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CN 34-1304/RISSN 1674-3679

2023 Vol. 27, No. 9

Maternal and Child Health
Relationship between dietary balance index during pregnancy and infant body weight development: a cohort study
HONG Bin, LU Qinggui, XIE Luqin, WU Shengchi, CHEN Yujing, WU Shu, WANG Xin, LIN Lizi, CAI Li
2023, 27(9): 993-997. doi: 10.16462/j.cnki.zhjbkz.2023.09.001
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  Objective  To prospectively explore the longitudinal association between dietary balance index during pregnancy and infant body weight development.  Methods  Using food frequency questionnaire, we collected data on the dietary intake of women during the second trimester of pregnancy in the past month based on the birth cohort. The revised dietary balance index for pregnancy (DBI-P) was utilized to evaluate dietary quality of pregnant women. Follow-ups were conducted for offspring up to the age of 2 years, with body weight measurements taken at 1, 6, 12, 18, and 24 months respectively. The Z-score of body weight for age and the Z-score of body weight for age from 0 to 24 months of age were calculated. The mixed linear model and multiple regression were used to analyze the correlation.  Results  A total of 543 mother-child pairs were included, of which 13.45% of pregnant women had overall low intake, 84.53% had an overall low intake, and 88.77% had an uneven diet. Fruit intake score during pregnancy was positively correlated with the body weight of infants aged 0-24 months (β=0.065, P=0.002). Gestational added sugar score and DBI-P high bound score (HBS) was positively correlated with weight change at 0-24 months of age (β=0.091, P=0.032). Alcohol consumption score during pregnancy was negatively correlated with weight change of age from 0-24 months (β=-0.282, P=0.032).  Conclusions  There is a significant dietary imbalance among women in the second trimester of pregnancy in Guangzhou. It is crucial to encourage increased fruit intake, reduce excessive and added sugar consumption, and completely avoid alcohol during pregnancy.
Maternal sensitivity to thyroid hormones and birth outcomes: a cohort study
HUANG Yun, SUN Xiaojie, LI Yuanyuan, XU Shunqing, LIU Hongxiu
2023, 27(9): 998-1002. doi: 10.16462/j.cnki.zhjbkz.2023.09.002
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  Objective  The objective of this study was to explore the association between sensitivity to thyroid hormones during pregnancy and birth outcomes.  Methods  A total of 5 411 pairs of mother-newborn from large birth cohorts in Wuhan were included based on the inclusion criteria. The thyroid hormones sensitivity indicators, including thyroid stimulating hormone index (TSHI), thyrotroph thyroxine resistance index (TT4RI), and thyroid feedback quantile-based index (TFQI) were calculated based on values of thyroid function indicators free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) which were detected during routinely prenatal care. The outcomes included birth weight, gestational duration, birth weight Z-score, low birth weight, preterm birth, and small for gestational age (SGA). Multiple linear regression and logistic regression were used to assess associations of exposures with continuous and categorical outcomes, respectively, adjusting for potential confounders.  Results  FT4, TSHI, TFQI were significantly negatively associated with birth weight and birth weight Z-score (all P≤0.01). Higher TSHI, TT4RI, TFQI were associated with higher risk of SGA (TTSHI: OR=1.52, 95% CI: 1.12-2.06, P<0.01; TT4RI: OR=1.15, 95% CI: 1.03-1.29, P=0.02; TFQI: OR=1.41, 95% CI: 1.10-1.81, P<0.01). No thyroid indicators were significantly related to low birth weight or preterm birth. The associations were almost unchanged when pregnant women with hypothyroidism were excluded.  Conclusions  Impaired sensitivity to thyroid hormones during pregnancy is an independent risk factor of SGA.
Exploring the influencing factors of antenatal depression based on random forest algorithm and multivariate logistic regression model
DENG Ganyuan, YANG Zhongting, DU Xingmei, DENG Chunyan, SONG Ting, LI Ruiyu, HE Jieyu, DENG Rui, HUANG Yuan, CHEN Ying
2023, 27(9): 1003-1009. doi: 10.16462/j.cnki.zhjbkz.2023.09.003
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  Objective  To analyze the prevalence of antenatal depression, to explore the possible influencing factors of antenatal depression, and and to recognize high-risk groups, thereby contributing to prevention strategies.  Methods  In May 2022, pregnant women in a county of Yunnan Province were surveyed and antenatal depression were screened by Edinburgh Postpartum Depression Scale (EPDS). Random forest algorithm was adopted to rank the importance of the influencing factors of antenatal depression. The sliding window sequential forward selection method was employed to decide the number of influencing factors. The influencing factors with the highest importance score and the lowest out-of-bag error were incorporated into the Multivariate logistic regression model to estimate the effect size.  Results  A total of 732 pregnant women were screened by questionnaire, the prevalence of antenatal depression was 13.8% (101/732).The out-of-bag error was lowest when the number of influencing factors was 7 based on random forest algorithm and sliding window sequential forward selection. We included the top 7 influencing factors in the logistic regression model, and the results showed that antenatal anxious, history of negative emotions, financial concerns of having children, and baby gender expectation were the risk factors for antenatal depression. In contrast, the second pregnancy, high social support were the protective factors. Self-reported poor health was found unrelated to antenatal depression.  Conclusions  Women with anxiety during pregnancy are more likely to develop depression. The concerns of financial costs, baby gender and bad emotions experience increase the risk of triggering depression during pregnancy, while the adequate social support and pregnancy experience reduce the risk. It is recommended that high-risk group screening should be given to women during the pregnancy to prevent antenatal depression.
Comparative of the results of different thyroid volume correction indexes for children aged 8-10 in Fujian Province
WANG Muhua, JI Shumi, CHEN Diqun, CHEN Zhihui
2023, 27(9): 1010-1012. doi: 10.16462/j.cnki.zhjbkz.2023.09.004
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  Objective  We aimed to analyze the relationship between thyroid volume and physical development in children aged 8-10 years, and to explore the suitable correction method for thyroid volume in children.  Methods  During 2020-2021, 3 732 children aged 8-10 years in Fujian Province were selected using the multi-stage stratified cluster random sampling method. The thyroid volume was evaluated using the B-ultrasonic method, and urinary iodine levels along with the iodine content in their diet were measured. Correction of thyroid volumes was done using height volume index (HVI), weight height volume index (WHVI), body mass volume index (BMIV), and body surface volume index (BSAV).  Results  There was a statistically significant association between thyroid volume and age, height, weight, BMI and BSAV after HVI correction (all P<0.001). The HVI corrected thyroid volume had the strongest correlation with the original thyroid volume (r=0.918), followed by the BSAV (r=0.884). However the BSAV was not affected by body weight, and had a better fit.  Conclusion  The BSAV method is recommended as a calibration method for thyroid volume in children.
Investigation of factors influencing congenital heart disease among children in Qinghai Province
ZHANG Shuqin, YANG Huilian, QI Jirong
2023, 27(9): 1013-1018. doi: 10.16462/j.cnki.zhjbkz.2023.09.005
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  Objective  This study aimed to analyze the factors influencing congenital heart disease (CHD) in children within Qinghai Province.  Methods  A 1∶2 sex- and age-matched (age difference less than 1 year) case-control study was employed, incorporating 315 children under 6 years (105 in the case group, 210 in the control group). Conditional logistic regression models were utilized to analyze influencing factors.  Results  Univariate conditional logistic regression model identified 14 significant factors (P<0.001) influencing congenital heart disease, including altitude of residence, ethnicity, birth weight, maternal education, family income, receiving missionary education during pregnancy, first pregnancy, vitamin supplementation during pregnancy, main drinking water during pregnancy, consumption of vegetables and fruits during pregnancy, consumption of fried foods during pregnancy, have physical exercise during pregnancy, keeping animals during pregnancy, and regular medical checkups during pregnancy. Multivariate conditional logistic regression identified six significant factors, including altitude >2500 m (OR=4.84, 95% CI: 1.17-20.08, P=0.030), birth weight ≥2.5 kg (OR=0.10, 95% CI: 0.01-0.81, P=0.031), maternal education level of university or above (OR=0.23, 95% CI: 0.07-0.76, P=0.016), monthly per capita household income >1 500 yuan (OR=0.03, 95% CI: 0.01-0.21, P=0.001), vitamin supplementation during pregnancy (OR=0.06, 95% CI: 0.01-0.40, P=0.004), and consumption of purified water during pregnancy (OR=0.05, 95% CI: 0.01-0.35, P=0.003).  Conclusions  The risk of CHD was found to be 4.84 times higher in high-altitude residences compared to low-altitude ones. Furthermore, family income, maternal education, and maternal lifestyle during pregnancy may be linked with the occurrence of CHD.
Analysis of mortality monitoring results of children under 5 years old in Shaanxi Province from 2010 to 2020
LI Min, WANG Baozhu
2023, 27(9): 1019-1024. doi: 10.16462/j.cnki.zhjbkz.2023.09.006
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  Objective  This study aims to analyze the mortality and primary death causes in children under five years old in Shaanxi Province from 2010 to 2020, and thus providing guidance for furture intervention strategies.  Methods  Mortality data for children under five years in Shaanxi Province were collected. The Joinpoint regression model was applied to analyze both mortality and major cause-specific mortality trends.  Results  From 2010 to 2020, the mortality rates among children under five years in Shaanxi Province were exhibited a significant decrease trend. The Joinpoint regression model showed a consistent monotonous downward trend in mortality rate across overall, urban and rural children under five years groups, with no turning point (overall APC=-11.23, P<0.001;urban APC=-4.87, P=0.038; rural APC=-12.23, P<0.001). No significant differences were found in the trend for annual changes of mortality between urban and rural groups from 2010 to 2013 (P=0.709); however, a significant difference emerged from 2013 to 2020 (P=0.015). The main cause-specific death rates, including asphyxia, congenital heart disease, preterm birth/low birth weight and pneumonia, all significantly decreased. The Joinpoint regression showed that the changing trend of the mortality for asphyxia had a turning point (APC=-43.80 and P=0.108 for 2010-2012, APC=-12.16 and P=0.023 for 2012-2020). The mortality rates for congenital heart disease, preterm birth/low birth weight and pneumonia showed a monotonous downward trend, with APC=-13.21 and P<0.001 for congenital heart disease, APC= -11.47 and P<0.001 for preterm birth/low birth weight, APC=-7.67 and P=0.038 for pneumonia.  Conclusions  From 2010 to 2020, the mortality rate among children under five years in Shaanxi Province showed an consistent downward trend. This trend was evident both in urban and rural child populations and across all main causes of death.
Prevalence and risk factors of dental fluorosis among children from minority areas of Gansu Province
LYU Chengcheng, CHEN Xiaoyan, ZHANG Jie, ZHANG Yong, YANG Lin, YAN Juan, LIU Yanli, ZHANG Benzhong
2023, 27(9): 1025-1029. doi: 10.16462/j.cnki.zhjbkz.2023.09.007
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  Objective  This study seeks to understand the prevalence of dental fluorosis in children residing in ethnic minority areas of Gansu Province and to explore the risk factors of dental fluorosis.  Methods  Between June and November 2019, 1 344 students from eight ethnic minority counties in Gansu Province were included using the stratified cluster random sampling method. These participants underwent data collection, dental fluorosis diagnosis and fluoride detection in urine samples.   Results   The prevalence of dental fluorosis among children aged 8-12 years in minority areas of Gansu Province was 29.1%, with a geometric mean urinary fluoride concentration of 1.02 mg/L. Living in the areas of Aksai (OR=2.625, 95% CI: 1.530-4.597, P=0.001), Sunan (OR=2.421, 95% CI: 1.411-4.154, P=0.001), Tianzhu (OR=2.813, 95% CI: 1.599-4.946, P < 0.001) and Xiahe (OR=1.719, 95% CI: 1.022-2.892, P=0.041) counties, having tea-drinking habits (OR=1.508, 95% CI: 1.072-2.120, P=0.018), older age (8-12 years old)(OR = 1.122, 95% CI: 1.021-1.233, P=0.017) and high urinary fluoride concentration (0.10-5.87 mg/L)(OR=1.549, 95% CI: 1.223-1.962, P < 0.001) were risk factors affecting the prevalence of dental fluorosis in children.  Conclusions  The prevalence of dental fluorosis among children is high in ethnic minority areas of Gansu Province. The factors such as region, tea-drinking habits, age, and urinary fluoride can affect the prevalence of dental fluorosis. Continuous prevention and treatment of tea-drinking type dental fluorosis should be carried out in a targeted manner.
Effectiveness of the Lanzhou lamp rotavirus vaccine against rovavirus gastroenteritis among children aged 2-35 months: a test-negative design study
LIN Zian, YANG Weikang, QIU Shuangyan, ZHANG Yuying, CHEN Wensheng, ZHANG Lijun, CHEN Hongbiao, YU Chuanning
2023, 27(9): 1030-1036. doi: 10.16462/j.cnki.zhjbkz.2023.09.008
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  Objective  This study aimed to assess the effectiveness of the Lanzhou lamp rotavirus vaccine (LLR) in mitigating laboratory-confirmed rotavirus gastroenteritis (RVGE) in children, with the objective of informing disease prevention and control policy-making.  Methods  Data pertaining to confirmed paediatric RVGE and the corresponding LLR vaccination history in Longhua District, Shenzhen City, from 2019-2021 during the RVGE epidemic season, were collected from the China Disease Prevention and Control Information System and the Vaccination Information Management System. A test-negative study design was employed. The adjusted odds ratios (aOR) for LLR vaccination rate and vaccine effectiveness (VE) were calculated using unconditional and conditional logistic regression analysis.   Results   Of the 1052 children with laboratory-confirmed RVGE included in the study, 849 were positive (RVGE+) and 203 were used as a negative control group (RVGE-), with 326 cases successfully matched (163 cases each in the RVGE+ and RVGE- groups). In the analysis model, the VE of ≥1 dose of LLR vaccine were 45.3 (95% CI: 17.8-63.6) and 50.4 (95% CI: 11.7-72.1) in the unconditional and conditional logistic regression models, respectively.  Conclusions  This suggests that the LLR vaccine offers moderate effectiveness in preventing RVGE in children aged 2-35 months during the epidemic season. However, the study also exposed a low coverage rate of LLR vaccination in children aged 2-11 months, indicating delayed first-dose inoculation. It is recommended that children who have missed the opportunity for pentavalent human-reassortant rotavirus vaccine should receive the LLR vaccine as soon as feasible.
Relationship between the incidence of sexual behavior and childhood abuse among students in a university in Chongqing
HU Chunmei, LYU Xiao, HE Lingling
2023, 27(9): 1037-1040. doi: 10.16462/j.cnki.zhjbkz.2023.09.009
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  Objective  To investigate the relationship between the incidence rate of sexual behavior and childhood abuse among students in a university in Chongqing and to provide suggestions for sexual education in college.  Methods  Using convenience sampling, a total of 2 504 college students from a university in Chongqing were selected and completed the Sexual Behavior Questionnaire and Childhood Trauma Questionnaire. Logistic regression was used to analyze the impact of childhood abuse on the incidence rate of sexual behavior.   Results   The prevalence of sexual behavior among college students was 16.6%. Significant difference were found in the prevalence of sexual behavior across various characteristics (both P < 0.05). Sexual behaviour was more prevalent in men (25.5%) than that in women (9.8%), and higher in second and third-year student (19.1%, 20.9%) than first-year students (10.9%). Students from urban areas (19.5%) and those studying physical majors (44.5%) showed higher rates than those from rural areas (14.7%) and those in arts, science and fine arts majors (8.9%, 10.7%, 18.8%). Students who had experienced physical abuse, sexual abuse, emotional neglect, and physical neglect during childhood exhibited higher prevalence (23.9%, 31.5%, 20.4%, 21.1%) than those who had not (16.2%, 15.6%, 15.7%, 15.0%). Childhood sexual abuse (OR=1.137, 95% CI: 1.005-1.221) and emotional neglect (OR=1.036, 95% CI: 0.944-1.039) were positively associated with the prevalence of sexual behavior.  Conclusions  Colleges should carry out sexual education that consider the influence of childhood abuse on sexual behavior, aiming to guide students to avoid coping with the negative impact of childhood abuse through sexual behavior.
Effects of different immunization methods on varicella antibody levels in preschool children in Shenzhen City
PENG Yuanzhou, LI Wenhao, ZHANG Yanwei, WU Yu, CHENG Jinquan
2023, 27(9): 1041-1044. doi: 10.16462/j.cnki.zhjbkz.2023.09.010
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  Objective  To evaluate the level of varicella antibody in preschool children in Shenzhen, and to provide a scientific basis for effective varicella vaccine immunization strategy.  Methods  Blood samples were collected from preschool children in Shenzhen through stratified random sampling. The varicella antibody titer in the serum was measured using an enzyme-linked immunosorbent assay. The influence of different immunization conditions, such as the number of vaccinations and the interval between vaccinations, on the geometric mean concentration (GMC) and positive rate of varicella IgG antibody was analyzed.  Results   The GMC of chickenpox IgG antibody in preschool children in Shenzhen was 11.20 U/ml, and the positive rate of chickenpox IgG antibody was 61.5%. The GMC of chickenpox IgG antibody in non-vaccinated group, once vaccinated group and twice vaccinated group were 4.31 U/ml, 12.15 U/ml and 15.86 U/ml, respectively (F=11.11, P < 0.001). And the positive rate of chickenpox IgG antibody was 26.1%, 39.5% and 74.5% in these groups, respectively(χ2= 41.42, P < 0.001); The GMC of chickenpox IgG antibody in the first needle timely vaccination group and extended vaccination group were 14.17 U/ml and 8.07 U/ml, respectively (t=3.11, P=0.002), with positive rate of 70.8% and 47.9%, respectively(χ2=11.12, P < 0.001).  Conclusions  Timely completion of the second vaccination for preschool children in Shenzhen can improve the antibody levels.
Assessing susceptibility to smoking among non-smoking youth in Wuhan City, China
MEI Xin, ZHONG Qing, LI Junlin, LI Yilin
2023, 27(9): 1045-1051. doi: 10.16462/j.cnki.zhjbkz.2023.09.011
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  Objective  To estimate the susceptibility to smoking among non-smoking youth in Wuhan and identify contributing factors.  Methods  Using a cross-sectional study design and a multi-stage stratified cluster random sampling method, the participants were selected from all public and private, junior and senior high schools across 15 administrative districts in Wuhan from September to November 2019. The multivariate logistic regression model was used to analyze the smoking susceptibility of non-smoking youth and related factors.   Results   The prevalence of smoking susceptibility of non-smoking youth in Wuhan was 6.2% (95% CI: 5.324-7.131), of which the prevalence of susceptibility of male was 6.8% (95% CI: 5.460-8.186), and the prevalence of susceptibility of female was 5.6% (95% CI: 4.644-6.489). The multivariate logistic regression analysis showed risk factors for increased susceptibility to smoking in non-smoking youth, which included having good friends who smoke (OR=2.981, 95% CI: 2.269-3.917, P < 0.001), observed teachers smoking at school (OR=1.626, 95% CI: 1.302-2.029, P < 0.001), noticed tobacco advertisements or promotions (OR=1.442, 95% CI: 1.189-1.750, P < 0.001) and exposure to second-hand smoke (OR=1.267, 95% CI: 1.021-1.573, P=0.032). In contrast, protective factors included seeing anti-smoking media content (OR=0.722, 95% CI: 0.602-0.866, P < 0.001) and a weekly disposable income of 1- < 20 yuan (OR=0.690, 95% CI: 0.487-0.978, P=0.037).  Conclusions  It is crucial to enhance media campaigns and education on tobacco control, eliminate all forms of tobacco advertising, promotions, and sponsorships, and implement comprehensive smoke-free campus policies in schools. Health education for peers and teachers on smoking cessation should be provided. Comprehensive smoke-free legislation should be urgently enacted to create a smoke-free environment, thereby reducing the susceptibility of young people to smoking.
Elderly Health
A comparative study of differences in cognitive frailty in older adults with different social participation patterns
HAN Jiaying, CHAO Jianqian, LUO Zongyu, SU Fan
2023, 27(9): 1052-1058. doi: 10.16462/j.cnki.zhjbkz.2023.09.012
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  Objective  To understand the current status of cognitive frailty in older adults, investigating the divergence in cognitive frailty and its contributing factors across various patterns of social participation.  Methods  Utilizing the 2018 Chinese longitudinal healthy longevity survey, we performed a multi-factor stepwise forward logistic regression analysis and Fairlie decomposition to discern the status of cognitive frailty in older adults.   Results   The prevalence of cognitive frailty among the 7 772 older adults was 5.83% for the group interaction type and 21.53% for the self-pastime type, with a statistically significant difference (χ2=426.10, P < 0.001). Multifactorial logistic regression results showed that low age, having an educational background, having a spouse, better economic conditions, alcohol drinking, exercising and having family support were protective factors for cognitive frailty. Fairlie decomposition results showed that 55.63% of the health differences between the two social participation patterns were explainable by observed factors, while 44.37% of the health differences were caused by the two patterns themselves.  Conclusions  The cognitive frailty status was better in group-interactive older adults than in self-pastime older adults. To mitigate health disparities, it is recommended that older adults are encouraged to actively engage in social activities and maintain regular exercise.
COVID-19 Related Prevention and Control
Peak prediction and spatial distribution characteristics of COVID-19 in Beijing-Tianjin-Hebei region based on baidu index
XIA Xuecang, LIU Yu, WANG Xiaowan, QIU Wensong, FANG Shaojie, LIU Chao
2023, 27(9): 1059-1066. doi: 10.16462/j.cnki.zhjbkz.2023.09.013
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  Objective  To analyze the progression cycle and spatial clustering of the coronavirus disease 2019(COVID-19)in Beijing-Tianjin-Hebei region from November 11 to December 22, 2022.  Methods  Based on the daily fever keyword Baidu index search data in each city, the logistic model was used to simulate and predict the development process of this round of COVID-19 infection. The infection progression cycle was divided into an increasing period, a rapid increase period and a slow increase period, and the peak day of infection growth was predicted. At the same time, the global and local spatial autocorrelation analysis of the fever Baidu index search rate was conducted.  Results  The logistic model simulation and prediction yielded a robust model fitting effect. The epidemic progression speed and stage of COVID-19 infection varied across cities. Shijiazhuang City, Baoding City and Xingtai City were the first to enter the rapid increase stage of infection. Spatial autocorrelation analysis showed that there was a significant global spatial positive correlation in Beijing-Tianjin-Hebei region only for 5 days (Moran′s I: 0.314~0.491, P value was < 0.05), whereas other times exhibited random distribution.  Conclusions  This round of COVID-19 infection epidemic in Beijing-Tianjin-Hebei region shows an outbreak trend. The epidemic progress stage and infection peak in each city are significantly different, and most of the time there is no significant spatial autocorrelation, which provides a reference for health care configuration.
Epidemiological characteristics of Omicron variant infection in Anhui Province
ZHOU Minghua, GUO Qian, GONG Lei, SONG Dandan, WU Jiabing
2023, 27(9): 1067-1070. doi: 10.16462/j.cnki.zhjbkz.2023.09.014
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  Objective  To analyze the epidemic characteristics of the COVID-19 in Anhui Province, and to explore the epidemic rule of the COVID-19, so as to provide reference for the prevention and control of the epidemic.  Methods  The information of sex, age, occupation, epidemiological history, vaccination history and main clinical symptoms of the cases in the province from March 8 to May 31, 2022 were collected. The frequency (constituent ratio) and histogram were used to describe the epidemic characteristics. WPS 2022 software was used for data entry and data management. SPSS 23.0 was used for data analysis.  Results  A total of 1 775 local cases were reported in Anhui Province, of which 97.30% (1 727/1 775) were asymptomatic, and no death occurred. Cases were reported in 16 cities in the province, and the current address of the cases involved 69 counties and districts, with a coverage rate of 65.71%. Among the 1 775 cases, the minimum age was 1 month, the maximum age was 88 years, and the median age was 38 years. In this outbreak, the cases were mainly detected through centralized isolation (48.79%). The vaccination rate was high, mainly inactivated vaccine.  Conclusions  The epidemic develops rapidly. Population is susceptible. Asymptomatic infection accounts for a high proportion. Omicron latency is shorter, and the infectivity is stronger. The proportion of asymptomatic infections among vaccinated people is higher than that among unvaccinated people, which may be related to measures such as high vaccination rate, centralized isolation and nucleic acid screening for close contacts At the same time, it is necessary to strengthen publicity to increase the awareness of prevention and control among the population. All communities and schools need to do a good job of regular epidemic prevention and control to prevent the outbreak of the epidemic again.
Original Articles
Influence factors of job burnout of medical staff in the anesthesiology department of Nanjing general hospital
JIN Lingling, YU Rongbin
2023, 27(9): 1071-1077. doi: 10.16462/j.cnki.zhjbkz.2023.09.015
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  Objective  To investigate the current status of job burnout levels among medical staff in the anesthesiology department of Nanjing City and to identify its influencing factors.  Methods  Maslach Burnout Inventory-Human Service Survey (MBI-HSS) and the general information questionnaires were used to evaluate the job burnout status among 263 medical staff members from five hospitals in Nanjing. The unconditional logistic regression model was employed to investigate the influeneing factors of job burnout.  Results  The detection rate of job burnout and severe job burnout among doctors and nurses in the anesthesiology department were 80.53% and 8.01%, respectively. Multivariate logistic regression analysis showed that being not an administrator (OR=0.164, 95% CI: 0.065-0.415), regular after-work socializing (OR=0.360, 95% CI: 0.167-0.776), having good health condition (OR=0.441, 95% CI: 0.239-0.815) and having low working intensity (OR=0.505, 95% CI: 0.273-0.934), increasing monthly income (OR=0.478, 95% CI: 0.328-0.696) were associated with decreased risk of job burnout. Conversely, having high number of emergency rescue per month (OR=1.754, 95% CI: 1.094-2.813), without hobbies after work (OR=2.069, 95% CI: 1.145-3.739), can not receive feedback for requirement timely (OR=2.244, 95% CI: 1.213-4.154), lack of good career development (OR=2.087, 95% CI: 1.196~3.642) were associated with a increased risk of job burnout.  Conclusions  Job burnout is common among medical staff in anesthesiology department of Nanjing City, and the burnout was associated with a variety of factors.
Application of continuous Bayesian networks in the association study between uric acid and chronic metabolic diseases
CUI Yu, SONG Weimei, ZHAO Ruiqing, REN Hao, WANG Xuchun, QIAO Yuchao, ZHAO Zhiyang, REN Jiahui, LIU Jing, LI Yiting, QIU Lixia
2023, 27(9): 1078-1083. doi: 10.16462/j.cnki.zhjbkz.2023.09.016
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  Objective  The study aimed to construct a continuous Bayesian networks using improved partial-correlation-based (IPCB) algorithm, investigate the metabolic influencing factors of blood uric acid (UA). Meanwhile, traditional multiple linear regression model was compared to discuss the effect and advantages of Bayesian network in disease risk factor detection.  Methods  Chronic disease surveillance data involving 4 846 cases in Shanxi Province in 2015 was taken for study. Both continuous Bayesian networks and multiple linear regression models were utilized for correlation analysis between UA and the indexes of nine metabolic diseases. Afterwards, the advantages and disadvantages of the two models were compared.  Results  Multiple linear regression stepwise analysis showed that triglyceride (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), low density lipoprotein (LDL) and high density lipoprotein (HDL) were directly correlated with UA, explaining 9.5% of the variation. The continuous Bayesian networks comprised 24 directed edges, and age, TG, LDL, HDL, SBP, and DBP were directly related to UA. As age, TG, LDL increase and HDL decreases, UA levels rise, which in turn leads to an increase in SBP and DBP. Besides, total cholesterol (TC) was indirectly related to UA.  Conclusions  Continuous Bayesian networks allows for more direct and indirect influencing factors for UA, which features a better overall explanation.
Review
Research progress of quantitative evaluation tool of healthy aging
RONG Shuang, JIE Lingyao, LI Wenfang, ZHANG Ting, YANG Jiajia, LI Yuanyuan, CHEN Ting, BAO Wei
2023, 27(9): 1084-1090. doi: 10.16462/j.cnki.zhjbkz.2023.09.017
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Healthy aging is an important approach to address population aging in China. Nowadays, research on the concept and influencing factors of healthy aging has progressed. However, studies focusing on quantitative evaluation of healthy aging are relatively few, and in-depth reviews are lacking. Therefore, this paper reviews the development history of quantitative evaluation models of healthy aging and the commonly used quantitative evaluation tools based on the evidence of relevant literature at home and abroad, thereby to provide more insights for the future research.
Short Reports
Interaction abetween occupational stress and dyslipidemia on the prevalence of hypertension
FU Ailing, LIU Xin, LI Xinze, LIU Jiwen
2023, 27(9): 1091-1095. doi: 10.16462/j.cnki.zhjbkz.2023.09.018
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Abstract:
  Objective  This study aimed to investigate the interaction between occupational stress and dyslipidemia on the prevalence of hypertension.  Methods  Using cluster sampling, the study selected 2 149 oilfield workers from eight Karamay oilfield branches. Participants′ occupational stress was investigated using the Effort-Reward Imbalance (ERI) scale, and their physical indicators were also assessed. Logistic regression analysis and Delta method were used to determine the association between the interaction of occupational stress and dyslipidemia and hypertension prevalence.  Results  The prevalence of hypertension was found to be 27.3%. The prevalence of hypertension was significantly higher both in the occupational stress group and dyslipidemia group(all P < 0.05). After adjustment for confounding factors, logistic regression analysis showed that occupational stress (OR=1.243, 95% CI: 1.027-1.505, P=0.025) and dyslipidemia (OR=2.089, 95% CI: 1.712-2.548, P < 0.001) were independently associated with the risk of hypertension. Occupational stress and dyslipidemia had additive (RERI=5.556, API=0.649, S=3.774) and positively multiplicative (OR=2.327, 95% CI: 1.755-3.085, P < 0.001) interaction on hypertension. Occupational stress combined with dyslipidemia was associated with 8.6 times higher risk compared to the group without occupational stress and dyslipidemia.  Conclusions  Occupational stress, dyslipidemia and their interaction were associated with an increase risk of hypertension.
Current status of overweight and obesity and its impact on hypertension among students aged 6-18 between 2017 and 2019 in Longhua District, Shenzhen
ZHOU Miao, TANG Rui, ZHU Xia, ZHOU Hairong
2023, 27(9): 1096-1100. doi: 10.16462/j.cnki.zhjbkz.2023.09.019
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Abstract:
  Objective  This study aims to determine the detection rate of overweight, obesity, and hypertension in students aged 6-18 years between 2017 and 2019 in the Longhua District, Shenzhen, and to examine their interrelation, thus providing a basis for relevant preventive measures.  Methods  The study used student health examination data from 2017 to 2019 sourced from the Central Hospital of Longhua District, Shenzhen. We delineated the prevalence of overweight, obesity, and hypertension among students across different years, genders, and ages. And a logistic regression model was used to analyze their effects.  Results  The total number of students who underwent health examinations from 2017 to 2019 were 41 275, 46 907, and 51 222, respectively. The detection rates for overweight were 9.66%, 9.01%, and 9.89%; for obesity, 6.84%, 6.22%, and 7.07%; and for hypertension, 22.07%, 21.16%, and 17.53%, respectively. After adjusting for age and gender, compared with the normal group, the risk of hypertension in the overweight and obesity groups was significantly higher, with 2.191 times (OR=2.191, 95% CI: 2.038-2.355, P < 0.001) and 3.984 times (OR=3.894, 95% CI: 3.566-4.186, P < 0.001) in 2017; 2.338 times (OR=2.338, 95% CI: 2.179-2.509, P < 0.001) and 3.861 times (OR=3.861, 95% CI: 3.565-4.181, P < 0.001) in 2018; 2.076 times (OR=2.076, 95% CI: 1.937-2.226, P < 0.001) and 3.753 times (OR=3.753, 95% CI: 3.486-4.040, P < 0.001) in 2019.  Conclusions  The detection rates of overweight, obesity, and hypertension in children in Longhua District, Shenzhen, were considerably elevated. Overweight and obesity were found to significantly escalate the risk of hypertension, underscoring the need for increased vigilance and prevention efforts.
Spatio-temporal analysis of hepatitis E in Zhejiang Province from 2005 to 2020
CHEN Yijuan, SUN Wanwan, CHEN Zhiping, MIAO Ziping
2023, 27(9): 1101-1106. doi: 10.16462/j.cnki.zhjbkz.2023.09.020
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Abstract:
  Objective  This study endeavors to delineate the epidemiological characteristics and changing patterns of hepatitis E (HE) infection in Zhejiang Province from 2005 to 2020. The findings aim to provide evidence for the development of measures to prevent and manage the HE epidemic.  Methods  Data on the incidence of HE in Zhejiang Province were extracted from the Chinese notifiable infectious disease reporting system. The temporal and spatial distribution characteristics were examined using descriptive epidemiological methods.  Results  From 2005 to 2019, the reported cases and incidence rate of HE in Zhejiang Province fluctuated narrowly without a notable rising trend. Although the incidence rate of HE is still higher in males than in females, the overall trend is down for males. Spatial autocorrelation analysis indicated that there was significant spatial-temporal clustering of HE in Zhejiang Province, and "High-high" clustering areas were mainly located in cities such as Hangzhou and Quzhou.  Conclusions  The epidemic situation of HE showed a stable trend in Zhejiang Province, but the trend was varied by gender and age groups.
Epidemiological characteristics and dengue cases in Hefei from 2015 to 2020
ZHAO Kefu, ZHANG Lei, LIU Xuxiang
2023, 27(9): 1107-1111. doi: 10.16462/j.cnki.zhjbkz.2023.09.021
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Abstract:
  Objective  To analyze the epidemiological characteristics of dengue fever cases reported in Hefei in 2015-2020 years, and to provide a reference for scientific and effective prevention and control.  Methods  Information on dengue fever cases reported in Hefei in recent years were collected and their epidemiological characteristics were analyzed using descriptive analysis.  Results  A total of 40 imported dengue cases and 1 local dengue case were investigated through online reports in Hefei from 2015-2020, including 3 clinically diagnosed cases, 38 confirmed cases, no severe or fatal cases, and 1 local dengue cluster outbreak. These 41 dengue fever cases were distributed in 23 towns (streets) in 7 districts (counties) in Hefei, 78.04% of the cases were concentrated in April to September, with young adult males predominating. The reasons for going abroad in 39 imported cases were mainly labor export (51.28%), commercial services (26.83%) and tourism (17.07%). There were statistically significant differences in diagnostic levels between overseas and domestic hospitals, as well as between domestic provinces, cities, counties and below (all P < 0.001). The median interval between onset-visit and onset-diagnosis was 1 day and 4 days, respectively. Approximately 85.61% of the cases could be diagnosed within 0-5 days after onset, and 4 serotypes coexist.  Conclusions  The duration of the epidemic in Hefei is lengthening, the epidemic intensity is increasing, and the input pressure is increase year by year. There is a risk of severe disease and local epidemic. It is necessary to establish a long-term inter departmental cooperation mechanism, strengthen monitoring and education, improve the awareness of timely medical treatment, the recognition ability and diagnosis and treatment technology of the hospital, in order to achieve early detection and isolation, early standardized treatment, so as to reduce severe cases.
Epidemiological characteristics and spatial-temporal clusters of scrub typhus in Taizhou City from 2011 to 2021
ZHANG Zhiyi, HU Yafei, ZHENG Xiang, ZHAO Yishuang, LIANG Hongbiao, CHEN Cairong, HE Na, LIN Haijiang
2023, 27(9): 1112-1116. doi: 10.16462/j.cnki.zhjbkz.2023.09.022
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Abstract:
  Objective  To analyze the epidemiological characteristics and spatial-temporal clusters of scrub typhus in Taizhou during 2011-2021, and provide scientific evidence on prevention and control for scrub typhus.  Methods  Information on scrub typhus cases in Taizhou from 2011 to 2021 was obtained from Taizhou Center for Disease Control and Prevention. Spatial-temporal clusters analysis and result visualization were performed using SaTScan 9.6 software.  Results  A total of 225 cases of scrub typhus were reported from 2011 to 2021 in Taizhou, with an average annual incidence of 0.32/100 000. The primary affected demographic was individuals aged 50-69 years, which constituted 65.78% (148/225) of the cases. Farmer was the primary occupation and accounted for 87.11% (196/225). Xianju County is located in the northwest of Taizhou City, mainly with low mountainous landforms, which emerged as a high-incidence area with 53.33% (120/225) reported cases. This area is also the first cluster area. And the second cluster area was the junction area of Tiantai County, Sanmen County and Linhai City.  Conclusions  The incidence of scrub typhus in Taizhou from 2011 to 2021 was showing an upward trend. The susceptible people are mainly middle-aged and elderly farmers in mountainous areas. It is necessary to strengthen the publicity and education for these people, and personal protection should be done when working in the field to control the occurrence and prevalence of scrub typhus.