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CN 34-1304/R ISSN 1674-3679

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2025, Volume 29,  Issue 2

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Principles of Infectious Disease Prevention and Control
Molecular epidemiological characteristics and specific prophylactic and control strategy of hepatitis B
CHEN Yifan, CAO Guangwen
2025, 29(2): 125-131. doi: 10.16462/j.cnki.zhjbkz.2025.02.001
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Currently, there are approximately 257 million individuals globally infected with hepatitis B virus (HBV). In mainland China, about 75 million residents are chronically infected with HBV. Furthermore, the infection rate of HBV is 7.54% among those aged over 30 years. The prevalence of HBV infection is higher in rural areas than in urban areas. The highest rate of HBV infection is evident in the central and southern China. HBV has 10 genotypes, among which genotype B and C are endemic in China. Genotype B HBV is more apt to transmit horizontally in the young and cause acute hepatitis B, whereas genotype C HBV is more apt to cause intrafamilial transmission and induce liver cirrhosis and hepatocellular carcinoma (HCC). HBV vaccination effectively prevents the occurrences of chronic HBV infection, liver cirrhosis, and HCC. Chronic HBV infection accounts for 84.4% of HCC causes in mainland China. HBV promotes hepatocarcinogenesis via high replication, mutation and viral integration into the host genome. High replication of HBV activates and maintains inflammatory microenvironment that induces and selects the hepatocytes with somatic mutations and mutated HBV. Compared to the wild type, the oncogenic potential of HBV is significantly enhanced in mutated forms. The mutated HBV promotes the retro-differentiation of the mutated hepatocytes via activating key signaling pathways in the inflammatory microenvironment. HBV integration facilitates the selective growth advantage of the mutated hepatocytes via inactivating tumor suppressors and activating human telomerase reverse transcriptase. The high-risk HBV mutations can predict the occurrence, postoperative prognosis, and prophylactic effect of antiviral treatments. Antiviral treatments are able to significantly decrease the occurrence and postoperative prognosis, especially in those carrying HBV mutations in the core promoter region, thus fulfilling the specific prophylaxis and control of HBV-related HCC.
Original Articles
Association between prenatal exposure to multiple environmental chemicals and birth weight
CAO Xiuli, WANG Jingyu, LI Yuanyuan, XU Shunqing, ZHOU Yuanzhong, LIU Hongxiu
2025, 29(2): 132-138. doi: 10.16462/j.cnki.zhjbkz.2025.02.002
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  Objective  To investigate the association between maternal prenatal exposure to a chemical exposome consisting of metals, phenols, phthalates, hydroxybenzoates, benzotriazoles and benzothiazoles, and the birth weight of newborns.  Methods  A total of 829 mother-infant pairs who joined a birth cohort in Wuhan from 2014 to 2015 were selected as the study population. Pregnant women were guided to fill out baseline questionnaires, and their urine samples were collected repeatedly. The concentrations of 33 metals, 8 phenols, 8 phthalates, 3 hydroxybenzoates, 4 benzotriazoles, and 4 benzothiazoles metabolites in urine samples were measured. An exposome-wide association study (ExWAS) was applied to test the association of each exposure with birth weight. Subsequently, the elastic net (ENET) model was used to select significant variables from the ExWAS approach, and the selected variables were incorporated into the Bayesian kernel machine regression (BKMR) model to evaluate the effect of their mixture.  Results  The ExWAS results showed a negative correlation between bisphenol S (BPS), bisphenol F (BPF), aluminum (Al), gallium (Ga), and benzothiazole (BTH) with birth weight, and for each interquartile range (IQR) increase in the concentrations of these exposures, the differences in birth weight were -36.76 (95% CI: -66.79--6.73) g, -36.05 (95% CI: -67.59--4.51) g, -26.59 (95% CI: -52.81--0.37) g, -37.82 (95% CI: -68.60--7.04) g, and -47.89 (95% CI: -85.81--9.96) g, respectively. Besides, BPS, Ga, and BTH were selected by ENET model, then their mixture was significantly associated with reduced birth weight in BKMR model. Compared to the 50th percentile, increasing the concentration of the mixture to the 75th percentile resulted in a reduction in birth weight of 47.45 (95% CI: 19.21-75.69) g. Sex-stratified analysis revealed that BPS, Ga, and BTH only affected the birth weight of male infants.  Conclusions  Maternal exposure to BPS, Ga, and BTH during pregnancy is associated with a decrease in infant birth weight, particularly in male infants.
Association between novel blood lipid indicators and risk of diabetes among Shenzhen residents
YANG Yuchao, LYU Deliang, WU Xiaobing, XIE Fengzhu, SHANG Qinggang, XIE Wei, ZHAO Zhiguang
2025, 29(2): 139-144. doi: 10.16462/j.cnki.zhjbkz.2025.02.003
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  Objective  This study aimed to explore the association between novel lipid indicators, triglyceride glucose (TyG) index, lipid accumulation product (LAP), and visceral adiposity index (VAI) and the risk of diabetes among residents in Shenzhen, providing a reference for the early prediction and warning of diabetes.  Methods  A cross-sectional survey on cardiovascular and cerebrovascular diseases and their risk factors among residents in Shenzhen was conducted from April to October 2021. Through multi-stage stratified cluster random sampling, face-to-face questionnaire filling, physical examinations, and laboratory tests were adopted to collect indicators such as waist circumference (WC), BMI, fasting plasma glucose (FPG), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C). According to the quartile intervals of the novel lipid indicators of the study subjects, they were divided into Q1, Q2, Q3, and Q4 groups. The odds ratio (OR) and its 95% confidence interval (95% CI) of the novel lipid indicators and diabetes were calculated using the logistic regression model, and the potential linear association was analyzed using the restricted cubic spline (RCS) model.  Results  Finally, 5 324 residents were selected in this study, among them, there were 378 diabetic patients (7.10%) and 4 946 non-diabetic patients (92.90%). After adjusting for potential confounding factors in the logistic regression model, for TyG, compared with the Q1 group (≤8.16), the risk of diabetes in the Q4 group (>8.94) increased (OR=8.85, 95% CI: 5.05-16.81); for LAP, compared with the Q1 group (≤12.69), the risk of diabetes in the Q4 group (>34.82) also increased (OR=3.30, 95% CI: 1.85-6.23); for VAI, the risk of diabetes in the Q4 group (>1.85) was 1.31 times than that of the Q1 group (≤0.93) (OR=2.31, 95% CI: 1.54-3.53). The results of the RCS model showed that the associations of TyG, LAP, and VAI with the risk of diabetes were nonlinear (P < 0.05).  Conclusions  TyG, LAP and VAI are positively correlated with the risk of diabetes and can be used as assessment indicators for the risk of diabetes.
Study on the impact of chronic disease comorbidities on depression symptoms in middle-aged and elderly people based on health ecology models
HUANG Aiwen, LUO Min
2025, 29(2): 145-151. doi: 10.16462/j.cnki.zhjbkz.2025.02.004
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  Objective  To explore the impact of chronic disease comorbidities on depression symptoms in middle-aged and elderly people, providing a theoretical basis for optimizing psychological health interventions in this population in China.  Methods  Data from 9 583 middle-aged and elderly individuals in the 2018 China Health and Retirement Longitudinal Study (CHARLS)were analyzed. Chi-square testing and binary logistic regression were performed using SPSS 26.0, and a column chart model for the risk of depression symptoms in those with chronic disease comorbidities was created using R 4.3.3.  Results  The comorbidity rate of chronic diseases among middle-aged and elderly people in China was 38.81%, and the prevalence of depressive symptoms among those with comorbidities was 61.98%. The likelihood of developing depressive symptoms in those with comorbidities was 1.556 times higher than in those without (95% CI: 1.382-1.753). The prevalence of depressive symptoms increased with the number of chronic diseases (P < 0.001). Additionally, the column chart model showed that depressive symptoms in middle-aged and elderly people were associated with demographic traits, behavioral characteristics, and the policy environment (all P < 0.05).  Conclusions  Chronic comorbidities increased the risk of depression symptoms among middle-aged and elderly people in China. Therefore, it is necessary to strengthen the health management of middle-aged and elderly people with chronic comorbidities and pay attention to their mental health.
A cross-sectional study of common comorbidity patterns in patients with type 2 diabetes mellitus
GAO Ning, SHENG Dan, TANG Shaoyan, WANG Minzhen
2025, 29(2): 152-157. doi: 10.16462/j.cnki.zhjbkz.2025.02.005
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  Objective  To investigate the comorbidity conditions and patterns among patients with type 2 diabetes mellitus, and to provide data support for the management of comorbidities in these patients.  Methods  The participants of the present study included 3 592 patients with type 2 diabetes from the Jinchang cohort, based on baseline surveys conducted from June 2011 to December 2013. By combining data from epidemiological investigations, physical examinations, and clinical biochemical tests, our study included 18 chronic diseases with prevalence rates greater than 5%, and the comorbidity status of patients with type 2 diabetes were analyzed. The Apriori algorithm was used to explore common comorbidity patterns, and the results were visualized through network diagrams, grouped matrix plots, and parallel coordinate plots.  Results  The comorbidity rate among the Jinchang cohort patients with type 2 diabetes was as high as 98.58% (3 541/3 592), primarily involving 2-4 comorbidities. The top three individual diseases were hyperlipidemia (78.29%), hypertension (63.20%), and fatty liver (46.97%). The most common binary, ternary, and quaternary comorbidity patterns were hypertension and hyperlipidemia, followed by hypertension and hyperlipidemia and fatty liver, and finally arrhythmia and fatty liver and hyperlipidemia and hypertension, respectively. Differences in comorbidity patterns were observed across different genders and age groups.  Conclusions  Comorbidity is a common phenomenon among patients with type 2 diabetes in the Jinchang cohort, with hyperlipidemia, hypertension, and fatty liver being the core diseases in these patterns. There should be an emphasis on screening and prevention of these three chronic diseases among patients with type 2 diabetes.
A cross-sectional study of the association between handgrip strength and hypertension among adults in Lu′an City, Anhui Province, China
ZHOU Zhihao, LIU Mengfei, YE Shu, ZHOU Yumo, JIANG Cao, CHANG Hongwei, CAO Hongjuan, LIU Yang, SUN Zisuo, LI Meiling, ZHANG Zhuang, YANG Wanshui
2025, 29(2): 158-163. doi: 10.16462/j.cnki.zhjbkz.2025.02.006
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  Objective  This study aimed to investigate the association between handgrip strength and hypertension, providing scientific evidence for the prevention, screening, and intervention of hypertension.  Methods  This study was based on a population-based cross-sectional study conducted in the Lu′an, Anhui Province, from July 2020 to July 2021. The handgrip strength was measured using a calibrated CAMRY handgrip strength dynamometer. Multivariable logistic regression was used to assess the association between handgrip strength and hypertension. Subgroup analyses were conducted according to factors such as age, gender, and BMI, and their interactions were analyzed using the Wald test. During the sensitivity analysis, participants with a family history of hypertension were excluded.  Results  Of the 2 694 participants, 1 309 (48.6%) were diagnosed with hypertension. After adjusting for age, gender, BMI, and other covariates, participants in the highest quartile of handgrip strength had a 39% lower risk of hypertension compared to those in the lowest quartile (OR=0.61, 95% CI: 0.43-0.86, Ptrend < 0.001).  Conclusions  Greater handgrip strength is linked to a lower prevalence of hypertension, indicating that individuals should prioritize improving muscle strength in their daily routines to promote health and reduce the risk of developing hypertension.
Prevalence of post-traumatic stress disorder and analysis of influencing factors among left-behind middle school students
WANG Jiangxue, WU Xian, ZENG Xiaoduo, XIANG Bing, YANG Mei, ZHOU Feng, XIE Xinyan, ZENG Jing
2025, 29(2): 164-170. doi: 10.16462/j.cnki.zhjbkz.2025.02.007
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  Objective  This study examines the prevalence of Post-Traumatic Stress Disorder (PTSD) and its influencing factors among left-behind middle school students, providing a scientific basis for mental health interventions.  Methods  From September 2021 to June 2023, a multi-stage cluster sampling method was used to select left-behind middle school students aged 10-18 from six provinces with a significant population of left-behind children for mental health interventions. A questionnaire collected data on demographics, traumatic experiences, and PTSD. The prevalence of PTSD was analyzed using chi-square tests and t-tests, while logistic regression identified the influencing factors.  Results  Among the 8 878 left-behind middle school students, 4 496 (50.6%) reported experiencing trauma, and 965 exhibited PTSD symptoms, resulting in an overall PTSD prevalence rate of 10.9% and a prevalence rate of 21.5% among those who had experienced trauma. The highest PTSD prevalence (42.6%) was found in students who reported being physically assaulted, threatened, or severely harmed in their town. Students who experienced "other" types of trauma had the highest PTSD prevalence at 18.1%. The prevalence of PTSD increased with the number of traumatic events experienced. Multivariate analysis identified several risk factors for PTSD, including female gender (OR=1.49, 95% CI: 1.28-1.73), moderate (OR=1.33, 95% CI: 1.09-1.62) or poor family environments (OR=2.77, 95% CI: 2.04-3.75), unstable caregivers (OR=1.26, 95% CI: 1.05-1.52), and certain parenting styles such as reprimanding (OR=1.51, 95% CI: 1.23-1.86), spoiling (OR=1.30, 95% CI: 1.01-1.66), corporal punishment (OR=1.52, 95% CI: 1.10-2.19), or neglect (OR=2.56, 95% CI: 1.66-3.94). Protective factors included having a close or average relationship with caregivers, moderate economic conditions, and good security near the school (all P < 0.05). Additionally, the risk of PTSD was 8.72 times higher for those who experienced more than 7 traumatic events compared to those who experienced only one. Students who experienced trauma categorized as "other" or multiple types had a higher risk of PTSD than those who only faced "accidents or injuries".  Conclusions  Left-behind middle school students exhibit a high risk of PTSD, particularly those with traumatic experiences, highlighting the urgent need for targeted mental health interventions and preventive measures.
Analysis of the prevalence and influencing factors of iron deficiency and anemia among students in monitoring area of the nutritional health status of students in Hunan Province
TANG Jiapeng, TAN Yaqing, CHEN Yanhua, WANG Fei, LI Kaiyu, SUN Mengting, LUO Manjun, WEI Jianhui, RUAN Xiaorui, QIN Jiabi
2025, 29(2): 171-177. doi: 10.16462/j.cnki.zhjbkz.2025.02.008
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  Objective  To investigate the current status of iron deficiency(ID) and anemia among students in the nutrition improvement programme areas of Hunan Province in 2023, and to explore the the potential factors.  Methods  During the period October-December 2023, a total of 4 652 students were included in this study using a multistage stratified whole cluster random sampling method, out of which 1 108 students were tested for serum ferritin (SF). Logistic regression was used to analyze the factors influencing anemia, ID and iron deficiency anemia (IDA).  Results  The average hemoglobin (Hb) level of students in the 2023 nutrition improvement program area of Hunan Province was (131.49±12.92) g/L, and the prevalence of anemia was 11.54% (95% CI: 10.62-12.46); the average SF level was 53.47 (34.53, 81.35) μg/L, and the prevalence of ID and IDA was 5.23% (95% CI: 3.92-6.55) and 1.35% (95% CI: 0.67-2.04), respectively. Multifactorial analysis showed that girls (OR=1.482, 95% CI: 1.125-1.778) and students whose school location was a township or village (OR=1.420, 95% CI: 1.138-1.771) had a higher risk of anemia, while students aged 10-15 years had a lower risk of anemia compared to those aged 6-10 years (OR=0.806, 95% CI: 0.656-0.992). In the analysis of ID and IDA, girls and junior high school students had a higher risk of the diseases (ID: ORfemale=3.523, 95% CI: 1.898-6.542, ORjunior high school=4.120, 95% CI: 2.251-7.541; IDA: ORfemale=6.933, 95% CI: 1.551-130.984, ORjunior high school=8.837, 95% CI: 1.979-39.462).  Conclusions  Nutrition Improvement Program areas in Hunan Province still need to further increase the prevention and control of ID and IDA among students, strengthen nutritional monitoring, pay attention to the health of key populations, and give targeted dietary guidance and health education.
Long-term effect of AIDS infected individuals with hepatitis B virus infection on abnormal liver enzymes in Guangzhou
CHEN Mingyu, LIU Cong, TANG Xiaoping, LI Quanmin, LI Linghua, GU Jing, CAI Weiping
2025, 29(2): 178-185. doi: 10.16462/j.cnki.zhjbkz.2025.02.009
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  Objective  To analyze the impact of concurrent HBV infection on the occurrence of liver enzyme abnormalities in HIV-infected individuals during long-term antiviral therapy in Guangzhou City.  Methods  A retrospective cohort study was conducted in December 2023, using follow-up data from HIV-infected individuals who received antiviral treatment at the Eighth People′s Hospital of Guangzhou from January 1 2010, to June 30 2021, as recorded in the "Comprehensive AIDS Prevention and Control Data Information Management System." The study employed a joinpoint regression model to analyze the changing trend in the risk of liver enzyme abnormalities. Propensity score matching was applied to enhance comparability between individuals co-infected with HBV and those simple HIV infections. Additionally, a multilevel logistic regression model was used to analyze the impact of concurrent HBV infection on liver enzyme abnormalities.  Results  After applying the inclusion and exclusion criteria, 13 829 HIV-infected individuals were screened, and following propensity score matching, a total of 9 050 HIV-infected individuals were included in the analysis. Among individuals infected with HIV alone and those with HBV, 61.8% and 70.4% experienced liver enzyme abnormalities, respectively. The risk of occurrence showed a rapid decrease within 9 months of treatment, a slow decrease from 9 to 27 months of treatment, and a stable three stage period after 27 months of treatment. For HIV-infected individuals, the co-infection with HBV within the first 9 months of antiviral treatment is a risk factor for liver enzyme abnormalities (OR=1.637, 95% CI: 1.437-1.866), but after 9 months of continuous antiviral treatment, there was no association between ca-HBV and liver enzyme abnormalities (P>0.05).  Conclusions  In the follow-up and management of AIDS, the liver function of patients with HBV infection should be focused on in the first year after starting antiviral treatment.
The spatio-temporal dynamic distribution characteristic and evolvement rule of the tuberculosis epidemic in China
SUN Ke, DENG Ziyan, LI Liqing
2025, 29(2): 186-192. doi: 10.16462/j.cnki.zhjbkz.2025.02.010
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  Objective  This study aims to explore the spatio-temporal dynamic distribution and evolution of tuberculosis epidemic in China, providing a scientific basis for predicting the spatial epidemic trend and conducting control of tuberculosis.  Methods  Dagum Gini coefficient, barycenter-standard deviation ellipse, spatial autocorrelation and spatio-temporal transition were used to analyze the global and local spatio-temporal dynamic distribution and evolution of tuberculosis incidence in China from 2006 to 2020.  Results  The regional variations of the incidence of tuberculosis mainly came from the differences among east, middle and west regions. The average difference contribution rate of regional variations was 53.78%. The standard deviation ellipse was in the east and middle regions, and continuously shifted to the northwest. The distribution barycenter was mainly distributed in Shaanxi and Gansu. With the spatial correlation pattern of "high in the west and low in the east" (the mean value of Moran′s I was 0.36, P < 0.01), It was probable that the provinces and their neighbors would not transition. The proportion of type Ⅳ was 85.9%.  Conclusions  There are the characteristics of regional difference, spatial disequilibrium, spatial relevance and local spatial structure stability of the incidence distribution of tuberculosis in China. It is necessary to clarify the sources of regional differences, aim at key directions and regions, make inter-regional cooperation closer, and strengthen resource sharing in order to scientifically prevent and control tuberculosis.
Epidemiological characteristics and spatiotemporal analysis of influenza in Fujian Province, from 2010 to 2023
HUANG Zhengqiang, CAI Shaojian, ZHAN Meirong, CHEN Wu, OU Jianming, WU Shenggen
2025, 29(2): 193-198. doi: 10.16462/j.cnki.zhjbkz.2025.02.011
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  Objective  To analyze the epidemiological characteristics and spatiotemporal distribution of influenza incidence in Fujian Province from 2010 to 2023, and provide a reference for scientific prevention and control.  Methods  The Joinpoint regression model was used to analyze the incidence trend, the epidemiological characteristics of influenza were described by using the descriptive analysis methods. ArcGIS 10.3 software was used to draw the incidence map and perform spatial auto-correlation analysis. The retrospective spatiotemporal scanning analysis was conducted using the SaTScan 10.1.2 software.  Results  From 2010 to 2023, a total of 343 909 cases of influenza was reported in Fujian Province, with an average annual incidence rate of 63.38 per 100 000 people. The incidence rate generally showed an upward trend, with an average annual percentage change (AAPC) of 38.56% (Z=6.86, P < 0.001). The disease mainly affected people aged 0-14 years old. There was both global and local autocorrelation in the incidence of influenza, with high-high clustering areas mainly located in some counties and districts along the southern coast of Zhangzhou and Xiamen. Spatial-temporal scan analysis has found that the main clustering areas were mainly in Zhangzhou and Xiamen, with clustering periods mostly occurring between November of each year and January of the next year, and occasionally occurring between June and August.  Conclusions  The incidence of influenza in Fujian has an upward trend from 2010 to 2023, and it is necessary to strengthen monitoring and prevention measures in key areas and populations, and more studies should be carried out to analyze the factors that affect the areas with high incidence of influenza and formulate corresponding prevention and control policies.
Association between land cover and hemorrhagic fever with renal syndrome in Gansu
GOU Faxiang, WEI Kongfu, WANG Xuxia, YAO Jinxi, CHENG Yao, LIU Xinfeng, WANG Lijuan, MA Wenjuan, WANG Long, ZHANG Xiaoshu
2025, 29(2): 199-203. doi: 10.16462/j.cnki.zhjbkz.2025.02.012
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  Objective  To explore the relationship between land cover and the risk of hemorrhagic fever with renal syndrome (HFRS).  Methods  Annual HFRS cases and landcover in epidemic areas of Gansu Province during January 1, 2012 and December 31, 2022 were collected and analyzed. Poisson regression model was applied to assess the relative risk of main land cover, landcover percentage and the risk of HFRS, and restricted cubic spline was applied to determine the corresponding exposure-response relationship.  Results  The HFRS risk in areas with main land cover of grassland was 2.781 (95% CI: 2.336-3.310, P < 0.01) times in comparison with which in cropland areas, and the risk of forests and shrub areas was lower than which in cropland areas, with the coresponding RRs were 0.455(95% CI: 0.319-0.648, P < 0.01) and 0.130(95% CI: 0.041-0.401, P < 0.01). And the risk of HFRS increased with the percentages of grassland increasing, decreased with the percentage of cropland and barren increasing, and showed an inverse V-shaped relationship with the percentage of forests and shrub.  Conclusions  Land cover is associated with the risk of HFRS. The formulation of prevention and control strategies and measures for HFRS should consider land cover and its changes to reduce the epidemic risk of HFRS.
Epidemiological analysis of plague among animals in epidemic focus of meriones unguiculatus in Inner Mongolia Autonomous Region from 2006 to 2020
LIU Dan, BAI Gang, WANG Qi, SUN Xuesong, KANG Ningshuo, AN Xinyuan, LI Naizhe, WANG Wenrui, LI Jianyun, LIU Zhengran
2025, 29(2): 204-210. doi: 10.16462/j.cnki.zhjbkz.2025.02.013
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  Objective  To understand the epidemic situation and epidemic characteristics of plague among animals in the focus of Meriones unguiculatus in Inner Mongolia Autonomous Region, so as to provide scientific basis for the prevention and control of plague in Inner Mongolia Autonomous Region.  Methods  The monitoring data of plague in Inner Mongolia Autonomous Region from 2006 to 2020 were collected and sorted out. Using Excel 2010 software, data on hosts, vectors, pathogens, and serology were entered separately, and descriptive epidemiological methods were used for statistical analysis based on different age and species composition.  Results  The 15 years included in the analysis was divided into three time periods with a 5-year interval. The mice density and the positive rate of plague among animals showed a trend of increasing first and then decreasing in each time period, showing a certain periodicity. The average mice density was 2.91 rats/hm2, the total capture rate of nocturnal rodents was 3.16%, the flea-infected rate was 27.61%, and the average flea index was 0.83 in the focus of Meriones unguiculatus. Plague bacilli was isolated in 13 years of the 15 years included in the study; the average positive rate for 15 years was 0.33%, and the positive rate of indirect hemagglutination test was 0.49%.  Conclusions  The results of this study show that the plague among animals in epidemic focus of Meriones unguiculatus is continuously active, so it is necessary to do good jobs in monitoring and early warning of mice density and epidemic situation among animals, reducing the occurrence and epidemic risk of plague of animals.
Analysis of neutralizing activity of antibody in serum and its influencing factors in natural population in high incidence areas of severe fever with thrombocytopenia syndrome in Anhui Province
GONG Lei, CHEN Qingqing, WANG Jinsheng, XU Pengpeng, CHENG Donglin, LIU Xuxiang, YANG Kun, SUN Yong, CHU Na, WU Jiabing
2025, 29(2): 211-216. doi: 10.16462/j.cnki.zhjbkz.2025.02.014
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  Objective  The purpose of this study was to understand the level of IgG in serum of natural people in areas with high incidence of severe fever with thrombocytopenia syndrome (SFTS) in Anhui Province and its influencing factors, so as to provide basis for the prevention and control of SFTS.  Methods  The serum samples and epidemiological data of natural population in areas with high incidence of SFTS were collected in the year of 2021 and divided into immunoglobulin G (IgG) negative group and positive group according to the results of IgG antibody test, and compare the demographic characteristics, past health status, environmental and medium exposure between the two groups. χ2 or Z test were used for univariate analysis, and logistic regression model was used for multivariate analysis.  Results  A total of 1 255 cases were included in this study, of which 174 cases (13.86%) were IgG antibody positive. The univariate analysis showed that there was a significant difference in the demographic characteristics of the two groups in terms of village type and age (all P < 0.05). There was a significant difference in the past health status of the two groups in terms of whether SFTS was diagnosed or not (χ2 =13.678, P < 0.05). There was a significant difference in the environmental exposure of the two groups in terms of engaging in agricultural production, being bitten by ticks, living with weed and ticks around residential areas, and working in the field (P < 0.05). There was a significant difference in the medium exposure of the two groups in terms of sitting and lying near the rat hole (χ2 =8.576, P < 0.05). The binary logistic regression analysis showed that the monitoring villages (OR=2.093, 95% CI: 1.489-2.941), high age (OR=1.028, 95% CI: 1.013-1.043), had been diagnosed with SFTS (OR=3.089, 95% CI: 1.021-9.346), engaged in agricultural production (OR=1.728, 95% CI: 1.090-2.741), and had been bitten by ticks (OR=1.990, 95% CI: 1.366-2.898) were the risk factors for IgG antibody positive (all P < 0.05).  Conclusions  This study finds that the IgG antibody positive rate is higher in natural populations in areas with high incidence of SFTS in Anhui province. Therefore, it is necessary to strengthen health interventions for populations in these areas to reduce the risk of infection.
Study on the relationship between TLR2 and TLR4 polymorphism and CpG island methylation and anti-tuberculosis drug-induced liver injury
LI Yue, MA Shuo, LIU Yue, TANG Qinyan, GUO Yu, LIU Yang, PEI Shengfei, FENG Fumin
2025, 29(2): 217-223. doi: 10.16462/j.cnki.zhjbkz.2025.02.015
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  Objective  To investigate the relationship between single nucleotide polymorphisms rs7656411, rs3804099, rs1927914, rs1927911 in Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) genes, as well as CpG island methylation in the TLR2 gene promoter region, and anti-tuberculosis drug-induced liver injury (ADLI).  Methods  From July 2019 to March 2022, 322 tuberculosis patients with ADLI and 322 tuberculosis patients without ADLI were selected and matched 1∶1 based on gender, age, and treatment regimen. Gene polymorphisms and methylation patterns were detected using methylation-specific polymerase chain reaction(PCR) and PCR-restriction fragment length polymorphism(PCR-RFLP) technique.  Results  The wild-type genotype of TLR2 gene rs3804099 site (OR=0.55, 95% CI: 0.31-0.96) and CpG island methylation rate (OR=1.81, 95% CI: 1.07-3.06) were significantly higher in ADLI patients than in the control group (P < 0.05), with no statistical difference in the genotype frequency of other polymorphic sites between the two groups. Multivariate analysis showed that the wild-type TT of TLR2 gene rs3804099 site was associated with the progression of ADLI, and the wild-type TT may be a protective factor for ADLI OR=0.53 (95% CI: 0.38-0.75). In addition, high methylation of CpG island in TLR2 gene was independently associated with the risk of ADLI, with adjusted OR of 1.86 (95% CI: 1.05-3.28). The interaction between the mutation of rs3804099 site and high methylation of CpG island increased the risk of ADLI, being 2.12 times that of the control group (OR=2.12, 95% CI: 1.36-3.29).  Conclusions  There is an association between TLR2 gene polymorphism and CpG island methylation and ADLI. The interaction between CpG island methylation in the TLR2 gene promoter region and the gene polymorphism at rs3804099 is associated with a high risk of ADLI.
Reviews
Health behavior models and relevant influencing factors related to medication adherence
LU Qiaoshan, MA Xiaohong, YE Junjie, ZHAO Lin, HU Xinxuan, CHEN Qiulan, QIN Huijie, TANG Xianyan
2025, 29(2): 224-230. doi: 10.16462/j.cnki.zhjbkz.2025.02.016
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Adherence is defined as the extent to which a patient′s or individual′s behavior aligns with the professional recommendation of the healthcare provider regarding medication, dietary modifications, and lifestyle alterations. Adherence is important to a patient′s or individual′s health status and treatment outcome. We summarized health behavior models of medication adherence and underlying principles. Furthermore, we systematically reviewed the relevant influencing factors regarding socio-economic status, the healthcare system, diseases, treatments, and patient characteristics that would affect patients′ medication adherence, based on the five dimensions of adherence proposed by the World Health Organization. Findings in this study would provide scientific evidence to improve patients′ medication adherence and prognosis outcomes.
Short Reports
Analysis of the burden and trends of dengue fever in China on the global perspective
JIANG Yuqi, LONG Jiang, ZHAO Jinhua, ZHANG Yang, DENG Ping, QIN Shenglin
2025, 29(2): 231-236. doi: 10.16462/j.cnki.zhjbkz.2025.02.017
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Abstract:
  Objective  To analyze the disease burden and trend of dengue fever in China from 1990 to 2021, and compare it with global data, aiming to provide scientific evidence for the formulation of dengue prevention and control strategies in China under the context of globalization.  Methods  Relevant data of the global burden of disease 2021 (GBD 2021) database were collected to extract and calculate the age standardized incidence rate (ASIR), age standardized prevalence rate (ASPR), age standardized mortality rate (ASMR), age standardized disability-adjust life years(DALY) rate (ASDR) and other indicators of China and the global burden of dengue disease from 1990 to 2021. Data preprocessing was conducted using Excel 2019, data visualization with R 4.3.1, and trend analysis using the Joinpoint 5.0.2 software for average annual percentage change (AAPC).  Results  From 1990 to 2021, the number of dengue cases in China increased from 4 364 to 26 748, a relative increase of 512.92%; prevalence rose from 256 to 1 579, a relative increase of 516.80%; the number of deaths decreased from 46 to 9, a decrease of 80.43%; DALY decreased from 3 568 person-years to 622 person-years, a reduction of 82.57%. The age-standardized incidence and prevalence rates showed an overall upward trend (AAPC=5.39%, 5.40%, both P < 0.001), while age-standardized mortality and DALY rates showed an overall downward trend (AAPC=-7.01%, -6.96%, both P < 0.001). In both 1990 and 2021, the highest incidence and prevalence rates in China were observed in the 5- < 15 age group, while the highest mortality was seen in the < 5 age group, consistent with global patterns. From 1990 to 2021, China′s dengue disease burden indices were consistently lower than the global average.  Conclusions  The disease burden of dengue fever in China is lower than the global average, but both incidence and prevalence are still on the rise. This suggests the need to strengthen dengue prevention and control measures, with particular attention to vulnerable populations such as women, children, and the elderly.
Characteristics and spatiotemporal distribution analysis of reported HIV/AIDS aged ≥50 infected through commercial heterosexual behavior in Chongqing from 2015 to 2023
HE Yaping, ZHOU Chao, LIN Jing, ZHANG Wei
2025, 29(2): 237-242. doi: 10.16462/j.cnki.zhjbkz.2025.02.018
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Abstract:
  Objective  To analyze the characteristics and spatiotemporal distribution of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) cases among individuals aged ≥50 infected through commercial heterosexual behavior in Chongqing, and to provide scientific references for HIV/AIDS prevention and control among the elderly population.  Methods  The reported HIV/AIDS cases aged≥50 from 2015 to 2023 with a history of commercial heterosexual behavior were analyzed. SPSS 23.0 software was used for descriptive epidemiological, and ArcGIS 10.6 software was used for spatial analysis.  Results  From 2015 to 2023, Chongqing reported 16 096 HIV/AIDS aged ≥50 and infected through commercial heterosexual behavior, accounting for 72.3% of all HIV/AIDS infected through commercial heterosexual behavior, and the proportion showed an increasing trend (χ2 trend=631.208, P < 0.001). The cases were predominantly male (94.7%), married (59.0%), aged 50- < 70 years (68.9%), farmers (62.1%), and with primary school education or below (71.1%). The majority of cases were distributed in the central urban areas and main urban districts (82.7%), primarily detected through medical institutions (70.2%), with 68.8% having initial CD4+ T cell counts < 350 cells/μL. Spatial analysis indicated that the cases were clustered and centered around Yongchuan District, Dazu District and Rongchang District spreading to surrounding districts.  Conclusions  The proportion of HIV/AIDS cases aged ≥50 infected though commercial heterosexual behavior in Chongqing has been increasing annually, and the distribution of cases is clustered. Comprehensive intervention measures should target commercial heterosexual behavior.
A study on the influence of social support factors on life satisfaction of the elderly in Taizhou City
LI Menglin, QIAN Yu, GUAN Yunhao, GUAN Tianhang, PU Dong, NIU Jin, HE Yilin
2025, 29(2): 243-248. doi: 10.16462/j.cnki.zhjbkz.2025.02.019
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Abstract:
  Objective  To explore the effects of social support factors on life satisfaction of the elderly in Taizhou City, so as to provide a scientific basis for promoting healthy aging.  Methods  Level of social support factors and life satisfaction in the elderly were investigated based a cross-sectional survey study of health management of the elderly in Taizhou City in 2021. One-way chi-square test, categorical principal components analysis (CATPCA), and multi-factor logistic regression model were used to analyze the effects of social support factors on life satisfaction in the elderly.  Results  The level of life satisfaction of the elderly in Taizhou City was 76.3%. The principal component factor analysis extracted the social support factor variables as 8 public factors with a contribution rate of 78.02%. The results of multi-factor logistic regression analysis showed that the pension fund security, support for elderly chidren, labor income, and health burden coverage had a positive effect on the life satisfaction of the elderly, with OR of 1.254 (95% CI: 1.116-1.409, P < 0.001), 1.559 (95% CI: 1.424-1.707, P < 0.001), 1.132 (95% CI: 1.042-1.229, P=0.003) and 1.281 (95% CI: 1.115-1.472, P < 0.001).  Conclusions  The overall level of life satisfaction of the elderly in Taizhou City is high. High pension fund security, support for elderly chidren, labor income, and health burden coverage have a positive impact on the life satisfaction in the elderly.

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