中华疾病控制杂志

Issues of traffic noise pollution and health in the urbanization

HUANG Jing, GUO Xin-biao

2020, 24(8): 869-870, 960. doi: 10.16462/j.cnki.zhjbkz.2020.08.001

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The impact of traffic noise pollution on health is an important environmental and health issue in the urbanization. According to the research evidence, traffic noise has become one of the important environmental risk factors which affect the physical and mental health including nervous system, psychological well-being and cardiovascular system of the public. It is essential to differentiate the health impacts of different types of traffic noise, and explore the comprehensive effects of traffic noise, air pollution, green space and other related environmental factors together in future research. The findings will provide scientific basis for traffic noise pollution control and public health protection in the urbanization.

Fluctuation analysis and long-term and short-term prediction of class B respiratory infectious diseases in China

LIU Chao, TIAN Long-long, WANG Ke-han

2020, 24(8): 871-875, 901. doi: 10.16462/j.cnki.zhjbkz.2020.08.002

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Objective To analyze the fluctuation law of the incidence of class B respiratory infectious diseases in China,to make long-term trend prediction and short-term prediction,and to provide scientific basis for formulating prevention and control strategies. Methods Based on CensusX-12 seasonal adjustment method and the Hodrick-Prescott (HP)filtering method,the monthly time series data of the incidence of class B respiratory infectious diseases in China was separated.The irregular changes,seasonal factors,trend factors and circulation factors were separated in order to study its fluctuation rules.The long-term trend prediction and short-term prediction were realized by using the regression model and the Holt-Winter seasonal index smoothing model. Results The incidence of class B respiratory infections diseases was greatly affected by seasonal factors,and showing cyclical fluctuations.The long-term trend of the incidence was found to be decreasing year by year.Meanwhile,the Holt-Winter seasonal index smoothing model was used to obtain a good short-term prediction effect. Conclusions Censusx-12 seasonal adjustment method and HP filter method can be effectively used to analyze the seasonal characteristics and circulation cycle characteristics of class B respiratory infectious diseases in China,and achieve long-term trend prediction and short-term prediction.The results have guiding significance for the formulation of disease prevention and control strategies.

Analysis of spatial autocorrelation of hemorrhagic fever with renal syndrome in Jiangxi Province from 2013 to 2018

SONG Ning-juan, XIE Yun, DING Sheng, LIU Xiao-qing, PAN Huan-hong, YUAN Hui

2020, 24(8): 876-880. doi: 10.16462/j.cnki.zhjbkz.2020.08.003

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Objective Spatial autocorrelation analysis of hemorrhagic fever with renal syndrome (HFRS) in Jiangxi Province from 2013 to 2018 was carried out to explore its spatial distribution characteristics. Methods Excel 2003 and SPSS 23.0 software were used to collect and sort out the data of HFRS, using ArcGIS 10.2 software to make the vector map of provincial county and district, and using spatial autocorrelation statistical method to analyse the global and local aggregation of HFRS monitoring data at county-level scale. Results From 2013 to 2018, there were 3 861 HFRS cases, and the incidence rate was 1.41/100 000.The incidence rate in the elderly aged 60 and above was 2.22 /100 000, which was the highest one among all groups. Global spatial autocorrelation analysis showed that the Moran's I coefficients from 2013 to 2018 were in 0.233-0.343 (all Moran's I>0, all P < 0.05). Local spatial autocorrelation analysis suggested that the incidence rate of HFRS presented three spatial aggregation patterns: "high-high", "low-high", "low-low", all the distribution patterns were statistically significant (all P ≤0.05). The "high-high" clustering areas were mainly concentrated in the east-central of Yichun City, which was consistent with descriptive analysis of the high incidence area. Counties or districts that located in Jian City and Ganzhou City presented the "low-low" relation. Conclusions The incidence rate of HFRS in Jiangxi Province appeared a significant spatial aggregation distribution. Yifeng County, Gaoan County, Shanggao County and Fengxin County in Yichun City were "high-high" clustering areas, indicating that it is necessary to strengthen the work in prevention and control.

Analysis of epidemiological characteristics and trend prediction of influenza in Yinchuan City from 2009 to 2018

SHA Xiao-lan, LI Yan, LIU Xiao-juan, LIU Lan

2020, 24(8): 881-885, 928. doi: 10.16462/j.cnki.zhjbkz.2020.08.004

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Objective To analyze the incidence and epidemiological characteristics of influenza in Yinchuan City from 2009 to 2018, and predict the incidence trend, so as to provide scientific evidence for prevention and control of influenza. Methods Descriptive study was used to describe the epidemiological characteristics of influenza in Yinchuan City from 2009 to 2018, and autoregressive integrated moving average model (ARIMA model) was used to forecast the incidence trend of influenza from January 2019 to June 2020. Results A total of 2 254 cases of influenza were reported in Yinchuan City from 2009 to 2018. The average annual incidence rate was 11.22/100 000. The incidence of influenza showed an overall downward trend (χ²_Trend=28.95, P < 0.001). Influenza occurred most frequently in autumn and winter. The peak months were from November to January of the following year. The highest incidence region was Xixia district (504 cases, 18.34/100 000), and the lowest one was He Lan county (75 cases, 3.59/100 000). The incidence of influenza was higher in men than in women (11.86/100 000 vs 10.56/100 000, χ²=7.580, P < 0.001). It was distributed in all age groups. The main age rang was 0-5 years old (528 cases, 23.43%). Most cases were students (776 cases, 34.43%), scattered children (471 cases, 20.90%) and farmers (240 cases, 10.65%). The ARIMA model showed that the incidence of influenza in Yinchuan City from January 2019 to June 2020 was the same as that in 2018. Conclusions The incidence of influenza in Yinchuan City decreased from 2009 to 2018. Xixia district was the key prevention and control area of influenza. Students, scattered children and farmers were the vulnerable groups, which suggest that we should pay more attention to the health of vulnerable groups, strengthen surveillance and management of influenza in high-risk areas and children under the age of five.

Prevalence and healthcare-seeking practices of children with acute respiratory infections in Pudong, Shanghai during 2018—2019

LIU Si-jia, ZHANG Li, WANG Yuan-ping, YE Chu-chu, HAO Li-peng, ZHU Wei-ping, CHEN Yu

2020, 24(8): 886-891. doi: 10.16462/j.cnki.zhjbkz.2020.08.005

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Objective To acquire the incidence of acute respiratory infections (ARI) and influenza like illness (ILI) among children in Pudong New Area, Shanghai, and to explore the characteristics of their healthcare-seeking practices and the influencing factors. Methods Cross-sectional study design and multi-stage random sampling method were used to conduct face-to-face questionnaire interviews with guardians of children aged 0-14 years old in Pudong New Area, Shanghai. ARI related conditions and healthcare-seeking practices during the winter and spring of 2018-2019 were investigated through those interviews. The influencing factors were analyzed by multivariate Logistic regression model. Results A total of 2 375 valid questionnaires were collected. The prevalences of ARI and ILI among children in Pudong New Area, Shanghai during the winter and spring of 2018-2019 were 36.1% (858/2 375) and 14.0% (332/2 375). The prevalence of ARI in children aged 2-4 years old (42.4%) was significantly higher than other age groups (OR=2.072, 95% CI: 1.482-2.896). Suffering from basic respiratory diseases (OR=2.740, 95% CI: 1.865-4.025) was the risk factor for ARI in children. Compared with children in kindergarten, the risk of ARI in diaspora children (OR=0.579, 95% CI: 0.426-0.785) and in school students (OR=0.547, 95% CI: 0.434-0.688) were lower. The rates of ARI related healthcare-seeking and hospitalization were 58.5% (502/858) and 1.7% (15/858), respectively. Healthcare-seeking rate of 2-4 years old children (OR=0.297, 95% CI: 0.170-0.521) and 5-14 years old children (OR=0.286, 95% CI: 0.149-0.549) were significantly lower than children under 1 year old. The main factors affecting the behavior of consultations were symptoms (fever, cough, sore throat, sputum, and fatigue)(all P < 0.05). 81.1% (407/502) of children had gone to the secondary medical institutions for healthcare. Conclusions The burden of disease caused by ARI among children in Shanghai cannot be ignored. Comprehensive monitoring based on communities and medical institutions should be continued to obtain a more accurate disease burden data, and vaccination against respiratory infectious diseases such as influenza and pneumonia and other preventive measures should be promoted.

An investigation on the situation of infectious diseases among the China medical team members

WANG Xiao-jie, HUO Xiang, MAO Jing-lai, BAO Jie

2020, 24(8): 892-895. doi: 10.16462/j.cnki.zhjbkz.2020.08.006

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Objective To know the situation of infectious diseases among the China medical team (CMT) members working abroad in recent years. Methods A electronic questionnaire survey was conducted on some CMT members who had participated in foreign medical assistance mission from January 2015 to November 2019, and the infection rate and other indicators were calculated. Results The infection rate of 479 subjects was 19.83%, 16 were infected twice or more, and the incidence density was 0.168 times per person year. Among the infected, 65.26 percent were infected within 6 months. Malaria was the most common infections among CMT members accounting for 61.06%. There were 68.69% of respondents believing that the risk of contracting infectious diseases during working abroad was very high, while 41.97% were satisfied with the precautions taken. The infection rate of CMT members were statistically significant (all P < 0.05) among different sending provinces, types of difficult areas, distribution of assisted areas, perceived risk, as well as satisfaction with prevention and control measures. Furthermore, the more difficult the country in which the CMT members worked, the higher the infection rate was (χ²=61.667, P < 0.001); The higher the perceived risk was, the higher the infection rate was (χ²=15.602, P < 0.001). Conclusions The CMT members are at higher risk of contracting infectious diseases while working abroad. Targeted measures should be taken to prevent and control infectious diseases among CMT members.

The status and trends of cancer deaths in Guangxi, from 2008 to 2016

QIN Xiao-dan, HUANG Kai-yong, HUANG Wen-xiu, WANG Ke, HE Zhi-kui, YANG Li

2020, 24(8): 896-901. doi: 10.16462/j.cnki.zhjbkz.2020.08.007

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Objective To observe the mortality and trend of malignant cancers in Guangxi from 2008 to 2016, so as to provide evidence for formulating strategies for preventing and treating malignant cancers. Methods Data on deaths from malignant cancers in Guangxi residents was collected from seven national monitoring sites in death cause monitoring system. The crude mortality rate, standardized mortality rate, constituent ratio were calculated. The trend of cancer mortality was analyzed with Joinpoint model. Results The crude mortality rate of cancer was 128.60/100 000, and the standardized mortality rate was 129.80/100 000 in Guangxi from 2008 to 2016. The standardized male-female mortality ratio was 1.94:1 and the urban-rural ratio was 1.25:1. The mortality of malignant cancers had increased with age. The top five causes of death were liver cancer, lung cancer, stomach cancer, colorectal cancer, and nasopharyngeal cancer. Joinpoint model analysis revealed that the mortality rate of malignant cancers had increased first and then decreased slowly from 2008 to 2016. It had a tendency to increase from 2008 to 2010, with the annual percent change (APC) of 23.38%, but showed a slowly declined trend from 2011 to 2016 (APC=-0.62%). The mortality rate of cancer had increased first and then decreased slowly in males, but it changed not obviously in females. The mortality rate of cancer showed an increasing trend in urban areas, and in rural areas it rose first and then slowly declined. The mortality rate of lung cancer (APC=4.73%) and colorectal cancer (APC=6.31%) showed an increased trend, for both male and female in urban and rural areas. The mortality rates of liver cancer, stomach cancer, and nasopharyngeal cancer were relatively stable. Conclusion The mortality rate caused by cancer in Guangxi is still at a relatively high level in China. Particularly, the mortality rate of urban residents and the mortality of lung cancer and colorectal cancer shows an increased trend.

Association of FTO gene with obesity in Yi adults of Sichuan Province, China

LIU Qian-qian, PAN Li, WAN Shao-ping, YI Huo-wu-li, YANG Fang, LI Zheng, WANG Ye, YONG Zheng-ping, HE Hui-jing, SHAN Guang-liang

2020, 24(8): 902-907. doi: 10.16462/j.cnki.zhjbkz.2020.08.008

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Objective To investigate the association between fat mass and obesity associated (FTO) gene and obesity in Yi adults in Sichuan Province. Methods A case-control study was performed by recruiting 322 obesity cases [body mass index (BMI)>28 kg/m²] from the Yi migrant study conducted in Sichuan Province. 644 non-overweight and non-obese controls were selected as control group (BMI < 24 kg/m²), they were frequency-matched to the cases by age and gender. FTO gene (rs1121980 and rs17817449) were genotyped using the TaqMan method.Unconditional Logistic regression analysis was used to test the association between genetic polymorphisms and obesity. Results The rs1121980 polymorphism was associated with obesity in Yi farmers (OR=1.45, 95% CI: 1.01-2.07, P=0.042, under additive model; OR=1.52, 95% CI: 1.01-2.31, P=0.048, under dominant model). No significant association between rs17817449 polymorphisms and obesity was observed in Yi farmers(all P>0.05). In Yi migrants, we found no significant association between the FTO single nucleotide polymorphism(SNP) and obesity(all P>0.05). Conclusion In Yi farmers, FTO rs1121980 polymorphism was independently associated with adult obesity. In Yi migrants, we found no significant association between the FTO SNPs and adult obesity.

Correlation between estrogen receptor alpha gene polymorphism and risk of bladder cancer

JIA Min, ZHAO Ling-yan, BAI Rui-xia, QIAO Jian-kun, LIU Jun-feng, PANG Hui, GAO Yu-min

2020, 24(8): 908-913. doi: 10.16462/j.cnki.zhjbkz.2020.08.009

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Objective To study the relationship between single nucleotide polymorphisms of estrogen receptor alpha gene and susceptibility to bladder cancer. Methods 220 new cases of bladder cancer patients and 220 healthy controls were collected from two hospitals. The general demographic characteristics of the study subjects was collected through questionnaires. Electronic medical records were used to collect clinical examination data. Detection of genotypes was detected by improved multiple ligase detection reaction (iMLDR). Enzyme-linked immunosorbent assay was used to detect the expression of estrogen receptor alpha (ESRα) in the serum of cases and control groups. Results The body mass index, diet and other habits of the case group and clinical examination results such as hemoglobin and neutrophil percentage were significantly different from those of the control group (all P < 0.05). The rs1801132 locus gene and genotype frequency were related to pathological grade (χ² = 9.607, P = 0.022;χ² = 24.468, P < 0.001) and distant metastasis (χ² = 2.367, P = 0.027;χ² = 21.758, P = 0.001). The expression of ESRα receptor in the serum of bladder cancer patients was significantly lower than that in the normal population (t=5.588, P < 0.001). The polymorphism of rs1801132 locus was statistically different in bladder cancer risk among different genotype populations [GG:OR (95% CI) = 0.325 (0.141-0.751), P = 0.009; GC: OR (95% CI) = 0.409 (0.198-0.847), P = 0.016]. Conclusion The polymorphism of the rs1801132 is associated with bladder cancer, and the GG/GC genotype plays a protective role in bladder cancer. There was no correlation between rs2234693 polymorphism and bladder cancer.

Association between physical activity and prevalence of sarcopenia in community-dwelling elderly

MENG Xin-yu, ZHAO Wen-jing, ZHANG Jin-hua, ZHAO Yan-mei, CUI Xue-yan, ZHANG Hai-yan, SU Miao-miao, ZHOU Xiao-yan, ZHANG Hong-xia

2020, 24(8): 914-918. doi: 10.16462/j.cnki.zhjbkz.2020.08.010

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Objective To explore the effect of daily physical activity and exercise habits on sarcopenia in the community older people. Methods The community-dwelling elderly people aged 65 and above were recruited in May-August, 2019. The prevalence of sarcopenia was investigated by using the diagnostic criteria recommended by the Asian Working Group for Sarcopenia.The general demographic data and living habits of the elderly were collected by self-made questionnaire. The daily physical activity of the elderly was assessed by the international physical activity questionnaire (IPAQ-s). Logistic regression models were used to examine the relationship between sarcopinia and daily physical activity, exercise habits. Results The prevalence of sarcopinia in the community-dwelling elderly was 12.3%. After adjusting the confounding factors such as demographic characteristics and living habits, the incidence of sarcopinia in the elderly with exercise habit was 2.759 times (OR=2.759, 95% CI: 1.213-5.919, P=0.017) lower than that in non-exercise habit. For every year that the number of years of regular exercise increased, the risk of sarcopenia decreased by 0.070 (OR=0.930, 95% CI: 0.878-0.985, P=0.013). Increases each additional hour of exercise in the elderly, the risk of sarcopenia decreased by 0.611(OR=0.389, 95% CI: 0.187-0.809, P=0.012). Conclusion The prevalence of sarcopinia is high among the elderly in China. The risk of sarcopinia can be reduced in the elderly by regular exercising as early as possible in middle age, for more than 2 days a week and more than 25 minutes each time.

The influencing factors of sleep time and its relationship with cognition and depression in middle-aged and elderly people

CHEN Chen, LI Jiang-ping, ZHANG Jia-xing, ZHAO Yuan, GUO Zhong-qin

2020, 24(8): 919-922. doi: 10.16462/j.cnki.zhjbkz.2020.08.011

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Objective To explore the associations of sleep time with cognition and depression in Chinese middle-aged and elderly people. Methods 17 175 subjects were selected according to the inclusion criteria and exclusion criteria from 2015 China health and retirement longitudinal study (Charls). Chi-square test was used to compare the detection rate of depression in different sleep time groups. The relationship between cognition and sleep time was adjusted by covariance analysis. Multiple linear stepwise regression was used to analyze the influencing factors of sleep time. Results The depression were more likely to be detected in short sleep time group (χ²= 461.352, P < 0.001). In view of cognitive level, the normal sleep time group performed the best while the long sleep group performed the worst. The multiple linear stepwise regression showed that gender, age, residence, alcohol drinking, health self-evaluation and depression were influencing factors of the sleep time, and there was interaction between sleep and depression (all P < 0.05). Conclusion The sleep time of middle-aged and elderly people is closely associated with cognitive ability and depression. So comprehensive intervention measures should be taken to improve the sleep quality of these people, which can slow down their cognitive aging and reduce the risk of depression.

The status and influencing factors of non-suicidal self-injury among middle school students in Anhui Province

HU Yan, XU Hui-qiong, WAN Yu-hui, SU Pu-yu, FAN Yin-guang, YE Dong-qing

2020, 24(8): 923-928. doi: 10.16462/j.cnki.zhjbkz.2020.08.012

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Objective To describe the status and influencing factors of non-suicidal self-injury (NSSI) among middle school students in Anhui Province. Methods Designed questionnaires were delivered to 7 125 middle school students who were selected by stratified cluster sampling from 3 cities. The detection rate of NSSI was compared among different demographic characteristics. Multivariable Logistic regression models were used to explore the associations between correlation factors and non-NSSI, occasional NSSI and recurrent NSSI. Results The most common NSSI behaviors were hitting with fists among boys and pinching among girls. The detection rate of non-NSSI, occasional NSSI and repetitive NSSI were 49.0%, 21.4% and 29.6%, respectively. The differences of non-NSSI, occasional NSSI and repetitive NSSI detection rate between different genders and left-behind states, or among different grades and depressive symptoms were statistically significant (all P < 0.05). Being a boy, left-behind, mild and moderate depressive, having poor self-rated scoresand fewer friends were independent risk factors for occasional and repeated NSSI. Conclusion The detection rate of NSSI of Anhui middle school students is high, and a variety of internal and external factors are related to the engagement of NSSI.

Evaluation of the colorectal cancer missing rate by colonscopy

LIU Yu-ying, WEI Jun-li, LI Yan-hong, YAN Yue, ZHAO An-shi, LUO Lin-na, WU Min-qing, XIE Chuan-bo

2020, 24(8): 961-964. doi: 10.16462/j.cnki.zhjbkz.2020.08.019

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Objective To evaluate the colonscopy missed colorectal cancer rate using the data collected from Prostate, Lung, Colorectal, and Ovarian (PLCO) study. Methods The colorectal cancer patients who were enrolled in the screening arm of PLCO study and completed the baseline or 3 or 5 years endoscopy screenings were selected as participants. The missing rate was defined as the number of colorectal cancer patients missed by colonscopy divided by the number of colorectal cancer patients confirmed by colonscopy, annual questionnaire, or cancer registry system. Results 59 out of 338 colorectal cancer patients were missed by colonscopy, which accounted for 17.5% of the total patients. The patients aged 65-69 years old (24.2%), with moderately differentiated histological type (32.4%), and with lesion s at proximal colon sites(47.4%)had high missing rates. Conclusions Colonscopy missed a relatively high proportion of colorectal cancer patients especially for those occurring at proximal colon. To improve the diagnostic accuracy of noninvasive screening method might overcome the limitation of high missing rate of endoscopy.

Mental health status of medical staff based on SCL-90 in Anhui Province during the epidemic situation of COVID-19

CHEN Gui-mei, RONG Jian, HE Xin-ran, YUAN Hong-xu, CHEN Ren, WANG Li, XU Wang-quan, ZHENG Tao, DING Hong

2020, 24(8): 965-970. doi: 10.16462/j.cnki.zhjbkz.2020.08.020

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Objective To understand the current situation and the influencing factors of psychological symptoms of medical staff in Anhui Province during the epidemic situation of coronavirus disease 2019 (COVID-19), and to provide scientific basis for targeted psychological intervention and guidance for medical staff. Methods The data were collected from February 12 to March 4, 2020. Symptom checklist 90 (SCL-90) was used to evaluate the mental health status of medical staff in Anhui Province. A total of 12 759 valid questionnaires were obtained. Descriptive analysis, t-test, χ² test and binary Logistic regression model were employed for statistical analysis. Results The total factor score of SCL-90 was (1.41±0.45), and the positive rate of psychological abnormality detection was 36.1%. Compared with the Chinese normal population, the scores of obsessive-compulsive symptoms, interpersonal sensitivity, depression, hostility, paranoia, psychosis and sleeping and eating state of the medical staff were lower than those of the Chinese norm, while the score of phobia factor was higher than that of the Chinese norm, and the differences were statistically significant (all P < 0.05). The results of Binary Logistic regression showed that female, senior professional, in provincial or county type hospital were risk factors for mental health of doctors (all P < 0.05), and female, 30-39 age group, in provincial, municipal or county type hospital were risk factors for mental health of nurses (all P < 0.05). Conclusions The overall mental health level of medical staff during the epidemic of COVID-19 in Anhui Province is relatively stable, which is better than the Chinese norm, but the positive rate of psychological abnormal is high. The risk factors of psychological abnormalities are different in doctors and nurses. It is suggested that targeted measures should be taken to improve mental health level of medical staff.

Study on the trend of health literacy and its influencing factors in Chongqing, 2012-2016

LIU Ya-xin, LIU Hong-yan, SHENG Yang, LYU Jia, GU Dian, ZHAO Yong, ZENG Huan, YUAN Jun

2020, 24(8): 929-933. doi: 10.16462/j.cnki.zhjbkz.2020.08.013

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Objective To understand the changing trend of health literacy level of residents in Chongqing from 2012 to 2016, and to explore the influencing factors of health literacy level, so as to provide scientific basis for the improvement of health related policies. Methods Stratified multi-stage random sampling was used in the questionnaire survey of residents in Chongqing from 2012 to 2016. Results The health literacy levels of residents in Chongqing City from 2012 to 2016 were 4.94%, 8.38%, 8.71%, 10.16%, and 11.82% respectively. The analysis of multiple factors showed that female (OR=1.018, 95% CI:1.015-1.021, P < 0.001), people under the survey aged between 25 and 34 (OR=1.037, 95% CI:1.033-1.041, P < 0.001), people under the survey aged between 34 and 44 (OR=1.143, 95% CI:1.139-1.148, P < 0.001), primary school(OR=2.065, 95% CI:2.044-2.087, P < 0.001), junior middle school (OR=3.804, 95% CI:3.765-3.843, P < 0.001), senior high school, vocational high school and technical secondary school (OR=6.245, 95% CI:6.179-6.311, P < 0.001), junior college, undergraduate degree and degrees above those (OR=12.305, 95% CI:12.173-12.438, P < 0.001), the annual average household income between 3 000 and 5 000 yuan (OR=1.570, 95% CI:1.560-1.580, P < 0.001), the annual average household income between 5 000 and 10 000 yuan (OR=1.897, 95% CI:1.887-1.907, P < 0.001), the annual average household income between 10 000 and 15 000 yuan(OR=1.885, 95% CI:1.875-1.896, P < 0.001) and the annual average household income more than 15 000 yuan(OR=2.097, 95% CI:2.086-2.108, P < 0.001) were protective factors for health literacy; rural areas, the people under this survey aged between 45 and 54 the people under this survey aged between 55 and 64 and the people under this survey aged between 65 and 69 were risk factors of the health literacy. Conclusions From 2012 to 2016, the health literacy level of the residents in Chongqing City has been increasing year after year, and health education should be conducted for rural residents. The health education should be concentrated on people in rural areas, male, the elderly, people with lower education level, and people with lower average annual household income.

Molecular epidemiological characterization for VP1 region gene of coxsackievirus A6 in China

FAN Yun-yan, OU Song-feng, CHEN Min-mei

2020, 24(8): 934-938, 945. doi: 10.16462/j.cnki.zhjbkz.2020.08.014

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Objective To analyze the epidemic and genetic evolution principals of Coxsackievirus group A type 6 (CV-A6) VP1 region from 2010 to 2018 in China so as to provide scientific basis for the prevention and treatment of Hand-foot-mouth disease (HFMD). Methods The full-length VP1 nucleotide sequence of CV-A6 virus from 2010 to 2018 in China was obtained from GenBank. The phylogenetic trees based on VP1 sequences of CV-A6 were constructed by the MEGA V7.0 and Interactive Tree of Life V5 (iTOLV5) software, and the nucleotide homology was analyzed with DNAstar V8.1.3. Results The CV-A6 D3 was the main sub-genotype, accounting for 95.45% of the total 880 strains. The homology of nucleotides sequences in different genotype was between 80.8% and 86.0% while the homology of nucleotides sequences in the same genotype was between 88.1% and 100.0%.The VP1 sequences of D2 was relatively stable without any global amino acid variation. However, the VP1 sequences of D3 had multi-point amino acid substitutions, in which A5T, T283A, N137S, V242I, A30V and I174V amino acid substitution occurred circularly. This evolutionary pattern was similar to that in Vietnam but different from that in Japan. The proportion of 5T, 30A, 137N and 242V in the VP1 region increased year by year, which may be related to the increasing proportion of the mild and severe cases of HFMD caused by CV-A6 in China. Conclusions The emergence of CV-A6 D3 Sub-genotype strains with high genetic diversity in VP1 region could be a factor associated with the repeated epidemics, which helps to explain the epidemics and characteristics of CV-A6 in China.

The mechanism of CRISPR-mediated drug resistance and the relationship between the characteristics of CRISPR and isolation site in Klebsiella pneumoniae

CUI Cong-cong, LIANG Wen-juan, YANG Hai-yan, CHEN Shuai-yin, LONG Jin-zhao, DUAN Guang-cai

2020, 24(8): 939-945. doi: 10.16462/j.cnki.zhjbkz.2020.08.015

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Objective To understand the regulatory mechanism of clustered regularly interspaced short palindromic repeats (CRISPR) to drug resistance of Klebsiella pneumoniae in respiratory specimens, and to analyze the relationship between the characteristics of CRISPR and the location of isolation. Methods 120 strains of Klebsiella pneumoniae were collected and genomic DNA was extracted. CRISPR-positive strains were identified by amplifying CRISPR/CRISPR-associated(Cas) related genes CRISPR 1 and CRISPR 2. The resistance phenotype of CRISPR-positive strains was detected by the BD Phoenix-100 bacterial identification instrument. CRISPR Target was used to look for homologous bacteriophages or plasmids with spacer sequence, find the drug resistance information of homologous bacteriophages or plasmids in Center for Genomic Epidemiology and detect the drug resistance genes of the strain where the spacer sequence is located, and analyze the relationship between the drug resistance genes of the two. CRISPR Finder was used to analyze CRISPR and multi-sequence alignment was used to analyze the consistency of spacer sequences. Results The positive rates of CRISPR 1 and CRISPR 2 were 12.50% and 13.33%; The homologous plasmids of the spacer sequence and the strains in which they were both carried common drug resistance genes, and the resistance phenotype of the strain was highly consistent with the drug resistance genes they carry. At the same location, the CRISPR distribution of the strains was extremely similar. Conclusions Klebsiella pneumoniae regulates drug resistance by integrating foreign plasmid resistance gene fragments into the strain's genome. The distribution of spacer sequence in CRISPR is closely related to the location of the strain isolation, which provides a theoretical basis for clinical treatment and infection control work.

Antibiotics use in general hospitals in Beijing from 2010 to 2015

WANG Zi-jing, WU Yao, WU Jun-hui, WANG Meng-ying, WANG Xiao-wen, WANG Jia-ting, WU Tao, WU Yi-qun, HU Yong-hua

2020, 24(8): 946-950. doi: 10.16462/j.cnki.zhjbkz.2020.08.016

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Objective To know the situation of the use of antibiotics in general hospitals at all levels in Beijing from 2010 to 2015, and to provide a basis for antibiotics management and policy formulation. Methods Data of this study were from Beijing medical insurance database for employers (BMCDE). Based on stratified random sampling, 18 primary hospitals, 9 secondary hospitals and 12 tertiary hospitals in Beijing were selected. Drug prescription data of outpatient and inpatient departments from January 2010 to December 2015 in each hospital was extracted from BMCDE. The proportion of antibiotic prescriptions in outpatient, the rate of patients who receiving antibiotic therapy in inpatient and the percentages of commonly antibiotics prescribed were analyzed. Results From 2010 to 2015, the proportion of antibiotic prescriptions in outpatient of general hospital decreased from 16.0% to 10.8%, and the rate of patients who receiving antibiotic therapy in inpatient decreased from 70.9% to 53.0%. The reduction in secondary and tertiary hospitals was higher than that in primary hospitals. The proportion of broad-spectrum antibiotics prescription in outpatient fluctuated around 70.0%, while the proportion in hospital increased from 61.8% to 63.9%. The overuse of broad-spectrum antibiotics in secondary hospitals was serious. Cephalosporins, quinolones and penicillin were the three most commonly used antibiotics, especially the second and third generation cephalosporins. Conclusions From 2010 to 2015, in general hospitals in Beijing, the use of antibiotics showed a trend of continuous improvement, and primary hospitals should be the focus of monitoring. The proportion of broad-spectrum antibiotics prescriptions is still high, especially in secondary hospitals, which should be paid attention to.

Development and application of SIS model on C. sinensis transmission and intervention with preventive chemotherapy

HUANG Xiao-hong, FANG Yue-yi, LAI Ying-si

2020, 24(8): 951-955. doi: 10.16462/j.cnki.zhjbkz.2020.08.017

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Abstract:
Objective To develop a clonorchis sinensis(C. sinensis) transmission dynamic model for the assessment of the long-term effects of preventive chemotherapy. Methods A susceptible-infected-susceptible (SIS) compartmental transmission model was developed to describe the dynamics of C. sinensis infection. The corresponding parameters were estimated through a data-driven Bayesian melding approach, based on data from a typical setting of clonorchiasis. With application of the model, we simulated the long-term effects of preventive chemotherapy under different delivery modes (pulse/continuous), coverages, frequencies and intervention durations. Results The model evaluation showed good capacities of fitting and prediction. The long-term effects of preventive chemotherapy against clonorchiasis between pulse and continuous delivery modes were similar. Preventive chemotherapy had significant control effects against clonorchiasis. Particularly, higher coverages, higher frequencies and longer duration of intervention could result in better effects. However, the effects were not sustainable, as the prevalence would rebound after intervention stopped. Conclusions The model we developed is able to assess the long-term effects of preventive chemotherapy against clonorchiasis effectively. The effects of preventive chemotherapy are not sustainable. Health education and environmental improvement should be combined to improve the sustainability for disease control.

The efficacy, safety and cost-minimization analysis of different doses of pegylated recombinant human granulocyte-colony stimulating factor

FU Chang-fang, HAN Xing-hua, LI Yan, SHEN Ai-zong

2020, 24(8): 956-960. doi: 10.16462/j.cnki.zhjbkz.2020.08.018

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Objective To evaluate the efficacy, safety and economics of myelosuppression treated by different doses of pegylated recombinant human granulocyte-colony stimulating factor(PEG-rhG-CSF), so as to provide reference for clinical use. Methods 106 patients with grade IV myelosuppression after chemotherapy from January 2017 to December 2018 were collected. According to different doses, patients were divided into two groups: 64 cases in group A (PEG-rhG-CSF 3 mg) and 42 cases in group B (PEG-rhG-CSF 6 mg). Clinical efficacy and adverse reactions were compared, and treatment cost was calculated so that cost-minimization analysis in pharmacoeconomic was compared between the two groups. Results There was no significant difference in clinical efficacy and adverse reactions between group A and group B (all P>0.05). The cost of these two regimens was RMB 1 705 for group A and RMB 3 410 for group B. The regimen in group A was more economical. Conclusions The regimen in group A(PEG-rhG-CSF 3 mg)is the proper option for grade IV myelosuppression in China, considering the efficacy, safety, and cost-minimization analysis of the drug.

Analysis and recommendation for the Non-Expanded Program on Immunization vaccines based on the immunogenicity and safety data

BAI Yun-hua, WANG Lin, ZHENG Dong-yi, ZHANG Li-li, SHI Xin-miao, WANG Xiao-yan, LU Qiang, LIU Yao-yao, LI Qian, LI Shu-ping, ZHANG Zhen, LIU Zhao-qiu, TAN Mei-zhen

2020, 24(8): 971-976. doi: 10.16462/j.cnki.zhjbkz.2020.08.021

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How to guarantee the safety and delay of the vaccination is our key focus in the present vaccination work. In this paper, we made specific vaccination suggestions through analysis on the safety and effectiveness of delayed vaccinations for commonly used Non-Expanded Program on/Immunization vaccines in adults in China, in order to provide evidence for the scientific use and play the preventive role of the vaccine.

Characteristics of HIV-positive patients diagnosed in a general hospital in Chengdu from 2016 to 2018

ZHANG Yu-jing, ZHAO Hai-ming, HUANG Xiao-feng, YAO Wei, LI Jing, CAO Wen-ping, LEI Li, GUO Jia-Xun, SONG Guo-ying

2020, 24(8): 977-980. doi: 10.16462/j.cnki.zhjbkz.2020.08.022

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Objective To investigate infection status and epidemiologic characteristics of human immunodeficiency virus (HIV)positive patients diagnosed in a general hospital in Chengdu from 2016 to 2018, and to provide scientific reference for prevention and control of HIV in hospital. Methods The antibody screening test for HIV during 2016 to 2018 was collected through the hospital inspection system. Furthermore, the demographic characteristics and the department information of HIV-infected patients were retrospectively collected. The SPSS 20.0 software was used for statistical analysis. Results The plasma HIV antibodies of 204 641 inpatients were detected, 489 plasma samples were positive with the positive rate of 2.39‰.The positive rates for three years were 2.45‰, 2.26‰ and 2.47‰, respectively. The main patients were males (84.05%), aged 50 years and over (42.54%), and married (43.76%). More than half of the patients (56.03%) were detected by other symptoms visits. The top two departments with the most positive patients were dermatological department and convenient outpatient service (2.32% and 1.27%, respectively). Conclusions Dermatological department and convenient outpatient service are the key departments. Screening test for key departments and high-risk groups should be strengthened.

Consistency study of two methods in detection of human epidermal growth factor receptor-2 in breast cancer

YANG Yi, MENG Gang

2020, 24(8): 981-984. doi: 10.16462/j.cnki.zhjbkz.2020.08.023

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Objective To evaluate the consistency of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) for the detection of human epidermal growth factor receptor-2 (HER-2) in breast cancer. Methods The patients who were diagnosed with breast cancer in a third-class A hospital in Anhui Province from 2013 to 2018 were selected. IHC and FISH were used to detect HER-2, and the differences and connections were compared. Results In the selected 276 breast cancer patients, FISH detection of HER-2 amplification was related to the histological grade of breast cancer. For patients with HER-2 of 3+ detected by IHC, the positive amplification rate of FISH could reach higher than 90%. When IHC was -/+ and 3+, the consistency of detection results between the two methods was the best.For patients with 2+ in HER-2 test, compared with FISH test, the coincidence rate of IHC was only 67.9%. Conclusions HER-2 gene amplification is associated with increased malignancy of breast cancer, HER-2 screening results of 2+ breast cancer by IHC requires additional FISH test, which is of guiding significance for the further diagnosis and treatment of patients.

Study on the burden of cancer in Liuzhou City from 2010 to 2017

LAN Jian, LI Ming-qiang, CUI Xue-lian, QIN Yu-lu, CHEN Ning-yu

2020, 24(8): 985-988. doi: 10.16462/j.cnki.zhjbkz.2020.08.024

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Objective To understand the burden of malignant tumors in Liuzhou City, and to explore its epidemiological characteristics, so as to provide a basis for targeted development of comprehensive tumor prevention and control strategies. Methods The death cases of malignant tumors in Liuzhou City from 2010 to 2017 were collected, and the burden of malignant tumors with disability adjusted life years (DALY) was calculated. Results The burden of malignant tumors in Liuzhou City was 200 939.13 person-years from 2010 to 2017, men accounted for 62.00% and women accounted for 37.99%. The DALY loss per thousand people was 21.59 per 1 000. From 2010 to 2017, the burden of malignant tumors in Liuzhou showed an upward trend. The burden of malignant disease increased with age, and the burden of disease increased significantly after the age of 30. Conclusions The burden of malignant tumors in Liuzhou is higher than the average levels in Guangxi and the national level, strengthening prevention and control measures on cancer should be taken.

The pioneer of public health in British: Edwin Chadwick

LIAO Tao, WU Jun, YE Dong-qing

2020, 24(8): 989-992. doi: 10.16462/j.cnki.zhjbkz.2020.08.025

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Edwin Chadwick (1800—1890)was a famous politician of British and an outstanding public health leader. His paper, report on the sanitary condition of the labouring population of Great Britain, promoted the awakening of public health awareness in Britis hand is one of the most influential files in the history of public health; He led the first public health campaign of British, and the idea of managing public health by the state has become the basis of the future public health system.

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2020 Vol. 24, No. 8

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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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