中华疾病控制杂志

Lung cancer screening guideline of China (T/CPMA 014-2020)

Chinese Preventive Medicine Association

2021, 25(1): 1-7. doi: 10.16462/j.cnki.zhjbkz.2021.01.001

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Inheritance and development, keep the pace with times——Review on the construction of epidemiology textbooks for preventive medicine undergraduates in the past 40 years in China

ZHAN Si-yan

2021, 25(1): 8-11. doi: 10.16462/j.cnki.zhjbkz.2021.01.002

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It has been 40 years since the publication of Epidemiology Textbook (Edition 1) for undergraduates in preventive medicine in 1980 in China. By way of the joint efforts of several generations of epidemiologists, the textbook has been updated to the Eighth Edition in 2017. It has become the core of the three-dimensional textbook system of epidemiology and played an important role in discipline construction and talent cultivation. This article aimed to review the compilation process of this set of textbooks, and compare and analyze the contents of each edition of the textbooks, so as to provide reference for improving the construction of undergraduate textbook.

Research progress of clinical trials with artificial intelligence intervention

XU Lu, WANG Sheng-feng, ZHAN Si-yan

2021, 25(1): 12-15, 36. doi: 10.16462/j.cnki.zhjbkz.2021.01.003

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With artificial intelligence technology increasingly developed and applied in the field of health care, clinical trials with artificial intelligence intervention have been emerging in recent years. This article will introduce the status quo, protocol guidelines, reporting guidelines, challenges and prospects of clinical trials with artificial intelligence intervention, so as to facilitate future researchers to carry out clinical trials in a standardized manner, and promote the development and application of artificial intelligence technology in the field of health care.

Methodological progress in selection of control in observation study in the context of big data

WANG Sheng-feng, ZHAN Si-yan

2021, 25(1): 16-19, 120. doi: 10.16462/j.cnki.zhjbkz.2021.01.004

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Control selection is the core of epidemiological study. With the increase of studies based on big data in healthcare, the strategies for control selection were continued to enrich and improve. The methodologies to estimate the potential impact of each control selection strategies were also proposed. To facilitate the utilization of big data in healthcare, the Chinese epidemiologist should keep in step with the international trend in the field of control selection, and should find ways to localize the strategies for control selection.

Applications of bioinformatics in molecular epidemiology

ZHANG Ding, ZHAO Ya-shuang

2021, 25(1): 20-24. doi: 10.16462/j.cnki.zhjbkz.2021.01.005

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Molecular epidemiology mainly studies the occurrence and development of diseases and their influencing factors based on the molecular level. The primary aspect of molecular epidemiological research is based on identifying biomarkers. Bioinformatics, an instrumental discipline of analyzing biology data, can combines and analyses high-throughput data of genomics, transcriptomics, epigenomics and proteomics. Bioinformatics plays an important role in epidemiological screening and researching biomarkers for disease susceptibility, cause exploration, disease diagnosis and prognosis and others. The purpose of this review was to provide an overview of applications of bioinformatics in molecular epidemiology.

Chronic diseases and sleep duration in association with falls of different severity among the Chinese elderly

LIN Jin-long, WEI Yue, CHEN Gong, PEI Li-jun

2021, 25(1): 25-31. doi: 10.16462/j.cnki.zhjbkz.2021.01.006

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Objective To explore the relationship between chronic diseases, sleeping time and the risk of falls of different severity in the elderly, so as to provide effective prevention of falls scientifically. Methods Based on the data of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015, a case-control study was conducted to analyze the relationship between multiple exposure factors and the risk of falls in different severity in the elderly. Results The report rate of common falls and serious falls medical in 11 912 elderly Chinese within two years were 7.82% and 17.09%, respectively; logistic regression results show that, hearing impairment, body pain, depression, kidney disease, arthritis and disability were the same risk factors of common falls and serious falls in the elderly(all P < 0.05). Hyperglycemia was associated with the risk of common falls (OR=1.43, 95% CI: 1.13-1.81, P=0.002) and stroke (OR=1.34, 95% CI: 1.03-1.75, P=0.031) was associated with the risk of serious falls; sleep duration of 5- hours and ≥ 7 hours were negatively associated with the risk of two types of falls (all P < 0.05). Conclusions The common falls and serious falls have multiple same risk factors in the elderly, and adequate sleep is the common protective factor for both. It is suggested that fall prevention education should be carried out for the elderly and risk factors should be effectively intervened.

Relationship between life satisfaction and mental health of Daur left-behind students

JIA Yue-hui, GE Jie, YAO Ye-xiang, HAN Yun-feng, BAI Li

2021, 25(1): 32-36. doi: 10.16462/j.cnki.zhjbkz.2021.01.007

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Objective To explore the impact of life satisfaction of Daur left-behind students on their mental health and to provide a reference for improving their mental health. Methods The cluster sampling method was used to conduct an anonymous questionnaire survey among students from five middle schools (two junior high schools, three senior high schools) in the Daur gathering area of Fularji in Qiqihar. The SAS 9.2 software was used for statistical analysis. Results Left-behind students in family satisfaction (Z=-2.363, P=0.018) and life satisfaction total scores (Z=-2.028, P=0.043) were lower than non-left-behind students. Left-behind students in somatization (Z=2.992, P=0.003), obsessive-compulsive symptoms (Z=2.009, P=0.045), depression (Z=2.473, P=0.013) and mental health scores (Z=2.834, P=0.005) were higher than non-left-behind students. The scores of life satisfaction and dimensions in left-behind students were negatively correlated with SCL-90 factors and total scores (all P < 0.05). Multivariable linear regression model showed that the dimension of school satisfaction (β=-1.619, t=-2.95, P=0.003) and environment satisfaction (β=-1.555, t=-2.23, P=0.026) had negative effects on mental health. Compared with students in junior high school, the students in senior high school (β=-9.692, t=-2.39, P=0.017) had a negative effect on mental health. Conclusions The life satisfaction and mental health of Daur left-behind students need to be improved. The scores of life satisfaction are negatively correlated with the scores of mental health. Therefore, positive measures should be taken to improve the level of life satisfaction of left-behind students, thereby improving their mental health.

Association and interaction effect between lifestyle index and gene polymorphisms on hyperuricemia in Liangshan residents

LI Ting-ting, LI Shuang-jing, TIAN Tian, NIE Zhi-chao, XU Wang-dong, LIU Long-jian, JIA Hong

2021, 25(1): 37-42. doi: 10.16462/j.cnki.zhjbkz.2021.01.008

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Objective To explore the impact of lifestyle index and gene interaction on hyperuricemia of residents in Liangshan area. Methods Questionnaire survey, physical measurement and blood sample were conducted from 2 646 residents in Liangshan area. Lifestyle index was constructed by using smoking, drinking, physical activity and body mass index (BMI). Logistic regression model was used to explore the relationship among lifestyle index, SNP locus and HUA. The additive and multiplication model were used to analyze the impact of lifestyle index-gene interaction on HUA. Results Logistic regression analysis showed that after adjusting for age, gender and ethnicity, a lifestyle index score of 3 reduces the risk of HUA by 63.7% compared with score of 0 (OR=0.363, 95% CI: 0.232-0.566, P < 0.001); The TT mutation genotype at rs2231142 had HUA 2.993 times than that of GG wild type (OR=2.993, 95% CI: 2.015-4.445, P < 0.001), the TT mutation genotype at rs11722228 increased the risk of HUA by 39.2% (OR=1.392, 95% CI: 1.029-1.884, P=0.032). The interaction analysis showed that there was a synergistic additive interaction between the lifestyle index and the ABCG2 gene rs2231142 locus on HUA (RERI=1.136, 95% CI:0.036-2.236; AP=0.311, 95% CI: 0.115-0.507; S=1.749, 95% CI: 1.168-2.620), but there was no multiplicative interaction between lifestyle index and rs2231142 and rs11722228. Conclusions There is a synergistic additive interaction between the lifestyle index and the ABCG2 gene rs2231142 locus on HUA. When an individual carries the T mutation genotype, adopting an unhealthy lifestyle will increase the risk of HUA.

Epidemiological characteristics and trend prediction of varicella in Fujian Province from 2014 to 2018

QI Xiao-qi, ZHU Han-song, CHEN Wu, CAI Shao-jian, XIE Zhong-hang, WU Sheng-gen, OU Jian-ming

2021, 25(1): 43-47, 112. doi: 10.16462/j.cnki.zhjbkz.2021.01.009

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Objective To analyse the epidemiological characteristics and to predict the cases of varicella in Fujian Province in 2014-2018. This would provide a scientific evidence for varicella prevention and control strategies. Methods Varicella case data was collected from China Infectious Disease Report Information Management System. Varicella emergency report data was collected from Public Health Emergency Management Information System. ArcGIS 10.2 and R 3.4.3 software were used to perform statistical description and analysis. Results A total of 58 934 cases of varicella were reported in Fujian Province from 2014 to 2018. The average annual incidence was 30.65/100 000, with a rising trend from 2014 to 2018(F=20.055, P=0.021); The incidence of varicella was significantly seasonal with a bimodal distribution. The incidence peak was from May to June and from November to January in the following year. The majority of the patients were children under 15 years old, accounting for 66.28% of the total cases. The average annual incidence of varicella in males (32.68/100 000) was higher than that in females (28.57/100 000)(χ²=52.895, P < 0.001); The main occupation of patients were students, accounting for 45.75%. 183 public health emergencies of varicella involving 208 809 people were reported during the same period. The average attack rate was 2.08% and mainly occurred in primary schools, accounting for 71.04%. According to the autoregressive integrated moving average (ARIMA) model, the number of varicella cases in November and December in 2019 were predicted to be 3 834 and 5 369, respectively, both of them exceeded the number of cases in the same month in 2018. Conclusions The varicella epidemic situation is on the rise in Fujian Province. Therefore, the prevention and control strategies should be strengthened, especially for the key groups (children under 15 years old) and in the key institutions (primary schools) during the peak incidence seasons.

HBV prevalence and associated factors among persons receiving premarital medical examination in Dehong Dai and Jingpo Autonomous Prefecture during 2016-2018

GONG Yu-rong, ZHANG Han-xi, TANG Shu-ping, YANG Shi-jiang, YIN Shou-huan, YANG Yue-cheng, YE Run-hua, WANG Lu, DING Ying-ying, HE Na, DUAN Song

2021, 25(1): 48-53. doi: 10.16462/j.cnki.zhjbkz.2021.01.010

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Objective To investigate the hepatitis B virus (HBV) prevalence among the pre-marital medical examination population in Dehong Dai and Jingpo Autonomous Prefecture from 2016 to 2018, and to explore the main factors of HBV infection. Methods Hepatitis B surface antigen was detected in serum samples of premarital medical examination subjects from 2016 to 2018. And, the main influencing factors of HBV infection were explored by multivariable Logistic liner regression model based on paired premarital subjects which were according to the serum test number. Results A total of 65 639 premarital subjects were tested, and HBV infection rate was 3.05%(1 874/61 352). Based on the HBV infection results, we divided the participants into four categories: both negative, male positive but female negative, male negative but female positive and both positive. The results showed that there were 1 773 pairs in which more than one person was positive accounted for 5.90% (1 773/30 068), and most of that was male positive but female negative, which accounted for 3.59% (1 079/30 068). According to the analysis of the composition of the four groups of people in each year, it was found the decrease in the category of both negative and in the category of male negative but female positive, and the increase in the category of both negative (P < 0.05). The results of multivariate analysis showed that the risk factors were female age ≥ 30 years old, Chinese nationality of male, foreign nationality of female and foreign nationality of both sides (all P < 0.05) in the male negative but female positive compared with both negative. Conclusions Detection of HBV infection in the premarital medical examination population in Dehong Dai and Jingpo Autonomous Prefecture was decreased, and HBV-positive female may play an important role in local HBV transmission. The finding of risk factors of HBV infection might be useful for reducing the spread of HBV.

Spatial and temporal distribution and epidemic intensity of hand, foot and mouth disease in Shaanxi Province from 2009 to 2018

ZHU Ni, ZHOU Ti-cao, YANG Guo-jing, LI Xin-xin, WANG Shu, ZHANG Yi

2021, 25(1): 54-59. doi: 10.16462/j.cnki.zhjbkz.2021.01.011

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Objective To describe the epidemiological characteristics of hand, foot and mouth disease (HFMD) and explore the spatial-temporal change tendency from 2009 to 2018 in Shaanxi Province. Methods The descriptive statistic method was used to describe epidemic situation of HFMD and moving epidemiological method (MEM) was used to detect the epidemic season, and possible spatial-temporal clusters of HFMD among down towns in Shaanxi Province from 2009 to 2018. Results The average morbidity from 2009 to 2018 was 143.01 per 100 000.The male-female ratio of HFMD was 1.47:1. The age of patients ranged from 1 day to 80 years old and the median age was 2 years old. The incidence of HFMD was increasing generally from 2009 to 2018, and from the end of April to July every year was the peak of HFMD in Shaanxi Province. The results from MEM model showed that the incidence of HFMD exceeded the given threshold value of low epidemic situation at 19th week, then reached to medium epidemic situation in the next week and lasted for 11 weeks. After that, the incidence rate came down back to low epidemic and normal situation at 31th and 33 th week respectively in the year of 2018. The results from the space-time scanning analysis showed that the epidemic period was from April 2010 to July 2010 from the time dimension, and some counties in Xi'an, Xianyang and Weinan (RR=5.71, 95% CI: 5.70-5.73, P < 0.001) were the main gathering areas of HFMD, and the main gathering areas were relatively fixed in 10 years. Conclusions There are significant spatial-temporal cluster patterns for the distribution of HFMD incidence in Shaanxi. The Guanzhong area is the main gathering area. The prevention and control intervention should be strengthened accordingly.

Epidemiological characteristics of hand-foot-mouth disease in Inner Mongolia Autonomous Region from 2009 to 2018

ZHANG Ying-ying, WANG Yan-ling, LIU Ying, YUN Han-xuan, ZHAO Le, ZHAO Jing

2021, 25(1): 60-65. doi: 10.16462/j.cnki.zhjbkz.2021.01.012

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Objective To analyzed the epidemiological and seasonal characteristics of hand-foot-mouth disease (HFMD) in Inner Mongolia Autonomous Region from 2009 to 2018. Methods The surveillance data of HFMD in Inner Mongolia Autonomous Region from 2009 to 2018 were analyzed using statistic methods, and concentration method and circular distribution method were used to analyze the seasonal variations. Results A total of 178 063 cases were reported in Inner Mongolia Autonomous Region from 2009 to 2018, with an annual average reported incidence of 71.99 per 100 000. The overall incidence showed a downward trend (χ²_trend=3 584.162, P < 0.001). A total of 1 216 severe cases were reported, revealing an overall downtrend (χ²_trend=8.772, P < 0.001). The incidence concentration ratio M-value was 0.876, exhibiting a strong seasonal characteristic. The concentration trend of HFMD circular distribution was 0.523, α=209.446° (144.187°, 274.705°) (Z=48 660.177, P < 0.001). The incidence was mainly reported between May 2 and September 26 and peaked on July 16. The severe cases concentration ratio M-value was 0.919, indicating a strict seasonality. The concentration trend of severe cases circular distribution was 0.592, α=210.688° (152.025°, 269.352°) (Z=426.240, P < 0.001). The most common peak day of severe cases was August 3, and the peak season was from June 4 to November 1. The incidence in Inner Mongolia Autonomous Region Wuhai City was highest (176.91/100 000), and the difference of the average annual incidence in different cities was statistically significant (χ²=1 548.865, P < 0.001). Moran's Index was -0.023 (P=0.688), suggesting that there was no regional aggregation. The cases were mainly concentrated in the population under 10 years old which accounted for 98.82%, in which scattered children and Kindergarten children accounted for 48.50% and 42.31%, respectively. There was statistically difference in morbidity between men and women (χ²=30.482, P < 0.001). Conclusions Though the incidence of HFMD in Inner Mongolia Autonomous Region had a downtrend with each passing year, prevention and control strategies were still needed to be carried out.

Analysis for characteristics of genetic mutations among multi-drug resistant Mycobacterium tuberculosis (MDR-TB) isolates from Zhejiang Province

ZHAO Gang, JIA Qing-jun, WU Yi-fei, HUANG Yin-yan, TANG Lei-ming, ZENG Mei-chun

2021, 25(1): 66-71. doi: 10.16462/j.cnki.zhjbkz.2021.01.013

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Objective To analyze the characteristics of genetic mutations associated with isoniazid (INH) and rifampicin (RIF)-resistant Mycobacterium tuberculosis (MDR-TB) isolates. Methods Culture positive sputum specimens from suspicious TB were subjected to species identification. Genomic DNAs of Mycobacterium tuberculosis complex (MTBC) were extracted. InhA, katG, and Rifampicin Resistance Determining Region (RRDR) of rpoB gene were amplified. Amplicons were performed with Sanger sequencing. Results A total of 3 317 TB were identified, including3 009 new treated, 308 retreated, and 84 MDR-TB, accounting for 2.53% (84/3 317). In INH resistant isolates, 47 had single-point mutation in katG (315 site) or inhA (-15 or -8 site), and 19 had both katG and inhA mutations. The coincidence rate of genotype with phenotype was 78.57% (66/84). The most frequent mutation was Ser315Thr (47.62%, 40/84). In RIF resistant isolates, 79 had mutations in rpoB (sites 511, 512, 513, 516, 522, 526 and 531), and 2 had mutations in 511/513 or 511/516. The most frequent mutation was Ser531Leu (58.33%, 49/84). The coincidence rate of genotype with phenotype was 96.43% (81/84). Conclusions Genetic mutations of inhA, katG and rpoB gene in Zhejiang are concentrated relatively on common gene sites, and Xpert MTB/RIF is still of high application value to screen MDR-TB in Zhejiang.

Application of a bayesian joint model for the association of changes in pulse pressure and all-cause mortality in the elderly

XIE Wei-hua, YU Xiao-jin, DAI Pin-yuan, SUN Jin-fang, WANG Li-na, QIN Yu, WU Ming, ZHAO Jian

2021, 25(1): 72-77. doi: 10.16462/j.cnki.zhjbkz.2021.01.014

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Objective To explore application strategies and statistical performance when fitting Bayesian joint models to interrelate longitudinal and survival outcomes, and provide methodological guidance for the analysis of similar data. Methods A nonlinear mixed-effects model of longitudinally measured pulse pressure was fitted with a natural cubic spline function, and a B-spline method was used to construct the baseline hazard function for all-cause survival data. A Bayesian joint model was established by associating two processes through shared random effects and Gibbs sampling was used to calculate model parameters. The results of Bayesian joint model were compared with the classical two-stage joint model. Results The Bayesian joint model showed a higher baseline pulse pressure (α₁=0.72, 95% CI: 0.43-1.13) and faster rise in pulse pressure in years 0 to 3, 3 to 6, and 6 to 9 (α₂₁=0.34, 95% CI: 0.20-0.45; α₂₂= 0.45, 95% CI: 0.10-0.75; α₂₃=0.42, 95% CI: 0.24-0.62), which may contribute to a higher risk of all-cause death in the elderly. Bayesian and two-stage joint models were consistent in the direction of parameter point estimates, with Bayesian interval widths greater than two-stage methods. Conclusions Bayesian joint model is a reasonably valid statistical method for joint analysis of longitudinal and survival data when there is an association between them. This study has shown that both high baseline pulse pressure and rapid increases in pulse pressure in older adults are associated with higher all-cause mortality.

The prevalence and influencing factors of multiple chronic diseases in the elderly in Taiyuan

YANG Juan, ZHENG Xiao, HOU Li-hong, XUE Ya-qing, LI Mi-mi, ZOU Jia-yu, ZHENG Jian-zhong, ZHANG Chi-chen

2021, 25(1): 78-83, 107. doi: 10.16462/j.cnki.zhjbkz.2021.01.015

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Objective To investigate the prevalence and influencing factors of multiple chronic diseases in the elderly in Taiyuan, so as to provide references for improving the health level of the elderly and optimizing the prevention and management of chronic diseases. Methods Using multi-stage cluster random sampling method, 3 637 elderly persons aged 60 years or older were selected from Taiyuan City, Shanxi Province for face-to-face questionnaire survey. Chi-square test was used for comparison between groups and multinomial Logistic regression model was used to analyze the influencing factors. Results Among the 3 637 respondents, the prevalence of chronic diseases was 68.8%, and the prevalence of multiple chronic diseases was 21.0%; common dual disease combinations are: hypertension + diabetes, hypertension + coronary heart disease, hypertension + rheumatoid; common three disease combinations are: hypertension + diabetes + coronary heart disease, hypertension + diabetes + rheumatoid, hypertension + diabetes + eye disease. The elderly, who live in rural areas, with a family history, overweight or obesity, and an irregular diet (all P < 0.05), have a high incidence of multiple chronic diseases. Conclusions The prevalence of chronic diseases in the elderly aged 60 and above is relatively high, and the prevalence of multiple chronic diseases is not optimistic. Comprehensive intervention measures should be taken according to the characteristics of the disease and risk factors.

Awareness, treatment and control of high blood pressure and its determinants in the aged patients with hypertension of Nu ethnic group: a multilevel model analysis

WANG Xiu-qing, MAO Yong, LONG Xin-tian, CHEN Jie, ZHOU Jia, SUN Cheng-huan, LAI Chun-mi, ZHANG Qian, CHU Tian-shu

2021, 25(1): 84-89. doi: 10.16462/j.cnki.zhjbkz.2021.01.016

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Objective To identify the status of awareness, treatment and control of high blood pressure in the aged patients with hypertension of Nu ethnic group, and to determine the associated determinants. Methods A sample of 1 080 persons, which was sampled by the multiple-stage sampling method from the aged population of Nu ethnic group, was investigated and examined cross-sectionally. Results There were 319 patients with hypertension in the 1 080 participants. The rate of awareness, treatment and control of high blood pressure in the whole patients was 38.6%, 25.7% and 10.3%; that in male patients was 44.4%, 30.0% and 15.0%; that in female patients was 32.7%, 21.4% and 5.7%; that in the middle-economic level area was 48.9%, 33.2% and 14.2%; and that in the low-economic level area was 23.3%, 14.7% and 4.7%, respectively. Comparison to the control groups, the aged patients with hypertension resided in the middle-economic area and those with middle medical burden had a higher awareness rate (48.9% vs. 23.3%, 42.9% vs.27.1%), treatment rate (33.2% vs.14.7%, 30.0% vs.12.9%) and control rate (14.2% vs. 4.7%, 12.9% vs.2.9%); the male patients with hypertension had a greater awareness rate and control rate (44.4% vs.32.7%, 15.6% vs.15.0%); the patients with dyslipidemia and hypertension had a larger awareness rate and treatment rate (100.0% vs.36.4%, 54.6% vs.24.70%). The results of covariate-adjusted multilevel logistic regression model indicated that there was cross-level interaction, which was between economic level and male, on the rates of awareness, treatment and control (all P < 0.05). Dyslipidemia, which was an individual covariate, had a positive effect on the rate of awareness (OR=5.191, 95% CI: 3.141-8.578, P=0.042), treatment (OR=6.101, 95% CI: 3.120-11.930, P=0.043) and control (OR=6.699, 95% CI: 4.625-9.702, P=0.047), respectively. Low salt diet, however, had a negative effect on the rate of awareness (OR=0.329, 95% CI: 0.134-0.810, P=0.019). Conclusions The rates of awareness, treatment and control of high blood pressure in the aged patients with hypertension of Nu ethnic group were lower than those of national population. The dominant determinants were male, economic level, dyslipidemia and low salt diet, etc.

A case-control study on risk factors for atrial fibrillation among people over 50 years old in a community in Nanjing

ZHI Hong, HU Jia-shu, WANG Ai-lian, GUAN Jie-qiong, SONG Wen-jing, WANG Li-na

2021, 25(1): 90-94. doi: 10.16462/j.cnki.zhjbkz.2021.01.017

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Objective To explore the risk factors of atrial fibrillation (AF) in people aged 50 years and above in Nanjing, Jiangsu Province. Methods An epidemiological survey was conducted among the elderly in a community healthcare center in Qixia District from March 1, 2019 to April 30, 2019. The case group was defined as patients with AF diagnosed by 12-lead electrocardiogram (ECG), and the controls were a non-AF population matched by age and sex, with a matching ratio of 1:4. Univariate and multivariate conditional Logistic regression analysis model were used to analyse possible influencing factors. Results A total of 3 444 cases were investigated. The ratio of male to female is 1:2, and the detection rate of AF was 1.19%. The univariate Logistic regression analysis indicated that serum uric acid (OR=1.01, 95% CI: 1.00-1.01), hematocrit (HCT, OR=1.11, 95% CI: 1.01-1.23) and red blood cell distribution width (RDW, OR=1.50, 95% CI: 1.05-2.14) might be risk factors for AF. The multivariate Logistic regression analysis model results showed that each increase of 1% in HCT and RDW was associated with a 13% (OR=1.13, 95% CI: 1.01-1.27) and 61% (OR=1.61, 95% CI: 1.00-2.59) increased risk of AF respectively. Conclusions HCT and RDW may be independent risk factors for atrial fibrillation in the elderly in Nanjing community. In addition, the results of this study need to be further verified due to the limited sample size.

Analysis of prevalence and influencing factors of impaired fasting glucose in residents of Tangshan

WANG Cun, CHEN Zhi-xin, REN Hong-yun, WANG Zi-chao, GUO Yuan-yuan, CAI Xiang-ying, SHEN Pei-xuan, HOU Li-ying, LIU Hai-feng, LI Yun

2021, 25(1): 95-100. doi: 10.16462/j.cnki.zhjbkz.2021.01.018

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Objective To investigate the prevalence and influencing factors of impaired fasting glucose(IFG) in residents of Tangshan, and to provide evidence for the prevention and control of diabetes and cardiovascular risk factors in the region. Methods Based on the survey of chronic diseases and their risk factors in Tangshan city, 11 475 adult residents in urban and rural districts of Tangshan were randomly enrolled in this study from January 1, 2018 to December 31, 2018. All data were collected by questionnaire and physical examination. The prevalence of IFG was calculated. The Logistic regression analysis model was used to analyze the risk factors of IFG. Results A total of 10 510 valid questionnaires (91.6%) were retrieved. Among all the subjects, there were 829 cases of IFG, with a total prevalence of 7.89%. The prevalence was 8.59% for males and 7.04% for females, and the difference was statistically significant (χ² =15.458, P < 0.001). The prevalence was 10.95% for urban residents and 6.36% for rural residents, (9.56% for residents in mountainous areas, 6.55% for residents in plain areas and 3.59% for residents in coastal areas). Multivariate unconditional Logistic regression analysis showed that age, body mass index, hypertension, hyperlipidemia, family history of diabetes, urban or rural areas were associated with the risk of IFG. Conclusions The prevalence of IFG is relatively high for adult residents in Tangshan area. Age, overweight, hypertension, hyperlipidemia, family history of diabetes and urban area are the influencing factors of IFG.

Disease burden of stroke from 1990 to 2017 in Hunan Province

LIU Yuan, XU Qiao-hua, YIN Lei, JIN Dong-hui

2021, 25(1): 101-107. doi: 10.16462/j.cnki.zhjbkz.2021.01.019

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Objective The objective of this study is to investigate the disease burden of stroke in Hunan Province, which may help to guide priority in control and prevention of stroke. Methods Data were extracted from Global Burden of Diseases Study 2017 (GBD 2017). Mortality, years of life lost (YLLs), years lived with disability (YLDs), disability adjusted life years (DALYs) associated with stroke, together with the age-standardized rates and change of the indexes mentioned above between 1990 and 2017 in Hunan were selected and described. Results From 1990-2017, death number of stroke in Hunan witnessed an increase of 85.84% (1990 vs 2017: 76 900 vs 114 300), and death number of male increased by 122.56%, while that of females increased only by 2.12%. Age-standardized mortality rate of stroke decreased by 37.58% (1990 vs 2017: 218.55/100 000 vs 136.41/100 000). Males' age-standardized mortality of stroke decreased only by 4.16%, while that of female decreased sharply by 58.18%. YLLs of stoke increased by 84.79% (1990 vs 2017: 1 637 400 vs 2 035 700 person years); Males' YLLs of stroke increased largely by 94.94%, while that of females decreased by 22.62%. Age-standardized rate of YLL of stoke decreased by 41.67% (1990 vs 2017: 3 742.85/100 000 vs 2 183.06/100 000), while females' age-standardized rate of YLL decreased by 64.45%, ahead of that of male's 6.62%. YLDs of stroke increased by 171.63% (1990 vs 2017: 113 500 vs 308 300 person years). Males' YLDs of stroke increased by 197.58%, and that of females also increased by 151.72%. Age-standardized rate of YLD also witnessed an increase of 41.74%(1990 vs 2017: 235.13/100 000 vs 333.28 /100 000); Males' age-standardized rate of YLD increased by 58.89%, while that of females increased by 28.22%. DALYs increased by 33.88% (1990 vs 2017: 1 750 900 vs 2 344 100 person years), while age-standardized rate of DALY decreased by 36.74% (1990 vs 2017: 3 977.98/100 000 vs 2 516.34/100 000). Hemorrhagic stroke contributed the most part for DALYs among different kinds of stroke, while DALYs of ischemic stroke increased rapidest by 142.64%. Conclusions Disease burden of stroke from 1990-2017 in Hunan witnessed an increase, with an obvious gender difference. Hemorrhagic stroke contributed the most part for disease burden compared with other strokes, while ischemic stroke increased most rapidly.

Results of Hubei Provincial malaria diagnostic reference laboratory from 2014 to 2018

SUN Ling-cong, WU Dong-ni, DONG Xiao-rong, TU Zhen, LIN Wen, XIA Jing

2021, 25(1): 108-112. doi: 10.16462/j.cnki.zhjbkz.2021.01.020

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Abstract:
Objective To analyze the results of samples testing of Hubei provincial malaria diagnostic reference laboratory from 2014 to 2018, so as to provide the evidence for improving the malaria diagnostic performance in the province. Methods The samples of reported malaria cases in Hubei were collected by the provincial reference laboratory (PRL) from 2014 to 2018. The microscopy and nested polymerase chain reaction (nested PCR) were performed to confirm the infection of plasmodium species of each case. The agreement rate of diagnosis of malaria and plasmodium species among different years and different regions were calculated. The microscopic and nested PCR results of PRL were analyzed as well. Results A total of 674 malaria cases were reported in Hubei Province from 2014 to 2018. Among the 672 samples which were re-examined by PRL, 633 cases were confirmed plasmodium infections. The total positive coincidence rate was 94.20%. The positive coincidence rate of each year and each district were higher than 80.00%, and there were differences among the 16 districts (χ² =42.49, P < 0.001). The total species coincidence rate was 89.73%. The species diagnostic coincidence rates among different years and different districts existed differences (all P < 0.001). The consistency rate between microscopic and nested PCR results in the PRL was 88.89%, and there were differences among the different species (χ² =57.37, P < 0.001). Conclusions From 2014 to 2018, the malaria diagnostic quality of medical technicians is generally high in Hubei Province. However, the ability to identify non-falciparum parasites remains to be improved.

Investigation on oral health knowledge, attitude and practice among migrant workers in Chengdu

HUANG Jin-cheng, ZHANG Xi, DAI Xue-mei, ZHOU Jing, LIAO Yu-ting, DUAN Xiao-xia, YUAN Ping

2021, 25(1): 113-116. doi: 10.16462/j.cnki.zhjbkz.2021.01.021

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Objective To investigate the awareness of oral health knowledge, attitude and practice (KAP) among migrant workers in Chengdu, so as to provide a basis for exploring oral health intervention measures for migrant workers. Methods Using the response-driven sampling method, a questionnaire survey was conducted among migrant workers in Chengdu. Results A total of 579 migrant workers were surveyed. The awareness rate of oral health knowledge was 63.36%. The correct rate of answer to each item ranged from 37.89% to 85.96%. The holding rate of oral health attitude was 62.25%, that of each item ranged from 45.25% to 85.32%. The formation rate of oral health practice was 35.67%, that of each item ranged from 10.73% to 63.39%. There were significant differences in the awareness rate of oral health knowledge and formation rate of oral health practice among different gender, age, education levels, income and occupation population (all P < 0.05), and there were significant differences in the holding rate of oral health attitude among different educational levels, income and occupational groups (all P < 0.05). Conclusions The overall oral health KAP of migrant workers in Chengdu urgently need to be improved. The differences in the oral health KAP is related to demographic characteristics. We should pay attention to this kind of key population, strengthen oral health education and health promotion.

Epidemic status and influencing factors of cardiovascular disease at high risk among urban and rural residents in Tibet

YU Yue, ZHAXI Zong-ji, BAI Guo-xia, SHI Heng, CUI Kai, HUANG Qian

2021, 25(1): 117-120. doi: 10.16462/j.cnki.zhjbkz.2021.01.022

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Objective To understand the current status and influencing factors of the population at high risk of cardiovascular disease in urban and rural residents of Tibet Autonomous Region, and provide a basis for the prevention and control measures of cardiovascular disease in Tibet. Methods From May 2016 to October 2019, a random cluster sampling method was used and 41 476 participants aged 35-75 years old was selected from 7 project cities (districts) in Tibet. Questionnaires, physical measurements and laboratory tests were used to investigate urban and rural residents. Results Among the 41 476 urban and rural residents eligible, 9 185 high-risk persons were screened out, with a high-risk rate of 22.15%. Among the high-risk groups, there were 7 882 people with one risk factor (85.81%), 1 457 people with 2 risk factors (15.86%) and 146 people (1.59%) with 3 or more risk factors. The detection rate of historical cardiovascular disease type was 0.89%. The detection rate of high blood pressure type was 18.62%. The detection rate of dyslipidemia type was 3.74%. The detection rate of WHO's assessment of 10 years of risk more than or equal 20% was 2.17%. Aged more than or equal 40 years, farmers and residents living in rural areas were more likely to be at high risk of cardiovascular disease (all P < 0.05). Women and subjects who were married were less likely to be at high risk of cardiovascular disease. Conclusions Among the population at high risk of Cardiovascular diseases in Tibet, there were more males than females and more elderly than young people. The high risk factor for cardiovascular disease is mainly high blood pressure. Males, non-married, older, farmers are the key population for comprehensive prevention and treatment of cardiovascular disease in Tibet.

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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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