 224 178 subjects, the standardized DDS9 score increased by 0.2 over 11 years, with the qualified rate rising from 5.1% to 7.4% (P < 0.001). From 2008 to 2018, DBI_16 total score for urban residents in Beijing showed an increasing trend (β=0.16, P < 0.001), while the corresponding qualified rate decreased from 4.9% to 3.8%. The moderate or severe surplus of food intake rate increased from 43.7% to 54.3% (β=1.07, P < 0.001), and the qualified rate of the low bound score increased from 79.3% to 83.1% (β=0.35, P < 0.001), but no significant long-term trend was observed in any rate of dietary quality distance (P>0.05).  Conclusions  From 2008 to 2018, the insufficient dietary intake of Beijing′s urban residents improves, while the excessive dietary intake worses year after year, and the average dietary diversity is poor. Intervention measures, such as promoting a balanced diet and improving dietary quality, should be implemented to guide residents toward dietary diversity.
Nasopharyngeal cancer disease burden and equity study in China in 1990 and 2017
HOU Baojie, YUAN Ping
2024, 28(3): 323-328. doi: 10.16462/j.cnki.zhjbkz.2024.03.012
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  Objective  To analyze the disease burden and equity of nasopharyngeal carcinoma (NPC) in China and provide a scientific basis for prevention and treatment.  Methods  Using the 2017 Global Burden of Disease Study, the spatial distribution of the disease burden of NPC was analyzed using spatial autocorrelation in province-level division units, and the equity of the disease burden of NPC was analyzed by slope index (SI) and concentration index (CI).  Results  In 1990 and 2017, the high-high concentration areas were mainly in the south, while the low-low concentration areas were mainly in the north, showing the distribution characteristics of high disease burden in the south and low disease burden in the north. Compared to 1990, the disability adjusted life year (DALY) of NPC decreased by 11.20% overall, and standardized DALY rate decreased by 24.80% in 2017. However, the disease burden of NPC has increased in several regions such as Macau, Shaanxi and Xinjiang. In 1990, the SI of DALY and standardized DALY rate were -34.71 and -6.00, respectively. The CI were -0.08 and 0.14. In 2017, the SI were 9.74 and 12.46, and the CI were 0.07 and 0.04.  Conclusions  Compared to 1990, the disease burden of NPC in China has decreased in 2017. However, there is a significant imbalance in its distribution, and there are health inequalities. In some regions, the disease burden has actually increased. Therefore, it is crucial to prioritize areas with high disease burden and those experiencing a rise in disease burden. This will help address the unfairness associated with the disease burden of NPC.
Study on the epidemic trend of Omicron in Shanghai based on the reproduction number
WANG Zihan, XU Mengxia, FANG Liqun, ZHANG Yong
2024, 28(3): 329-334. doi: 10.16462/j.cnki.zhjbkz.2024.03.013
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  Objective  To study the epidemic trend of Omicron in Shanghai as of May 9, 2022 by estimating the early reproduction number (R) before closed management and the subsequent changes of effective reproduction number (Rt).  Methods  Exponential growth method, maximum likelihood method and next generation matrix method were used to estimate R, and Bayesian method, Time-Dependent and New Time-Varying were used to estimate Rt.  Results  As of March 29, 2022, the growth of Omicron epidemic in Shanghai followed the exponential growth. The early reproduction number R estimated by three methods was 2.36(95% CI: 2.33-2.38), 2.14(95% CI: 2.11-2.18) and 2.29(95% CI: 2.22-2.38), respectively.  Conclusion  s As the values of R were relatively large, the early epidemic situation in Shanghai was severe. The turning point of the epidemic was on April 7, and the implementation of sealing and control management measures had effectively slowed down the increment of the epidemic cases. Among the methods for calculating the Rt, the Time-Dependent and New Time-Varying can quickly respond to the dynamic trend of the epidemic, while the Bayesian method was relatively slow. Besides, when the reported data fluctuated greatly, the denominator would be zero, thus Rt would be unable to calculate.
Epidemiological characteristics analysis of re-positive patients infected with COVID-19 Delta variant strains
WANG Sijia, ZHANG Dongliang, YI Bo, CHEN Yi, CHU Yanru, YAN Kedong, LI Qiaofang, LEI Song, ZHANG Yanwu, XU Guozhang
2024, 28(3): 335-338. doi: 10.16462/j.cnki.zhjbkz.2024.03.014
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  Objective  To analyze the epidemiological characteristics of the re-positive patients in two COVID-19 outbreaks caused by Delta variant strains in Ningbo, to provide a scientific basis for better management.  Methods  The epidemiological and clinical information of the re-positive patients in two COVID-19 outbreaks in Ningbo from December 6, 2021, to May 31, 2022, were collected. The epidemiological characteristics, clinical manifestations, infectivity, and influencing factors were analyzed.  Results  A total of 112 patients with COVID-19 infection were included in this study, of which 65 were re-positive, the re-positive rate was 58.04%. Gender, age, occupation, vaccination, clinical severity, and genotype of delta strain did not affect the re-positive of previously infected patients (all P>0.05). The median hospital stay of re-positive was 5.00(3.25, 8.75) days, which was shorter than the median stay of 25.00(22.00, 31.50) days after the first diagnosis (U=-6.724, P < 0.001). All the re-positive persons were asymptomatic, and their clinical severity was lighter than that after the first diagnosis (χ2 =1.888, P7lt; 0.001). The infection rate of close contacts of the re-positive persons was lower than the infection rate after the case was first diagnosis (0.00%∶1.67%, P=0.262), but the difference was not statistically significant.  Conclusion  s Re-positive persons with previous infections of the COVID-19 Delta variant had no clinical symptoms and no infectivity. It is recommended that nucleic acid testing and isolation should not be carried out within the second half of the year after excluding secondary infection.
A cross-sectional study of Helicobacter pylori infection and metabolic syndrome
CHEN Yuanyuan, HU Zhiqiang, HU Jingcen, WU Yaxian, MA Zheng, LYU Jun, SUN Dianjianyi, MAN Sailimai, WANG Xiaona, WANG Bo, YU Canqing, LI Liming
2024, 28(3): 339-344. doi: 10.16462/j.cnki.zhjbkz.2024.03.015
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  Objective  To understand the cross-sectional association of Helicobacter pylori (H. pylori) infection with metabolic syndrome (MetS) and its four components among residents with health checkups in Beijing.  Methods  Participants aged 18 or older who attended health checkups at Beijing MJ Health Screening Center during 2009-2020 were included. The H. pylori infection status was identified by the 13C-urea breath test. The diagnoses of MetS and its four components (abdominal obesity, hyperglycemia, high blood pressure, and dyslipidemia) were defined according to the Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Multivariate logistic regression was performed to estimate the OR and 95% CI.  Results  Among the 31 369 participants, 58.7% were men, and the mean age was (45.3±11.6) years. The H. pylori-positive rate was 35.7%, and the prevalence rate of MetS was 25.6%. The overall prevalence of MetS in males was higher than in females. After adjusting for potential confounders, participants infected with H. pylori had elevated risks of MetS (OR=1.18, 95% CI: 1.11-1.25, P<0.001) and its four components. The ORs for abdominal obesity (OR=1.18, 95% CI: 1.11-1.24, P<0.001) and dyslipidemia (OR=1.14, 95% CI: 1.06-1.22, P<0.001) were higher. The association for dyslipidemia was stronger among females than males (P=0.003).  Conclusions  H. pylori infection is remarkably correlated with increased risks of MetS and its components after adjusting for potential confounders.
A cohort study on the relationship between women′s pre-pregnancy abnormal alanine aminotransferase, advanced age delivery and preterm low birth weight of newborns
YU Jingyun, ZHANG Xinjian, JIANG Bi, LIU Yuwei, LIANG Yu, ZENG Siliang, GAN Zhanpeng
2024, 28(3): 345-350. doi: 10.16462/j.cnki.zhjbkz.2024.03.016
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  Objective  To explore the relationship between women′s pre-pregnancy abnormal alanine aminotransferase(ALT), advanced age delivery and preterm low birth weight of newborns.  Methods  A historical cohort study was conducted to select women of childbearing age who participated in free pre-marital health check-ups and pre-pregnancy eugenic health check-ups in Dongguan from January 2015 to September 2020. The basic information and relevant examination results of the subjects were obtained, and their pregnancy outcomes were followed up. Multivariate logistic regressions were used to analyze the effects of women′s pre-pregnancy abnormal ALT and advanced age delivery on preterm low birth weight of newborns. The stability of the results was tested by subgroup analysis and sensitivity analysis.  Results  A total of 23 620 subjects were included in the analysis. The incidence of preterm low birth weight of newborns was 2.90%. Multivariate logistic regression analysis showed that after adjusting covariates, women′s pre-pregnancy abnormal ALT could increased the risk of preterm low birth weight (RR=1.527, 95% CI: 1.133-2.016, P=0.004). Delivery at an advanced age increased the risk of preterm low birth weight (RR=1.257, 95% CI: 1.006-1.562, P=0.042). Effect sizes were similar in subgroups of infant gender, mother′s delivery history and mode of delivery, and there was no statistically significant difference in heterogeneity between groups(all P>0.05). After excluding people with abnormal blood glucose(GLU) before pregnancy and hepatitis B surface antigen(HBsAg) positive before pregnancy, the effects remained.  Conclusions  Women′s pre-pregnancy abnormal ALT and advanced age delivery are associated with preterm low birth weight.
Reviews
Research advance on the association between occupational dust exposure and the risk of rheumatoid arthritis
ZHANG Zixing, FANG Xinyu, WANG Jia, MU Min, ZHU Fenglin, QIAN Tingting, YE Dongqing
2024, 28(3): 351-356. doi: 10.16462/j.cnki.zhjbkz.2024.03.017
Abstract(19) HTML (7) PDF(3)
Abstract:
Rheumatoid arthritis (RA) is an autoimmune disease associated with chronic inflammation. It primarily affects the joints, leading to joint pain, stiffness, and functional impairment. RA is also a chronic disabling disease that impacts patients′ quality of life and life expectancy, making it a significant public health concern that burdens both individuals and society. The etiology and pathogenesis of RA are not fully understood; however, in recent years, studies have suggested that occupational dust exposure may be a risk factor for RA development. Concurrently, epidemiological research has made progress in understanding RA′s causes, diagnosis, and prevention. This article reviews the progress in epidemiological research on the relationship between occupational dust exposure and the occurrence of RA, aiming to provide deeper insights and directions for further investigation.
Application progress of virus metagenomics in study of tick-borne virus
SUN Shiwei, LU Zhenhua, LONG Yong, SHAO Zhongjun
2024, 28(3): 357-360. doi: 10.16462/j.cnki.zhjbkz.2024.03.018
Abstract(13) HTML (5) PDF(1)
Abstract:
Ticks are specific blood-sucking ectoparasites which are widely distributed all over the world. They are one of the most important vector organism in the world, carrying pathogens including bacteria, viruses, spirochetes etc. Among them, tick-borne virus is the major arbovirus, which brings great burden to human and animal health. Virus metagenomics have been a virus research technology based on metagenomics in recent years. Its emergence provides strong support for the study of known and unknown viruses and their diversity, and brings new technical means and ideas to virus research. This paper reviews the research progress of viral metagenomics in tick-borne virus research to provide useful reference for tick-borne virus research.
Short Reports
Exploring important health problems for Chinese older adults based on Delphi method
CUI Jia, CHAI Xin, YE Lihong, SHAO Ruitai, SHI Xiaoming, LYU Yuebin, ZHANG Juan
2024, 28(3): 361-367. doi: 10.16462/j.cnki.zhjbkz.2024.03.019
Abstract(19) HTML (24) PDF(9)
Abstract:
  Objective  To explore important health problems for Chinese older adults based on the Delphi method.  Methods  A list of important health problems for Chinese older adults was identified through literature search and expert discussion. Using the Delphi method, 25 experts from various disciplines were invited from August to December 2022. Consultation questionnaires were distributed by email, and expert were asked to select the most important health problems, and assess the importance, controllability, familiarity for each health problems. Active coefficient, selection rate, importance score, controllability score and composite index were analyzed to identify the important health problems for Chinese older adults.  Results  The active coefficients in two rounds expert consultation were 96.00% (24/25) and 79.17% (19/24), respectively. Considering the expert selection rate, importance, controllability and composite index, five important health problems were identified, including disability of activities of daily life, falls, cognitive impairment, depression, and stroke.  Conclusions  Through two rounds of Delphi consultation, five important health problems for Chinese older adults were identified, which have certain guiding significance for establishing priorities for health problems of the elderly and formulating relevant health policies in China.
Association between plasma levels of IL-6 and TNF-α and mild cognitive impairment in the elderly
WU Yinru, ZHONG Yishi, GAO Jian, CHEN Peiliang, YOU Fangfei, SONG Weiqi, MAO Chen
2024, 28(3): 368-372. doi: 10.16462/j.cnki.zhjbkz.2024.03.020
Abstract(24) HTML (6) PDF(7)
Abstract:
  Objective  To analyze the association between plasma levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and mild cognitive impairment (MCI) in elderly individuals aged 65 years and older in Guangdong.  Methods  A total of 48 MCI elderly patients who visited a community health service center in Guangdong were selected as the case group, while 96 non-MCI individuals served as controls. Logistic regression models were used to analyze the association between plasma levels of IL-6 and TNF-α and MCI. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic value of plasma levels of IL-6 and TNF-α for MCI.  Results  A total of 144 elderly individuals were enrolled, including 48 MCI patients and 63 males (43.8%). The results of the multivariate logistic regression models showed that increased plasma levels of IL-6 and TNF-α could lead to a higher risk of MCI. Specifically, the risk of MCI increased by 53% and 51% for each standard deviation increase in plasma levels of IL-6 and TNF-α, respectively (OR=1.53, 95% CI: 1.02-2.29, P=0.040; OR=1.51, 95% CI: 1.04-2.20, P=0.029). The areas under the ROC curves for IL-6 and TNF-α were 0.60 and 0.64, respectively.  Conclusions  The increased risk of MCI in individuals aged 65 years and older may be associated with elevated plasma levels of IL-6 and TNF-α.

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