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CN 34-1304/R ISSN 1674-3679

2022 Vol. 26, No. 2

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Original Articles
The relationship between lipid accumulation product and the risk of diabetes
SHAO Qi, WU Yi-ling, JIANG Feng, LIU Xing, WANG Na, JIANG Yong-gen, ZHAO Gen-ming, ZHAO Qi
2022, 26(2): 125-130, 243. doi: 10.16462/j.cnki.zhjbkz.2022.02.001
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  Objective  To explore the relationship between lipid accumulation product (LAP) and the risk of diabetes among adults, and to compare the effectiveness of different obesity indicators in predicting diabetes.  Methods  A multi-stage stratified cluster sampling method was conducted among adults aged 20-74 in 4 communities in Songjiang District of Shanghai during June 2016 to December 2017. Questionnaire investigation, physical and biochemical examination were used to collect data. Logistic regression analysis models were used to evaluate the association LAP and diabetes, and receiver operating characteristics curve (ROC) was used to evaluate the predictive value of various obesity indicators in diabetes.  Results  The level of fasting blood glucose and HbA1c was increased with the increasing of LAP (P < 0.05). Compared to the first quintile of LAP level, risk of having diabetes in the fourth quintile were 1.81 times (95% CI: 1.53-2.14) for male and 2.87 times (95% CI: 2.43-3.40) for female respectively. The predictive value of LAP was higher than BMI (P < 0.05) both in male and female. It was also higher than waist circumference in female (P < 0.05). The cut-off point for LAP in predicting diabetes was 23.30 cm·mmol/L for male and 30.41 cm·mmol/L for female.  Conclusion  LAP could be used to predict the risk of diabetes, especially in women.
Association between venous fasting blood glucose and estimated glomerular filtration rate among adults in Beijing-Tianjin-Hebei Region
LIU Rui-hao, WANG Yu-xue, FAN Ya-qi, HE Jiang-shan, GUO Pei, WANG Jian-xiong, LI Chun-jun, ZHANG Li, ZHANG Mian-zhi, ZHANG Min-ying
2022, 26(2): 131-135. doi: 10.16462/j.cnki.zhjbkz.2022.02.002
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  Objective  To explore the relationship between venous fasting plasma glucose (FPG) and estimated glomerular filtration rate (eGFR) among adults in Beijing-Tianjin-Hebei Region, to provide a scientific basis for the early detection and intervention of chronic kidney disease (CKD).  Methods  The demographic characteristics, medical history, behavior and lifestyle of adult attendees at physical examination center were collected, and fasting venous blood samples were collected to detect blood glucose, blood lipids and renal function. The eGFR of each subject was estimated by chronic kindey disease epidemiology collaboration (CKD-EPI) equation. The relationship between FPG level and eGFR was analyzed by multiple linear regression.  Results  A total of 9 446 people were analyzed. After controlling the effects of demographic characteristics, behavior habits and chronic medical history on eGFR in the multiple linear regression model, there was a negative correlation between FPG and Log(eGFR) (β=-0.002, P < 0.001).  Conclusion  There is a linear correlation between venous FPG and eGFR, high FPG increases the odds of decreased eGFR.
The associations of Non-traditional lipid profiles with stroke: based on Inner Mongolia population
LIU Min, BAO Han, XU Xiao-qian, YAN Tao, ZHU Hao, ZHANG Nan, ZHAO Yu-qian, TIAN Zi-xuan, BI Yan-qing, YAN Wen-yan, ZHANG Xing-guang
2022, 26(2): 136-143. doi: 10.16462/j.cnki.zhjbkz.2022.02.003
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  Objective  Non-traditional lipid profiles are recognized as predictors for cardiovascular disease, but there are few researches on the association between non-traditional lipid profiles and stroke risk in Inner Mongolia. The purpose of this study was to explore the association between non-traditional lipid profiles and stroke in Inner Mongolia through the Program of Screening and Intervention Subjects with High-Risk Cardiovascular Diseases Survey.  Methods  From 2015 to 2017, demographic basic information and various blood lipid indicators were collected from permanent residents aged 35-75 in Inner Mongolia, North China. A total of 32 518 people was finally included in this study. We categorized plasma lipid measurements into quartile and calculated odds ratios (ORs) and their 95% confidence intervals (CIs) using adjusted Multivariate Logistic regression models.  Results  The study included 1 949 stroke patients. Comparing with the lowest quarter, the OR of stroke risk in the highest were 1.390 (95% CI: 1.206-1.601) for total cholesterol/ high-density lipoprotein-cholesterol(TC/HDL-C), 1.380 (95% CI: 1.201-1.585) for low-density lipoprotein-cholesterol/ high-density lipoprotein-cholesterol(LDL-C/HDL-C), and 1.473 (95% CI: 1.276-1.699) for triglycerides/ high-density lipoprotein-cholesterol(TG/HDL-C), respectively. Higher lipid profiles related to an increased risk for stroke (all P < 0.001). The TC/HDL-C, LDL-C/HDL-C and TG/HDL-C were still associated with the risk of stroke in different genders and age groups except for Non-high-density lipoprotein cholesterol (Non-HDL-C).  Conclusions  We found that TC/HDL-C, LDL-C/HDL-C and TG/HDL-C were associated with an increased risk of stroke. Compared with traditional lipid parameters, non-traditional lipids are more strongly associated with stroke, which can be used as a new indicator for risk stratification and primary prevention of stroke.
Dose-response relationship between obesity and hypertension in Chaozhou
ZHANG Jing-feng, LI Wen-yu, CHEN Min-qi, WANG Xu-lin, XIE Shao-lian, LI Shao-lin, YE Xiao-hua
2022, 26(2): 144-149. doi: 10.16462/j.cnki.zhjbkz.2022.02.004
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  Objective  To analyze the dose-response relationship between obesity and hypertension in Chaozhou, providing a reference for the appropriate blood pressure control scheme.  Methods  A multi-stage cluster random sampling method was used to carry out a questionnaire survey and physical examination for the residents of Chaozhou City. Logistic regression analysis model was used to investigate the association of body mass index (BMI), waist circumference and hypertension; The dose-response relationship between BMI, waist circumference and hypertension was analyzed with a restrictive cubic spline Logistic regression analysis model.  Results  Of the 7 637 residents, the prevalence of hypertension was 27.79%, the rate of overweight and obesity was 29.66%, and the rate of central obesity was 25.36%. The prevalence of hypertension in overweight and obese people was significantly higher than that in normal weight (OR=2.55, 95% CI: 2.26-2.87). The prevalence of hypertension in the central obesity population was significantly higher than that in normal weight (OR=2.81, 95% CI: 2.49-3.17). Comparing with that in normal weight, people with both overweight obesity and central obesity have a higher risk of hypertension (OR=3.65, 95% CI: 3.17-4.20) than those with overweight obesity alone (OR=1.67, 95% CI: 1.39-2.00) and central obesity alone (OR=1.93, 95% CI: 1.57-2.38). Restricted cubic spline models showed an non-linear dose-response relationship between BMI, waist circumference and the risk of hypertension.  Conclusion  Weight control has an important preventive effect on hypertension.
Associations of night sleep duration with blood lipid levels of adults in Tianjin
HE Jiang-shan, ZHANG Li, LI Chun-jun, GUO Pei, ZHANG Mian-zhi, WANG Jian-xiong, WANG Yu-xue, FAN Ya-qi, ZHANG Min-ying
2022, 26(2): 150-155. doi: 10.16462/j.cnki.zhjbkz.2022.02.005
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  Objective  We aim to assess the associations between night sleep duration and TC, TG, HDL-C and LDL-C among adults who have not been diagnosed with hyperlipidemia.  Methods  Using a multi-stage stratified cluster sampling method, employees from 498 units who underwent physical examinations at one of two hospitals in Tianjin from January 8, 2018 to January 9, 2020 were selected as the study population. Demographic characteristics, disease history, lifestyle and other information were collected by questionnaire. The simplified Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep duration. Fasting TC, TG, HDL-C, LDL-C, and height and weight were measured. Independent associations of night sleep duration with TC, TG, HDL-C, LDL-C, and BMI were evaluated with multiple U-shaped or linear regression models.  Results  A total of 17 807 participants with a median of 44 years completed the investigation. Sleep duration negatively associated with TC (β=-0.027, P < 0.001), LDL-C (β=-0.039, P < 0.001) and BMI (β=-0.167, P < 0.001) and U-shaped associated with LDL-C (βlinear term=-0.202, P < 0.001; βquadratic term=0.011, P=0.004). No associations were found between sleep duration and TG or HDL-C.  Conclusion  Night sleep duration was associated with TC, HDL-C and BMI, suggesting optimal sleep duration plays an important role in maintaining lipid homeostasis.
Evaluation of healthy-adjusted life expectancy in Beijing City, China: A comparative study of three calculating methods
SU Jian-ting, WANG Ping, DU Jing, WANG Jing, LIU Qing-ping, LI Gang, WEI Zai-hua
2022, 26(2): 156-161, 168. doi: 10.16462/j.cnki.zhjbkz.2022.02.006
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  Objective  To calculate the level of healthy-adjusted life expectancy (HALE) using three calculating methods, and assess the health status of residents aged ≥15 years in Beijing City.  Methods  This research collected the surveillance data of death causes, missing reports of death causes, data of self-reported health status survey and data of years lived with disability (YLD) from the Global Burden of Disease Study (GBD). These data were used to calculate self-reported disability weight, Hierarchical ordered probit model (HOPIT)-adjusted disability weight and GBD disability weight. And then Sullivan method was used to calculate healthy life years (HLY), HOPIT healthy-adjusted life expectancy (HALE_HOPIT), and GBD healthy-adjusted life expectancy (HALE_GBD) among residents aged ≥15 years in Beijing City.  Results  The life expectancy (LE) of residents aged 15- < 20 years was 67.7 years, and HLY, HALE_HOPIT, and HALE_GBD were 51.9 years, 44.1 years, and 57.8 years, respectively. The study observed HALE_GBD > HLY > HALE_HOPIT in any gender or age group. HLY, HALE_HOPIT, and HALE_GBD decreased with age. HLY and HALE_GBD in female residents were higher than male residents in all age groups. HALE_HOPIT in females was higher than in males among residents under 80 years of age, and HALE_HOPIT in females was slightly lower than in males among residents aged ≥80 years.  Conclusions  The calculating values of HALE using three methods were significantly different, but the trends were consistent across other gender and age groups. The results revealed that there were many years of healthy life lost due to disability among residents aged ≥15 years in Beijing City. The different effects across the three methods are related to the differences in health measurement. Thus, we should continuously carry out further investigations and researches.
Intergenerational transmission of short-term, middle-term and long-term health status and the Urban-rural heterogeneity
HE Hong, TAN Tian
2022, 26(2): 162-168. doi: 10.16462/j.cnki.zhjbkz.2022.02.007
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  Objective  To explore the intergenerational transmission of short-term, middle-term and long-term health status and the heterogeneity by residential areas of rural and urban.  Methods  Based on data of China Health and Nutrition Survey (CHNS), binary Logistic regression model and multivariate Linear regression model were used to analyze the associations between parental health status and their children's health status, and the interaction effect of residential areas (rural area and urban area) was further examined.  Results  Parents' short-term, middle-term and long-term health status were important factors of children's homologous health status (mother-children: ORshort-term=5.649, βmiddle-term=0.305, ORlong-term=3.719; father-children: ORshort-term=3.436, βmiddle-term=0.388, ORlong-term=3.483); residential areas of rural and urban modified the relationship between maternal and children's health status (Pshort-term=0.023, Pmiddle-term=0.038, Pshort-term=0.072), which showed that living in urban areas can buffer health transmission between mother and offspring.  Conclusions  Parent's short-term, middle-term and long-term health status are significantly factors for children's health status. Family health promotion is suggested to enhance all family members' health status.
Study on the association of residence tap water access and chronic diseases in middle-aged and elderly people
ZHAO Man, LIU Yun-duo, XU Chao-fan, GUO Chao
2022, 26(2): 169-174, 199. doi: 10.16462/j.cnki.zhjbkz.2022.02.008
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  Objective  Water is of utmost importance for human survival. Improving drinking water safety construction to ensure water safety and sanitation is a basic project for population health.  Methods  In this study, 12 211 middle-aged and elderly people aged 45 and over were selected from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Descriptive statistics were used to analyze the prevalence of chronic diseases in different populations. Logistic regression model and linear regression and propensity score matching methods were used to analyze the relationship between tap water and chronic diseases, as well as the number of chronic diseases.  Results  The proportion of middle-aged and elderly people in China who have tap water was 81.60%. The prevalence rate of chronic diseases in middle-aged and elderly people was 68.63%, and the average number of disease types was (1.112±1.118). After controlling confounding factors, middle-aged and elderly people who have tap water in their residence were less likely to suffer from chronic diseases (OR=0.836, 95% CI: 0.751-0.930), as well as have fewer chronic diseases than those without tap water (β=-0.080, 95% CI: -0.132--0.028). From the perspective of urban-rural differences, the number of chronic diseases among middle-aged and elderly people with tap water in the urban was more less (β=-0.097, 95% CI: -0.151--0.043). Those results above remain robust after matching the propensity value.  Conclusions  China's water improvement project should be continuously promoted, and the publicity of residents on drinking water safety should be strengthened. Besides, it is necessary to carry out chronic disease prevention based on the actual situation of the middle-aged and elderly.
Epidemiological characteristics and spatial-temporal cluster analysis of other infectious diarrhea in Hebei Province from 2015 to 2020
SU Tong, LIU Ying-ying, ZHAO Wen-na, YU Qiu-li, XIE Yun, LI Qi, QI Shun-xiang
2022, 26(2): 175-181. doi: 10.16462/j.cnki.zhjbkz.2022.02.009
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  Objective  To explore the spatial-temporal epidemical characteristics of other infectious diarrhea in Hebei Province from 2015 to 2020.  Methods  The monitoring data of other infectious diarrhea cases for each county from 2015 to 2020 in Hebei Province were collected from China Information System For Disease Control and Prevention. The three intersects distribution characteristics were analyzed by descriptive epidemiological method. The method for statistics, global and local autocorrelation, were used through GeoDa 1.18 software. Spatial-temporal clustering was applied by using SaTScan v9.7. The final visualized results were performed by using software ArcGIS 10.2.  Results  A total of 337 281 cases of other infectious diarrhea were reported in Hebei with an annual incidence rate of 75.03/100 000 from 2015 to 2020. It had been showed that there were two incidence peaks were present, with the highest peak in summer (June-August) and the second peak in autumn and winter (December-January of the following year). The obvious differences could be seen in regional distribution among counties. The global and local spatial autocorrelation analysis showed that Moran's I indicators were all above 0.26(P=0.001). Local indicators of spatial association (LISA) revealed that the high-high clusters areas were mainly distributed in the capital of Hebei with surrounding 13-15 counties, while low-low clusters areas were found in the border counties of Zhangjiakou, eastern Xingtai and Southern Hengshui and part of counties in Qinhuangdao. The results of spatial-temporal scanning were consistent with spatial correlation analysis, and the most likely clustering areas were always centered on Jingxing county or Jingxing mining county areas, covering 12-18 surrounding counties. The risk of disease in these areas were all above 3.61 (RR=3.61-4.92), and the clustering period was all occurred in the summer high-incidence period. The secondary cluster of high incidence areas was located in the central part of Hebei Province, showing a gradual expansion trend during the study period.  Conclusion  The spatial-temporal clustering areas of other infectious diarrhea of Hebei Province from 2015 to 2020 are mainly distributed in the capital of Hebei with surrounding counties and the central part of Hebei Province, showing a gradual expansion trend during the study period. So more attention should be paid on this high incidence clusters to establish new strategies for the disease control.
Trend and associated factors of follow-up and CD4+T cell testing among HIV/AIDS cases in Guangdong Province from 2008 to 2019
Liu Jun, Fu Xiao-bing, Yang Fang, Song Tie, Xie Shi-lan, Li Jian-rong, Liu You-zhao, Li Yan
2022, 26(2): 182-187, 205. doi: 10.16462/j.cnki.zhjbkz.2022.02.010
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  Objective  To assess the trend and the associated factors of follow-up and CD4+ T cell testing (CD4 testing) among HIV/AIDS cases in Guangdong Province from 2008 to 2019.  Methods  The historical databases were downloaded from the AIDS Comprehensive Prevention and Control Information System. The Joinpoint regression model was used to assess the annual percentage changes in the follow-up and CD4 testing status, and Logistic regression was used to analyze relevant influencing factors.  Results  The year 2012 was a Joinpoint in the trend of follow-up and CD4 testing rate, with a significant rapid increase from 2008 to 2012 (β=0.3, P < 0.001), while the speed slowed down after 2012; disequilibrium change of trends over time can be observed among regions as well as age groups. The completion rate of follow-up and CD4 testing can be influenced by different time periods of discovery, regions, sociodemographic characteristics, routes of transmission, routes of discovery, and mobility, after controlling for other factors.  Conclusion  Significant progress has been made in the follow-up management of HIV infected persons in Guangdong Province from 2008 to 2019, but the process slowed down after 2013. More attention should pay to the patients in non-Pearl River Delta regions and older age groups. Next step, develop targeted strategies which tailored to local conditions and population characteristics, improve capabilities of each follow-up unit, and to do a good job of referrals for off-site mobility.
Study on relationship among social support, anxiety and sleep quality of residents in Shanghai under COVID-19 epidemic
XU Ao, WANG Wei-bing, ZHU Dan-hong, GAO Jing
2022, 26(2): 188-192, 217. doi: 10.16462/j.cnki.zhjbkz.2022.02.011
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  Objective  To describe the social support, anxiety, and sleep quality of residents in the District of Shanghai during the COVID-19 and to analyze the to correlation of these factors.  Methods  A structured questionnaire was used to investigate residents' social support, anxiety, and sleep quality. The questionnaire consisted of social support rate scale, the self-rating anxiety scale (SAS) and Pittsburgh sleep quality index (PSQI), investigated the social support, anxiety, and sleep quality of residents in the District of Shanghai under the COVID-19 epidemic and analyzed their potential influencing factors. Structural equation model was constructed to understand the relationship among these factors.  Results  A total of 258 questionnaires were collected, with 237 being eligible for analyzeing. The results showed that there were statistically significant differences in sleep quality (P=0.004) and social support (P=0.009) among residents with different highest education levels. The structural equation model-fitting indices were CFI=0.929, NFI=0.891, IFI=0.930, NNFI=0.907, RMSEA=0.082, χ2 /df =2.599. It indicated that the fitting degree was good. The results showed that the social support of residents could affect their anxiety degree to some extent (r=-0.15). The higher the social support, the lower the anxiety degree they had. Moreover, the degree of anxiety could affect the sleep quality ( r=0.72), and the higher the degree of anxiety, the worse the sleep quality they had.  Conclusion  During the epidemic of COVID-19, residents' social support is related to their anxiety level, and the anxiety level is related to their sleep quality. By improving residents' support, their degree of anxiety could be reduced to improve their sleep quality.
Analysis of willingness and influencing factors of vaccination against novel coronavirus among college students in Shanghai
ZHOU Mei-ling, PAN Jin-hua, WANG Wei-bing, GUO Xiao-qin
2022, 26(2): 193-199. doi: 10.16462/j.cnki.zhjbkz.2022.02.012
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  Objective  To investigate the willingness and influencing factors with novel coronavirus vaccines(COVID-19 vaccines) among college students in Shanghai.  Methods  From February 23 to March 15, 2021, a web based questionnaire survey was conducted among students from four colleges to analyze the willingness rate of COVID-19 vaccines. Multivariate Logistic regression was used to analyze influencing factors of the willingness to receive vaccines.  Results  Of 4 462 subjects, 78.04% were willing to receive COVID-19 vaccines. Logistic regression analysis showed that students from the technology university and the vocational school had higher willingness to vaccinate (OR=1.53, 1.50), compared with those from medical college. Respondents did not agree that vaccines are important for protecting health (OR=0.11) and did not agree that all vaccines marketed through National Medical Products Administration are safe (OR=0.42) were less willing to be vaccinated. Those who had no one nearby to vaccinate against COVID-19 were less willing to be vaccinated (OR=0.68). The main reasons for refusing or hesitating to be vaccinated were concerned about the safety(73.88%) and efficacy(55.61%) of the vaccine. Further investigation showed that 37.86%, 48.27% and 35.31% of respondents who had previously chosen not to vaccinate or were unsure about vaccinating against COVID-19 were willing to vaccinate if recommended by the government, doctors, relatives and friends, respectively.  Conclusion  The willingness rate of COVID-19 vaccination among college students was high in Shanghai. The relevant departments should do a good job in the coordination of vaccination so that the vaccination work can be carried out effectively.
The relationship between residential greenness in the first 1 000 days of life and sleep in toddlers: a cohort study
WU Shu, XIE Lu-qin, CHEN Yu-jing, WU Sheng-chi, JING Jin, DONG Guang-hui, LIN Li-zi, CAI Li
2022, 26(2): 200-205. doi: 10.16462/j.cnki.zhjbkz.2022.02.013
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  Objective  To explore the association between residential greenness in the first 1 000 days of life and sleep problems in 2-year toddlers.  Methods  A prospective cohort study was conducted, from which we selected pregnant women who underwent prenatal examination in a Maternal and Child Health Hospital in Guangzhou. We have collected baseline information at 20-28 weeks of pregnancy. We also calculated normalized difference vegetation index (NDVI) with different buffers (250 m and 500 m) from remote satellite data based on maternal residential addresses to assess the level of residential greenness in the first 1 000 days of life. During the follow-up visits, we collected sleep outcomes during the last months of 2-year toddlers using the Chinese version of the brief infant sleep questionnaire. Logistic regression model and multiple linear regression model were performed to evaluate the association of residential greenness with sleep quality and sleep time, respectively.  Results  A total of 410 mother-toddler pairs were included, and the average daily sleep time of 2-year toddlers was 12.27 hours. The proportion of sleep quality problem was 39.27%, among which the highest was nocturnal awaking (16.83%), followed by difficulty to fall asleep (15.61%) and irregular sleep (13.41%). In the analyses of Logistic regression, the results indicated null associations of residential greenness in the first 1 000 days of life with the occurrence of difficulty to fall asleep, nocturnal awaking, irregular sleep, or any of the above sleep quality problems in 2-year toddlers (OR=0.77, 95% CI=0.39-1.54, P=0.465; OR=1.30, 95% CI=0.66-2.55, P=0.453; OR=0.87, 95% CI=0.40-1.88, P=0.714; OR=1.21, 95% CI=0.72-2.03, P=0.464). In the analyses of multiple linear regressions, the results indicated null associations between greenness exposure and sleep time at night, sleep time during daytime, and total sleep time in two-year-old toddlers (β±SE=-0.04±0.11, P=0.715; β±SE=-0.01±0.08, P=0.957; β±SE=-0.04±0.12, P=0.726).  Conclusion  No significant associations are found between residential greenness in the first 1 000 days of life and sleep quality problems and sleep time in 2-year toddlers.
Health risk assessment of Cadmium exposure on preschool children in a typical heavy metal polluted area
LIU Zi-jing, WANG Wei-ni, LI Rong, AI Shi-wei, DANG Yu-hui, LI Zhi-lan
2022, 26(2): 206-211. doi: 10.16462/j.cnki.zhjbkz.2022.02.014
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  Objective  To evaluate the health risk of Cadmium(Cd) on preschool children in a typical heavy metal polluted area.  Methods  We collected soil samples and edible parts of vegetables in a typical heavy metal contaminated area and detect the cadmium concentration, checked the cadmium concentration in the local air, wheat, rice and water, and evaluated the local preschool children's health through the health risk assessment model recommended by the US Environmental Protection Agency. For the health risks of cadmium exposure, hazard quotient (HQ) and incremental lifetime cancer risk (ILCR) were used to assess non-carcinogenic risks and carcinogenic risks.  Results  The total non-carcinogenic risk of preschool children in this area was 4.14, the HQ via ingestion and wheat intake were 4.10 and 2.77 respectively, and the others were all less than 1.00. The total carcinogenic risk of preschool children in this area was 1.54×10-3. The ILCR via ingestion was 1.53×10-3, and that via wheat intake > vegetables intake > rice intake > 1.00×10-4.  Conclusions  Preschool children in this typical heavy metal pollution area have non-carcinogenic and carcinogenic risks of cadmium exposure. Oral is the main route of cadmium exposure, wheat is the main contributor to non-carcinogenic risk, and wheat, vegetables and rice are the main contributors to carcinogenic risk.
The mediating role of depression in the relationship between social engagement and cognitive function in older persons
SUN Dan-dan, SUN Duo-duo, SUO Jing-dong, ZHANG Qing, HE Chong-xiang
2022, 26(2): 212-217. doi: 10.16462/j.cnki.zhjbkz.2022.02.015
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  Objective  To analyze the mediating effect of depression on the relationship between social engagement and cognitive function in older persons.  Methods  Based on data from the 2018 China Health and Retirement Longitudinal Study, 7 403 participants were screened for meeting the criteria. Structural Equation Model was used to verify the mediating effect of depression on the relationship between social engagement and cognitive function in older persons.  Results  There were 2 332 (31.50%) subjects with cognitive dysfunction among older persons. Social engagement was positively correlated with cognitive function (r=0.103, P < 0.001), social engagement was negatively correlated with depression (r=-0.050, P < 0.001), and depression was negatively correlated with cognitive function (r=-0.242, P < 0.001). The results of each fitting index of structural equation model showed that: χ2=4.094, P < 0.001, root mean square error of approximation (RMSEA)=0.020, comparative fit index (CFI)=0.985, Tucker-Lewis Index (TLI)=0.979, incremental fit index (IFI)=0.985, indicated the model fits well. The direct effect of social engagement on cognitive function was 0.380 (95% CI: 0.292-0.467), the indirect effect mediated by depression was 0.050 (95% CI: 0.027-0.073).  Conclusion  Social engagement positively affects cognitive functioning in older persons, depression negatively affects cognitive functioning in older persons, and depression has a partly mediating effect on the relationship between social engagement and cognitive functioning.
Short Reports
Comparison of the effects of decision tree model and Logistic regression analysis model on identifying risk factors of hypertension
YAN Rui-ping, WANG Xi-liang, YAO Fen-xia, ZHANG Wei-dong
2022, 26(2): 218-222. doi: 10.16462/j.cnki.zhjbkz.2022.02.016
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  Objective  To analyze the risk factors of hypertension in Qingfeng County, and to compare the differences between the two analysis methods.  Methods  A multi-stage stratified cluster sampling method was adopted to seket samples from 4 087 permanent residents from 15-74 years old in Qingfeng County. After the survey, decision tree and Logistic regression analysis model were established.  Results  Both the decision tree model and the Logistic regression analysis model showed that elder age, central obesity, educational level below junior middle school, rural areas, diabetes, smoking, drinking, and family history of hypertension were risk factors of hypertension. The overweight/obesity variable was included in the decision tree model and eliminated from the Logistic regression analysis model. The collinearity diagnosis indicated that the central obesity and overweight/obesity variables had strong collinearity. Area Under the Curve (AUC) and Integrated Discrimination Improvement (IDI) all indicated that in terms of the ability to predict the hypertension, the decision tree model was slightly higher than that of the Logistic regression analysis model.  Conclusion  The predictive ability of the decision tree model is slightly higher than that of the Logistic regression analysis model. The decision tree model is feasible and intuitive in the analysis of risk factors of hypertension. Besides, it is not affected by the collinearity between variables. The Logistic regression analysis model can fully demonstrate the quantitative interdependency between the independent variable and the dependent variables. It is supplementary to the decision tree model and it can be combined with the decision tree model to describe the risk factors of hypertension.
Investigation of female prisoners' awareness of AIDS, syphilis and gonorrhea and analysis of the effect of knowledge intervention
MA Yu-qian, JIANG Dai-xi, LAN Lei, YANG Shi-gui
2022, 26(2): 223-226,237. doi: 10.16462/j.cnki.zhjbkz.2022.02.017
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  Objective  To understand the cognition and influencing factors of female prisoners on acquired immunodeficiency syndrome (AIDS), syphilis, and gonorrhea, and analyze the effect of systematic input education intervention to reduce the infection of female prisoners with these diseases.  Methods  A total of 405 female prisoners with a total sentence of more than one year were included. A self-made questionnaire was used to conduct a baseline survey. After a year of systematic education intervention, the survey was conducted and the data was analyzed using SPSS 21.0 software.  Results  The overall awareness rate of newly admitted female prisoners about AIDS, syphilis, and gonorrhea was 49.68%. Among them, the average awareness rates of AIDS, syphilis, and gonorrhea knowledge were 44.44%, 48.61%, and 56.01%, respectively. After the intervention, the overall awareness rate increased to 78.05%, and the average awareness rate of AIDS, syphilis and gonorrhea increased to 74.11%, 76.98% and 83.06%, respectively. Before and after the systematic educational intervention, there was a statistically significant difference in the knowledge scores of gonorrhea, AIDS and syphilis among newly admitted female prisoners (P < 0.001). Educational level had an impact on the knowledge score of AIDS, syphilis and gonorrhea, as well as age and crime type (all P < 0.05).  Conclusions  Female inmates have a low awareness rate of AIDS, syphilis, and gonorrhea. Age, educational level and crime type have an impact on knowledge score. Systemic education interventions unique to prisons can effectively improve their cognition.
Analysis of seasonal characteristics of human brucellosis in Gansu Province based on the concentration and circular distribution method
DONG Huan-huan, LIU Xing-rong
2022, 26(2): 227-231. doi: 10.16462/j.cnki.zhjbkz.2022.02.018
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Abstract:
  Objective  To analyze the seasonal characteristics of brucellosis in Gansu Province, and to provide references for the prevention and control of brucellosis.  Methods  We collected the monthly incidence data of brucellosis in Gansu Province from 2011 to 2019, used the concentration and circular distribution method to analyze the seasonal characteristics of brucellosis.  Results  From 2011 to 2019, a total of 11 207 cases of brucellosis were reported in Gansu Province, with no death cases, the incidence rate increased from 0.196/100 000 (2011) to 6.291/100 000 (2017). The overall M=0.183 from 2011 to 2019, indicated that there was poor seasonality, there was certain seasonality in 2012 (M=0.357), 2013 (M=0.342), 2014 (M=0.333), 2015 (M=0.323). Overall r=0.183 from 2011 to 2019, ā=165.167°, s=105.528° (Z=376.917, P < 0.01), indicated that the peak day was in June 16th, and the epidemic peak was March 1st to October 1st. From 2012 to 2017, the peaks occurred in the second quarter, and most in June, the peaks occurred in the third quarter in 2018 and 2019. The M-value was highly correlated with the r-value (r=1.000, P < 0.001).  Conclusion  The peaks of brucellosis in Gansu Province mainly occurred in summer and autumn, it is necessary to take effective prevention and control measures on time around the peak period of incidence.
Identification of high-risk spatio-temporal areas for the incidence of hand, foot and mouth disease in Xinjiang in 2018 based on a spatio-temporal kernel estimation method
ZHANG Meng-juan, SHI Yue, ZHANG Hui-guo, HU Xi-jian
2022, 26(2): 232-237. doi: 10.16462/j.cnki.zhjbkz.2022.02.019
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Abstract:
  Objective  The study aimed to describe spatial and temporal changes in the incidence risk of hand, foot and mouth disease (HFMD) in Xinjiang Province from January to December 2018, to identify high-risk spatio-temporal areas for HFMD, and to provide a reference for the prevention and control of HFMD in the future.  Methods  Data on the incidence of HFMD in 100 Cities and Counties (municipal Districts) in Xinjiang Province from January to December 2018 were collected to describe the characteristics of the three-way distribution of the data; the spatio-temporal kernel estimation method proposed in this paper was used to detect high-risk spatio-temporal regions, and the results were compared with those of the traditional spatio-temporal scanning analysis method.  Results  From January to December 2018, the annual incidence rate of HFMD in 100 Cities and Counties (municipal Districts) in Xinjiang Province was 45.01/100 000, with a male-to-female sex ratio of 1.49:1; children aged 0-5 years were the main incidence group, accounting for 80.16% of all cases; cases mainly originated from children in early childhood care and children living in the diaspora, accounting for 45.76% and 43.94% of the total number of cases, respectively. The high-risk spatio-temporal regions identified based on the spatio-temporal kernel estimation method mainly contained two peak periods (May to July and September to November), and a changing significant high-risk spatial region (northeast of Xinjiang Province), and the spatio-temporal scan results verified the feasibility of the method.  Conclusions  There are significant temporal, spatial and population differences in the occurrence of HFMD in Xinjiang Province. It is suggested to strengthen the prevention and control of HFMD in peak hours and high incidence areas, and strengthen the preventive measures of families and kindergartens for infants aged 0-5 years, to reduce the risk of HFMD.
Source-tracing investigation and analysis of a case of nucleic acid detection of 2019 Novel Corona Virus positive environmental samples in a medical institution
YUE Yong, CHEN Heng, FENG Jing, LYU Tian-ping, TIAN Wen-jia, ZHAO Chen-lu, LIAO Jun, HU Min, LI Jun-fan, CHENG Yue, LIU Hui, LIU Zhu
2022, 26(2): 238-243. doi: 10.16462/j.cnki.zhjbkz.2022.02.020
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Abstract:
  Objective  This study is conducted against a case of positive nucleic acid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of environmental samples in a medical institution in Chengdu. Epidemiological investigation methods and laboratory tests are used to investigate the source and analyze the cause of the case, to explore the nucleic acid monitoring mode and the disposal scheme of abnormal conditions of SARS-CoV-2 in the medical institution environment.  Methods  Chengdu and Shuangliu district CDC jointly investigate A Medical Institution (A refers to a specific anonymous medical institute). Epidemiological surveys were conducted though related influencing factors of the medical institution. SARS-CoV-2 nucleic acid detection kits were used for detection. Sequencing was carried out on a second-generation sequencing platform.  Results  From Jan.18th 2021 to Jan.20th 2021, a total of 62 smear samples of environment and articles were collected, among which 30 samples were positive for SARS-CoV-2 nucleic acid. 30 positive samples were divided into Gongwei building (9) and Zhonghe building (21) according to the sampling location. The samples' Ct values of ORF1ab gene in Gongwei building were lower than that in Zhonghe building, and the difference was statistically significant (t=2.452, P=0.036). According to the nature of the specimens, they were divided into external environment smear samples (24 samples) and cleaning tool smear samples (6 samples). The N gene Ct values of external environment smear samples were lower than that of cleaning tools, and the difference was statistically significant (Z=-2.204, P=0.028). Through gene sequencing analysis, the sequence of SARS-CoV-2 nucleic acid positive environmental samples detected this time is highly homologous with SARS-CoV-2 vaccine (> 99.9%).  Conclusions  The positive environmental samples of SARS-CoV-2 nucleic acid in the medical institution are caused by the damage and leakage of COVID-19 vaccine ampoules in the process of vaccination, which led to the contamination of the vaccination room of public health building, and then transmit to the hospital environment of fever clinic and complex building through cleaning tools by cleaning workers. With the progress of COVID-19 vaccine vaccination, there is a high probability of environmental pollution of vaccine liquid in the vaccination area of medical institutions. Therefore, it is necessary in combination with the current normalization monitoring requirements of domestic COVID-19 epidemic situation to refine the specific implementation plan, conduct vaccination in a scientific and orderly manner, and reduce the social impact.
Association between DNA methylation of IL6, IL12A/B, IL13 genes and low response level of hepatitis B vaccine in children
LI Jia-ling, SU Yong-jian, DONG Bai-qing, WU Qi-jun, YANG Qing-li, CHEN Qin-yan, CHEN Shi-yi, TAN Chao, JU Yu, LI Hai
2022, 26(2): 244-248. doi: 10.16462/j.cnki.zhjbkz.2022.02.021
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Abstract:
  Objective  To explore the correlation between DNA methylation at interleukin 6 (IL6), interleukin 12A/B (IL12A/B), and interleukin 13 (IL13) gene cytosine-phosphoric-guanylic (CpG) sites in Guangxi Han children and the level of hepatitis B vaccine immune response.  Methods  The non-matched case-control method was used to study 263 Han children from three hospitals in Guangxi who were 8-9 months old and had been vaccinated with HepB. According to the research object, subjects with anti-HBs level < 100 mIU/ml were selected to the case group, and subjects with anti-HBs ≥100 mIU/ml was chosen to the control group. Using multiplex PCR technology, bisulfite sequencing, high-throughput sequencing and other technologies, the relationship between DNA methylation at 85 sites of IL6, IL12A/B and IL13 genes and the level of HepB immune response were analyzed and studied.  Results  The average methylation levels of IL6 gene 117, IL12B gene 103, and IL13_2 gene 167 of the case group was higher than those of the control group, and the average methylation level of IL12A gene 85 of the case group was lower than that of the control group (all P < 0.05). Unconditional Logistic regression showed that IL6 gene 117 and IL13_2 gene 167 increased the risk of low HepB response (OR=1.07, 95% CI: 1.02-1.13; OR=1.04, 95% CI: 1.00-1.07).  Conclusion  It is suggested that the DNA methylation modification of IL6 gene 117 site and IL13_2 gene 167 site may be the risk factor of the low response of HepB immune response in Guangxi Han children.

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