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CN 34-1304/R ISSN 1674-3679

2019 Vol. 23, No. 5

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Literature Review
Research progress in infodemiology study
PAN Hai-feng, ZHAO Chan-na, YE Dong-qing
2019, 23(5): 497-500. doi: 10.16462/j.cnki.zhjbkz.2019.05.001
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Abstract:
Web technologies, such as search engines and social media, have provided an opportunity for the management of user generated data in real time. Through the analysis of these web-based data, people can understand the health issues of concern, which can be used for the prediction of the epidemic of infectious diseases and the monitoring of chronic non-communicable diseases. The emergence of Infodemiology, also known as Information Epidemiology, aims to study the occurrence, distribution and influencing factors of health information from electronic medium, so as to raise awareness of disease and health problems among people, and provide the basis for the formulation of disease prevention and control strategies. This review summarizes the research progress in Infodemiology.
Original Articles
Joinpoint regression analysis of road traffic injuries tendency in China from 1997 to 2016
YE Wan-bao, YAN Shu-zhen, LI Li-ping
2019, 23(5): 501-505. doi: 10.16462/j.cnki.zhjbkz.2019.05.002
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  Objective  To analyze the tendency of road traffic injuries and explore its main influencing factors in China from 1997 to 2016, so as to provide references for decision-making of prevention and control.  Methods  Data was collected from national data website. Annual percent change (APC) and average annual percent change (AAPC) were calculated and trend tests were performed by Joinpoint Regression Program 4.6.0.0.  Results  The overall trend of the indexes was basically the same, reaching the highest record in 2002. The following downward tendency was different and tended to level off after 2009. However, the forecast showed that the fatality of road traffic accidents would increase slightly in recent years. For different road traffic modes, only the average annual percent change of motor vehicle injuries statistically descended (AAPC=-1.83, Z=-2.23, P=0.026). The average annual decreases of non-motor vehicle deaths were statistically significant (AAPC=-1.98, Z=-2.47, P=0.014), and the number of injured showed a notable upward trend instead (AAPC=3.95, Z=5.16, P < 0.001). The indexes of walking and riding were declined markedly (AAPC ≥ 7.90, P < 0.001).  Conclusions  The status of walking and riding had been improved significantly, but motor vehicles injuries were still the main traffic mode causing road traffic injuries. The safety situation of non-motor vehicles was increasingly serious. Adopting legal compulsory measures and other intervention to routine systematic management was quite necessary.
Analysis of the mortality trend of female reproductive system cancer in China from 2004 to 2016
WEI Chang-hui, ZHU Ji-cun, NIU Yuan-na, WANG Lu, HE Jun-jian, MA Jing, SUN Chang-qing
2019, 23(5): 506-511. doi: 10.16462/j.cnki.zhjbkz.2019.05.003
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  Objective  To describe and analyze the level and variation trend of mortality of female genital malignancies in China from 2004 to 2016, so as to provide scientific evidence for the formulation and implementation of cancer prevention and control measures.  Methods  The mortality data of cervical cancer, corpus cancer and ovarian cancer were selected from the mortality monitoring data of the national disease monitoring system, the crude mortality and standardized mortality rates were calculated respectively, the annual change trend was analyzed by Joinpoint software.  Results  From 2004 to 2016, the mortality rate of cervical cancer in Chinese women increased significantly. The mortality trend obviously accelerated after 2011(annual percent change, APC=13.7%), and the mortality rate in rural areas was higher than that in urban areas. The mortality rate of corpus cancer was relatively stable, and showed a downward trend after 2013(APC=-23.5%). Ovarian cancer mortality rate slightly increased, but the death trend was not statistically significant.  Conclusions  From 2004 to 2016, the mortality of corpus cancer in Chinese women had improved, the mortality of cervical cancer was still relatively serious, and there were differences between urban and rural areas.
Mortality analysis among HIV/AIDS cases in Guizhou Province from 1995 to 2017
CAO Wen-jie, YUAN Zhi, ZHENG Min, WEI Wei, LU Jun-duan, YAO Yong-ming, HE Na
2019, 23(5): 512-516, 521. doi: 10.16462/j.cnki.zhjbkz.2019.05.004
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  Objective  To investigate the distribution of death among human immunodeficiency virus/acquired immuno deficiency syndrome(HIV/AIDS) cases in Guizhou Province from 1995 to 2017.  Methods  The HIV/AIDS death cases from 1995 to 2017 were downloaded from "Chinese National Comprehensive HIV/AIDS Prevention and care Information system" in Guizhou Province and were analyzed.  Results  From 1995 to 2017, Guizhou Province reported a total of 43 794 HIV/AIDS cases and 11 527 deaths according to current address. After excluding missing persons, the HIV/AIDS mortality rate of the province was 29.8%. The proportion of reported HIV/AIDS cases died in the same year (χ1995-20122=139.5, P < 0.001;χ2012-20152=28.2, P < 0.001) and the proportion of HIV/AIDS cases (χ1995-20122=109.1, P < 0.001;χ2012-20142=57.2, P < 0.001) who survived at the beginning but died later in the year all showed a trend being low-high-low. In the analysis of the detection history of death cases, the detection proportion of cluster of differentiation 4(CD4) T-cell and the proportion of antiviral treatment had been increasing year by year. The analysis of the cause of death found that the proportion of death caused by AIDS increased firstly and then declined, and the proportion of death due to excessive drug abuse showed a trend of declining year by year.  Conclusions  The mortality rate of HIV/AIDS in Guizhou Province was still high, and decreased rather slow. Expanding the coverage of HIV monitoring and screening is one of the key tasks of AIDS prevention and control. CD4+T-cell testing and free antiviral treatment should be strengthened to reduce the mortality rate of HIV/AIDS in Guizhou Province in the future.
The relationship between inflammatory factors and the risk of breast cancer in Kailuan cohort
WANG Gang, LI Ni, FENG Xiao-shuang, LV Zhang-yan, WEI Luo-pei, LI Xin, CHEN Yu-heng, GUO Lan-wei, CHEN Hong-da, YIN Jian, CUI Hong, REN Jian-song, WU Shou-ling, SHI Ju-fang, DAI Min, HE Jie
2019, 23(5): 517-521. doi: 10.16462/j.cnki.zhjbkz.2019.05.005
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  Objective  To investigate whether elevated baseline levels of high sensitivity C-Reactive Protein (hsCRP) and neutrophil (NE) are associated with an increased risk of breast cancer in Kailuan female cohort.  Methods  Females from Kailuan cohort (2006-2007) were included in this study. Information on check-up, hsCRP and NE were collected at baseline for all subjects. Multivariable Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (95%CI) of association between baseline hsCRP and NE values and breast cancer risk.  Results  By December 31, 2015, a total of 18 866 participants were enrolled in this study. During the follow-up, 183 new cases of breast cancer were observed. All participants were divided into three groups according to the level of hsCRP (< 1 mg/L, 1-3 mg/L and >3 mg/L). The cumulative incidence of breast cancer were 829/105, 1 211/105 and 1 495/105 in these 3 groups, respectively (χ2=12.08, P=0.002). Compared with participants with lower hsCRP levels (< 1 mg/L), individuals with the highest hsCRP (>3 mg/L) levels had significantly increased risk of breast cancer (HR=1.71, 95%CI: 1.18-2.47, P=0.005), howerver, we didn't find the statistically significant association between NE level (< 3.70×109/Lvs. ≥ 3.70×109/L) and the risk of brease cancer (P>0.05).  Conclusions  Elevated levels of hsCRP at baseline might increase the risk of breast cancer in females.
Cohort study on thin, overweight and obesity of preschool children among 7 cities in China
WANG Fu-man, YAO Yi, YANG Qi
2019, 23(5): 522-526. doi: 10.16462/j.cnki.zhjbkz.2019.05.006
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  Objective  To understand the development trend of thin, overweight and obesity of preschool children among 7 cities in China, and in order to provide basis for physical development intervention of preschool children.  Methods  Cluster sampling method was used and preschool children of kindergartens in 7 cities were selected, the children's height and weight were measured. All of the 3 494 children who had participated in baseline and 4 follow-up were enrolled in the analysis.  Results  Among the children, the detection rate of thin, normal, overweight and obese was 2.12%, 79.14%, 10.88% and 7.87% respectively. From the first follow-up to the fourth follow-up, the detection rate of thin, overweight and obese among the children were all increasing gradually, and the increase rate of average 6 month was 12.91%, 3.76% and 10.34% respectively. Boys had higher detection rate in overweight and obesity, and the difference values were increasing along with the children developed. In the four follow-ups, 30% of the children who was thin in baseline were also thin, the children who were normal physical in baseline developed into overweight and obesity were increasing gradually, the children who were overweight in baseline developed into obesity were increasing gradually, and more than 70% of the children who were obesity in baseline were also obesity.  Conclusions  Preschool children had high detection rate of overweight and obesity in the survey areas, the detection rate and the difference values of the detection rate between the boys and girls were increasing along with the children developed, the thin status of the children also occurred in these survey areas. Parents and medical workers should pay attention to the children's physique development.
Analysis of the prevalence and influential factors for overweight and obesity of ninth grade students in China
HU Yi-song, YAO Ya-nan, SONG Yue-ping, WANG Wei-dong
2019, 23(5): 527-531. doi: 10.16462/j.cnki.zhjbkz.2019.05.007
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  Objective  To investigate the prevalence of overweight and obesity in Chinese ninth grade students and to analyze the influential factors that contribute to this situation.  Methods  A total of 5 967 students were selected from the 2016 China Education Panel Survey. Chi-square test was used to examine the differences in the prevalence of overweight and obesity among different groups and Logistic regression models were used to analyze the factors affecting obesity in boys and girls.  Results  The prevalence of overweight and obesity was 15.23%, 18.55% and 11.84% in total, male and female ninth grade students respectively. The multiple Logistic regression analysis indicated that the risk factors between boys and girls were significantly different. The main factors affecting boys obesity rate were one-child, boarding, both parents obesity, taking health education courses, having indoor stadium and screen time. Meanwhile, for girls the factors were boarding, both parents obesity and sports time.  Conclusions  Schools should arrange the schedule of boarding students and offer health education courses based on the characteristics of boys and girls. Meanwhile schools should unite parents to control adolescents' screen time and nutrition balance, which is benefit for preventing adolescents overweight and obesity.
Clinicopathological features of LINE-1 gene methylation with esophageal cancer in a high incidence area in China
CUI Guo-yan, YANG Jian-zhou, CHEN Yun-xia, HU Wen-qing, WANG Jin-sheng
2019, 23(5): 532-535. doi: 10.16462/j.cnki.zhjbkz.2019.05.008
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  Objective  To study the function of long interspersed nucleotide element-1 (LINE-1) promoter region methylation in the development of esophageal cancer.  Methods  Pyrosequencing was applied to detect methylation levels of the promoter region of LINE-1 in 96 cases of esophageal cancer tissuses, pericancerous tissue and tissues distant from esophageal cancer. Statistical methods were performed to correlate the level of LINE-1 methylation with clinical features and living habits of the patients.  Results  The methylation level of LINE-1 was not significantly different among the esophageal cancer tissuses, pericancerous tissue and tissues distant from esophageal cancer (all P>0.05). Among 96 cancer tissuses, no association was found between methylation status of LINE-1 promoter region and age, drinking, family history, histopathological types, tumor locaton and tumor stage (all P>0.05). Metylation status of LINE-1promoter region was associated with gender, smoking history and tumor differentiation (all P < 0.05).  Conclusion  The methylation of LINE-1 is frequently happened to esophageal cancer. Promoter region hypermethylation of LINE-1 is often occurred to poor differentiated esophageal cancer and advanced TNM stage. The methylation of LINE-1 may play an important role in the diagnosis and prognosis monitoring of esophageal cancer.
Study on genotype-associated HPV infection in cervical lesions
WANG Lan-fang, HU Shuang-jie, GE Xiao-wei, WANG Chao-hong, SUN Yu-xiu, SHEN Ji-long
2019, 23(5): 536-539, 544. doi: 10.16462/j.cnki.zhjbkz.2019.05.009
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  Objective  To explore the association of genotypes of human papillomavirus (HPV) with cervicitis, cervical intraepithelial neoplasia (CIN) and carcinoma in situ of cervix.  Methods  A total of 464 patients with cervical biology admitted to Hefei women and child health care hospital from October, 2014 to October, 2015 were selected. Among them, there were 242 cases of cervicitis, 222 cases of CIN (76 of group Ⅰ, 71 of group Ⅱ, and 66 of group Ⅲ), and 9 cases of cervical cancer. Hybrid chip technology was used to detect cervical secretions of patients, and 21 kinds of HPV DNA were typed according to histopathological biopsy.  Results  The HPV infection was found in 464 patients with cervical lesions. Among them, 354 cases (76.3%) had HPV infection with 232 cases (65.5%) of single HPV infection and 122 cases (34.5%) of multiple infections included. The rate of HPV infection was 64.9% in the group of cervicitis, while the rate was 86.8% in group Ⅰ of CIN and in group Ⅱ of CIN, the rate of HPV infection was 87.3%. Surprisingly, the HPV infection rate in group Ⅲ of CIN was as high as 90.9%. The infection rate of HPV in the patients with CIN was significantly higher than those with cervicitis (P < 0.001). All patients with cervical cancer were infected with HPV.  Conclusions  Persistent infection of high-risk HPV subtypes increases the hazard of cervical tumor and CIN. Therefore, genotyping of HPV DNA is helpful for screening and prediction of cervical cancer.
Analysis of transmission rate of hand-foot-mouth disease in different provinces in China
WANG Yan-fen, WANG Xu-feng, ZHAO Ji-jun
2019, 23(5): 540-544. doi: 10.16462/j.cnki.zhjbkz.2019.05.010
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  Objective  To understand the periodicity of the incidence of hand, foot and mouth disease (HFMD) in representative provinces from different climatic zones in China, and to analyze the seasonality and the factors influencing the HFMD transmission rate, to provide a scientific reference for the prevention and treatment of HFMD.  Methods  Five climate-representative provinces including Hainan, Hunan, Shandong, Qinghai and Inner Mongolia were selected as research objects. Wavelet analysis was used to analyze the cyclic pattern of HFMD incidence. Time series susceptible infected recovered (TSIR) model was established to examine the HFMD transmission rate of the five provinces and of the entire country. The parameters in the TSIR model were estimated by markov chain monte carlo (MCMC). Linear regression model was used to analyze the effects of climate factors, school terms and the Spring Festival travel rush on the transmission rate of HFMD.  Results  (1) HFMD incidence in the provinces and the entire country exhibited annual or semi-annual cycles and the transmission rates in all provinces showed obvious seasonality with similar patterns. February to May was the peak period of HFMD transmission rate. (2) The transmission rate of HFMD was affected by the climate or the contact rate, depending on which factor was dominant.  Conclusions  The transmission rate of HFMD had obvious seasonality, which had increased significantly in February, and it was necessary to strengthen its prevention and control during the Spring Festival.
The impact of air pollution on children's respiratory diseases in Tianjin: a case-over study
ZHANG Jing-wei, FENG Li-hong, HOU Chang-chun, XIAO Fu-chang, ZHAO Yan, YU Hao, WANG Yu-wen, GU Qing
2019, 23(5): 545-549. doi: 10.16462/j.cnki.zhjbkz.2019.05.011
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  Objective  To explore the effect of air pollution on children's respiratory diseases in Tianjin, so as to provide reference for the prevention and control of diseases.  Methods  Conditional Logistic regression model of single pollutant and multiple pollutants was used to estimate the relationships between air pollutants concentration and children's respiratory system diseases.  Results  Conditional Logistic regression model of single pollutant conditions showed that the excess risk (ER) effects and 95% CI of NO2, PM2.5, PM10 and CO appeared were 2.823%(2.581-3.065), 0.476%(0.382-0.569), 0.437%(0.368-0.506), 22.263%(15.449-29.478), respectively. Logistic regression analysis of multiple pollutants conditions showed that NO2 exposure had the greatest effect on children's respiratory diseases in cold season, and the excess risk (ER) was 7.395%(6.595-8.202).  Conclusion  The elevated daily average concentration of NO2, PM10, PM2.5, and CO can increase the risk of children's respiratory diseases.
Study on the etiology of rash and fever illness in Pudong New Area of Shanghai from 2010 to 2017
FEI Yi, DENG Peng-fei, YANG Tian, YANG Lai-bao, WANG Wei-ping, WANG Qi-zhang, ZHOU Cui-ping, HAO Li-peng
2019, 23(5): 550-554. doi: 10.16462/j.cnki.zhjbkz.2019.05.012
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  Objective  To investigate the pathogens spectrum and epidemiological characteristics of rash and fever illness (RFIs) from January 2010 to December 2017 in Pudong New Area, in order to provide scientific evidence for the prevention and control ofRFIs.  Methods  Enzyme-linked immunosorbent assay and real-time fluorescence quantitative polymerase chain reaction were used to detect the pathogens of enterovirus, measles virus, rubella virus and others from 2 831 clinical samples, and statistical analysis was performed.  Results  Pathogens were found in 1 633 samples in total, accounting for 68.59%. The top 4 viruses in the pathogen spectrum were enterovirus (52.54%), measles virus (28.54%), rubella virus (13.04%), and varicella-zoster virus (3.37%). There was significnat difference in the detection rate of rubella pathogens among patients of different genders(P=0.026). In the pathogen spectrum of infections of different age groups, the detection rate of enteroviruses at the age of 3-6 years was higher than that of other age groups. The detection rate of varicella-zoster virus at the age of 6-18 years old was higher than that of other age groups. The detection rate of virus including measles virus, rubella virus, dengue virus and small DNA virus in age of 18 and older was higher than that of other age groups. There was significant difference in the detection rate of pathogens in different age groups (all P < 0.05).The incidence of RFIs was the highest in spring (41.52%) and the lowest in winter (15.00%). There was a statistical difference in the detection rate of enterovirus, measles, rubella and dengue virus in different seasons (P < 0.05).  Conclusions  Enteroviruses and measles viruses are the main pathogens leading to RFIs in Pudong New Area, and the activity level of RFIs pathogens should be monitored for a long time.
Identification and risk monitoring of potential risk areas of schistosomiasis in Dongting Lake area
XU Jun, HE Qing-yun, HU Ben-jiao
2019, 23(5): 555-560. doi: 10.16462/j.cnki.zhjbkz.2019.05.013
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  Objective  To identify and monitor potential risk areas of schistosomiasis in Dongting Lake area.  Methods  With remote sensing (RS)and geographic information system(GIS) technology, potential risk areas of schistosomiasis in Dongting Lake area were extracted by using spectral characteristics and environmental factors. Based on epidemiological data and land use data, the regional epidemic index and environmental susceptibility index were fused with potential epidemic risk areas in the grid system of Dongting Lake area to form the epidemic risk surveillance map of schistosomiasis in Dongting Lake area from 2006 to 2016.  Results  From 2006 to 2016, the high risk areas of schistosomiasis epidemic in Dongting Lake area were concentrated in the central and Northern lakeside areas of Changde City (Annual average epidemic index R=0.330 5, Regional average susceptibility index Y=2.458 2), the sensitive land types were Lake area (Sensitivity coefficient β=1.236 6), the surrounding area of Datong Lake in Nanxian and Northern Yuanjiang City (R=0.426 0, Y=0.836 8), paddy field area (β=0.202 1) and other construction land (β=0.308 0). The extremely high risk areas were concentrated in some lake-facing areas in Jinshi (R=0.449 1, Y=3.917 0) and the sensitive land type is woodland(β=1.234 5). The risk of river basin from high to low was respectively the Lishui River, the Yuanjiang River, the Zijiang River and the Xiangjiang River.  Conclusions  The high-risk and extremely high-risk areas should be the focus of future epidemic control. The snail control and environmental renovation of epidemic-sensitive areas such as sparse woodland, grassland with high coverage, reservoir pits and ponds should be done well in Dongting Lake area.
Investigation of free ticks carrying CRT and compound infection with SFTSV in Yanbian area of Jilin Province
LI Ji-xu, ZHAO Xin, JIN Guang-xing, JIN Guang-jun, MA Gui-jun, JIN Jing-nan, QUAN Sheng-huan, Shin-Hyeong Cho
2019, 23(5): 561-566, 572. doi: 10.16462/j.cnki.zhjbkz.2019.05.014
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  Objective  To understand the condition of tick carrying CRT(Candidatus rickettsia tarasevichiae) and compound infection with SFTSV(Sever fever thrombocytopenia syndrome virus) in Yanbian area of Jilin province.  Methods  Free ticks were collected from 6 counties including Yanji, Wangqing, Hunchun, Dunhua, Antu and Helong in the Korean Autonomous Prefecture of Jilin Province(Yanbian Prefecture) by using the flagging, and they were classified morphologically. The CRT and SFTSV in ticks were detected by Nest PCR(Nested polymerase chain reaction) and Real Time RT-PCR(Real-time Quantitative polymerase chain reaction) methods. Target DNA sequencing was performed for CRT positive products, and the homology of gene sequence and phylogenetic relationship were analyzed.  Results  A total of 1032 ticks were collected in this study, including ixodes persulcatus (35.56%) and dermacenter silvarum (20.64%). haemaphysalis japonica (20.45%), haemaphysalis longicornis (10.47%), haemaphysalis concinna (8.33%), others(4.55%). The CRT was detected from the Ixodes persulcatus, Haemaphysalis longicornis, Haemaphysalis japonica Dermacentor silvarum. The MIR(Minimum infection rate per 100 ticks) of CRT was 10.47%.The SFTSV was detected from the Haemaphysalis-concinna, Haemaphysalis-japonica, Ixodes-persulcatus, Haemaphysalis-longicornis, Dermacentor-silvarum. The MIR of SFTSV was 2.52%. Three species of ticks, including Ixodes persulcatus(2.45%), Haemaphysalis japonica(1.42%), and dermacentor silvarum(0.47%), had CRT and SFTSV compound infections, and the MIR of two pathogens compound infections was 1.26%. In this study, the gene sequence of CRT positive PCR products ompA and 17kDa with nucleotide sequence of Xinyang plant of HeNan XinYang strain (KX365196.1), had homology of 100%. Phylogenetic analysis showed that CRT ompA and the HeNan XinYang strain (KX365196.1) gene sequences formed a cluster in Yanbian, while the 17 kDa gene formed an independent branch.  Conclusions  For the first time, CRT was detected from free ticks in Yanbian area of Jilin Province, and it was found that Ixodes persulcatus may be the main medium of transmission of the pathogen. At the same time, it was found that CRT and SFTSV have compound infection in ticks of Yanbian area. Therefore, it can be clearly identified that Yanbian area in Jilin Province is the natural source of CRT, and there are two pathogenic compound infections in the local ticks.
Study on the source of human infection with H9N2 influenza virus from live poultry markets in Changsha
ZHUANG Ru-sheng, HUANG Zheng, LIU Xiao-lei, YAO Dong, CHEN Jing-fang, YUAN Jie, OU Xin-hua, SUN Bian-cheng Changsha
2019, 23(5): 567-572. doi: 10.16462/j.cnki.zhjbkz.2019.05.015
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  Objective  To explore the source of human infection H9N2 avian influenza virus (AIV).  Methods  Environmental AIV nucleic acid monitoring was conducted for live poultry markets in Changsha city from 2014 to 2015, and data of human infection H9N2 subtype AIV cases worldwide were collected. Phylogenetic trees of hemagglutinin(HA), neuraminidase(NA)and non-structural protein(NS)genes from human infection H9N2 subtype AIV, the live poultry markets environmental H9N2 subtype AIV and partial avian H9N2 subtype AIV were constructed using the MEGA 6.06 software, respectively.  Results  In 2014-2015, H9 subtype AIV had the highest nucleic acid positive rate (44.76%) in the live poultry markets environment of Changsha city, and the pollution was serious. A total of 27 cases of human infection with H9N2 subtype AIV had been reported worldwide, and most of these patients recovered after treatments.Epidemiological survey showed that 59.26% (16/27) of cases had a clear history of exposure to poultry or live poultry markets. The phylogenetic trees of HA, NA and NS genes showed that the human infection H9N2 subtype AIV isolates isolated from Hunan and Guangdong were closely related to the H9N2 subtype AIV isolated from the live poultry markets environment in Hunan and Guangdong provinces from 2013 to 2016. The nucleotide similarity was as high as 97%-99%.  Conclusion  Live poultry market is one of the sources of human infection with H9N2 influenza virus.
Association between family support and self-management behavior among patients with type 2 diabetes mellitus in China
YAO Jing-jing, WANG Hai-peng, HUANG Xiao-min, LI Qi, SUN Qiang
2019, 23(5): 573-577. doi: 10.16462/j.cnki.zhjbkz.2019.05.016
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  Objective  To evaluate the relationship between family support and self-management behaviors among patients with type 2 diabetes mellitus (T2DM) in Shandong province, China.  Methods  A multi-stage stratified random sampling was used and 2 520 patients with T2DM were selected from urban and rural and communities in Shandong province. The correlation between family support and self-management behavior were analyzed using logistic regression analysis.  Results  A total of 1 866 patients with T2DM prescribed with drug were included for analysis, comprising 938 patients from urban areas and 928 patients from rural area.The mean C-DFBC scores were (16.3±5.3).The Logistic regress analysis revealed that the family support was associated with the dietary control (OR=1.03, 95%CI: 1.01-1.05, P < 0.001), physical excise (OR=1.07, 95%CI: 1.06-1.09, P < 0.001) and blood monitoring(OR=1.03, 95%CI: 1.01-1.04, P < 0.05))but not with medication adherence (P=0.68).  Conclusion  The family support can improve the self-management indietary control, physical excise and blood monitoring.
Association between physical activity and glycemic control among type 2 diabetic patients with a good compliance level
JIN Ling-ling, MA Yu-yang, YE Qing, QIN Zhen-zhen, DONG Yi-ping, WANG Zhi-yong, XU Fei
2019, 23(5): 578-581, 587. doi: 10.16462/j.cnki.zhjbkz.2019.05.017
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  Objective  To examine the relationship between physical activity and glycemic control among type 2 diabetic patients with a good compliance level in China.  Methods  A total of 1 272 patients diagnosed with type 2 diabetes with a good compliance level were recruited from five community health centers in Nanjing Chemical Industry Administrative Zone from 2014 to 2016. Logistic regression models were used to examine the relationship between physical activity and glycemic control.  Results  In this cross-sectional study, 1 272 type 2 diabetic patients (596 men and 676 women) were recruited. The participants' mean (standard deviation, SD) age was (64.63±9.04) years old. Male participants who achieved sufficient physical activity had the odds ratio (OR) of 2.11 (95%CI: 1.17-3.18, P=0.013) for a tight glycemic control compared to their counterparts who had sufficient physical activity, after controling for the potential confounders, no significant association between physical activity and glycemic control status existed in women.  Conclusions  Physical activity is positively associated with glycemic control among male type 2 diabetic patients who had a good compliance level in Nanjing. Specific physical activity interventions should be implemented to type 2 diabetic patients.
Evaluation of self-management model among HIV-infected men who have sex with men
ZHANG Peng, GAO Jing, ZHANG Yong, YIN Hua-qing
2019, 23(5): 582-587. doi: 10.16462/j.cnki.zhjbkz.2019.05.018
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  Objective  To evaluate practical effects of self-management model among HIV-infected men who have sex with men (MSM), and to provide evidence for the development of HIV/AIDS comprehensive management strategies for this population.  Methods  Respondent-driven sampling (RDS) sampling was used to recruit subjects with the help of the non-governmental organization. Selected MSM were randomly divided into intervention group and control group. The intervention group implemented a self-management model and established a self-management group to conduct health education courses and peer-education based on chronic disease self-management (CDSM) theory. The control group was organized by the center for diseases control and prevention (CDC) to carry out medical follow-up and other related activities. After one year, the evaluation survey was carried out, and the data was statistically analyzed using SPSS software.  Results  The CDSM team had different degrees of improvement in the scores of general health, role function, quality life, health transition and mental health sumonary scores. The proportion of self-management groups with anxiety symptoms decreased from 38.6% to 22.6%, the proportion of condom use increased from 43.3% to 47.3%, and the proportion of adherence to medication increased from 68.2% to 78.8%.  Conclusion  The self-management model can effectively break through the bottleneck of HIV/AIDS management for MSM and can improve quality of life of them.
The analysis of influence factors of transfer patients who had increased methadone dosage after missed doses in transfer services utilization
GONG Cheng, LIU Yin, LU Qian, LING Li
2019, 23(5): 588-591, 596. doi: 10.16462/j.cnki.zhjbkz.2019.05.019
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Abstract:
  Objective  To investigate the effect of transfer service utilization in increased methadone dosage after missed dose of participants in methadone maintenance treatment (MMT).  Methods  We selected 9 MMT clinics in Guangdong Province and collected the data from the web-based system of MMT management. All the participants who had utilized the transfer service from January 2008 to December 2016 were included in our study. We explored multilevel Logistic regression analysis to explore the associated factors of changing methadone dosage after missed dosage of transfer participants.  Results  A total of 197 patients were included in the study for a total of 840 person-time transfer services. Of these, 119 (14.26%) had increased-dose after transfer. The patients whose (1) dose of methadone was less than 60 ml/d during the transfer period (OR=2.88, 95%CI: 1.85-4.50, P < 0.001), (2)had longer transfer period (OR=1.02, 95%CI: 1.01-1.03, P < 0.001), and (3) fewer cumulative transfertimes (OR=0.97, 95%CI: 0.95-0.99, P=0.004) were more likely to increase the methadone dosage after the missed.  Conclusions  The characteristic of transfer service utilization could result in the increasing methadone dosage after missed doses in transfer participants. This finding suggest MMT clinic should strengthen the supervision of transfer patients, especially those who failed to return on time after transfer. The doctors in MMT should carefully consider the dose adjustment requirements from patients and improve the efficacy of methadone maintenance treatment.
A structural equation model of HIV-related stigma, stress and depression among people living with HIV and depression in Guangzhou
QIAO Jia-ying, XU Zhi-meng, ZHANG Han-xi, ZENG Cheng-bo, CAI Wei-ping, GUO Yan
2019, 23(5): 592-596. doi: 10.16462/j.cnki.zhjbkz.2019.05.020
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Abstract:
  Objective  To examine the mechanism among HIV-related stigma, perceived stress, and severity of depression among people living with HIV and depression (PLWHD).  Methods  A total of 300 PLWHD were recruited from a large HIV treatment hospital in Guangzhou, China from August to October in 2017. Participants completed measures assessing HIV-related stigma, perceived stress, depression, and socio-demographic characteristics at baseline. Structural equation modeling (SEM) was performed to examine the direct and indirect associations between stigma and depression.  Results  Among the 300 participants (mean age=28.21 years, 92.3% male), the median score of CES-D was 23.0 (19.0, 28.0).The global model showed good model fit (Chi-square value=25.97, CFI=0.98, RMSEA=0.04, SRMR=0.04). Structural equation model revealed that stigma had significantly direct (pathway coefficient=0.31, P < 0.001) and indirect (pathway coefficient=0.25, P < 0.001) effects on depression.  Conclusions  Stress plays an important role in the mechanism between stigma and depression, thus future interventions need to pay more attention on stress.
Study on obsessive-compulsive symptoms and influencing factors in college students with left-behind experience
LIU Wei, LI Juan, YU Bang-lin, QIN Ruo-fang, CAO Xiu-jing
2019, 23(5): 597-601. doi: 10.16462/j.cnki.zhjbkz.2019.05.021
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Abstract:
  Objective  To understand the obsessive-compulsive symptoms (OCS) and relative influencing factors among college students with left-behind experience.  Methods  College students with left-behind experience were selected from three universities in Anhui Province. The Chinese Obsessive-Compulsive Inventory-Revised (OCI-R), Rosenberg Self-Esteem Scale (RSES), Self-Rating Depression Scale (SDS) and self-edited basic situation questionnaires were used to measure the OCS, self-esteem, depression and left-behind experience. Multivariate logistic regressions model was applied to examine the influential factors of OCS.  Results  A total of 2 291 college students with left-behind experience were investigated. The detection rate for OCS in college students with left-behind experience were 26.5%. Regarding the OCS in college students with left-behind experience, significant differences were found in the following aspects: frequency of meeting with parents, parenting style, conflicts with caregivers, smoking and drinking (all P < 0.05). Logistic regression analysis showed that caregiver adopts strict parenting style (OR=1.300, 95%CI: 1.025-1.649, P=0.030), indulgent parenting style (OR=1.372, 95%CI: 1.017-1.852, P=0.038), smoking (OR=1.982, 95%CI: 1.305-3.011, P=0.001), depressive symptoms (OR=2.423, 95%CI: 1.954-3.005, P < 0.001), medium self-esteem (OR=0.604, 95%CI: 0.481-0.759, P < 0.001) and high self-esteem (OR=0.488, 95%CI: 0.362-0.659, P < 0.001) were influencing factors of OCS.  Conclusions  The prevalence rate of OCS among college students with left-behind experience is high. Some interventions should be taken to reduce the OCS among college students with left-behind experience.
Associations between normal serum levels of uric acid and knee symptoms, joint structures in patients with knee osteoarthritis
BIAN Fu-qin, XU Jian-hua, WANG Kang, RUAN Guang-feng, REN Jia-le, CHANG Bing-ru, DING Chang-hai
2019, 23(5): 602-606, 612. doi: 10.16462/j.cnki.zhjbkz.2019.05.022
Abstract(289) HTML (149) PDF(13)
Abstract:
  Objective  To investigate the associations between normal serum uric acid (UA) levels and knee symptoms and structural changes in patients with knee osteoarthritis (OA).  Methods  A total of 205 patients with knee OA were enrolled. According to the inclusion and exclusion criteria, 122 patients with OA were included in the study. The general condition of patients were investingated. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was used to assess severity of the knee joint symptoms. The Kellgren-Lawrence (K-L) grading system was used to assess radiological severity of the knee joint. Osirix software was used to assess changes of knee structure in magnetic resonance imaging (MRI). Peroxidase method was used to measure the serum levels of uric acid. Patients with normal range of uric acid were included in the study.  Results  The patients with lower levels of UA (split at the median level, 263 μmol/L) had a higher proportion of women, lower height, weight and lower proportions of K-L grade ≥ 2. After adjustment for sex, age and body mass index, serum UA was negatively associated with total WOMAC scores (β=-16.15, P=0.018), WOMAC pain (β=-3.15, P=0.037), and WOMAC stiffness (β=-1.65, P=0.025). However, there were no significant associations between serum UA levels and knee joint structure changes.  Conclusions  In OA patients with normal serum UA, serum UA is negatively associated with the severity of joint symptoms, suggesting that UA within normal range may play a protective role in OA symptoms.
Persistence of rabies antibody 3 years after postexposure prophylaxis with 2-1-1 regimen of Vero-cell rabies vaccine for human use and antibody response to two booster doses
HUANG Zhu-hang, SU Jia-li, ZHENG Hui-zhen, ZHANG Yi-bin, TANG Yan, XIA Yan-hui, CHEN Yi-jian, ZHANG Lei, FAN Ren-feng, ZHANG Ji-kai
2019, 23(5): 607-612. doi: 10.16462/j.cnki.zhjbkz.2019.05.023
Abstract(782) HTML (406) PDF(46)
Abstract:
  Objective  To evaluate the antibody persistence following rabies postexposure prophylaxis (PEP) with 2-1-1 regimen and antibody response to two booster doses.  Methods  A total of 314 healthy volunteers at year 1, year 2, year 3 who had received a complete rabies PEP using 2-1-1 regimen were recruited. Two booster doses of rabies vaccine were inoculated, and blood samples were obtained before and 14 days after two booster doses. Human rabies virus IgG antibody was evaluated by ELISA, and the antibody levels and antibody positive rates were analyzed.  Results  The antibody GMC of 303 people at year 1, year 2, year 3 after a complete immunization was 1.33 IU/mL, 1.04 IU/mL and 0.72 IU/mL, with an antibody positive rate of 77.78%, 66.67% and 55.56%, respectively. Among 282 people who received 2 doses for booster immunization, the antibody GMC at day 14 of 1 year, 2 year and 3 year immunization group was 16.83 IU/mL, 19.37 IU/mL and 21.05 IU/mL respectively, which was higher than that before booster immunization (t=16.54, P < 0.001; t=13.85, P < 0.001; t=16.02, P < 0.001). The antibody positive rate was 100.00%, 99.00% and 100.00%, respectively.  Conclusions  The immune persistence of rabies antibody after PEP with antirabies vaccine using the 2-1-1 regimen is good so as to the immune response after 2 doses of booster immunization in 3 years is effective.
Short Reports
The trends of maternal mortality in China and principal component analysis of health status
ZHU Li-ling, MENG Fan-jun, LI Jia-lin
2019, 23(5): 613-616. doi: 10.16462/j.cnki.zhjbkz.2019.05.024
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Abstract:
  Objective  To describe the trend of maternal mortality in China from 2005 to 2015, and analyze the maternal health status in various regions of China in 2015, so as to provide scientific basis for the rational allocation of health resources by relevant departments.  Methods  The dynamic series method was used to describe the trend of maternal mortality in China from 2005 to 2015. The principal component analysis method was used to evaluate the maternal health status in China in 2015.  Results  From 2005 to 2015, the maternal mortality in the whole country and urban and rural areas showed a downward trend. The average growth rate was respectively -0.0756, -0.0210, -0.0852. The majority of the coastal provinces and cities had a balanced development of maternal health care, and Jiangsu Province had two main component values ranked first (F1=218.3, F2=60.6).  Conclusion  China's maternal health care industry have achieved remarkable results. The development direction should be shifted from coastal to inland, laying a good foundation for the realization of the next goal in the future.
History of Public Health
Founder of analytical probability theory: Pierre Simon Laplace
BAO Yu-qing, WU jun, YE Dong-qing
2019, 23(5): 617-620. doi: 10.16462/j.cnki.zhjbkz.2019.05.025
Abstract(821) HTML (524) PDF(41)
Abstract:
Pierre Simon Laplace (1749-1827), known as "Newton of France", was the founder of analytical probability theory, invented Laplace's law and integrated celestial mechanics. He promoted the development of analytical probability theory, led classical probability theory to follow the world trend, and also laid a solid foundation for the emergence of modern probability theory. He actively extended the application of probability theory to the fields of decision-making theory and maritime insurance. Laplace's law was not only applied in the field of physics, but also in the field of medicine, especially in cardiovascular, urology, anorectal and other disciplines, which is crucial for the interpretation of clinical symptoms and the selection of treatment methods. Laplace also used calculus to explore classical mechanics, successfully explained Newton's legacy of multi-planetary interaction.

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