中华疾病控制杂志

Transformation and application of low temperature environment in metabolic disease prevention and treatment

LU Huan-yu, LUO Wen-jing

2020, 24(7): 745-747, 784. doi: 10.16462/j.cnki.zhjbkz.2020.07.001

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Considering the incidence of metabolic diseases has been increasing in recent years, and seriously affecting human health and quality of life, it is of great urgency to carry out in-depth research on the prevention and treatment of metabolic diseases. The cold environment is closely related to the body metabolic status. Recent studies have shown that exposure to cold environment can increase adipose tissue thermogenesis, enhance the body metabolic rate, and improve metabolic disorders. Based on the characteristics and mechanisms of cold environment on body metabolic status, it is significant to explore and identify the cold environment mediated signaling pathways, and provide new strategies for the prevention and treatment of metabolic diseases.Therefore, this review aims to systematically summarize the three major pathways (neurohumoral signals, immune cell pathways, and lipid metabolites) that mediate adipose thermogenesis by cold environment stimulus, and further reveals the great value and significance of cold environment in the transformation research of metabolic disease prevention and treatment.

Association between prediabetes and dietsry patterns for the elderly in rural China

ZHAO Hui, LI Yu-qian, MU Di, YUAN Xiao-lin, SONG Peng-kun, HE Li

2020, 24(7): 748-753. doi: 10.16462/j.cnki.zhjbkz.2020.07.002

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Objective We aimed to find out the dietary patterns and analyze the relationship between influencing factors (especially dietary patterns) and prediabetes in Chinese rural elderly. Methods Data were obtained from the Chinese nutrition and health surveillance during 2010 to 2012, and a total of 4 577 participants aged 60~79 years old were included. A food frequency questionnaire was performed to conduct a dietary survey. Factor analysis was used to extract dietary patterns, while Logistic regression models were used to analyze relationship between dietary patterns and prediabetes. In addition, classification tree model was applied to analyze the influencing factors of prediabetes. Results Three dietary patterns were found among the elderly participants by factor analysis, including the wheat-coarse cereals, fruit-vegetables, and aquatic-beans-eggs patterns. The result of Logistic analysis showed that there was an interaction between wheat-coarse cereals pattern and aquatic-beans-eggs pattern.In detail, the T3 level of wheat-coarse cereals pattern and the T1 level of aquatic-beans-eggs pattern was associated with low risk of prediabetes(OR=0.518, 95% CI:0.328-0.819), while the T1 level of wheat-coarse cereals pattern and the T4 level of aquatic-beans-eggs pattern was associated with high risk of prediabetes(OR=2.060, 95% CI:1.347-3.151). In addition, eight influencing factors and three group at high-risk for prediabetes were identified by classification tree model. The influencing factors were central obesity, BMI, income, age, aquatic-beans-eggs pattern, wheat-coarse cereals pattern, fruit-vegetables pattern, and drinking. Conclusions Our results suggest that dietary factors are closed related to prediabetes, and adopting a balanced diet, maintaining a healthy weight and good living habits may help to reduce the risk of prediabetes in chinese rural eldery.

The study on the association between dietary pattern and the incidence of hypertension in different genders in Shanxi Province

REN Ze-ping, ZHAO Jun-kang, CHEN Jing, ZHANG Ran, WANG Miao, LIANG Jie, HE Yu-ling, YANG Xiao-juan, LINHU Li-qin, ZHANG Rui-fu, WANG Tong

2020, 24(7): 754-760. doi: 10.16462/j.cnki.zhjbkz.2020.07.003

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Objective The purpose of this study was to examined gender differences in the association between dietary patterns and the risk of hypertension. Methods A multistage stratified random cluster sampling method was used to carry out a dietary nutrition survey on 2 667 males and 2 982 females in Shanxi Province. The intake of each food was evaluated by food frequency questionnaire (FFQ) containing 64 food groups, and the dietary patterns were extracted and named by factor a-nalysis. Logistic regression model was used to analyze the relationship between hypertension and dietary patterns in different genders. Resultsc Four dietary patterns were derived in men:high protein pattern; high fat and sweet pattern; grain, potato and pickles pattern; vegetable and fruit pattern; Five dietary patterns were derived in women:low carbohydrate pattern; grain and vegetable pattern; high protein pattern; high fat and sweet pattern; potato pickles pattern. There are three similar dietary patterns:high protein pattern; high fat and sweet pattern; potato and pickles pattern. The results of the Logistic regression model analysis showed that OR=1.361(95% CI:1.069-1.732, P=0.012) for high fat and sweet pattern of man, OR=1.357(95% CI:1.064-1.731, P=0.014) for low carbohydrate pattern of woman. Conclusions The relationship between dietary patterns and hypertension is different between man and woman. High fat and sweet pattern of man and low carbohydrate pattern of woman may increase the risk of hypertension.

Analysis of gut microbiomes and dietary patterns in patients with type a combination of 2 diabetes mellitus and obesity

WANG Xian, PAN Yan, WAN Hong, BA Ming-yu, FU Yu, YAN Shu-xun

2020, 24(7): 761-766. doi: 10.16462/j.cnki.zhjbkz.2020.07.004

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Objective To observe the differences of diet structure as well as intestinal microflora between patients with type 2 diabetes mellitus(T2DM) combined with obesity and healthy people, so as to provide evidence for the reconstruction of intestinal microflora in patients with type 2 diabetes mellitus combined with obesity through nutritional therapy. Methods 32 patients and 32 health volunteers were selected according to the inclusion and exclusion criterias. A Semi-quantitative food frequency method as well as 3d-24h dietary investigations were used to collect the food intake data of the two groups within one year, and the principal component analysis was used to evaluate the dietary patterns differences of the two years.Meanwhile, the differences of abundance and the composition of the gut microbiota were analyzed by Illumina Miseq high-throughput sequencing after feces collection and DNA extraction. Results The main dietary pattern characteristic of T2DM combined with obesity group was the consumption of more fat while the vegetables intake was low, while the healthy volunteers had a more balanced dietary pattern of cereals, vegetables and protein. In terms of the gut microbiota, the diversity in patients was significantly lower than that in healthy groups. Below the phylum level, the relative abundance of Ruminococcaceae(P < 0.001, FDR=0.037), Clostridiales(P < 0.001, FDR=0.014)and Blautia(P=0.042, FDR=0.049)which were correlated with dietary fiber was lower in T2DM combined with obesity group when compared with health group. Conclusions Imbalanced dietary pattern and insufficient dietary fiber intake may be related to the occurrence of T2DM combined with obesity by affecting the structure and abundance of intestinal microecology.For the nutritional treatment of T2DM patients combined with obesity, attention should be paid to the dietary structure balance and dietary fiber supplement.

A case-control study on the association between egg consumption and risk of non-alcoholic fatty liver disease

CHEN Bing-bing, LI Hui-quan, PAN Xin-ting, LI Yang-fan, LIU Wen-juan, YAN Jian-hui, XU Shang-hua, PENG Xian-e

2020, 24(7): 767-772. doi: 10.16462/j.cnki.zhjbkz.2020.07.005

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Objective To explore the association between egg consumption and risk of non-alcoholic fatty liver disease(NAFLD). Methods We conducted a retrospective case-control study including 541 patients diagnosed with NAFLD and 541 controls matched by sex and age from the Affiliated Nanping First Hospital of Fujian Medical University in Nangping City. Information on dietary intake was collected using a semiquantitative food frequency questionnaire and egg consumption was calculated. Binary Logistic regression model was used to estimate OR and the 95% confidence interval (95% CI) was for the association between egg consumption and NAFLD risk. Results Compared with 7 times/week egg consumption, non-egg consumers was associated with higher risk of NAFLD, and the adjusted ORs and 95% CI 1.86 (95%CI:1.10-3.15). The sensitivity analyses and stratified analysis results showed that non-egg consumers was significantly associated with risk of developing NAFLD. Conclusions Non-egg consumption was significantly associated with higher risk of NAFLD, largely independent of other risk factors.

The interactive effects of occupational noise exposure and high temperature on cardiovascular system

XU Zi-han, DAI Dong-mei, GAO Jiao-jiao, DUAN Jun, WEI Qian-nan, YI Wei-zhuo, PAN Ru-bing, HE Yang-yang, LIU Xiang-guo, TANG Chao, SONG Sha-sha, SU Hong

2020, 24(7): 773-778. doi: 10.16462/j.cnki.zhjbkz.2020.07.006

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Objective To investigate the effects of different noise exposure levels on the cardiovascular system, so as to evaluate whether there was an interactive effect between occupational noise exposure and other exposures (ambient temperature or harmful gas exposure). Methods Retrospective cohort study designs were used. Occupational health examination results from 2014 to 2018 in the largest chemical enterprise in Anhui, China, were collected. According to the noise exposure assessment, selected subjects were divided into high-exposure group (≥ 80 dB(A)), medium-exposure group (70-79 dB(A)) and low-exposure group (< 70 dB(A)). The ambient temperature was graded (Grade I-IV) according to the high temperature operation classification standard. SPSS 23.0 software was used to establish the Cox regression models to analyze exposure-effect relationship. χ² test was applied to compare the constitution of cigarette usage, alcohol intake, regular exercise and others among the three exposure groups. Results Compared with the low-exposure group, workers exposed to occupational noise ≥ 80 dB(A) and 70-79 dB(A) were at risk for hypertension, respectively, with hazard ratio(HR)and 95% confidence interval of 1.85 (95% CI:1.36-2.52) and 1.29 (95% CI:1.03-1.60). Occupational exposure to noise levels above 80 dB(A) could increase the risk of electrocardiogram abnormality (HR=1.31, 95%CI:1.06-1.63). In addition, workers exposed to both high temperature and occupational noise ≥ 80 dB(A) exhibited a further increased risk of hypertension (HR=8.98, 95% CI:3.25-24.86). Conclusions Occupational noise exposure can increase the risk of cardiovascular disease in occupational population, and there is an interactive effect between occupational noise exposure and high temperature.

Relationship between resting heart rate and high risk of cardiovascular disease

WU Ling-ling, ZHENG Chun-zao, LIU Fu-dong, QIN Yu, SU Jian, CUI Lan, DU Wen-cong, ZHOU Jin-yi

2020, 24(7): 779-784. doi: 10.16462/j.cnki.zhjbkz.2020.07.007

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Objective To explore the relationship between resting heart rate (RHR) and risk of cardiovascular diseases in Jiangsu Province and to provide scientific basis for the prevention and treatment of cardiovascular diseases. Methods A community-based screening project on high-risk of cardiovascular diseases was conducted in 6 sites of Jiangsu Province from 2015 to 2018, and 95 210 participants were included in the study. The participants were divided into 5 groups according to the RHR measurement value: ≤ 68.5, 68.5-, 74-, 81- and >90 beats/min(bpm). The relationship between RHR and cardiovascular disease risk was analyzed by using non-conditional Logistic regression model. Results The high-risk rate of cardiovascular diseases was 25.10% (23 897/95 348). Compared to the RHR < 68.5 bpm group, the cardiovascular disease risk was lower in the 68.5- bpm group (OR=0.90, 95% CI:0.86-0.94), and the groups of 81- and >90 bpm group increased the risk (OR=1.11, 95% CI:1.06~1.17; OR=1.52, 95% CI:1.43-1.61). Male with RHR > 90 bpm had higher OR (1.65) of cardiovascular disease risk than women (OR=1.35) and participants aged 35-45 years with RHR > 90 beats/min had the highest OR of 2.03. Conclusions The elevated RHR (>90 bpm) increased the risk of cardiovascular disease among 35-75 group in Jiangsu Province, and the risk is higher in man and those aged 35 - 45 years.

Hypertension treatment and control rates among HIV-infected individuals in Taizhou City

XU Xiao-hui, CHEN Xiao-xiao, LIN Hai-jiang, GAO Mei-yang, HE Na, DING Ying-ying

2020, 24(7): 785-790. doi: 10.16462/j.cnki.zhjbkz.2020.07.008

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Objective To investigate the treatment and control rates of hypertension among HIV-infected individuals in Taizhou City and provide evidences for prevention and control of hypertension. Methods Data was assessed from baseline survey of Comparative HIV and Aging Research in Taizhou (CHART) in 2017 and HIV-infected individuals who met diagnostic standard of hypertension at baseline were surveyed when they came to local Centers for Disease Control and Prevention to receive regular follow-up medical care and assessment, between September and December 2019. Questionnaire interview and physical examination were carried out. Results Rates of hypertension treatment and control were 44.2% and 54.5%, respectively. The rate of hypertension treatment were significantly higher among those aged over 45 years, with family history of hypertension and hyperlipemia (all P < 0.05). The rate of hypertension control was significantly lower among those on antihypertensive therapy than those without antihypertensive therapy (χ²=12.067, P < 0.001). Among those on antihypertensive therapy, family history of hypertension (aOR=0.153, 95% CI:0.055-0.420) and have been diagnosed with mild (aOR=0.130, 95% CI:0.041-0.406) or moderate and severe hypertension (aOR=0.263, 95% CI:0.075-0.915) at baseline were significantly associated with rate of hypertension control, whereas among those without antihypertensive therapy, only the time of antiviral treatment ≥ 6 years (aOR=0.355, 95% CI:0.165-0.765) was significantly associated with rate of hypertension control. No significance difference in hypertension control was found between those using single treatment drug and those using combined treatment drugs. Conclusions The hypertension treatment and control rates among HIV-infected individuals in Taizhou City remain to be improved. There is an urgent need for blood pressure screening and treatment management among HIV-infected individuals. Further research is needed to develop the effective hypertension treatment strategies for this population.

Genetic variation and genotype distribution of HIV-1 epidemic strains in Yunnan Province from 2014 to 2018

ZHOU Xi-shu, LI Jian-jian, ZHANG Mi, LIU Jia-fa, YANG Bi-hui, PAN Xiao-man, DONG Xing-qi

2020, 24(7): 791-796, 850. doi: 10.16462/j.cnki.zhjbkz.2020.07.009

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Objective To investigate the distribution of human immunodeficiency virus type 1(HIV-1) strain genotypes and recombinants, simultaneously trace original transmission of which in Yunnan Province from 2014 to 2018. Methods A total of 2 604 HIV/acquired immune deficiency syndrome(AIDS) plasma specimens with epidemiological information were collected during 2014 to 2018 from 16 prefectures of Yunnan Province. HIV-1 pol genes were amplified, Genotyping, BLAST tool of online analysis and MEGA 6.06 software were used to determine strain subtypes. By calculating genetic distance and phylogenetic tree analysis, we elucidated the distribution characteristics of HIV-1 gene subtypes in Yunnan Province. Results A total of 1 843 pol sequences were successfully amplified and sequenced. The major subtypes with proportion of HIV-1 strains in our province are CRF08_BC (55.8%), CRF07_BC (13.4%), CRF01_AE (14.3%), C subtype (3.1%), B (B') subtype (2.6%), unique recombinant forms(URFSs) (8.1%), and others (2.7%), respectively. CRF08_BC was the dominant subtype compared with other subtypes. There were statistically significant differences in the distribution of HIV-1 genotypes in age, infected routes, and ethnicity(all P < 0.05). Moreover, significantly differences of HIV-1genotypes distribution were also found between 16 prefectures of Yunnan Province(all P < 0.05). Among them, Dehong, Baoshan and Nujiang were dominated by CRF01-AE subtype, Lijiang and Diqing were dominated by CRF07-BC subtype, and the rest prefectures were dominated by CRF08_BC. Conclusions The CRF08_BC is the predominant epidemic HIV-1 subtype in 16 prefectures of Yunnan Province, and all kinds of HIV common subtypes exist. New circulation recombinant forms(CRFs) are still emerging. Compared with the data from 2012 to 2014, the subtypers of HIV-1 gene in Yunnan Province have changed in terms of areas, ethnicity, ages and transmitted routes, which should be closely monitored.

Epidemiological characteristics of measles and vaccination analysis with measles containing vaccine in Zhongshan City from 2005 to 2018

WANG Cui-ling, LYU Hai-ying, CAI Qian-chun, CHEN Xiao-hong, HUANG En-miao

2020, 24(7): 797-800, 864. doi: 10.16462/j.cnki.zhjbkz.2020.07.010

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Objective To analyze epidemiological characteristics of measles in Zhongshan City and to estimate the vaccine effectiveness (VE) of measles containing vaccine (MCV). Methods Descriptive epidemiological methods were applied to analyze the incidence of measles during the period from 2005 to 2018. A case-control study design was used to estimate the VE of MCV. MCV vaccination data were obtained from field survey of vaccination rate in Zhongshan in 2017 and 2018. Results A total of 6 516 measles cases were reported in Zhongshan from 2005 to 2018. The average annual incidence was 15.4/10⁵, ranging from 0.5/10⁵ (2017) to 63.7/10⁵ (2005). The incidence reached peak from April to September. The male to female ratio was 1.4:1. The majority of measles cases were scattered children (59.4%). 77.4% of meas-les cases aged from 8 months to 10 years had MCV unvaccinated. In 2017 and 2018, the vaccination rate of MCV in Zhongshan was 97.6% and 98.4% respectively, and the timely vaccination rate of the first-dose of MCV was 65.2% and 58.0% respectively. Among children aged 1-10 years, VE estimates were 93%(95% CI:89%-96%)and 96% (95% CI: 93%-98%) for one dose and two doses of MCV, respectively. Conclusions The incidence of measles decreased significantly from 2005 to 2018 and kept low in recent years, but the spread of measles virus was not interrupted. We should continue to strengthen measles surveillance, and maintain a high level of vaccination rate and timely vaccination rate of MCV, and finally achieve the goal of measles elimination.

The correlation between PM₁₀ and lung cancer death risk in Nanjing City

WEI Fei-ran, XIONG Li-lin, HONG Xin, LI Wei, CHEN Bao-an

2020, 24(7): 801-807, 834. doi: 10.16462/j.cnki.zhjbkz.2020.07.011

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Objective To explore the lag-correlation between Particulate matter with particle size below 10 mic(PM₁₀) and the risk of lung cancer death in Nanjing, China. Methods We collected daily mortality and air pollution data of Nanjing from 2013 to 2017. Generalized additive model (GAM) and distributed lag non-linear models (DLNM) were used to estimate the effects of short-term exposure to PM₁₀ on daily lung cancer mortality. Results A total of 14 693 deaths from lung cancer in Nanjing from 2013 to 2017, with the average daily death from lung cancer was 8.05. The proportion of men (72.20%) was higher than that of women (27.80%); The daily average PM₁₀ concentration was 103.91 μg/m³, with obvious seasonality trend, and the daily average PM₁₀ concentration exhibited a declining trend from 2013 to 2017 (χ²=120.16, P < 0.05); Short-term exposure to PM₁₀ had the highest risk of mortality on the day (lag0), and the effect disappeared after lag4; with the increaseed of PM₁₀ concentration, the risk of death increased; With each 10 μg/m³ increaseed in PM₁₀ concentration, the maximum excess risk of death at lag 3 day was 1.004 3 (1.001 0-1.007 7) for the single-day effect, the maximum excess risk of death at lag 0-6 was 1.008 0 (1.002 5-1.013 5) for the multiple-day cumulative effect of PM₁₀ exposure. The single-day effect and multi-day cumulative effect on the risk of lung cancer death among different seasons, different genders and different age groups were different, with each 10 μg/m³ increaseed in PM₁₀ concentration. Conclusions There was a positive lag-association between PM₁₀ and daily lung cancer mortality in Nanjing, with the concentrations of PM₁₀ increased, the lung cancer death risk got higher.

Comparisons of the side effects of the post-operative chemotherapies in esophageal squamous cell carcinoma patients

LI Shan-shan, LIN Zheng, MA Ming-yang, SU Kun-hui, CHEN Ya-ting, LIU Yong-lan, HU Zhi-jian

2020, 24(7): 808-813. doi: 10.16462/j.cnki.zhjbkz.2020.07.012

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Objective To investigate the relationship between post-operative chemotherapy, prognosis and side-effects of esophageal squamous cell carcinoma (ESCC). Methods This study enrolled a total of 188 patients with ESCC in the First Affiliated Hospital of Fujian Medical University and Fujian Cancer Hospital from June 2014 to November 18th 2018. The cumulative survival rates were estimated using the Kaplan-Meier method and comparisons were performed using the log-rank test. The Cox proportional hazards model was performed for analysis of the impact factors of survival and the Kruskal-Wallis H test was used to compare side-effects of chemotherapy regimens. The unconditional Logistic regression was performed to analyze the correlation between postoperative chemotherapy regimens and side-effects. Results The chemotherapy regimen was an independent risk factor for poor survival of ESCC patients. Compared with "docetaxel (DOC)+cisplatin (DDP)/nedaplatin (NDP)" group, ESCC patients in "paclitaxel (PTX)+luoplatinum (LBP)/oxaliplatin (OXA)" group and "DOC +LBP/OXA" group had better overall survival. The post-operative chemotherapy regimen was related to blood/bone marrow abnormalities and other side-effects (χ²=11.741, P=0.008). Compared with "DOC+DDP/NDP" group, "DOC+LBP/OXA" group increased the risk of leukocyte reduction (OR=4.089, 95% CI:1.073~15.585, P=0.039) and decreased the risk of lymphocyte reduction (OR=0.257, 95% CI:0.075~0.878, P=0.030). Conclusions The chemotherapy regimen is the impact factor for the prognosis and side-effects of patients with ESCC. The prognosis of "DOC+LBP/OXA" group and "PTX+LBP/OXA" group is better than "DOC+DDP/NDP" group. The "DOC+LBP/OXA" group reduces the risk of side-effects.

A study on the prevalence and influencing factors of thyroid nodules in a district of Hefei City, China

DENG Da-tong, HOU Le-le, WANG You-min, ZHAO Xiao-tong, XU Mu-rong, XU Feng-qin, CHEN Ming-wei

2020, 24(7): 814-818. doi: 10.16462/j.cnki.zhjbkz.2020.07.013

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Objective To analyze the influencing factors of thyroid nodule in a district of Hefei City, in order to guide the prevention and treatment of thyroid nodule. Methods A total of 2 584 residents over 18 years old in a district of Hefei were selected by cluster sampling method to complete the laboratory index collection and thyroid B-ultrasonic examination, and the questionnaire survey was completed by the investigator. Multiple Logistic regression analysis was used to explore the related factors of thyroid nodules in Hefei. Results The detection rate of thyroid nodule was 11.20%. The results of Logistic regression analysis showed that there was a correlation between thyroid nodule and various diseases. Women, body mass index(BMI), glycosylated hemoglobin A1c(HbA1c), low density lipoprotein cholesterol(LDL-C), median urinary iodine(MUI) and family history of thyroid diseases were independent risk factors of thyroid nodule (all P < 0.05). Conclusions It is necessary to strengthen the early screening and intervention of thyroid nodules in high risk population in Hefei.

The effect of interaction between orphanin FQ and pregnancy complications on postpartum depression

CHEN Lu, ZHANG Yan-ting, HU Jin-ping, TA Ming-hua, NIU Jian-mei, SHANG Yu-xiu

2020, 24(7): 819-823. doi: 10.16462/j.cnki.zhjbkz.2020.07.014

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Objective To discuss the effect of orphanin FQ (OFQ) and pregnancy complications and their interaction on postpartum depression (PPD). Methods A total of 200 pregnant women were selected from the Yinchuan Maternal and Child Health Hospital and the Zhongwei Traditional Chinese Medicine Hospital. The OFQ level, family factors, pregnancy complications and 42 days postpartum depression were evaluated by enzyme-linked immunosorbent assay, self-designed questionnaire, and the Edinburg Postnatal Depression Scale. Results The OFQ level 48.52 (37.56, 57.13) pg/ml in the postpartum depression group was higher than that in the control group 18.37 (16.63, 25.35) pg/ml, and the difference was statistically significant (Z=-6.761, P < 0.001). The prevalence rate of postpartum depression with poor relationship between mother-in-law and daughter-in-law (P=0.014) and pregnancy complications (χ²=6.505, P=0.011) were higher than that in normal female. Unconditional logistic regression analysis showed that OFQ (OR=21.464, 95% CI:6.859-67.167, P< 0.001) and pregnancy complications (OR=3.600, 95% CI:1.013-12.794, P=0.048) was risk factors of PPD. Interaction model analysis showed an interaction between OFQ and pregnancy complications (OR=2.229, P=0.021). Conclusion OFQ and pregnancy complications are risk factors for PPD.

Quantitative analysis of differential proteins in lung tissue of silicosis rats by using iTRAQ profile

ZHU Ying, DUAN Yu-xia, CHENG Qi-yun, YAO Jing-xin, XU Hong, YUAN Ju-xiang

2020, 24(7): 824-829. doi: 10.16462/j.cnki.zhjbkz.2020.07.015

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Objective We aimed to screened the differential protein of silicosis in the lung tissue of rats exposed to movable dust and verified it in vivo and in vitro, so as to provide new targeted for the early diagnosis of silicosis and the related molecular mechanism. Methods The animal model of silicosis was established by rats exposed to movable dust. The differential proteins in lung tissue were screened by isobaric tags for relative and absolute quantification(iTRAQ) and liquid chromatography-trandem mass spectrometry(LC-MS/MS). Western blot was used to detect the expression of differential protein in lung tissue of animal model and type Ⅱ alveolar epithelial cells induced by SiO₂. Results Our results identified a total of 471 differential proteins, 252 of which were up regulated and 219 down regulated. There were 28 differentially expressed proteins, twenty of which were up-regulated. The expression of Factor B, PTPN2, VRK1 and MOT4 protein were up-regulated in lung tissue of animal model and type Ⅱ alveolar epithelial cells induced by SiO₂ (all P < 0.05). Conclusions Differential proteins Factor B, PTPN2, VRK1 and MOT4 proteins may the novel key proteins in the process of silicosis fibrosis, which provides a new target for silicosis fibrosis.

Epidemiological and clinical characteristics of COVID-19 in Hunan Province

WANG Bin, GENG Juan, ZHANG Rong-guang, CHANG Shuai-lei, CHEN Shuai-yin, YANG Hai-yan, XI Yuan-lin, DUAN Guang-cai

2020, 24(7): 830-834. doi: 10.16462/j.cnki.zhjbkz.2020.07.016

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Objective To investigate epidemiological and clinical characteristics of Coronavirus disease 2019 (COVID-19) in Hunan, China. Methods The epidemic data on COVID-19 in Hunan Province as of Apr 1th, 2020 were collected, and the epidemiological and clinical characteristics of the confirmed cases and influencing factors for this epidemic were described and analyzed. Results A total of 1 019 confirmed COVID-19 cases were reported in Hunan. Form the confirmation of the first imported case on Jan 21th to Apr 1th, 2020, the increase of cases first experienceed a period of rapid growth, and the early reported were mainly imported cases. The number of local new cases exceeded the number of imported new cases after Feb 2th. In the middle of February, the number of cases tended to be stable. The period from late Feb to 14th Mar was a regression period for the sustained increase in the number of cured cases. The first clinical symptom was fever in 52.7% of the cases, but some cases had gastrointestinal symptoms such as diarrhea and nausea. The gene-ration spacing of clustered cases was 5.0 (2, 9)days, the median incubation period of first-generation cases was 7.5 (5, 11) days, and the median incubation period of second-generation cases was 10.0 (7, 14) days. The cumulative incidence rate in each city was positively correlated with the migration index of the corresponding city, with the correlation coefficient r=0.628 (P=0.016). Conclusions The overall outbreak of COVID-19 in Hunan has been under control, but there is great pressure to prevent and control imported cases. Meanwhile, resuming work and study has increased the population migration, and the current situation of epidemic prevention and control is still severe.

Analysis of influencing factors and early clinical features of severe cases of COVID-19

ZENG Min-min, TIAN Ke-qing, LIU Tian, LIN Mao-wen, YAO Meng-lei, HUANG Ji-gui

2020, 24(7): 835-839. doi: 10.16462/j.cnki.zhjbkz.2020.07.017

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Objective This paper aimed to found the risk factors and early clinical features of coronavirus disease 2019(COVID-19) severe cases by according to the epidemiological data of COVID-19 cases in Jingzhou City. Objective χ² test and Logistic regression model analysis were used to sought the risk factors and early clinical features of COVID-19 cases. Results There were 1 580 confirmed and clinically diagnosed COVID-19 cases reported in Jingzhou City. The proportion of severe cases was 23.61% (373/1 580).Multivariate analysis showed that age ≥ 49 years (OR=2.342, 95% CI:1.803-3.043), confirmed cases (OR=2.772, 95% CI:1.735-4.428), cardiovascular and cerebrovascular diseases (OR=2.872, 95% CI:1.542-5.349) were the risk factors of COVID-19 severe cases, and lymphocyte percentage decrease (OR=1.881, 95% CI:1.105-3.202), fever (OR=1.845, 95% CI:1.340-2.541), fatigue (OR=1.616, 95% CI:1.246-2.097), chest tightness (OR=1.870, 95% CI:1.197-2.923) were the early clinical features of COVID-19 severe cases. Conclusions COVID-19 cases who were the el-derly, with cardiovascular diseases, and were fever, fatigue, chest tightness, and lymphocyte percentage decrease at early clinic stages should be on alert for its severe progression.

Correlation analysis of regional distribution in COVID-19 imported cases from abroad in China

CHEN Chun, KANG Yan, CAI Wen-feng, QI Juan, WU De-ping, LIU Yuan, LIANG Bo-heng

2020, 24(7): 840-844. doi: 10.16462/j.cnki.zhjbkz.2020.07.018

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Objective This study aimed to analyze the relation of regional distributions between coronavirus disease 2019(COVID-19) imported cases and global cases and help policy making for accurate prevention. Objective Regional data of global cases and imported cases from other countries or districts to China were collected. Descriptive epidemiology and Spearman correlation analysis were used in statistical analysis. Results Up to April 9th, the number of 995 COVID-19 imported cases from abroad were reported, most in Shanghai (20.20%), Guangdong (17.59%), Beijing (17.19%) and Heilongjiang (8.74%).The imported cases were mainly from the United Kingdom (27.74%), the United States (14.87%), Russia (12.16%), Spain (8.74%), respectively.Spearman correlation analysis were performed between cases in 6 regions of WHO member countries (and regions) and imported cases from these regions, 4 regionsincluding the regions of European, Americas, Eastern Mediterranean and African were showed statistical significances(all P < 0.05). Conclusions Our study showed an overall correlation between the COVID-19 imported cases to China and the cases in these countries. Epidemic of COVID-19 might be underestimated in some countries and regions with poor health systems and resources. Therefore, we should pay more special attentions to backward countries and regions in Africa, Southeast Asia and South America to reduce the number of imported cases. Riska ssessment of imported epidemic also need to be conducted according to regional distribution in each province to prevent accurately and manage precisely.

Analysis of the use of masks and disinfection products and their influencing factors during the outbreak of COVID-19

ZHOU Jin-hua, LI Xiao-ning, WU Hao-ying, LIU Jie, GENG Hong-yuan, ZHANG Yan, LI Yong-xian, ZENG Jin-heng, HE Zheng, LIU Yuan

2020, 24(7): 845-850. doi: 10.16462/j.cnki.zhjbkz.2020.07.019

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Objective To analyze the use of masks and disinfection products and their influencing factors during the outbreak of 2019 novel coronavirus disease (COVID-19), and to provide scientific basis for epidemic prevention and control. Objective We evaluated the reliability and validity of the questionnaire with Cronbach's α coefficient and KMO value. Through the internet we investigated the demographic characteristics, the use of masks and disinfection products from March 4 to 5 in 2020. In our study, we also analyzed the influencing factors of using masks and disinfection products. Results 1 713 valid questionnaires in total were collected and 492 residents were male (28.72%). Among them, 382 (24.12%) thought it would be safe to wear multiple masks. In addition, there were 269 (15.70%) believed that masks could be used after being boiled and 265 (15.47%) thought that masks sprayed with alcohol could be used. There were 1 529 (89.26%) using disinfection products in the last month. The main sites of disinfection were door handle/switch/button (84.96%), floor (71.88%) and toilet/urinal (70.70%), respectively. Multivariate Logistic regression analysis showed that residents with higher education, older age, higher monthly income, and enterprise staff were used more masks and disinfection products. Conclusions During the epidemic of COVID-19, the rate of residents who used masks and disinfection products were high. But there were still some misunderstandings. Education level, age, occupation and monthly income had an impact on wearing masks and using disinfection products, so targeted publicity and education should be conducted.

Application of Logistic model combined with ROC curve and Bayes discriminant function in the diagnosis of severity of COVID-19

ZHANG Yu, SHU Xiao-li, ZHONG Bo, LI Rong-zhi, LIU Qian, ZHENG Si-si, LIU Yang

2020, 24(7): 851-855. doi: 10.16462/j.cnki.zhjbkz.2020.07.020

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Objective corona virus disease 2019(COVID-19) patients were predicted by two statistical methods (Logistic model combined with ROC curve and Bayes discriminant function), in order to assist the clinical classification of patients for early diagnosis. Methods Demography related information, clinical data and epidemiological investigation data of 538 confirmed cases was collected. Number of cases (%) was used to describe categorical data. Logistic model is used for single factor and multi factor regression analysis; ROC curve method is used to find the optimum critical point; Bayes discriminant method is used to classify the subjects. Results The overall prediction accuracy of the Logistic combined ROC curve method was 0.682, the prediction accuracy of severe symptoms cases was 0.784, and that of mild symptoms cases was 0.662. The overall prediction accuracy of Bayes discriminant method was 0.703, the prediction accuracy of severe symptoms cases was 0.705, and that of mild symptoms cases was 0.702. Conclusions Logistic regression analysis model combined ROC curve method and Bayes discriminant analysis both have high accuracy in the diagnosis of clinical severity of COVID-19, and each has its own advantages. Both of them have certain application value.

Analysis of the incidence and risk factors of breast cancer-related upper limb lymphedema in postoperative patients

MA Xiao-kai, HUANG Jian-kang, WANG Wan-xia, GAO Xue-yun, PENG De-feng, CHEN Chun-chun, LI Yu-long

2020, 24(7): 856-859. doi: 10.16462/j.cnki.zhjbkz.2020.07.021

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Objective The purpose of this study was to explore the risk factors of breast cancer-related upper limb lymphedema (BCRL) in postoperative patients. Methods There were 62 patients were enrolled from the First Affiliated Hospital of Bengbu Medical College in the present study from July 2008 to November 2019. The 5-point circumference measurement method combined with the Norman questionnaire to assess the occurrence of upper extremity lymphedema, and to analyze the incidence and risk factors of BCRL according to the clinical data. Results Of the 62 patients, upper limb lymphedema occurred in 22 (35.5%), 20 had mild edema, and 2 had moderate edema. Univariate analysis results suggest that BCRL is related to the patient's age, body mass index (BMI), number of axillary lymph node dissection, axillary group Ⅲ lymph node dissection, and postoperative time (all P < 0.05). Binary logistic multivariate analysis results suggest that age, BMI, and postoperative time are independent risk factors for BCRL (all P < 0.05). Conclusions BCRL had a certain incidence, and it can occur in the early postoperative period, especially for patients age ≥ 53 years old, BMI ≥ 27 kg/m², and those who accepted operation more than 6 months, preventive interventions should be action taken to prevent and reduce the occurrence of BCRL.

Epidemiological analysis of first-aid trauma in Beijing from 2011 to 2017

ZHU Ying-xuan, LIU Meng-yang, LIU Yue, LI Zhi-wei, GUO Xiu-hua, ZHANG Jin-jun

2020, 24(7): 860-864. doi: 10.16462/j.cnki.zhjbkz.2020.07.022

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Objective To analyze the epidemiological characteristics of pre-hospital emergency trauma patients in Beijing from 2011 to 2017 and to provide a theoretical basis for the formulation of comprehensive trauma prevention and control measures. Methods Data on first-aid trauma cases from 2011 to 2017 were collected from the Beijing Emergency Medical Center. Data were analyzed by descriptive epidemiological methods from population, time, and space angles while taking various causes of trauma into account. Results A total of 593 453 trauma patients were enrolled in this study. The ratio of male to female was 1.40:1. The age group of the highest incidence amount was 35-64 years old, with a percentage of 36.63%; Followed by 15-34 years old, with a percentage of 31.96%. Classified by the cause of the injury, traffic accidents accounted for the largest proportion of 28.19%. Traffic accidents were the leading cause of injury in people under 65 years old. Moreover, falls were the leading cause of injury in people aged 65 and over. Generally speaking, the number of trauma patients increased significantly by year. There were more patients in urban areas than in the suburbs. The occurrence of trauma was closely related to the activity level of the group. It was more during the day than at night, especially from 7 am to 8 am, which is the peak period of fall injury and traffic accidence injury. Conclusions Pre-hospital emergency trauma in Beijing has apparent characteristics of population, time, and space distribution, which is of considerable significance to guide the rational allocation of hospital first-aid resources and to formulate effective trauma prevention and control measures.

The Discoverer of Vaccination and Smallpox Vaccin: Edward Jenner

WANG Hai-li, WU Jun, WANG Bin, YE Dong-qing

2020, 24(7): 865-868. doi: 10.16462/j.cnki.zhjbkz.2020.07.023

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Edward Jenner (1749-1823) is a famous British doctor, scientist, and the founder of modern immunology. He found the subtle relationship between cowpox and smallpox through careful observation of natural phenomena, and proved the immunity of vaccinia against smallpox through a rigorous scientific verification process, saving the lives of miuions of people; he also coined the terms of "vaccine" and "virus", which is still in use today.

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2020 Vol. 24, No. 7

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

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