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CN 34-1304/RISSN 1674-3679

Administrative Authorities: National Health Commission of the People's Republic of China

Sponsor: National Health Commission of the People's Republic of China

Editing Publishing: Editorial Board of Chinese Journal of Disease Control & Prevention

Established in: March 1997

Editor in Chief: Ye Dongqing(Anhui)

CN 34-1304/R ISSN 1674-3679

Core Journal of China

China Boutique Scientific and Technological Periodical

Articles in press have been peer-reviewed and accepted, which are not yet assigned to volumes /issues, but are citable by Digital Object Identifier (DOI).
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Original Articles
Age-related differences in the role of lifestyle for stroke
WANG Jingru, JIANG Yonggen, WU Yiling, SU Xuyan, XIE Yijing, ZHANG Pengyan, XIA Ding, ZHAO Qi, XU Kelin, ZHNAG Tiejun, CHEN Xingdong, ZHAO Genming, JIANG Yanfeng, SUO Chen
2024, 28(1): 1-7.   doi: 10.16462/j.cnki.zhjbkz.2024.01.001
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  Objective  To investigate whether there are differences in the influence of lifestyle on stroke risk in different age groups in Songjiang district of Shanghai.  Methods  A total of 31 771 study participants from the Songjiang District in the Shanghai Suburban Adult Cohort and Biobank were selected to calculate their healthy lifestyle scores (including non-smoking, active physical activity, balanced diet, and normal body weight) and were followed until December 31, 2021. Cox proportional risk regression and Poisson regression were used to determine the HR (95% CI) and RR (95% CI) of different lifestyle or healthy lifestyle scores associated with stroke in various baseline age groups and exposed age groups, respectively. Baseline age was stratified by young (20- < 62 years), middle (62- < 68 years), and old (≥68 years) groups. Exposure age was stratified by young (20- < 65 years), middle (65- < 70 years), and old (≥70 years) groups.  Results  Over a median follow-up of 5.0 years, 488 participants developed stroke. After adjusting confounding factors, the associations between non-smoking, active physical activity, balanced diet, or normal body weight and the risk of stroke were not significantly different across age groups, regardless of the method used. The risk of stroke was lower in the group with a score of ≥3 in the young, middle, and old stratum compared with the group with a baseline lifestyle score ≤1 (HR=0.67, 95% CI: 0.43-1.03, P=0.072; HR=0.59, 95% CI: 0.39-0.91, P=0.015; HR=0.64, 95% CI: 0.42-1.00, P=0.043; RR=0.63, 95% CI: 0.42-0.96, P=0.028; RR=0.61, 95% CI: 0.40-0.94, P=0.023; RR=0.63, 95% CI: 0.40-0.99, P=0.045).  Conclusions  No age-related differences in the association of different lifestyles with stroke are found among residents of Songjiang District, Shanghai. It implies that a healthy lifestyle should be emphasized regardless of age. In addition, a healthy lifestyle can substantially reduce the risk of stroke.
A cohort study on the changes of serum uric acid in the pre- and post-menopause
DAI Qiaoyun, WU Shouling, YANG Xueying, CHEN Shuohua, CAO Zongfu, ZHANG Yaya, MA Xu
2024, 28(1): 8-13.   doi: 10.16462/j.cnki.zhjbkz.2024.01.002
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  Objective  To investigate the changes of serum uric acid (SUA) around menopause.  Methods  The linear and piecewise linear mixed effect models were used to analyze SUA changes in the pre-and post-menopause on the Kailuan Health Examination cohort. Multiplicative interaction effects between baseline age as well as baseline BMI and segmented time periods pre- and post-menopause were also analyzed.  Results  A total of 3 747 female with 21 223 health examination records from 2006 to 2020 (7 health examinations) were included in the analysis. The average age at the first health examination was (46.19 ± 4.11) years, and the median age at menopause was 51(50, 53) years. Compared to pre-menopause, SUA increased by 10.15 μmol/L in post-menopause. SUA started to increase gradually from 11 years before menopause, with an average annual increase of 1.99 μmol/L; From 5 to 2 years before menopause, SUA increased by an average of 3.30 μmol/L per year; During the 2 years before and after menopause period, SUA increased by an average of 4.60 μmol/L per year. After that, the average annual increase slowed, and after 5 years of menopause, the average annual increase in SUA dropped to 1.77 μmol/L. There was an interaction between baseline age < 40 years and the time segments of postmenopausal 2- < 5 years after menopause (Pinteraction=0.009) and 5 years or more after menopause (Pinteraction < 0.001), as well as between baseline age 40- < 45 years and the 2 years before and after menopause (Pinteraction=0.033). Except for age under 40 years, which had an impact on SUA changes during 2 years after menopause, the SUA changes around menopause in other baseline age groups were consistent. There was no multiplication interaction effect between baseline BMI and various time segments around menopause (all Pinteraction>0.05).  Conclusions  Menopause has an adverse effect on SUA. Middle-aged women should pay attention to their SUA levels around menopause and adopt proactive prevention and control strategies.
Cross-lagged analysis of the relationship between serum uric acid and dyslipidemia
YIN Tianxiu, ZHU Xiaoyue, HE Zhiliang, BAI Hexiang, SHEN Chenye, CAI Le, LI Ruoyu, WANG Bei
2024, 28(1): 14-19.   doi: 10.16462/j.cnki.zhjbkz.2024.01.003
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  Objective  To study the relationship between elevated serum uric acid levels and serum lipids, and to provide evidence for the prevention and control of dyslipidemia and hyperuricemia.  Methods  A multi-level stratified random sampling method was used to conduct a baseline survey among permanent residents aged 18 and above in Yandu District, Yancheng City, Jiangsu Province from April to July 2017. And the cohort was followed up in 2022. The Cross-lag model was used to investigate the relationship between serum uric acid (SUA) level and blood lipid, including serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C). In addition, gender stratified analysis was conducted to explore whether there were gender differences in the relationship between SUA level and dyslipidemia.  Results  A total of 1 347 eligible subjects were included in the study. The path coefficients from baseline TC to follow-up SUA were statistically significant in the general population (β=3.402, P=0.048) and men (β=7.214, P=0.012). The path coefficients from baseline SUA to follow-up TC were not statistically significant (P=0.958). The path coefficients from baseline TG to follow-up SUA were statistically significant in the general population (β=2.357, P=0.011) and men (β=3.425, P=0.011). The path coefficients from baseline SUA to follow-up TG were not statistically significant (P=0.188). The path coefficients from baseline SUA to follow-up HDL-C were statistically significant in the general population (β=0.002, P < 0.001), men (β=0.001, P < 0.001), and women (β=0.003, P < 0.001). The path coefficients from baseline HDL-C to follow-up SUA were not statistically significant (P=0.461). The path coefficients of baseline SUA to follow-up LDL-C were statistically significant in the general population (β=0.002, P < 0.001), men (β=0.004, P < 0.001), and women (β=0.001, P=0.015). The path coefficients from baseline LDL-C to follow-up SUA were not statistically significant (P=0.436).  Conclusions  Serum uric acid and lipid levels interact with each other. The increase of TC and TG levels may lead to an increase in SUA level, the increase of SUA level may lead to an increase in LDL-C level, and the increase in SUA level may lead to a decrease in HDL-C level.
An epidemiological features and risk factors study of osteoporosis among residents aged 40 and over in four counties of Hunan, 2018
LIU Yuan, PENG Lihong, YIN Li, HU Liping, JIN Donghui
2024, 28(1): 20-25.   doi: 10.16462/j.cnki.zhjbkz.2024.01.004
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  Objective  This research focuses on understanding the epidemiology, prevalence, and associated risks of osteoporosis and low bone mass among individuals aged 40 and over in four counties of Hunan Province. It aims to bolster the efforts in bone health management and osteoporosis prevention in the region.  Methods  A multi-stage stratified random sampling was conducted for this epidemiological study, encompassing questionnaire survey, bone mass measurement and physical measurement such as body weight and height measurements. Rate, constituent ratio and mean were used for statistical despcrition of the data. Rao-Scott χ2 test was conducted for rate comparisons, and Survey logistic regression model was used for risk factors analysis. All the statistic procedures mentioned above were conducted by SAS 9.4 software.  Results  A total of 1 597 subjects were finally investigated, including 704 males (44.08%) and 893 females (55.92%). The overall prevalence of osteoporosis in the cohort was 15.37% (95% CI: 12.08-18.65), increasing with age (Rao-Scott χ2 =131.00, P < 0.001)and higher in females than males (26.95%∶4.55%, Rao-Scott χ2 =54.34, P < 0.001). Low bone mass was prevalent in 53.33% of the population (95% CI: 49.61-57.04, P < 0.001), while low bone mass was 54.28% prevalent in the studied males and 52.01% in females, and no statistically significant gender differences was found (Rao-Scott χ2 =0.63, P=0.420). Risk factors for osteoporosis in males included a BMI < 18.5 kg/m2 (OR=6.52, 95% CI: 1.51-28.12, P=0.010). While in females, they risk factors included menopause before 45 (OR=2.47, 95% CI: 1.53-3.90, P < 0.001), history of fracture (OR=2.76, 95% CI: 1.62-4.65, P < 0.001), BMI < 18.5 kg/m2 (OR=17.67, 95% CI: 2.54-122.87, P=0.004), and being aged ≥60 years (OR=11.35, 95% CI: 3.62-35.56, P < 0.001).  Conclusions  Osteoporosis prevalence is notably high in Hunan Province, particularly among females. The study underscores the significant potential risk for osteoporosis in both genders.
Association of multimorbidity patterns with activity of daily living and instrumental activity of daily living disability among ≥45 years middle-aged and elderly population in China
LI Yanping, WANG Yuan, JI Zhilin, BAI Jingyan, ZHANG Yanbo, LU Jiao
2024, 28(1): 26-31.   doi: 10.16462/j.cnki.zhjbkz.2024.01.005
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  Objective  To cluster the epidemic situation of multimorbidity patterns in middle-aged and elderly people aged 45 years and above in China, and explore the relationship between multimorbidity patterns and activity of daily living (ADL)/instrumental activity of daily living (IADL) disability.  Methods  Based on the 2018 China Health and Retirement Longitudinal Study (CHARLS), the study included a total of 19 745 individuals aged 45 years and older from the middle-aged and elderly population. To identify non-random multimorbidity patterns, a two-way clustering framework (TCF) was utilized for clustering people, while logistic regression was employed to analyze the association between multimorbidity patterns and ADL/IADL disability.  Results  The number of middle-aged and elderly patients with multimorbidity in China was 10 941, accounting for 55.4% of the sample, which could be clustered into three patterns: cardio-cerebrovascular-metabolic pattern, respiratory system-visceral pattern and digestion-articular-mental pattern. According to the association strength of multimorbidity patterns, the population was divided into five multimorbidity association groups. ADL/IADL disability burden was the highest in people with highly related cardio-cerebrovascular-metabolic pattern and digestion-articular-mental pattern (OR=4.696, 95% CI: 4.196-5.255, P < 0.001; OR=3.155, 95% CI: 2.840-3.504, P < 0.001). The risk of ADL /IADL disability in people with highly related cardio-cerebrovascular metabolic pattern and moderate related respiratory system-visceral pattern was the second (OR=2.821, 95% CI: 2.210-3.602, P < 0.001; OR=2.662, 95% CI: 2.120-3.342, P < 0.001).  Conclusions  The risk of ADL /IADL disability is the highest in middle-aged and elderly people with highly related cardio-cerebrovascular metabolic patterns.
Analysis of disease burden and risk factors of Alzheimer disease in China from 1990 to 2019
YIN Mengfan, CUI Yurong, CHEN Zhihui, AN Honglei, ZHAO Manli, HUO Lei, LI Yuandong, KONG Yujia, WANG Suzhen
2024, 28(1): 32-39.   doi: 10.16462/j.cnki.zhjbkz.2024.01.006
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  Objective  To analyze the trend and their risk factors of the burden of Alzheimer disease (AD) and other dementia in China from 1990 to 2019, and to provide theoretical foundation for rational allocation of health resources and developing strategies for the prevention and treatment of AD and other dementias.  Methods  The data of disease burden of AD and other dementias in China in 1990, 2000, 2010, and 2019 were collected from the global burden of disease 2019 study (GBD 2019). Indicators such as years lived with disability (YLD), years of life lost (YLL), disability adjusted life years (DALY) and population attributable fraction (PAF) were used to describe the disease burden and risk factors of AD and other dementias in China from 1990 to 2019. The differences in disease burden of AD between China and the world were compared.  Results  In 2019, disease burden such as YLD, YLL and DALY of AD in China increased with age, and the highest disease burden was found in people over 95 years old. From 1990 to 2019, the age standardized YLD rate, YLL rate, and DALY rate of AD in China increased by 1.35%, -0.12%, and 0.29%, respectively. However, the global standardized YLD rate, YLL rate and DALY rate increased by 0.28%, 0.15% and 0.19%, respectively. The risk attribution analysis of AD in China from 1990 to 2019 showed that both behavioral and metabolic factors contributed to the increase of the disease burden of AD. The risk of disease due to behavioral factors was higher in females than in males. However, the risk of disease due to metabolic factors was higher in males.  Conclusions  Although the burden of AD continues to increase, it can still be effectively controlled through the development of targeted prevention and control strategies for risk factors, including behavioral and metabolic factors.
Trends in the prevalence of metabolic syndrome among the ≥65 years elderly from 2020 to 2022 in Qixia District of Nanjing
GUO Lijuan, WANG Yuanyuan, SUN Guiju
2024, 28(1): 40-45.   doi: 10.16462/j.cnki.zhjbkz.2024.01.007
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  Objective  To investigate the trend of metabolic syndrome (MS) prevalence and related factors in elderly people aged ≥65 in Qixia District of Nanjing, and provide reference for targeted intervention measures.  Methods  Employing a method which the sampling technique was stratified and randomized, A stratified random sampling method was adopted. Elderly individuals aged ≥65 in the Qixia District of Nanjing who underwent health check-ups between 2020 and 2022 were selected as subjects. The trend in the prevalence of MS and the associated factors were analyzed.  Results  The overall prevalence rates of MS among the elderly in Qixia District of Nanjing were as follows: 36.72% in 2020, 35.17% in 2021, and 33.80% in 2022. The standardized prevalence rates were 36.60%, 35.11%, 33.67%, respectively. These rates indicated a decreasing trend (trend χ2 =41.021, P < 0.001). When the data which was stratified by urban-rural differences, the prevalence of MS among urban elderly displayed a downward trend (trend χ2 =95.499, P < 0.001). The prevalence of MS among rural elderly displayed an upward trend (trend χ2 =16.237, P < 0.001).  Conclusions  Although the overall prevalence of MS in the elderly in Qixia District of Nanjing decreases from 2020 to 2022, it is still high. Especially in rural areas, the prevalence of MS shows an upward trend, particularly among rural females who urgent need for intervention.
The prevalence and related factors of maternal anxiety and depression in Shanghai: a multicenter study based on health ecology model
ZHU Tingyu, WANG Ziwen, XIONG Chenhan, SHEN Ye, GU Tingting, JIN Longmei, GU Chunyi, WANG Liping, HUANG Ling, SHI Yunmei, WU Jianfeng, XIE Zhenyu, JIANG Hong
2024, 28(1): 46-55.   doi: 10.16462/j.cnki.zhjbkz.2024.01.008
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  Objective  To understand the prevalence of maternal anxiety and depression in Shanghai and to explore the factors associated with them based on the Health ecology model.  Methods  Multistage stratified sampling method was used. A multicenter, cross-sectional survey was conducted from November 2022 to April 2023 in Shanghai. Generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) were used to evaluate anxiety and depression symptoms of pregnant women. Related factors and their effect size were analyzed based on the health ecology model.  Results  A total of 1 941 valid questionnaires were collected. Among these subjects, 891 were during pregnancy and 1 050 were during postpartum. The detection rate of anxiety and depression during pregnancy were 19.5% (95% CI: 0.169-0.221) and 30.4% (95% CI: 0.274-0.334), respectively. The detection rate of postpartum anxiety and depression symptoms were 18.2% (95% CI: 0.159-0.205) and 23.2% (95% CI: 0.207-0.258), respectively. The binary logistic regression model analysis showed that being in the first trimester, gravidity≥2, with history of mental illness, negative events during and after pregnancy, inactive physical activity, worse sleep quality, introversion, lower life satisfaction, less social support, poorer pregnancy related knowledge, unfavorite baby gender, and dissatisfaction with postpartum rest conditions were significantly associated with anxiety or depression symptoms during pregnancy or postpartum (all P < 0.05).  Conclusions  The detection rate of anxiety and depression in pregnant and postpartum women in Shanghai are relatively high. The factors associated with anxiety and depression are multidimensional. During prenatal and postpartum examinations, close attention should be paid to women with these risk factors and targeted mental health care services should be provided.
Methylation of SLC45A4 and AHSP gene in peripheral blood leukocytes and the risks of breast cancer: a case-control study
FU Qingzhen, LI Dapeng, FU Jinming, LIU Yupeng, SUN Hongru, ZHANG Lei, ZHANG Xianyu, PANG Da, ZHAO Yashuang
2024, 28(1): 56-63.   doi: 10.16462/j.cnki.zhjbkz.2024.01.009
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  Objective  To investigate the relationship between peripheral blood leukocyte solute carrier family 45 member 4 (SLC45A4) and alpha hemoglobin stabilizing protein (AHSP) gene methylation and the risk of breast cancer.  Methods  Datasets GSE51032, GSE104942 and GSE89093 were used to identify genes that potentially associated with the risk of breast cancer through differential methylation analysis and other methods. A case-control study with 545 breast cancer patients and 524 cancer-free controls was carried out to validate the correlation between the methylation levels of the screened genes and breast cancer susceptibility.  Results  In this study, four genes were selected. After controlling for potential confounding factors, hypermethylation of SLC45A4 and AHSP was associated with lower breast cancer risk (ORadj=0.218, 95% CI: 0.158-0.299; ORadj=0.535, 95% CI: 0.384-0.741, respectively). The association of SLC45A4 hypermethylation with breast cancer remained statistically significant in different subgroups. The maximum value of ORadj was 0.427(95% CI: 0.270-0.679) and the minimum value was 0.153 (95% CI: 0.085-0.274). However, the association of AHSP hypermethylation with breast cancer risk was statistically significant only in Luminal A, Luminal B subtypes, estrogen receptor + (ER+), and ≤60 age group. The association of heterogeneous nuclear ribonucleoproteins C (HNRNPC) methylation with the risk of breast cancer in our case-control study was inconsistent to the results of public datasets (ORadj=0.747, 95% CI: 0.569-0.980). There was no statistically significant association between zinc finger protein 425 (ZNF425) methylation and breast cancer risk (P=0.158).  Conclusions  Hypermethylation of SLC45A4 and AHSP in peripheral blood leukocytes may serve as protective factors for breast cancer.
The impact of sleeping behaviors on burnout among health emergency staff
LIU Lizhen, QU Yimin, CAO He, CHEN Hongbiao, JIANG Yu
2024, 28(1): 64-68.   doi: 10.16462/j.cnki.zhjbkz.2024.01.010
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  Objective  To investigate the relationship between sleeping status and burnout among health emergency staff.  Methods  A multi-center convenience sampling method was employed, and a total of 1 012 health emergency staff were recruited from Longhua District of Shenzhen City, Qingdao City, and Dingzhou City. A questionnaire survey, which included the Maslach burnout inventory-general survey (MBI-GS), was conducted to assess the participants′ sleeping and burnout status. Logistic regression model and sub-group analysis were utilized to explore the relationship between sleeping status and burnout after adjusting for confounding variables.  Results  Among the participants, 57.02% experienced sleep deprivation, defined as having less than 6 hours of sleep per night, 90.42% participants were classified as burnout, with 19.17% being highly burnout. The study found a positive relationship between both sleep deprivation (OR=2.28, 95% CI: 1.61-3.25, P < 0.001) and shortened sleeping time during COVID-19 (OR=3.89, 95% CI: 2.20-6.89, P < 0.001) and burnout. Sleep deprivation was found to be positively associated with exhaustion, cynicism, and professional efficacy, while shortened sleeping time was only related to exhaustion. Moreover, the relationship between sleep deprivation and burnout was found to be amplified in specific subgroups, including individuals aged 40 or younger (OR=3.10, 95% CI: 1.96-4.91, P=0.038), not married (OR=5.96, 95% CI: 2.58-13.78, P=0.010), those without children (OR=4.33, 95% CI: 2.06-9.10, P=0.049), and those with a monthly income of ≤5 000 yuan (OR=2.88, 95% CI: 1.90-4.37, P=0.027).  Conclusions  This study highlights the importance of ensuring sufficient sleeping time for health emergency staff, in order to alleviate burnout and enhance their ability to cope with health emergencies.
A simulation comparison and application study of extreme weighting methods in propensity score inverse probability weighting
XU Maomao, GAO Rongrong, GAO Qian, WANG Juping, WANG Jiale, WANG Tong
2024, 28(1): 69-74.   doi: 10.16462/j.cnki.zhjbkz.2024.01.011
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  Objective  This paper proposes a simulation study to compare the performance of propensity score inverse probability weighting (IPW) and its five alternatives under limited overlap and propensity score model misspecification. Additionally, it seeks to employ these methods to explore the relationship between serum total 25-hydroxyvitamin D [25(OH)D] deficiency and sleep duration in adults.  Methods  The statistical performance of these six methods was compared through Monte Carlo simulations by setting up simulation scenarios with different sample sizes, propensity score overlap, and model-specified cases.  Results  Simulation results showed that IPW is particularly sensitive to differences in overlap and model misspecification, while alternative methods showed greater stability and higher efficiency. Notably, the overlap weights (OW) method provided the most accurate effect estimates. It was observed that adults with total serum 25(OH)D deficiency have shorter sleep duration compared to those with adequate total serum 25(OH)D (P < 0.001).  Conclusions  The OW method can be used as an optimal alternative to the IPW method in the presence of extreme weights. The study also concludes that serum total 25(OH)D deficiency reduces sleep duration in adults.
Factors for the abundance and richness of parasitic fleas of wild small mammals in Jianchuan plague foci of Yunnan Province
WU Li, LUO Yunyan, LI Wenhong, HONG Rudan, AI Zhiqiong, YIN Jiaxiang
2024, 28(1): 75-82.   doi: 10.16462/j.cnki.zhjbkz.2024.01.012
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  Objective  To analyze the relationship between small mammal characteristics and environmental factors and parasitic fleas, as well as to identify the factors affecting the abundance and richness of parasitic fleas in wild small mammals in Jianchuan plague foci.  Methods  The small mammals, parasitic fleas and environmental factors were collected in different altitudes of Jianchuan county across four seasons. Utilizing the hurdle model, the study analyzed the factors affecting the abundance and richness of parasitic fleas in environmental factors (season, habitat, and elevation) and small mammal characteristics (species, sex, age, body length, tail length, hindfoot length, ear height, and weight).  Results  The multivariate hurdle negative binomial model of the abundance of parasitic fleas showed that the flea infestation rates of wild small mammals were reduced by 68%, 78%, and 45% in summer, autumn, and winter, respectively, compared to the spring season. There was a 35% reduction in wild small mammals in woodlands compared to the cultivated field. The flea infestation rate increased by 0.41 times for Eothenomys mileyus, decreased by 54% for Apodemus draco, and decreased by 39% for other species compared to Apodemus chevrieri. The number of infected fleas decreased by 60% for Apodemus draco compared to Apodemus chevrieri. The rate of flea infestation in female small mammals was reduced by 25%. The number of infected fleas in adult small mammals was reduced by 44%. The flea infestation rate increased by 0.48 and 0.53 times for longer body length and taller ear height, respectively. Infected fleas decreased by 49% in small mammals with longer tail lengths. The result of the multivariate Poisson hurdle model of the richness of parasitic fleas showed that the flea infestation rate was significantly lower in summer, autumn, and winter compared to spring, with 68%, 78%, and 45% decreased in distribution. Woodlands had 47% lower infected flea species than the cultivated field. The flea infestation rate increased 0.41 times for Eothenomys mileyus, 54% lower for Apodemus draco, and 39% lower for other small mammal species compared to Apodemus chevrieri. The rate of flea infestation in female small mammals was reduced by 25%. The flea infestation rate increased by 0.48 and 0.53 times for the longer body length and taller ear height, respectively.  Conclusions  Season, habitat, small mammal species, sex, age, body length, tail length, and ear height affected the abundance of parasitic fleas. Season, habitat, small mammal species, gender, body length, and ear height affected the richness of parasitic fleas.
Investigation on infection of severe fever with thrombocytopenia syndrome virus in two animals in Shangcheng County, Henan Province
LIU Wanshuang, CHEN Haorong, DAI Ke, JIANG Baogui, CHEN Jinjin, TIAN Shen, WU Jiahong, LIU Wei, FANG Liqun
2024, 28(1): 83-91.   doi: 10.16462/j.cnki.zhjbkz.2024.01.013
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  Objective  To clarify the risk and influential factors of severe fever with thrombocytopenia syndrome virus (SFTSV) transmission in natural foci of severe fever with thrombocytopenia syndrome (SFTS) by conducting an investigation and research on the infection of animal hosts in natural foci of SFTS, so as to provide scientific evidence for targeted prevention and control of SFTS.  Methods  Satellite positioning technology was used to continuously track the daily activities of domestic dogs in Qiuwan, Pingtang and Longtouqiao villages in Shangcheng County during two weeks of monitoring window. Serum samples of dogs were collected and detected SFTSV-IgG antibody by using indirect immunofluorescence assay (IFA) method. Multivariable logistic regression model was applied to analyze the effect of environmental influential factors for infection with SFTSV in domestic dogs. The species of rodents and small mammals in the active area of domestic dogs were investigated by night trapping, night-cage and sticky board methods. The conserved genes were identified by PCR. The SFTSV infection was detected by real-time PCR and enzyme linked immunosorbent assay (ELISA).  Results  The daily activity range of 26 domestic dogs was tracked by satellite positioning technology, and 52 serum samples were collected from 37 domestic dogs. The total positive rate of SFTSV antibody was 59.46%. A total of 419 rodents and small mammals were captured, and the dominant rat species were Rattus tanezumi, Mus musculus, and Apodemus agrarius, and no positive samples were detected for SFTSV. The longer distance from the domestic dog activity center to the main road and the higher frequency of visiting forest land were the risk factors for SFTSV infection. The longer distance from the domestic dog activity center to the forest land was the protective factor.  Conclusions  The positive rate of SFTSV antibody in domestic dogs in Shangcheng County is high, and the infection of SFTSV is related to the ecological environment. It is recommended to further expand the species of domestic animals for the future investigation and research on their pathogenic infection. In Shangcheng County, there is a large variety of rodent species yet no detection of SFTSV. Thus, the role of rodents in the natural cycle of SFTSV demands further investigation.
Advances in risk assessment of importation after elimination of malaria in China
LIU Qiao, LIU Jue
2024, 28(1): 92-95.   doi: 10.16462/j.cnki.zhjbkz.2024.01.014
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In 2021, China was recognized by the WHO as having successfully eliminated malaria, but is still at risk of importation of malaria from abroad. At present, malaria prevention and control in China should focus on prevention of importation and re-establishment. This paper reviewed the main issues of prevention of imported malaria that China faced and the established risk assessment index system for imported malaria, and made recommendations for future malaria prevention and control in China.
Research progress in the study of HPV E2, E5 oncogenic mechanism and related vaccine
CUI Xiangjie, SHI Li, TAO Yufen
2024, 28(1): 96-100.   doi: 10.16462/j.cnki.zhjbkz.2024.01.015
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Cervical cancer is one of the common malignancies affecting women worldwide, of which persistent infection with high-risk human papillomavirus (HPV) is the main cause. In the occurrence and development of cervical cancer, in addition to HPV E6, E7 and cervical cancer lesions have a major relationship, some other early proteins such as E2 and E5 also play an essential role. For example, E2 can initiate and maintain viral replication, and E5 can cooperate with E6 and E7 oncoproteins to promote proliferation of infected cells. In this paper, we aim to review the current research progress on the mechanism of HPV E2 and E5 proteins in the development of cervical cancer and the progress of research on E2 and E5 related therapeutic vaccines.
A review on the impact of environmental factors on the incidence of chickenpox
LUAN Guijie, ZHANG Weiyan, LIU Shaonan, CHEN Meng, SUN Liang
2024, 28(1): 101-107.   doi: 10.16462/j.cnki.zhjbkz.2024.01.016
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  Objective  We aims to provide a comprehensively analysis of the impact of environmental factors, such as meteorological factors and air pollution, on the incidence of chickenpox.  Methods  A systematic literature search using databases including China CNKI, Wanfang, Web of Science and PubMed was conducted, foucing on relevant articles published up to December 31, 2021, that explored the association between environmental factors and chickenpox. This involved analyzing basic study information, methodologies, and outcomes.  Results  Nineteen studies on meteorological factors and three studies on air pollution were included in this study. It was found that changes in temperature, relative humidity and precipitation are associated with increased chickenpox indidence. Additionally, we found regional differences in the correlation between atmospheric pressure, wind speed, sunshine and chickenpox. Furthermore, air pollutants, such as PM2.5, PM10 and NO2, were identified as risk factors for chickenpox.  Conclusions  There are significant correlations between both meteorological factors and air pollution with the incidence of chickenpox. It is imperative to take targeted protective measures.
Short Reports
Advances in consistency and periodicity across major global COVID-19 data sources
LIU Han, ZONG Huiying, HU Guoqing
2024, 28(1): 108-111.   doi: 10.16462/j.cnki.zhjbkz.2024.01.017
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Using rigorous methods to identify and interpret the consistency and periodicity of multi-source COVID-19 epidemic data is the basis of properly interpreting the epidemic characteristics of the COVID-19 epidemic and developing prevention and control measures. By conducting a systematic review, we found that: (1) the existing literature on consistency studies mainly focused on global COVID-19 epidemic data released by the WHO and Johns Hopkins University, revealing inconsistent across various aspects of data collection, statistical indicators, data sharing, as well as the value of the same indicators; (2) each kind COVID-19 epidemic data had typical periodicity. Existing studies about periodicity of COVID-19 epidemic data were primarily from developed countries. The length of epidemic periodicity varied greatly across countries and regions, with a varying periodicity of 3.5 days, 5.0 days, 7.0 days, and 62.0 days. Researchers linked the periodicity of COVID-19 epidemic to multiple factors, including sample testing, data reporting, biological, social, and environmental factors. To summarize, there were no studies that quantified the consistency across major COVID-19 data sources, examined differences in data consistency over time and across countries, and explored the periodicity variations of COVID-19 epidemic across countries around the world currently.
Comparison of propensity score matching with mixed-effect model in cluster randomized trial
ZHAO Hang, YU Xiaojin
2024, 28(1): 112-116.   doi: 10.16462/j.cnki.zhjbkz.2024.01.018
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  Objective  To compare the efficacy of propensity score matching (PSM) and mixed-effect model in statistical performance, providing methodological guidance for similar studies.  Methods  Employing a simulation study and a case study of acute ischemic stroke, this research compared the statistical performance of propensity score matching followed by univariate conditional logistic regression and mixed-effect model. It aims to illustrate their application scenarios and selection strategies in cluster randomized data involving confounders.  Results  In the simulation study, the balance of confounders between groups was significantly improved after PSM. Conditional logistic model provides similar treatment effect estimates but smaller P values compared with mixed-effect model. In the acute ischemic stroke case study, the standardized mean difference (SMD) of confounders were reduced below 0.1 after matching. Conditional logistic model identified the between-group difference in both outcomes. In contrast, mixed-effect model only identified the between-group difference in 7-day effective rate.  Conclusions  Propensity score matching can effectively improves groups comparability. Compared with mixed-effect model, conditional logistic model based on matched data has higher power of test. PSM is advisable for priority consideration in clinical cluster randomized trials, keeping in mind its specific application conditions and limitations.
The application of the sum of single effects regression model for colocalization analysis in multi-omics data
HUANG Ting, LIU Jincheng, LI Huilin, WU Yiwen, YU Er, JI Kai, TANG Shaowen, ZHAO Yang, DAI Juncheng, YI Honggang
2024, 28(1): 117-121.   doi: 10.16462/j.cnki.zhjbkz.2024.01.019
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  Objective  To explore the application of the sum of single effects (SuSiE) regression model for colocalization analysis with multi-omics data.  Methods  Taking the simulated data as an example, we introduced the basic principle of SuSiE regression model and the statistical analysis procedures using R software.  Results  The results showed that the SuSiE regression model could identify the shared casual variants as associated with traits through taking account the linkage disequilibrium (LD) between single nucleotide polymorphisms (SNPs). Despite the presence of multiple causal variants, the colocalization results were still stable.  Conclusions  Compared with those traditional approaches for colocalization, SuSiE regression model expands the applicability of the single causal variant hypothesis and it has higher computational efficiency, thus helping to detect multiple potential shared casual variants using multi-omics data.