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CN 34-1304/R ISSN 1674-3679

2019 Vol. 23, No. 6

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Literature Review
Prospect of systematic review: strengths and limitations
ZHANG Xi-ru, MAO Chen
2019, 23(6): 621-624. doi: 10.16462/j.cnki.zhjbkz.2019.06.001
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As the core method of evidence-based medicine, systematic review comprehensively summarizes all the evidence of a particular problem. It enables clinicians, scientific researchers, and health policy makers to quickly obtain a great deal of comprehensive, accurate, and reliable information in a short time, and are crucial tools for them to keep up with rapidly evolving areas of medicine. Adequate systematic reviews integrate the evidence that is accumulating in a particular field to narrate the distance between research evidence and medical practice. However, in recent years, people are always questioning and criticizing systematic review. In this situation, we introduce the origin and concept of the system review briefly and elaborate the strengths and limitations of the system review in detail. Finally, on the basis of application and current situation of the systematic review, we describe the prospect of the systematic review. Even though the methodology of the systematic review has some limitations, it is still the most authoritative method for synthesizing all research evidence in a given field, because we have no better way. If the results of a systematic review of all studies are unreliable, there is no reason to say that the results of one or several of them are impartial or unbiased.
Original Articles
Investigation and association analysis of multimorbidity in middle-aged and elderly population in China
CHENG Yang-yang, CAO Zhi, HOU Jie, ZHANG Xin-yu, LI Shu, WANG Yao-gang
2019, 23(6): 625-629. doi: 10.16462/j.cnki.zhjbkz.2019.06.002
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  Objective  To characterize the multimorbidity patterns of chronic diseases in middle-aged and elderly people in China, and explore the correlation and intensity among chronic diseases by using association rules.  Methods  A total of 17 796 people over 45 years old from 9 provinces and cities in China were sampled and surveyed. The data were analyzed by Apriori algorithm in R3.4.3 software to investigate the multimorbidity of chronic diseases.  Results  Among total 17 796 respondents, the number of patients with at least one chronic disease was 12 245 (68.81%), and the number of patients with two or more chronic diseases was 7 321 (41.15%). Among the selected association rules, according to the ranking of support degree, the most common three chronic disease multimorbidities were dyslipidemia and heart disease, diabetes mellitus and dyslipidemia, asthma and chronic lung disease. The rule support was 6.77%, 5.27%, 4.28%, and the rule confidence was 34.38%, 43.14%, and 70.81%, respectively. Multiple results of association rules pointed to heart disease. After screening, the greatest association rules were found in the age group over 75 years old.  Conclusions  Heart disease exists in a variety of chronic disease multimorbidity patterns. Screening and prevention measures should be strengthened. Dyslipidemia is strongly associated with diabetes and hypertension, and male patients are more vulnerable to suffer from dyslipidemia. Chronic diseases intend to be more common and complicated along with age increase.
The prevalence of five common chronic diseases and multi-morbidity and its relationship with socioeconomic position among rural older adults in Yunnan Province
LI Xiao, CAI Le, WANG Xu-ming, CUI Wen-long, LV Si-qi, HE Jian-hui
2019, 23(6): 630-634. doi: 10.16462/j.cnki.zhjbkz.2019.06.003
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  Objective  To analyze the relationship between socioeconomic position and prevalence of hypertension, diabetes, coronary heart disease, stroke, chronic obstructive pulmonary diseases (COPD) and multi-morbidity among older adults in rural Yunnan Province.  Methods  A total of 4 833 older adults aged 60 years and over were selected by multi-stage stratified random sampling method in rural Yunnan Province. Information was acquired from questionnaire and health examination. Principal component analysis was used to construct the socioeconomic comprehensive score.  Results  The prevalence of hypertension, diabetes, stroke, coronary heart disease, COPD and multi-morbidity in target persons was 50.6%, 10.2%, 6.4%, 5.5%, 5.4% and 16.1% respectively. The prevalence of hypertension and diabetes was much higher in female compared with male (both P < 0.05), in contrast the prevalence of COPD was much higher in male than female(χ2=5.499, P=0.019)The prevalence of hypertension, stroke, coronary heart disease, COPD and multi-morbidity was increased with age(all P < 0.05);Minority ethnic were more likely to develop hypertension, coronary heart disease, COPD and multi-morbidity than Han ethnic(all P < 0.05). The results of multivariate logistic regression analysis showed that older adults with lower socioeconomic position had higher probability of suffering from hypertension, coronary heart disease, stroke, COPD and multi-morbidity (all P < 0.05).  Conclusions  There are significant socioeconomic differences between socioeconomic position and prevalence of five major chronic diseases and multi-morbidity among older adults in rural Yunnan province. Older adults with low socioeconomic position should be key population for future prevention and control of chronic diseases.
Exploration of anti-aging life behavior in middle-aged and elderly people based on PPSHAS scale
LI Xiang, TU Jia-xin, LIU Xing, LIU Bin, WEI Yu, ZOU Ting-ting, ZHOU Jian-ming, HUANG He-lang, TANG Li-ping
2019, 23(6): 635-639. doi: 10.16462/j.cnki.zhjbkz.2019.06.004
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  Objective  To study the aging-related lifestyle and behaviors associated with the middle-aged and elderly so as to propose anti-aging strategies.  Methods  The aging degree of the elderly was measured by PPSHAS scale, which was certified by the national society. At the same time, the anti-aging factors were studied by questionnaire and logistic model.  Results  There were 836 effective PPSHAS scales and anti-aging questionnaires, 471 of which were significantly younger or older. Mann-Whitney U test showed that there was no significant difference in satiety and smoking between the two groups (Psatiety=0.295, Psmoking=0.294). By incorporating meaningful factors into logistic model, seven related anti-aging factors, such as dressing, drinking frequency and tea drinking habits, were obtained.  Conclusions  Aging can be delayed by paying attention to dressing, limiting alcohol, getting enough sleep, strengthening exercise, maintaining a harmonious family atmosphere, and drinking tea regularly.
The prevalence and risk factors of diabetes and hypertension in Deqing rural community
CHANG Rui, DONG Xiao-lian, WANG Yu-zhuo, CHEN Yue, ZHANG Yi-ming, ZHU Jian-fu, CHEN Yun, JIANG Qing-wu, FU Chao-wei
2019, 23(6): 640-645, 655. doi: 10.16462/j.cnki.zhjbkz.2019.06.005
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  Objective  This study aimed to describe the prevalence of both type 2 diabetes (T2D) and hypertension, and to explore possible risk factors.  Methods  A Cross-sectional study was conducted in eight towns cluster-sampled randomly from Deqing County, Zhejiang Province. Totally. 29 306 subjects aged ≥ 18 years old were recruited into this survey. Information on general information, life styles, health status and family history of chronic diseases was collected. Physical examinations including height, weight, blood pressure, etc. were done. Fasting plasma glucose was also tested.  Results  The prevalence of only T2DM, only hypertension and both of them was 3.34%, 28.72%, and 2.01%, respectively. Such prevalence of both reached a peak at the age of 70-79 years old.Family history of diabetes mellitus(OR=4.94, 95% CI: 3.24-7.54, P < 0.001) and having a spouse(OR=2.17, 95% CI: 1.18-4.00, P=0.013) were possible risk factors of diabetes mellitus, body mass index(BMI) < 24 kg/m2(OR=0.48, 95% CI: 0.39-0.59, P < 0.001) was the possible protective factor of diabetes mellitus, BMI < 24 kg/m2(OR=0.60, 95% CI: 0.56-0.64, P < 0.001), completing compulsory education(OR=0.54, 95% CI: 0.49-0.59, P < 0.001) and exercise(OR=0.77, 95% CI: 0.69-0.86, P < 0.001) were protective factors of hypertension, drinking(OR=1.18, 95% CI: 1.08-1.29, P < 0.001) was the possible risk factor of hypertension. BMI < 24 kg/m2(OR=0.26, 95% CI: 0.21-0.31, P < 0.001), completing compulsory education(OR=0.50, 95% CI: 0.35-0.72, P < 0.001) and drinking tea(OR=0.80, 95% CI: 0.64-0.99, P=0.045) were protective factors of these two diseases. Farmers(OR=1.35, 95% CI: 1.04-1.76, P=0.024), family history of diabetes(OR=4.21, 95% CI: 2.71-6.57, P < 0.001) and family history of hypertension(OR=1.86, 95% CI: 1.31-2.64, P=0.001) were risk factors for the co occurrence of two diseases.  Conclusions  The prevalence of diabetes among adults in Deqing County was relatively lower than other places. The prevalence of hypertension was close to the level of other regions. Age, overweight, alcohol consumption, family history of diabetes and hypertension were the risk factors of diabetes and hypertension. Diabetes mellitus was a high-risk group of hypertension. Further means should be taken to strengthen the self-management and treatment of this group. Further intervention action should be taken to promote health and quality of life.
Association between fasting glucose and branchial-ankle pulse wave velocity among hypertensive population in rural areas of Eastern China
CAO Jing-jing, ZHANG Jing-ping, WANG Bin-yan, QIN Xian-hui, ZANG Tong-hua, XU Xi-ping
2019, 23(6): 646-649, 689. doi: 10.16462/j.cnki.zhjbkz.2019.06.006
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  Objective  To explore the relationship between fasting blood glucose and branchial-ankle pulse wave velocity (baPWV) levels among hypertensive population in rural areas of Eastern China.  Methods  A cross-sectional analysis were conducted among hypertensive population in Lianyungang and Anqing city from July to September 2013. Multivariable linear regression models were used to analyze the association of serum glucose and baPWV.  Results  A total of 3 894 hypertensive participants were included in the present study. The prevalence of normal fasting glucose (NFG), impaired fasting glucose (IFG) and diagnosed diabetes (DM) were 44.5%, 43.0%, and 12.5%, respectively. Each 1-mmol/L increase in fasting blood glucose levels was significantly associated with a 26.2 cm/s increase in baPWV levels (95% CI: 19.6-32.8, P < 0.001). Consistently, significantly higher baPWV levels were observed in participants with IFG (β=50.4 cm/s, 95% CI: 28.4-72.3, P < 0.001) and DM (β=113.4 cm/s, 95% CI: 80.2-146.5, P < 0.001) when compared to those with NFG. Furthermore, a stronger positive association between fasting blood glucose and baPWV was observed in participants with systolic blood pressure (SBP) ≥ 140 mmHg (β=34.3 cm/s, 95% CI: 24.5-44.2, P < 0.001; vs. < 140 mmHg; β=18.1 cm/s, 95% CI: 9.1-27.2, P < 0.001; Pinteraction=0.027).  Conclusion  There was a positive association between fasting blood glucose and baPWV levels among hypertensive population in rural areas of Eastern China.
Study on relationship between hemoglobin content and blood pressure in pregnant women in Zhoushan islands
SHAO Ying-ying, WU Jin-hua, JIANG Wen, PU Liu-yan, HUANG Man-xian, SHAO Bu-le, MO Min-jia, WANG Shuo-jia, SHEN Yu, YU Yun-xian
2019, 23(6): 650-655. doi: 10.16462/j.cnki.zhjbkz.2019.06.007
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  Objective  To investigate the relationship between hemoglobin and blood pressure of pregnant women in Zhoushan islands, so as to provide scientific evidence for the etiological study of gestational hypertension.  Methods  A retrospective study was conducted among 1 383 pregnant women who received perinatal care in Zhoushan Maternal and Child Health Hospital of Zhejiang Province from January 2017 to June 2018. Pregnant women were monitored for hemoglobin content and blood pressure in the early, middle and late pregnancy. The multivariate linear regression was used to analyze the relationship between hemoglobin content and blood pressure in different pregnancy.  Results  The incidence of anemia in early, middle and late pregnancy was 7.74%, 25.45% and 15.76% respectively. The multivariate linear regression showed that hemoglobin levels during pregnancy had effects on systolic blood pressure in early, middle and late pregnancy, and the earlier hemoglobin levels were monitored, the more obvious the effect on systolic blood pressure was.With the increase of hemoglobin level, systolic blood pressure increased, such as the effect of hemoglobin on systolic blood pressure in early pregnancy, mid-pregnancy and late pregnancy. Hemoglobin of first trimster had the greatest effect (β=0.10, P < 0.001), Hemoglobin of second trimester had no obvious effect, and that of third trimester had the second effect (β=0.04, P=0.027).Hemoglobin levels and diastolic blood pressure levels were similar to their relationship with systolic blood pressure.  Conclusions  Hemoglobin levels during pregnancy have significant effects on systolic and diastolic blood pressure in first, second and third trimsters of pregnancy. Regular measurement of hemoglobin levels during pregnancy can improve the health of pregnant women.
Association between the combined effect of helicobacter pylori infection and the elevation of C-reactive protein and the prognosis of ischemic stroke
ZHANG Chen-huan, ZHANG Pei-pei, HUANG Pin, LV Li-ying, GUO Yu-mei, ZHOU Mo, ZHANG Yong-hong, XU Tan
2019, 23(6): 656-660. doi: 10.16462/j.cnki.zhjbkz.2019.06.008
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  Objective  To investigate the combined effect of Helicobacter pylori (HP) infection and elevated C-reactive protein (CRP) on the prognosis of acute ischemic stroke patients at 3 months.  Methods  A prospective cohort study was performed. 1 110 confirmed cases of ischemic stroke were included from 14 hospitals in China. Serum helicobacter pylori immunoglobulin G (HP-IgG) and CRP were tested at admission. Poor prognosis was defined as death and the combined outcome (death or cardiovascular events) at 3 months after onset. All patients were divided into four groups based on whether HP-IgG and CRP were elevated: G1 was low level HP-IgG+ low level CRP group, G2 was low level HP-IgG + elevated CRP group, G3 was elevated HP-IgG + low level CRP group, G4 was elevated HP-IgG + elevated CRP group. The combined effect of elevated HP-IgG and elevated CRP on poor prognosis of ischemic stroke for 3 months was analysed with COX regression analysis.  Results  Analysis of the combined effects of elevated HP-IgG and elevated CRP showed that, after multifactorial adjustment, G4 (elevated HP-IgG+elevated CRP)patients had a 13.45-fold risk (95%CI: 2.83-63.94, P=0.001) of death at 3 months and 3.97-fold (95%CI: 1.79-8.82, P < 0.001) risk of combined outcome compared with G1(low HP-IgG+ low CRP) patients.  Conclusion  The combined effect of HP infection and elevated CRP is associated with poor prognosis at 3 months after stroke onset.
Association between PM2.5 pollution in ambient air and cardio-cerebrovascular mortality in Suzhou in 2016: a time series analysis
CHEN Xin, WANG Lin-chi, GUO Qian-lan, HU Hao, LU Yan, ZHU Xiao-hong, LI Hong-mei
2019, 23(6): 661-666. doi: 10.16462/j.cnki.zhjbkz.2019.06.009
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  Objective  To explore the effect of PM2.5 on the mortality of cardio-cerebrovascular disease in Suzhou, China.  Methods  The death data, air pollutant data and meteorological data from January 1, 2016 to December 31, 2017 in Suzhou were collected. The general additive Poisson regression model was used to analyse the association of exposure to PM2.5 with the daily deaths due to cardio-cerebrovascular disease, and to calculate the relative risk (RR) and 95% confidence intervals (95%CI) for an interquartile range (IQR) increase in PM2.5.  Results  The number of deaths from cardio-cerebrovascular disease was 30 200. On average, there were approximately 41 deaths per day. The daily median concentration of PM2.5 was 37.13 μg/m3 and IQR was 30.75 μg/m3. The RR values of single-day death and average death from cardio-cerebrovascular disease were 1.017(1.001-1.034) and 1.055(1.019-1.093)with an IQR increase of PM2.5 concentration, respectively. Stratified by gender and age, female and the elderly aged over 65 had higher risks of death from the cardio-cerebrovascular disease.  Conclusion  The elevated level of ambient PM2.5 was positively associated with the increase of mortality of cardio-cerebrovascular disease.
Study on the association between ambient temperature and coronary heart disease in rural area based on weighted delay effect
LI Gang-gang, ZHU Qing, LEI Miao, LIU Rui-fang, WENG Jun, HAN Xiao-li, CUI Xu-dong, ZHANG Ben-zhong, PEI Hong-bo, REN Xiao-wei
2019, 23(6): 667-672. doi: 10.16462/j.cnki.zhjbkz.2019.06.010
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  Objective  To explore the relationship between temperature and the incidence of coronary heart disease, so as provide reference for early prevention and treatment of coronary heart disease.  Methods  Using the coronary heart disease and meteorological data of rural in Qingyang from 2010 to 2016, based on the short-term correlation and hysteresis effect of meteorological factors on the incidence of coronary heart disease, the weighted indicator was used to estimate the delay effect distribution, and the generalized additive model was used to analyze the relationship between weighted temperature indicators and the incidence of coronary heart disease by gender and age group.  Results  The temperature indicators in rural areas of Qingyang had significant effects on the incidence of coronary heart disease in males over 65 years old (All P < 0.05), and the effect of weighted 24 h temperature change was the largest. For every 1℃ increase in weighted 24 h temperature change, the risk of disease increased by 8.775% (95% CI: 4.630%-13.084%). The incidence of coronary heart disease in all populations was sensitive to weighted 24 h temperature change (All P < 0.05), and in the four groups of men over 65 years old, men under 65, women over 65 and women under 65, the effect value decreases in turn. The weighted maximum temperature and diurnal temperature range were only significant in people over 65 years old, and the male population effect was higher than women.  Conclusions  Temperature change has the greatest impact on the incidence of coronary heart disease. Whether it is sudden heat or cold, it will increase the risk of coronary heart disease. The temperature indicator has a significant impact on the daily incidence of coronary heart disease among males over 65 years old, and the short-term correlation of temperature indicators is obvious.
Lagged effect of temperature on non-accidental mortality and years of life lost in Wuxi: a time-series study
LIU Jia, QIAN Yun, ZHOU Wei-jie, CHEN Hai, DONG Yun-qiu, YANG Zhi-jie, GUO Liang-liang, WANG Lu
2019, 23(6): 673-678. doi: 10.16462/j.cnki.zhjbkz.2019.06.011
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  Objective  To evaluate the effect of air temperature on non-accidental mortality (A00-R99) and years of life lost in Wuxi city.  Methods  Data on daily non-accidental mortality and meteorology index were collected from 2012 to 2017. Distributed lag non-linear model (DLNM) was used to assess the effect of temperature on non-accidental death and YLL and the cumulative effects between cold and hot temperature on non-accidental mortality and years of life lost with different lag days.  Results  A V-shaped relationship was noticed between temperature and mortality. Cold effects were delayed by 3 days and persisted for 14 days. Hot effects appeared acute and reached the peak at the same day. Low temperature had stronger gross effect than high temperature had. There were differences of temperature effects between different age and gender groups.  Conclusions  Low and high temperature were associated with elevated mortality risk. Cold effect had lagged effect and persisted for long time, however, hot effects appeared acute and the impact of low temperature was greater.
Analysis of the influence of meteorological factors on the number of patients with pulmonary heart disease in Liangzhou district of Gansu Province
JIA Ru-ge, ZHANG Zhong-lin, FEI Shan-shan, ZHANG Jing
2019, 23(6): 679-684. doi: 10.16462/j.cnki.zhjbkz.2019.06.012
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  Objective  To investigate the effect of meteorological factors on the number of outpatients with pulmonary heart disease in Liangzhou district of Gansu province.  Methods  We collected the daily meteorological data (temperature, air pressure, precipitation, sunshine hours, etc.) of Liangzhou district of Gansu province and the number of daily outpatients with the pulmonary heart disease from 2014 to 2016, and used the distribution lag model to analyze the impact relationship and hysteresis effect of the meteorological factors on the number of outpatients to pulmonary heart disease clinics.  Results  The total number of outpatients with pulmonary heart disease was 20 462 in Liangzhou district from 2014 to 2016, and the average number of outpatients per day was 18.67. The number of outpatients with pulmonary heart disease per day was positively correlated with temperature and sunshine hours, and negatively correlated with air pressure, relative humidity and precipitation. Among them, the average daily temperature had the most significant effect on the number of outpatients with pulmonary heart disease (r=0.133, P < 0.001). At the highest daily average temperature, lagging 16 days, the relative risk coefficient (RR value) was the highest (1.26, 95% CI: 1.13-1.40). For every 1℃ increase in temperature, the number of outpatients with pulmonary heart disease increased by 1.26 (95% CI: 1.13-1.40). There was no risk of morbidity at an extreme low temperature (-18℃), and the relative risk of the number of the pulmonary heart disease outpatients was the greatest at lag 0-15 at an extreme high temperatures (29℃).  Conclusion  Meteorological factor is an important factor affecting the number of outpatients with pulmonary heart disease in Liangzhou district. The risk of pulmonary heart disease will increase due to temperature changes, and the impact will occur immediately on the same day. The high temperature effect is short-lived and the relative risk is high, while the relative risk of low temperature to the number of outpatients is relatively low and the lag time is long.
Analysis on the prevalence of hemorrhagic fever with renal syndrome in Jiangxi Province from 2012 to 2017
SONG Ning-juan, XIE Yun, YUAN Hui, LIU Xiao-qing, PAN Huan-hong
2019, 23(6): 685-689. doi: 10.16462/j.cnki.zhjbkz.2019.06.013
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  Objective  To analyze the epidemiological characteristics of HFRS and rodent monitoring data in JiangXi province from 2012 to 2017, so as to provide scientific basis for controlling HFRS prevalence.  Methods  Descriptive epidemiological method was adopted to analyze the changes in time, region, and population morbidity of HFRS and rodent monitoring data from 2012 to 2017 in the province.  Results  From 2012 to 2017, there were 3 763 HFRS cases with 33 deaths reported in JiangXi province, the incidence was 1.38/100 000, the case fatality was 0.88%.The incidence in males was significantly higher than that in females(χ2=452.282, P < 0.001).In the composition of occupation, the proprotion of farmers was decreased, while household workers, workers waiting for employment, students and other occupations were increased.There were two peaks in spring (from May to June) and winter (from November to January), and the winter peak was obviously higher than the spring peak. The average rat density at the two surveillance areas was 3.63%. Rattus norvegicus was predominant in residential areas and Apodemus agrarius was predominant in the wild.The six years on average index of rats with virus was 0.04.  Conclusion  The incidence of epidemic hemorrhagic fever in JiangXi Province generally showed an upward trend from 2012 to 2017, which suggest that we should continue to strengthen comprehensive prevention and control measures: rodent control in high-incidence areas, popularize vaccination and replenishment, and carry out health education for the whole population.
The epidemiological characteristics and the source of infection of reemerge human rabies from 2012 to 2017 in Qinghai
XU Li-li, ZHANG Hua-yi, RAO Hua-xiang, LEI You-ju, LI Yong-hong, ZHAO Jin-hua, CAO Hai-lan, FENG Hua-xiang, SHI Yan, LIU Gui-xiang, ZHAO Sheng-cang
2019, 23(6): 690-693, 699. doi: 10.16462/j.cnki.zhjbkz.2019.06.014
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  Objective  To understand the epidemic situation and the source of infection of the reemerge human rabies in Qinghai.  Methods  We collected the data on human rabies and the data on the cases of multi-victims bitten by the identical dog, and also the laboratory data of the nucleoprotein (N) gene of rabies virus from the samples which were detected by reverse transcription-polymerase chain reaction (RT-PCR) and direct immunofluorescence assay (DFA) from 2012 to 2017, to describe the epidemiological characteristics of human rabies and the prevalence of rabies virus in host animals, and to explore the source of infection of reemerge human rabies.  Results  A total of 7 human cases were reported in 2012-2017 in Qinghai province, among which 1 was bitted by wolf, 2 were bitted by stray dogs, 3 were bitted by domestic dogs which injured by stray dogs or wolfs. A total of 892 canine brain tissue samples were collected, from which 46 positive samples were detected with the positive rate of 5.16% (95% CI: 3.70%-6.61%). The positive samples were collected from the nomadic region, which were consistent had the location of the human rabies. The samples collected from the cases of multi-victims bitten by the identical dog/animal had the positive rate of 73.08%, and 4 out of 7 human rabies were exposed to the cases of multi-victims bitten by the identical dog/animal. Genetic sequencing of the rabies virus detected from canine brain tissue samples were belong to China Ⅳ lineage, which was closely related to the Arctic clade.  Conclusions  The reemerging rabies happened in nomadic region of Qinghai province could be a consequence of spillover from wildlife especially from wolfs. The better surveillance system covering the human, livestock and wildlife should be set up to mitigate the rabies virus spread from the wildlife.
Etiology spectrum of virus in acute upper respiratory infection in children from 2017 to 2018 in Qingdao
ZHANG Feng, SHI Xiao-yan, ZHAO Dan, YANG Wen, SUN Rui, SU Zhi-lei, WANG Zhao-guo, GAO Ru-qin
2019, 23(6): 694-699. doi: 10.16462/j.cnki.zhjbkz.2019.06.015
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  Objective  To understand the prevalence and epidemiological characteristics of respiratory viruses in influenza-like illness in children during March 2017 to March 2018 in Qingdao.  Methods  A random selection of influenza surveillance cases (influenza-like illness, ILI) among children in Qingdao area was selected as the research object, and 359 cases were detected. Nasopharyngeal swabs were collected for multiple-fluorescence real-time reverse transcription-polymerase chain reaction nucleic acid detection to screen 9 kinds of respiratory viruses.  Results  Among the 359 Cases, 200 cases were positive for at least 1 kinds of viruses, and the positive rate was 55.71%(200/359). Among these 200 cases, the most positive numbers were influenza B Yamagata (IVB Yamagata) 29.50%(59/200), followed by enterovirus 15.00%(30/200), respiratory adenovirus (AdV) 13.50%(27/200), respiratory syncytial virus A (RSVA) 12.5%(25/200), influenza A H1N1(IVA H1N1) 10.00%(20/200), etc. 2 cases were 3 kinds of mixed viruses infected and 1 case was 4 kinds of mixed viruses infected.  Conclusions  Nine kinds of respiratory viruses are prevalent in Qingdao during March 2017 -March 2018. The main prevalence viruses contain influenza B Yamagata, enterovirus, respiratory adenovirus, respiratory syncytial virus A, influenza A H1N1. There is obvious seasonal distribution of influenza, respiratory syncytial virus, enterovirus, metapneumovirus. A mixed infection exists between 9 kinds of respiratory viruses, and mixed infection occurs in the month of the virus epidemic.
Effect of PBMC HBV cccDNA in HBsAg-positive mothers on neonatal Th1/Th2 cytokines
YI Lin-zhu, SHI Xiao-hong, WANG Dan-dan, WU Li-na, WU Jia-xin, ZHANG Rui-jun, WANG Bo, FENG Yong-liang, WANG Su-ping
2019, 23(6): 700-705. doi: 10.16462/j.cnki.zhjbkz.2019.06.016
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  Objective  To explore the effect of PBMC HBV cccDNA in HBsAg-positive mothers on neonatal Th1, Th2 cytokines and the ratio of Th1/Th2.  Methods  HBsAg-positive mothers and their neonates delivered in the Third People's Hospital of Taiyuan between June 2011 and July 2013 were recruited. Questionnaires on general information were collected by an in-person interview. Electrochemiluminescence immunoassay (ECLIA) were utilized to detect HBV serological markers.HBV cccDNA in PBMC was detected with real-time PCR-TaqMan Probe method, Th1 cytokines (interleukin 2, interferon-γ and tumor necrosis factor-α) and Th2 cytokines (interleukin 4, interleukin 6 and interleukin 10) were detected with Procarta Plex Multiplex Immunoassays.  Results  Univariate analysis showed that the levels of IL-2, IL-6 and IL-10 in the positive group were significantly higher than those in the negative group, while the ratio of Th1/Th2 was lower than that in the negative group (P=0.034, P=0.007, P=0.048, P=0.029). The levels of IL-6 and IL-10 in neonates delivered by vagina were significantly higher than those by cesarean section, while the ratio of Th1/Th2 was lower than that by cesarean section (P < 0.001). The level of IL-10 in positive group of neonatal HBsAg was significantly higher than that in negative group, while TNF-α and Th1/Th2 ratio were lower than negative group (P=0.011, P < 0.001, P=0.027). The degree of Th2 predominant response was reflected by ratio of Th1/Th2. After adjusting potential confounding factors in non-conditional logistic regression analysis, compared to those born to mothers with PBMC HBV cccDNA negative, neonates whose mother with PBMC HBV cccDNA positive had an increased risk of having a strong Th2 predominant response (OR=2.42, 95% CI: 1.16-5.04, P=0.018). The risk of a strong Th2 predominant response in neonates delivered by vagina was 5.49 times higher than those by cesarean section (OR=5.06, 95% CI: 2.95-8.67, P < 0.001).  Conclusion  HBsAg-positive mothers' PBMC HBV replication and vaginal delivery may increase the risk of having a Th2 predominant response in neonates. It is suggested that we should pay attention to the effect of maternal PBMC HBV replication and the mode of delivery on neonatal Th1/Th2 cytokines.
Analysis of the risk factors of hepatitis B virus infection in hemodialysis patients in Lanzhou
LIU Rui-fang, CHEN Ji-jun, LEI Miao, LI Gang-gang, LI Yuan-lin, SHI Dai-yu, GAO Wen-long, QI Yue-jun
2019, 23(6): 706-710, 716. doi: 10.16462/j.cnki.zhjbkz.2019.06.017
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Abstract:
  Objective  To explore the risk factors of hepatitis B virus infection in hemodialysis patients.  Methods  The patients in hemodialysis center of five hospitals in Lanzhou were interviewed through a questionnaire survey. The data of social demography, medical history, hemodialysis process and laboratory test of HBV were collected and analyzed by univariate and Generalized Estimating Equation (GEE) model analysis.  Results  Among total 565 investigated hemodialysis patients, 31 were HBV positive, with the infection rate of 5.49%. The result of GEE analysis indicated that using blood products(before 1998:OR=8.077, 95% CI: 3.469-18.803;after 1998:OR=2.678, 95% CI: 1.719-4.170), blood transfusion (before 1998:OR=5.344, 95% CI: 2.212-12.910), dialysis time(OR=1.008, 95% CI: 1.002-1.014), surgical cosmetology(OR=1.954, 95% CI: 1.015-3.766) and poor educational background (OR=3.564, 95% CI: 1.881-6.753) were risk factors of HBV infection in hemodialysis patients. Compared to hemodialysis patients aged 25 years old and younger, those aged 40 years (OR=0.214, 95% CI: 0.064-0.712) and above had a lower HBsAg positive rate.  Conclusions  Using blood products, blood transfusion before 1998, dialysis time, surgical cosmetology and poor educational background can increase the risk of HBV infection; poor educational background increases the risk of HBV infection in the hemodialysis patients. More attention should be paid on the management and usage of blood and blood products in clinical treatment. Dialysis operation should be standardized and propaganda of HBV prevention should be strengthened.
Analysis on health literacy and its influencing factors about cancer prevention and control among urban residents in Guangxi
WU Ni, HUANG Kai-yong, YANG Li
2019, 23(6): 711-716. doi: 10.16462/j.cnki.zhjbkz.2019.06.018
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Abstract:
  Objective  To investigate health literacy and its influencing factors about the cancer prevention and control among urban residents in Guangxi.  Methods  Guangxi urban residents were selected by using multi-stage hierarchical cluster random sampling. Health Literacy resident cancer prevention and health literacy questionnaire, which was provided by National Urban Cancer Early Diagnosis and Treatment Project, were used for the face-to-face interview among participants.  Results  Among all the residents included in this study, 7.5% had health literacy. Univariate analysis showed that gender, age, education, occupation, family income were influencing factors of health literacy(all P < 0.05). The level of health literacy of female was higher than that of male. People aged 40-59 years old had the highest health literacy levels, while people aged 60 years old and above had the lowest health literacy levels. Business personnel and civil servant had higher health literacy levels than other professional staffs. The level of health literacy of residents with annual household income more than 8 ten thousand yuan was higher than that of other residents. Those with higher educational levels had better health literacy levels. Cancer prevention awareness and early detection, early diagnosis, early treatment awareness, two dimensions of cancer prevention and health literacy, was 57.2% and 17%, respectively. Logistic regression analysis indicated that gender, household income and occupation were independent factors influencing cancer prevention and health literacy in Guangxi urban residents.  Conclusion  The cancer prevention and health literacy levels of Guangxi urban residents are low and the development of cancer prevention awareness and early detection, early diagnosis, early treatment awareness is unbalanced. Gender, household income and profession are three independent factors influencing cancer prevention and health literacy.
Mitochondrial dysfunction induced by PM2.5 in human umbilical vein endothelial cells
FAN Ye, SUN Zhi-qiang, YU Jun-bo, YAN Sha-sha, WANG Tong
2019, 23(6): 717-722. doi: 10.16462/j.cnki.zhjbkz.2019.06.019
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Abstract:
  Objective  To investigate the mechanism of mitochondrial dysfunction of human umbilical vein endothelial cell EA. Hy926 cells.  Methods  EA. Hy926 cells were treated with traffic-related particulate matter 2.5(PM2.5)(0, 25, 50, 100 μg/mL) for 24 h, the damage of PM2.5 on mitochondrial function.  Results  EA. Hy926 cells treated with PM2.5 for 24h, decreased mitochondrial ATP production and mitochondrial DNA(mtDNA) level, and destruction of mitochondrial structural integrity. PM2.5 treatment also induced the increase in reactive oxygen species (ROS) generation, decline in mitochondrial membrane potential (ΔΨm).In addition, the treatment of EA. Hy926 cells with PM2.5 resulted in decreased mRNA expression of Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), increased mRNA expression of mitochondrial transcription factor A(Tfam), and increased the protein expression of parkin and dynamin 1-like protein 1 (Drp1) in the EA. Hy926 cells, but decreased the protein expression of PGC-1α.  Conclusions  PM2.5 can induce mitochondrial dysfunction in EA. Hy926 cells and these effects are mediated through the promotion of ROS overproduction, as well as the promotion of mitochondrial autophagy and mitochondrial biogenesis dysfunction.
Methology
Applicability of three surveillance methods for Aedes albopictus in dengue risk indication
CHEN Yan-xia, ZHANG Xi-ru, YE Shuang-lan, PENG Ming-ji, ZENG Yan-qing, CHEN Xiao-ting, LI Yong-zhi, CHEN Qing, YU Shou-yi
2019, 23(6): 723-727. doi: 10.16462/j.cnki.zhjbkz.2019.06.020
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Abstract:
  Objective  To disscus the applicability of three surveillance methods for Aedes albopictus in dengue risk indication.  Methods  Larval and adult mosquito surveillance were conducted in two villages of Guangzhou by using three vector monitoring methods. Meteorological data and dengue cases were obtained in the same period.  Results  The population dynamics of larvae and adult mosquitoes were affected by temperature and their overall trend was consistent, but there were differences between the abundance of larvae and adult mosquitoes. From December to February the next year, Breteau index(BI) ranged from 5.66 to 24.53 with a risk of level 1 to 3 for dengue fever, while the mosquito and oviposition positive index(MOI) and adult-mosquito density index(ADI) were 0 to 4.00 and 0 to 1 per man-hour, respectively, indicating no risk for dengue fever. In March, compared with BI which indicated a risk of level 3, MOI were 2.13 and 3.77, respectively, representing for no risk. ADI were 4 to 6 per man-hour, indicating a risk of level 1 and level 2, respectively. After April, the dengue risk level reflected by each indicator became to be consistent.  Conclusions  The risk of dengue fever indicated by BI is always higher than or equal to the risk indicated by the other two. Compared with BI, MOI and ADI are more sensitively in reflecting the activity of Ae. albopictus.
Application of ARIMA model and BP neural network model in prediction of tuberculosis incidence in Gansu Province
YANG Wen-Jiao, XIAO Jun-Ling, DING Guo-wu
2019, 23(6): 728-732. doi: 10.16462/j.cnki.zhjbkz.2019.06.021
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Abstract:
  Objective  To investigate the predictive effect of autoregressive integrated moving average (ARIMA) model and back propagation neural network (BPNN)in the prediction of tuberculosis incidence in Gansu Province, and to select appropriate models to predict the incidence.  Methods  Based on the data of tuberculosis in Gansu Province from 1997 to 2017, the ARIMA time series model and BP neural network model were established to predict the incidence from 2018 to 2019, and the prediction accuracy and modeling effect of the two models were compared.  Results  For the incidence of tuberculosis in Gansu Province in 2018 and 2019, the ARIMA model predicted results were 55.1075, 54.5373, MSE=92.24, MAE=7.5313, MAPE=9.26%; BP neural network model predicted results were 62.0132, 73.4460, MSE=9.6575, MAE=1.1449, MAPE=1.68%.  Conclusions  The BP neural network model has a better predictive effect on the incidence of tuberculosis in Gansu Province, and it shows that the incidence of tuberculosis in Gansu Province will increase slightly from 2018 to 2019.
Short Reports
Characteristics and spatial clusters analysis of falls in Yantian Distric of Shenzhen City, 2017
YUAN Jing-guo, LIN Kai, LI Heng, XIE Jin-yao, ZOU Yu-hua
2019, 23(6): 733-736. doi: 10.16462/j.cnki.zhjbkz.2019.06.022
Abstract(206) HTML (56) PDF(26)
Abstract:
  Objective  To investigate the distribution characteristics and spatial clusters of Falls in Yantian Distric of Shenzhen in 2017.  Methods  Descriptive analysis of the characteristics of Falls in Yantian District in 2017 was carried out, Arcgis 10.2 software was used to make thematic maps of Falls, Geoda l1.12 software was used to analyse the global spatial autocorrelation and local spatial autocorrelation of Falls.  Results  A total of 4 622 Falls cases were reported in Yantian Distric of Shenzhen City in 2017, accounting for 28.91% of all the injuries; the main age group was 0-15 years old, accounting for 37.19%. The sex ratio was 1.97:1. The number of female patients over 60 years old was higher than male cases. Most Falls occurred in winter (28.66%). The place of occurrence mainly was at home (28.10%); the nature of injury mainly was contusion/abrasion (48.27%); the severity of injury mainly was mild (76.66%); Falls mainly occurred in Mingzhu, Yongan, Donghai and Dameisha communities. Global spatial autocorrelation showed that there was a spatial aggregation in the occurrence of Falls in Yantian Distric (Moran's I=0.51, Z=3.29, P=0.004); Local spatial autocorrelation analysis found that there were high attribute value aggregations in four communities: Yongan, Mingzhu, Donghai and Tiandong (P=0.003), which were the 'Hot spot' areas where Falls occurred.  Conclusions  Children and elderly women in Yantian District of Shenzhen were the key prevention population for Falls which clustered geographically.
Study on the sleep quality and its influencing factors in rural hypertensive patients in Xuanen country of Hubei Province
ZHANG Yu-peng, ZHANG Yu-ting, DONG Zhuang-zhuang, HUANG Yu-wei, TAN Xiao-dong
2019, 23(6): 737-740. doi: 10.16462/j.cnki.zhjbkz.2019.06.023
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Abstract:
  Objective  To investigate sleep quality and it's influencing factors of hypertensives among rural area in Hubei Province.  Methods  The method of stratified sampling by selecting 569 hypertensives in Xuanen county of Hubei was applied to perform the questionnaire survey, including the sociodemographic data, daily life habits and physical health data, as well as pittsburgh sleep quality index(PSQI) and compliance of hypertensive patients scale(CHPS).  Results  The average score of PSQI in 569 hypertensives was 7.25±3.61, of which 251(44.11%) hypertensives were poor sleep quality. The influencing factors of sleep quality for hypertensives are gender (P=0.006, OR=1.626), the number of other diseases(P=0.001, OR=1.520), regular exercise (P=0.033, OR=0.660) and the compliance of hypertensives (P=0.024, OR=1.707).  Conclusions  The sleep quality of rural hypertensives in Xuanen county, Hubei Province is poor, which is affected by different factors. Therefore effective measures should be taken to improve the sleep quality of hypertensives.
History of Public Health
Daniel Bernoulli, the brick-picker of epidemiology
LI Qing-ru, WU Jun, YE Dong-qing
2019, 23(6): 741-744. doi: 10.16462/j.cnki.zhjbkz.2019.06.024
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Abstract:
Daniel Bernoulli (1700-1782) was a famous physicist and mathematician in the 18th century. He made a compelling statistical case for smallpox vaccination. He made important contributions to the knowledge of probability theory and calculus, and was the first person to put forward the question of statistical hypothesis test. At the same time, he applied probability theory to practical problems such as the ratio of male to female births. In the development of epidemiology and biostatistics, he seems to be a brick picker, moving indispensable cornerstone.

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