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CN 34-1304/R ISSN 1674-3679

2020 Vol. 24, No. 5

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Exploring the mystery of COVID-19, and strengthening precise prevention
LI Bao-zhu, YE Dong-qing
2020, 24(5): 497-500. doi: 10.16462/j.cnki.zhjbkz.2020.05.001
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In December 2019, coronavirus disease 2019(COVID-19) broke out in Wuhan City, Hubei Province. The disease has a fast transmission speed, a wide range of influence, and great difficulty to control, which has put forward new requirements for human epidemiological research. By reviewing the latest progress of the epidemiological research on COVID-19 at home and abroad, we summarized the epidemic process and the trend of the disease, and revealed the epidemic characteristics, so as to provide references for subsequent research and control.
The status of knowledge, attitude and practice about coronavirus disease 2019 epidemic among university students and its influencing factors
LIU Dan, CHEN Pei-liang, LI Zhi-hao, WANG Zheng-he, SHEN Dong, ZHANG Yu-jie, ZHANG Xi-ru, YANG Pei, ZHANG Wen-ting, YANG Hai-lian, WANG Jia-hui, WU Xian-bo, MAO Chen, YANG Xing-fen
2020, 24(5): 501-505. doi: 10.16462/j.cnki.zhjbkz.2020.05.002
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  Objective   To understand the knowledge, attitude and practice of Chinese university students during the epidemic of coronavirus disease 2019(COVID-19), so as to provide a theoretical basis for scientific prevention and control and accurate decision-making of public health in universities.   Methods   From January 31 to February 5, 2020, a total of 56 997 university students from four universities were selected to participate in the survey. A 32-item structured questionnaire was used to carry out an online survey.   Results   A total of 44 456 questionnaires were collected and the response rate was 78.0%(44 456/56 997). Among the university students, 94.1% of them believed that COVID-19 could be infected through contact with asymptomatic infected cases, and 76.4%-98.9% of them knew the main mode of transmission and clinical manifestations, but only 52.9% knew the prognosis of COVID-19. And 53.0% of them thought the epidemic was serious, and 28.5% students experienced panic and anxiety. The proportion of university students who adopt protective behaviors such as washing hands, wearing masks, and reducing going out and gathering ranged from 86.9% to 94.2%. Subgroup analysis results showed that the knowledge and practice levels among females, older age groups, those with higher education levels and urban university students were higher(allP < 0.05).   Conclusions   During the epidemic of COVID-19, university students scored highly in knowledge, attitude and practice, but the knowledge gap still existed, and some university students experienced panic and anxiety. Therefore, accurate health education should be carried out according to the weak point of epidemic prevention awareness among university students.
Exploring the mystery of COVID-19, and strengthening precise prevention
LI Bao-zhu, CAO Nu:-wei, ZHOU Hao-yue, CHU Xiu-jie, FAN Yin-guang, YE Dong-qing
2020, 24(5): 506-500. doi: 10.16462/j.cnki.zhjbkz.2020.05.003
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  Objective   To analyze the epidemic situation of coronavirus disease 2019(COVID-19) in Anhui Province, so as to provide epidemiological information for epidemic prevention and control.   Methods   Case data was obtained from daily case reports of COVID-19 on the websites of the Health Committee of Anhui Province and its cities. The distribution characteristics of the incidence of COVID-19 in time, space, and population in Anhui Province were described. Correlation between daily incidence rate and migration index(immigration data) was explored by Spearman rank correlation analysis. Arc GIS 10.6 software was used to draw the spatial-temporal distribution map of the number of confirmed cases in Anhui Province.   Results   From January 22, 2020 to February 15, 2020, the number of confirmed cases of COVID-19 in Anhui Province was 962. The cumulative incidence rate was 1.52/100 000. The proportion of discharged cases was 24.12%. There were 6 cases died, and the crude case fatality rate was 0.62%. The age of confirmed cases was concentrated in 30-59 years old(66.70%), and there were differences among different age groups(χ2=247.96, P < 0.001). COVID-19 cases had been diagnosed in 16 cities in Anhui Province, among which Hefei(17.57%), Bengbu(16.32%), and Fuyang(15.80%) had more cases. The daily incidence rate of Anhui was positively correlated with the migration index(migration coefficient) of 12 days ago(rs=0.74, P < 0.001).   Conclusions   COVID-19 cases have been reported in all cities of Anhui Province. As of February 15, the number of confirmed cases in all cities has increased with slowing. The confirmed cases are mainly concentrated in Hefei City and northern Anhui Province. Different ages are generally susceptible, with the highest proportion of confirmed cases occurring between 30 and 59 years old. The government should take measures to control the spread of COVID-19.
Analysis of the epidemic status of coronavirus disease 2019 in high altitude ethnic areas of China and discussion on related influencing factors
LI Xue-chun, WAN Shao-ping, CAI Hong-xia, ZHANG Wen-bin, WU Wen-bo, YI Fang, WANG Qing-qing
2020, 24(5): 516-522. doi: 10.16462/j.cnki.zhjbkz.2020.05.005
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  Objective   To analyze the epidemic status of coronavirus disease 2019(COVID-19) and related influencing factors in the high altitude ethnic areas of China, so as to provide basis for the formulation and implementation of COVID-19 prevention and control strategies and measures in this areas.   Methods   The descriptive epidemiological method was used to analyze the three distribution of epidemic situation, and the challenge was analyzed based on the theory of infectious disease control.   Results   119 confirmed cases in the high altitude ethnic areas of five provincial-level regions including Tibet, Qinghai, Sichuan, Yunnan, Gansu accounted for 14.5% of all the confirmed cases in five provincial-level regions, and for 0.1% of the whole country. The number of confirmed cases in Ganzi Prefecture was 78 at most, accounting for 14.5% of Sichuan Province and 65.5% of high-altitude ethnic areas. The total sex ratio of the patients was 1:0.8, with an average age of(41.7 ± 16.7) years. The youngest case was 3 years old, and the oldest case was 77 years old. 30 people had a history of living in Hubei, accounting for 25.2%, 69 people had a history of close contact with the diagnosed person, accounting for 58.0%. 30 imported cases accounted for 25.2% and there were no deaths.   Conclusions   The overall number of cases is small, the epidemic situation is stable, and the epidemic situation in some areas is prominent; the epidemic situation has increased in the early stage and declined in the later stage, and there has been no new increase in some areas for several consecutive days; the high-altitude ethnic minority areas are faced with such influencing factors as management and tracking of infectious sources, prevention and treatment, adverse natural environment, etc. So it is necessary to establish a long-term mechanism of cross regional COVID-19 and other infectious diseases joint prevention and control, and formulate COVID-19 and other infectious diseases in the high-altitude ethnic minority areas disease prevention and control plan, promote the long-term and effective development of the mechanism.
Mathematical modeling and infection control strategy of COVID-19
SUN De-shun, DUAN Li, WANG Da-ping, XIONG Jian-yi
2020, 24(5): 523-528. doi: 10.16462/j.cnki.zhjbkz.2020.05.006
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  Objective   The aim of this study was to propose a mathematical modeling for the coronavirus disease 2019(COVID-19) epidemic to predict the development trend of the epidemic, which will provide guidance to the epidemic prevention and control.   Methods   The mathematical modeling was performed using the SEIR model, and the data of the current number of infections, cures, and deaths issued by the National Health Commission of China(NHCC)from January 10, 2020 to February 28, 2020 were collected. Parameters of the model were estimated, and the trend of the epidemic was forecasted in terms of different parameters.   Results   Based on transmission mechanism of the COVID-19, a SEIR model was proposed. According to data published by NHCC, the parameters of mathematical model were estimated in different stages by fmincon and lsqnonlin functions. The correlations of the infected people and the removed were 99.9% and 99.8%, respectively. The prediction error rates were 0.67% and 0.89%, respectively.   Conclusions   Based on the data of COVID-19 in China issued by NHCC, this study established a mathematical model with effective prediction. The results suggest that the exposed and the infected population should be strictly isolated. At the same time, with continuously improving the removal rate of patients, the epidemic will be effectively under control and terminated.
Investigation of cognition and prevention and control behavior of COVID-19 among undergraduates in Anhui Province
HUANG Meng-yun, ZHU Li-jun, JIN Yue-long, FANG Zheng-mei, WU Nan, DU Meng-xue, JIANG Min-min, WANG Jing, CHEN Yan, YAO Ying-shui
2020, 24(5): 529-533. doi: 10.16462/j.cnki.zhjbkz.2020.05.007
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  Objective   To analyze the current situation of knowledge and practice of coronavirus disease 2019(COVID-19) among undergraduates in Anhui Province, so as to provide scientific basis for health education strategies for university students.   Methods   The questionnaire was designed by questionnaire star, and was adopted to conduct anonymous survey on network platforms such as WeChat, QQ, etc. SPSS 18.0 software was used to collect and analyze the data.   Results   According to the survey, the students obtained the epidemic information mainly through online social tools such as WeChat and QQ(98.5%), and 65.7% of students obtained information in three or more ways. Except for newspapers, magazines and online social tools, there were significant differences in the same route of transmission among urban and rural groups(all P < 0.05). In terms of the knowledge about COVID-19, 14.7% of the students answered all the 8 questions correctly, and the awareness rate of the female students was higher than the males(χ2=37.384, P < 0.001). In terms of treatment intention, 63.3% of the students chose designated hospitals, and 25% chose online fever screening. In terms of COVID-19 prevention and control, the top three measures were: "no gathering and less going out"(97.6%), "wear masks when going out"(92.8%) and "do not go to crowded and closed places"(90.8%), and statistical differences were observed in the choice of prevention and control measures by gender(allP < 0.05). Additionally, females had a higher selection rate than males in the willingness to change behavior(allP < 0.05). The knowledge was positively correlated with number of protective measures(rs =0.146, P < 0.05)and number of willingness to change behavior(rs =0.138, P < 0.05).   Conclusions   The undergraduates do not have a comprehensive knowledge of COVID-19, and varieties of methods are suggested to strengthen publicity and education. According to gender characteristics, targeted health education should be carried out, which is more conducive to improving the cognitive level of undergraduates groups and selecting appropriate prevention and control measures.
Study on the spatiotemporal clusters of coronavirus disease 2019 in Henan Province
ZHANG Yan-yang, XIAO Zhan-pei, YANG Kai-chao, ZHAO Dong-yang, LI Jun, ZHANG Ming-yu, ZHANG Xiao-xiao, MA Ya-ting, WANG Zhang-shuang, WANG Yan, CHEN Shuai-yin
2020, 24(5): 534-538. doi: 10.16462/j.cnki.zhjbkz.2020.05.008
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  Objective   To explore the spatiotemporal distribution pattern of coronavirus disease 2019(COVID-19) in Henan Province using geographic information systems(GIS).   Methods   Epidemiological data of COVID-19 were collected, and relevant GIS data bases were established. The global and local indicators of spatial autocorrelation analysis was carried out by GeoDa 1.8.12 software, and SaTScan 9.4 software was used to describe the spatiotemporal scan statistics.   Results   A total of 50 regions of high-high aggregation by local spatial association analysis observed in in Henan Province; five statically significant COVID-19 clusters were identified by the retrospective spatiotemporal scan.   Conclusions   The risk of COVID-19 transmission in Henan Province has experienced a process: from weak to strong, then to weak. The emergency strategies not only prevent the growth in time, but also effectively prevent its spread in space.
Analysis of clinical characteristics of coronavirus disease 2019 in 26 cases
ZHAO Zong-hao, YIN Ming, YIN Shi, LI Wen-ting, BAO Lei, WANG Yu, LI Yi
2020, 24(5): 539-542. doi: 10.16462/j.cnki.zhjbkz.2020.05.009
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  Objective   To analyze the epidemiological characteristics, clinical manifestations, laboratory examinations and imaging characteristics of coronavirus disease 2019(COVID-19).   Methods   The data of epidemiological characteristics and clinical data were collected for data analysis. SPSS 19.0 software was used for statistical analysis.   Results   11 patients(42.3%) had a history of staying in Wuhan, 6 patients(23.1%) had a history of contact with Wuhan residents, and 6 patients had a familial cluster onset; the median incubation period was 6 d. Among the 26 patients, as for the condition, 18 cases were common(69.2%), 6 cases were severe(23.1%), and 2 cases were light(7.7%). More severe patients had higher frequency of fatigue and chest tightness than the common type(all P < 0.05), but there was no significant difference in the incidence of fever, dry cough, muscle soreness, anorexia, sore throat, and abdominal pain between the two groups(allP > 0.05). Comparing the laboratory indicators of common and severe patients, lymphocyte(Lym) count, eosinophil(Eos) count, and CD3+, CD4+, and CD8+ T cell counts of the severe patients were lower than those of the common patients(all P < 0.05). The C-reactive protein(CRP) and serum amyloid A(SAA) severe groups were higher than the common type(allP < 0.05). Ground-glass opacities were seen in the CT of the lungs in 23(88.5%) patients, lobular septal thickening in 15(57.7%), mosaic signs in 10(38.5%) patients, and fibrotic lesions in the lungs in 5(19.2%) patients.   Conclusions   Most of the COVID-19 patients in this study had a connection with Wuhan. The imaging findings were mainly ground-glass opacities. The majority were common cases. Patients with decreased peripheral blood Lym counts, Eos counts, and CD3+, CD4+, and CD8+ T cells, and elevated CRP and SAA are predictive of exacerbations.
Application of autoregressive integrated moving average (ARIMA) model in global prediction of COVID-19 incidence
BAO Ya-wei, SHAO Ming, CHEN Yu-ting, LIU Xu-xiang, DING Xiao-qin, PAN Gui-xia, PAN Fa-ming, LI Xiao-jing
2020, 24(5): 543-548. doi: 10.16462/j.cnki.zhjbkz.2020.05.010
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  Objective   Autoregressive integrated moving average(ARIMA) model was used to predict the incidence of coronavirus disease 2019(COVID-19) in the world, providing reference and evaluation basis for prevention and control strategies and measures proposed by various countries.   Methods   The cumulative daily number of confirmed COVID-19 patients in various countries(Italy, Spain, Germany, France, and et al) on February 22, 2020(solstice, March 19) was collected. The ARIMA model was fitted with SPSS17.0 and R3.6.1 software.   Results   The dynamic trend of the predicted and actual values of ARIMA model is basically consistent, and the actual values are within the 95% confidence interval(CI) of the predicted values.   Conclusion   ARIMA model can better predict the incidence of COVID-19 globally, which has practical significance in guiding epidemic prevention and control.
Current risk status and spatial distribution of COVID-19 in China based on the day-on-day growth rate and spatial constrained clustering algorithm
HU Jian, ZHANG Jun, WANG Wen-ge, DONG Lin-juan, HUANG Jia-qi, ZHANG Zhi-jie
2020, 24(5): 549-554. doi: 10.16462/j.cnki.zhjbkz.2020.05.011
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  Objective   Analyze the current situation of COVID-19 epidemic prevention and control in various provinces in China, and propose a regionalized management method based on current status of epidemic prevention and control.   Methods   We calculated day-of-day growth rate of cumulative and new confirmed cases based on the reported confirmed cases between Jan 25 to Feb 8, and fitted it with the linear regression model accompanied with date. Furthermore, we applied auto zone procedure with simulator annealing(AZP-SA) spatial constrained clustering in cumulative confirmed cases and the linear trend, median, standard deviation of the growth rate, and provided a regionalized management suggestion based on previous result.   Results   The growth rate of cumulative confirmed cases in all provinces has shown a downward trend in recent. The growth rate of new confirmed cases did not show a significant trend. AZP-SA method partitions the mainland China into 8 regions. Region surrounding Hubei with relatively slow decline trend, and regions of the northwest and north provinces have good control of epidemic situation, and the eastern and Southeast provinces have a control effect between them.   Conclusions   The growth rate of the cumulative confirmed cases is a good indicator to measure the short-term trend of the epidemic. Based on the cumulative confirmed cases and its growth rate, the application of spatial constraint clustering can partitions the epidemic status of China, and provide a regionalized management for work resumption.
Trend analysis of COVID-19 in Fujian
OU Jian-ming, ZHU Han-song, XIE Zhong-hang, HUANG Wen-long, CHEN Wu, CAI Shao-jian, WU Sheng-gen, ZHENG Kui-cheng
2020, 24(5): 555-561. doi: 10.16462/j.cnki.zhjbkz.2020.05.012
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  Objective   To study the trend of COVID-19 epidemics in Fujian and predict the spatiotemporal clustering in order to provide a reference for risk assessment and prevention and control.   Method   The incidence of COVID-19 in Fujian Province from Jan 2, 2020 to Feb 18, 2020 was used to analyze and predict the spatiotemporal trend.   Results   The number of cases reported by COVID-19 from Jan 2, 2020 to Feb 18, 2020 in Fujian Province was 293, with no deaths. The cumulative number of counties(districts) reported at each time point(accumulated reports) were: 22 on Jan 19(35 cases), 53 on Jan 26(159 cases), 57 on Feb 2(244 cases), and 61 on Feb 18(293 cases). Local spatial autocorrelation analysis suggested that as of Feb 18, the hot spots in Fuzhou counties(districts) such as Gulou, Cangshan, Minhou, and Fuqing were highly clustered. As of January 26, the space-time gathering area had spread rapidly, with up to 7 first and second level gathering areas, centered on Licheng, Hanjiang, Siming, Lianjiang, Shaxian, Gutian, and Meibei, of which carp Licheng and Siming were predicted to occur from January 27 to February 18, with 54 and 24 cases expected. As of February 18, the space-time gathering area had been reduced to two, centered on Chengxiang and Nanan respectively.   Conclusion   Some counties(districts) in Quanzhou, Fuzhou, Putian and other regions have a high risk of spatiotemporal aggregation, and they should be focused on prevention and control, but low-risk aggregation areas should not be ignored.
Epidemiological characteristics and infection risk factors of people with close contact with coronavirus disease 2019 patients in Fujian Province
CHEN Wu, LIN Jia-wei, WU Sheng-gen, CHEN Bin, LIN Shao-kai, LIN Xi, DENG Yan-qin, WANG Ling-lan, OU Jian-ming, ZHENG Kui-cheng
2020, 24(5): 562-566. doi: 10.16462/j.cnki.zhjbkz.2020.05.013
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  Objective   To investigate the epidemiological characteristics and risk factors of close contacts of coronavirus disease 2019(COVID-19).   Methods   The characteristics of 111 close contacts of COVID-19 infection in Fujian Province in 2020 were described. Taking 111 close contacts of COVID-19 infection(102 confirmed and 9 asymptomatic infections) as the case group, and 2 337 non-infected close contacts as comparing group, Logistic regression analysis model was used to explore the risk factors of close contact infection.   Results   Among the 111 cases, 57 were males and 54 were females. The gender ratio was 1.1:1. The infection rate of close contacts is 1.7%(111/6 718) the median age of the close contacts was 49.5 years. 111 cases resulted in 47 clustering outbreaks. the incubation period of 7 cases was over 14 days. The tongest incubation period was up to 21 days. One outbreak revealed the disease could infected others 2 days before the onset of the primary case. The secondary attack rate in family was 4.2%(73/1 739), and in community was 10.1%(24/237), in nursing homes was 2.7 %(7/256), in social places was 2.0%(4/199), and in workplace was 3.0%(3/99). The difference was statistically significant(χ2=20.76, P < 0.001). The confirmed cases were mainly light and common type(88.2%), and the clinical severity of those in close contacts was no different from that of primary cases. The median of the interval time between final exposure to identification close contacts was 2 days. The median of the interval time between the identification close contacts to isolation was 1 day. The median of the interval time between the final exposure to the onset of the disease was 7 days. The median of the interval time between the onset to visit was 4.9 days. Those of 15-years(OR=4.22, 95% CI:1.79-9.96) and ≥50 years(OR=6.61, 95% CI:2.77-15.78) were more likely to develop infection. In comparison with occasional contact, those of general contact(OR=3.58, 95% CI:1.70-7.54) and regular contact(OR=8.30, 95% CI:4.65-14.80) were more likely to develop infection. And those exposed confirmed cases(OR=3.64, 95% CI:1.65-8.04) were at higher risk of infection as well.   Conclusions   The recondary attack rate of COVID-19 is higher than 2.0%. The clinical severity of close contacts infected with COVID-19 is not different from that of the primary cases. Age, frequency of exposure and primary cases in asymptomatic phase are the risk factors for close contacts of COVID-19. The degree of informatization of close contact tracking management is not high, and the results are not satisfactory.
Analysis on the epidemiological characteristics of an outbreak of coronavirus disease 2019(COVID-19) in Xi'an
BAI Yao, JI Zhao-hua, ZHANG Hui, JI Zhen-hao, LIU Ji-feng, CHEN Zhi-jun, CHEN Bao-zhong, LIU Kun, SHAO Zhong-jun
2020, 24(5): 567-572. doi: 10.16462/j.cnki.zhjbkz.2020.05.014
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  Objective   To explore the epidemic feature of an outbreak of 2019 novel coronavirus diseases(COVID-19) in Xi'an, so as to provide scientific basis for optimizing the control strategy of COVID-19.   Methods   Excel 2007, SPSS 18.0 and ArcGIS 10.3 software were used to describe the distribution of the disease as well as aggregated epidemic feature. The latent period of COVID-19 in Xi'an was calculated by interpolation method.   Results   By March 6 th, 2020, a total of 120 confirmed cases, 738 suspected cases of COVID were reported in Xi'an, with an average incidence of 1.20 per 100 000, and 1 death case with the case-fatality rate of 0.83%. There were more male cases(63) than female(57), most mild cases(92.50%) and aged 41-50 years old cases(21.97%) among confirmed cases. The epidemic curve show that the peak occurred on January 25 th as well as January 31 th, 2020, respectively. The high incidence area was mainly distributed in the four subdistricts of the main urban area of Xi'an city(21.67%, 26/120). The average time of stay in hospital of 108 discharged cases was 16.00 days(15.58±5.45 days). A total of 23 clusters of COVID-19 were occurred in Xi'an, with the average rate of recurrence of the second generation of cases was 31.73%, of which 13 outbreaks(56.52%) occurred in families. The average incubation period of COVID-19 in Xi'an was calculated as 9 days. A total of 25 cases of asymptomatic infection were reported, and accounted for 17.24% of those infected with the 2019 novel coronavirus.   Conclusion   The overall epidemic curve of Xi'an is divided into two stages. The cases are distributed in random focalization, and there is no local spread in Xi'an. It is necessary to be alert to the risk of family clustering and asymptomatic transmission.
Epidemiological characteristics and temporal-spatial clustering analysis of hand, foot and mouth disease in Shantou City
ZHANG Chi, ZHANG Xu-bin, YAO Li-jun, XU Lu, XU Guang-xing, ZHANG Zhi-hua, JIANG Su-hong, XIE Run-sheng, LI Li-ping
2020, 24(5): 573-578. doi: 10.16462/j.cnki.zhjbkz.2020.05.015
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  Objective   To explore the epidemiological characteristics and temporal-spatial clustering of hand, foot and mouth disease(HFMD) from 2009 to 2018 in Shantou City, as a means of providing a scientific basis for conducting effective control strategies.   Methods   The epidemic data of HFMD from 2009 to 2018 was collected. Spatial autocorrelation analysis and spatiotemporal scan statistics were used to analyse the clustering of HFMD in time and space.   Results   A total of 77 814 cases of HFMD were reported in Shantou City from 2009 to 2018. The annual average incidence was 143.52/100 000. Children under three years old comprised the HFMD high-risk population.The major HFMD-incidence peak period was from April to July, and the secondary incidence peak period was from September to November. Global and local spatial autocorrelation analysis demonstrated that positive spatial autocorrelation was observed at street(town) level. Twenty-five streets(towns) of Shantou City were hotspot areas, indicating the high incidence of HFMD. Two clustering was found by time-space scanning from 2009-2018, and the Class 1 clustering area(RR=3.56, LLR=9 444.26, P < 0.001) centred on Tongyi and Xinfu street, with a radius of 10.05 km, involving 25 streets(towns) of Shantou City.   Conclusions   A significant feature of spatiotemporal clustering was shown in the HFMD incidence in Shantou City from 2009 to 2018. Effective prevention and control measures should be undertaken for the high-risk population in high-prevalence area and season to decrease the incidence of HFMD in Shantou City.
Evolutionary analysis of influenza A viruses in Qingdao from 2014 to 2019
ZHAO Dan, ZHANG Xiao-yue, DONG Li-yan, SUN Rui, WANG Zhao-guo, GAO Ru-qin
2020, 24(5): 579-585. doi: 10.16462/j.cnki.zhjbkz.2020.05.016
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  Objective   To analyze the epidemiology and molecular characteristics of influenza A virus(IAV) circulated in Qingdao from 2014 to 2019.   Methods   Throat swab samples from 9 807 influenza-like cases were collected and viral RNA was extracted. All samples were screened for influenza virusby multiplex real-time reverse transcription PCR. Hemagglutinin(HA) and neuraminidase(NA) genes were amplifyed by one-step reverse transcription PCR and sequenced, and then molecular characteristics of them were analyzed.   Results   The characteristics of influenza virus in Qingdao from 2014 to 2019 were similar to those of the typical seasonal influenza in the northern hemisphere. A small peak of summer influenza was mainly attributed to H3 N2. Of these IAV positive cases, H1 N1 pdm09 and H3 N2 accounted for 57.6% and 42.4% respectively, both alternately popular in different years. Phylogenetic tree indicated that they belonged to the 6 B and 3 C subgroup respectively. The genetic evolution of H1 N1 pdm09 and H3 N2 was under purifying selection, but antigenic evolution might have different evolution patterns. Compared with strains in 2009, twenty-one and thirty amino acid substitutions in HA occurred respectively in H1 N1 pdm09 and H3 N2 viruses in 2019, and they were mainly located in the head domain, including 5 and 18 antigen sites respectively. Only one isolate with H275 Y mutation and one with S247 N known to reduce susceptibility to NA inhibitors(NAI) were detected in H1 N1 pdm09, and no NAI-resistant mutation was found in H3 N2.   Conclusions   H1 N1 pdm09 and H3 N2 are the most prevalent strains of seasonal IAV with rapid evolution in Qingdao. Strengthening influenza surveillance and research is necessary and influenza vaccine strains need to be updated in time.
Behavioral characteristics and influencing factors of multiple sexual partners among men who have sex with men in Chongqing
LI Yao, HE Xiao-qing, WAN Yan, CHEN Yao-kai
2020, 24(5): 586-590. doi: 10.16462/j.cnki.zhjbkz.2020.05.017
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  Objective   To understand the demographic and sexual behavioral characteristics and factors associated with multiple anal sexual partners(5 or more) among human immunodeficiency virus(HIV) negative men who have sex with men(MSM) in Chongqing.   Methods   From June 2018 to June 2019, eligible HIV negative MSM were recruited in our analysis. Based on questionnaire, we collected demographic characteristics, the percentage of condoms using, the status of sexually transmitted diseases, sex role, history of drug abuse, history of post-exposure prophylaxis(PEP), concerning about HIV knowledge and history of pre-exposure prophylaxis(PrEP) in the past 6 months. Univariate and multivariate Logistic regression models were used to analyze the factors associated with multiple anal sexual partners(5 or more) among HIV negative MSM.   Results   Among 319 HIV negative MSM, 34.5%(110/319) of them had sex with 5 or more in the past 6 months. Among 110 MSM who have anal sex with 5 or more, 63.6%(70/110) of them were 28-year-old or younger, and 75.4%(83/110) of them had bachelor or college degree. 50 MSM reported emotional status, of which 72.0%(36/50) were single. The results of multivariate Logistic analysis showed that having a history of PEP and always concerning about HIV knowledge were primary influencing factors of multiple anal sexual partners(5 or more) among HIV negative MSM.   Conclusions   Having multiple anal sexual partners is a common phenomenon among HIV negative MSM in Chongqing. It is necessary to increase the awareness of HIV prevention and education among MSM populations, especially among younger MSM populations. While promoting the use of PrEP and PEP in MSM populations, we should be vigilant about the risk compensation of them.
Relationship study between the IL-6 expression in maternal peripheral blood and intrauterine transmission of HBV
WANG Hai-rong, SHAO Yu-zhang, LI Fang, YAN Min, FU Ting, ZHANG Lei
2020, 24(5): 591-596. doi: 10.16462/j.cnki.zhjbkz.2020.05.018
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  Objective   To investigate the expression of IL-6 in peripheral blood of HBsAg positive parturients in HBV intrauterine transmission.   Methods   Epidemiological investigation was carried out on 314 HBsAg positive parturients delivered in Northwest Women and Children's Hospital of Shaanxi Province and 74 health parturientsas control group. Enzyme-linked immunosorbent assay(ELISA) was used to detect five makers of hepatitis B, real time PCR was used to detect HBV-DNA, and flow liquid chip method was used to detect IL-6 in peripheral blood of pregnant women and newborns.   Results   The incidence of dominant HBV infection(DBI), occult HBV infection(OBI) and BIT were 10.83%(34/314), 38.22%(120/314), 49.04%(154/314), respectively. The levels of IL-6 in peripheral blood of HBsAg-negative parturients were significantly lower than those of HBsAg-positive parturients(P < 0.001), NBIT group(P < 0.001), DBI group(P=0.006), OBI group(P < 0.001). In the antiviral treatment group, the level of IL-6 in DBI group was significantly lower than OBI group(P=0.008).In non-hepatitis B vaccine group, the level of IL-6 in DBI group was significantly lower than OBI group(P=0.012). The level of maternal IL-6 have positive relation to the maternal HBeAg status and HBV DNA load in maternal blood(all P < 0.05).The level of maternal IL-6 have negative relation to the maternal HBeAb status in maternal blood(P=0.011).   Conclusions   HBV can stimulate the expression of IL-6 in pregnant and lying-in women, but the expression of IL-6 in HBsAg-positive parturients shows intra-group differentiation. The level of IL-6 in maternal will increase in HBeAg-positive and HBV DNA high-load environment. DBI is prone to occur when IL-6 level decreases.
Rosiglitazone pretreatment alleviates renal oxidative stress in lipopolysaccharide-induced acute kidney injury
WEI Xiao, FU Lin, BO Qing-li, XU De-xiang, WU Yong-gui
2020, 24(5): 597-601. doi: 10.16462/j.cnki.zhjbkz.2020.05.019
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Abstract:
  Objective   To investigate the effects of pretreatment with rosiglitazone(RSG) on oxidative stress in lipopolysaccharide(LPS)-induced acute kidney injury(AKI).   Methods   Forty-eight male ICR mice were divided into six groups: Control group, RSG group, LPS 6 h group, LPS 24 h group, RSG+LPS 6 h group, and RSG+LPS 24 h group. In the LPS and LPS+RSG groups, mice were intraperitoneal injected with LPS(2 mg/kg). In the RSG and RSG+LPS groups, mice were administered with RSG(10 mg/kg) by gavage four consecutive days before LPS injection. All mice were sacrificed at 6 h and 24 h after LPS injection. Some kidneys were collected for HE staining. Renal GSH and MDA were detected using biochemical method. Renal oxidant stress related genes were analyzed through real time RT-PCR. Renal NADPH oxidase-2 and NOX-4 were measured by Western blot. Serum was acquired for renal function.   Results   LPS-induced AKI, as determined renal pathological damage, renal function injury and inflammatory cell infiltration, were attenuated in RSG-pretreated mice. Although it did not affect renal GSH level, RSG pretreatment evidently inhibited the elevation of renal MDA content. Mechanistically, RSG pretreatment distinctly repressed LPS-induced upregulation of P47phox mRNA and nicotinamide adenine dinucleotide phosphate(NADPH) oxidase(NOX)-2 and NOX-4 in the kidney.   Conclusion   RSG pretreatment attenuates renal oxidative stress in LPS-induced acute kidney injury partially through inhibiting upregulation of NADPH oxidase.
Advances in vitamin D intake and prevention of cognitive impairment in Chinese elderly
CHENG Le, ZHAO Hai-feng
2020, 24(5): 602-606. doi: 10.16462/j.cnki.zhjbkz.2020.05.020
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Abstract:
The reference intake of vitamin D in the elderly has been increased from 400 IU/d to 600 IU/d since its publication in 1981 in China. However, owing to insufficient outdoor activities or insufficient dietary intake, there are still more than one third of the elderly who have vitamin D deficiency. Vitamin D deficiency is one of the risk factors for Alzheimer's Disease(AD). Adequate vitamin D plays an important role in reducing amyloid β-proteindeposition and anti-inflammatory in AD. This review aims to provide an overview of the revision history of vitamin D reference intake and the status of in vivo levels and their relationship with AD in elderly people aged 65 years and older.
Correlation between cognitive function, social support and depression in the elderly in Luzhou
YU Xiao-jiao, DONG Ya-fei, TIAN Tian, JIA Hong, YANG Min
2020, 24(5): 607-609. doi: 10.16462/j.cnki.zhjbkz.2020.05.021
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Abstract:
  Objective   To explore the cognitive function of the elderly in Luzhou city and its correlation with social support and depression.   Methods   From March to June 2017, a total of 975 people aged ≥60 years were selected in Luzhou by convenience sampling. Mini-mental state examination(MMSE), ueriatric depression scale-15(GDS-15) and Duke social support scale(DSSI) were used.   Results   There were 127(13.03%) persons with cognitive dysfunction among the respondents. Cognitive function score was positively correlated with social support score(r=0.160, P < 0.001) and negatively correlated with depression score(r=-0.237, P < 0.001), the differences were statistically significant(allP < 0.05). The direct effect of social support on cognitive function was 0.116(95%CI: 0.053-0.178); the indirect effect through depression was 0.116(95% CI: 0.076-0.162).   Conclusions   Depression has a negative effect on the cognitive function of the elderly, social support has a direct positive effect on the cognitive function of the elderly, and depression has a partly mediating effect on the relationship between social support and cognitive function.
Analysis of clinical characteristics and risk of metastasis of 352 patients with pancreatic cancer in the tropical region of Hainan Province
ZOU Yan, HE Zhi-jun, MA Yue, SHEN Yong-mei, SUN Zheng-ke, WANG Tai-cheng, LI Kai, Makale Emmanuel C, HUANG Hai-rong, SUN Zao-xi
2020, 24(5): 610-613. doi: 10.16462/j.cnki.zhjbkz.2020.05.022
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Abstract:
  Objective   To analyze the clinical characteristics of patients with pancreatic cancer in tropical Hainan province and provide the evidence for timely discovering and giving reasonable diagnosis and treatment of pancreatic cancer.   Methods   Based on electronic medical record(EMR), the clinical data of pancreatic cancer patients were collected. SPSS software version 22.0 was used to conduct statistical analyses of the data.   Results   The male to female ratio of 352 patients was 1: 0.66. The age range was 20-95 years old, and the average age was(65±13) years. Among these patients, the jaundice and the abdominal pain accounted for 40.3% and 36.1% respectively. The non-metastasis and metastasis accounted for 33.5% and 66.5%, respectively. The results of percentile method indicated that lymphocytes and their ratio, glucose(Glu), alanine aminotransferase(ALT), aspartic acid aminotransferase(AST), direct bilirubin(DB), indirect bilirubin(IB), carcinogenic antigen(CEA), and tumor marker sugar chain antigen 19-9(CA19-9) were different from normal reference range. Mann-Whitney U test found that there were differences in white blood cell, neutrophil and its ratio, NLR, ALT, AST, DB, IB and CEA between groups(all P < 0.05). The results of binary logistic regression analysis showed that the risk of metastasis when NLR≥3.7 was 4.958 times(1.896-12.964) compared to that when NLR < 3.7. IB was negatively associated with metastatic risk.   Conclusions   For people around 65 years old with symptoms of jaundice and abdominal pain, the number and ratio of lymphocyte, Glu, transferase, bilirubin, CEA and CA19-9 are helpful for timely detection of pancreatic cancer. In addition, NLR and IB values may have guiding significance for the rational treatment of pancreatic cancer.
Investigation on the epidemiologic features of patients who have injuries caused by dogs and cats in a hospital
PANG Pei, WANG Ji-ping, GU Ye, LI Fen-fen, REN Jun, XUE Cheng, YIN Xiao-ya, WANG Shu-mei
2020, 24(5): 614-616. doi: 10.16462/j.cnki.zhjbkz.2020.05.023
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  Objective   To investigate and analyze the epidemiologic features of patients who were hurt by animals such as dog or cat in a hospital, and to provide scientific basis for preventing injuries caused by these animals.   Methods   A questionnaire was designed and then applied to the target population.A sample was selected from the patients in the dog-hurt-clinic in a hospital with the convenience sampling method, and then they were required to complete the questionnaire.   Results   1 009 injured patients were ruled in analysis. Men accounted for 46.68%. The patients aged 20 to 29 were 19.72% of the total studied population. Patients who were hurt at home accounted for 61.05% and by their own pets 50.94%, respectively. Chi-square test results showed that there were statistically significant differences between the sexes in patients' occupation, pet ownership, injury location and animal source(all P < 0.05). The causes, the way and the place of injury were statistically different among animal species(allP < 0.05).   Conclusions   There are no difference in gender and age among animals injuries.The safety of keeping pets at home is very important. Enhancing health education and improving self-protection consciousness are of great importance on the prevention of hurts by animals.
The father of demography: John Graunt
WU Qian, YE Dong-qing, PAN Hai-feng
2020, 24(5): 617-620. doi: 10.16462/j.cnki.zhjbkz.2020.05.024
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Abstract:
John Graunt(1620-1674) is a famous British statistician and one of the representatives of the school of political arithmetic. He firstly put forward the concept of "data reduction", and identified outliers in data and other statistical ideas. In addition, he also stressed the importance of data "reliability". He carried out the statistical analysis of the population phenomenon in London using the difference methods, and compiled the world's first live table, which opened the door of demography.

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