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CN 34-1304/R ISSN 1674-3679

2021 Vol. 25, No. 9

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Literature Review
Advances in applications of polygenic risk score in precision prevention
WANG Tian-pei, JIN Guang-fu, HU Zhi-bin, SHEN Hong-bing
2021, 25(9): 993-997. doi: 10.16462/j.cnki.zhjbkz.2021.09.001
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Abstract:
Genome-wide association studies have successfully identified numerous genetic loci for complex diseases. Polygenic risk score combining multiple loci together has been proved to effectively measure genetic risk of complex diseases, which poses opportunities for risk stratification and potential precision medicine application. This paper briefly reviews the recent progress in the development and evaluation of polygenic risk score, and summarizes its application in precision prevention.
Tumor Epidemiology
Association between MHC region and gastric cancer susceptibility in Han Chinese
LI Qian, YAN Cai-wang, JIN Guang-fu
2021, 25(9): 998-1002,1019. doi: 10.16462/j.cnki.zhjbkz.2021.09.002
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  Objective  To investigate the association between genetic variants in the major histocompatibility complex (MHC) region and gastric cancer (GC) susceptibility.  Methods  Based on a case-control study, MHC region was imputed with SNP2HLA v1.0.3 software by using the Han-MHC database as a reference panel. Logistic regression analysis model was used to identify the independent genetic loci associated with GC susceptibility in the MHC region. Functional annotation of the MHC region was based on online public databases and performed to find the susceptibility gene and potential functional variants.  Results  We found that rs2517714 was the only independent association signal associated with GC risk in the MHC region (OR=1.13, P=2.70×10-8). The results of functional annotation showed that HLA amino acid polymorphisms and single nucleotide polymorphisms (SNPs) located in the exon region of HLA-A may affect the stability of HLA-A protein. The SNP rs9295829 located in a non-coding region could remotely regulate the expression of HLA-A by affecting enhancer activity.  Conclusion  Functional genetic variations in the MHC region may affect the function of the susceptibility gene HLA-A to modulate GC susceptibility.
Association of blood lipid and genetic factor with cancer risk in men
HU Bei-ping, WANG Tian-pei, ZHU Meng, YAN Cai-wang, JIN Guang-fu
2021, 25(9): 1003-1007. doi: 10.16462/j.cnki.zhjbkz.2021.09.003
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  Objective  To investigate the potential roles of blood lipid levels and genetic factors in cancer development in men.  Methods  Male participants in the UK Biobank (UKB) were stratified into low, intermediate and high genetic risk groups. The number of abnormal lipid levels was used to divide study subjects into three categories. The association between abnormal levels of blood lipid and the risk of cancer incidence under different genetic risks were analyzed.  Results  A total of 178 171 men were included in the study, of whom 11 824 (6.64%) developed new cancer cases within the follow-up period. After adjustment for confounders including age, smoking, alcohol consumption, and fasting plasma glucose, abnormal lipid score was associated with the risk of cancer (all P < 0.001). Men with high genetic risk and high lipid abnormal score had 2.290 fold higher (95% CI: 2.039-2.571, P < 0.001) overall cancer risk than those with low genetic risk and low lipid abnormal score.  Conclusion  Abnormal levels of blood lipid may increase the risk of cancer across different genetic risk groups in men.
Joint effect of serum C-reactive protein and genetic risk in the pathogenesis of cancer
ZHU Meng-yi, WANG Tian-pei, YAN Cai-wang, ZHU Meng, JIN Guang-fu
2021, 25(9): 1008-1013. doi: 10.16462/j.cnki.zhjbkz.2021.09.004
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  Objective  To explore the joint effect of serum C-reactive protein (CRP) and genetic risk in the pathogenesis of cancer.  Methods  Based on UK Biobank data and the cancer polygenic risk score (CPRS) constructed previously, subjects were assigned into low, intermediate, and high genetic risk groups according to CPRS and were assigned into low, intermediate, and high groups based on natural logarithm of CRP. Cox proportional hazard model was used to test the association between serum CRP level and the risk of cancer in different genetic risk groups.  Results  A total of 420 940 subjects including 192 942 (45.84%) men and 227 998 (54.16%) women were included. The level of serum CRP was statistically associated with the risk of multiple cancers. High level of serum CRP was associated with an increased risk of overall cancer in male and female (male: HR=1.09, 95% CI: 1.07-1.11; female: HR=1.09, 95% CI: 1.07-1.11). The effect size of CRP on cancer risk was stronger in low genetic risk group (male: HR=1.38; female: HR=1.46) compared to that of high genetic risk group (male: HR=1.07; female: HR=1.17). There was a negative interaction between CRP and genetic risk in cancer.  Conclusions  High level of serum CRP can increase the cancer risk. Serum CRP level may have a stronger effect in low genetic risk population.
Original Articles
Association between vaccination and thrombocytopenic purpura: a case study of 13 cases
ZHONG Zhi-lei, SU Ting, ZHANG Shi-hong, CHEN Qiu-yu, MA Rui-lan, LI Qian, LI Jia-xuan, DONG Shao-zhong
2021, 25(9): 1014-1019. doi: 10.16462/j.cnki.zhjbkz.2021.09.005
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  Objective  The paper provides an analysis of 13 idiapathic thrombocytopenic purpura (ITP) cases after vaccination to discuss the causal association between vaccination and ITP, and the relevant measures to reduce the coincidental cases.  Methods  The paper sorts, describes and analyzes 13 cases of ITP after vaccination from Institute of Medical Biology, Chinese Academy of Medical Sciences during 2017-2020.  Results  Among 13 cases, 6 cases were irrelevant, 1 case was not likely irrelevant, 2 cases were not excluded, and 4 cases were probably related.  Conclusions  If ITP occurs after vaccination, infection factors should be excluded, and the time correlation between them should be analyzed a fair judgment of the causal association. It is suggested that the diagnostic criteria of ITP should be issued in time; the vaccination doctors should do a good job in health screening, so as to reduce the coincidental cases after vaccination as far as possible.
The mortality trend of digestive tract malignant tumor in China from 2004 to 2018
JIA Shan-qun, ZHOU Qian-yv, LIU Hui-min, LIU Dan-dan, SUN Chang-qing
2021, 25(9): 1020-1025. doi: 10.16462/j.cnki.zhjbkz.2021.09.006
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  Objective  To analyze the mortality status and trend of digestive tract malignant tumors in China from 2004 to 2018.  Methods  The mortality data of digestive tract malignant tumors in the national disease surveillance areas from 2004 to 2018 were collected. The crude and standardized mortality rates with various digestive tract malignant tumors were calculated. The trend of standardized mortality was analyzed using Joinpoint regression model.  Results  From 2004 to 2018, the standardized mortality rates of esophageal cancer and gastric cancer in China showed a general downward trend, with an average annual percent change (AAPC) of -4.7% and -4.3%(all P < 0.05), respectively. The mortality rate of colorectal cancer showed no significant change(AAPC=0.4%, P=0.733). The mortality rates of various digestive tract malignant tumors increased with age. The standardized mortality rates of various digestive tract malignant tumors among males were higher than those of females, and the average annual decline was smaller. The standardized mortality rates of esophageal cancer and gastric cancer in rural areas were higher than those in urban areas, but the average annual decrease was larger. The standardized mortality rate of esophageal cancer in eastern areas was the highest. The standardized mortality rate of gastric cancer in central areas was highest, and the rate of decline was faster. The mortality rate of colorectal cancer in western areas increased slowly.  Conclusions  From 2004 to 2018, the mortality rates of esophageal cancer and gastric cancer had improved, but the mortality rate of colorectal cancer was still on the rise in western areas. The preventive measures of digestive tract malignant tumors should be strengthened to reduce the burden of digestive tract malignant tumors.
Analysis for mortality trend and age-period-cohort of kidney cancer in China from 1990 to 2019
CHEN Lei, XU Jie-ru, WANG Mian, ZHANG Min, RANG Wei-qin
2021, 25(9): 1026-1033,1111. doi: 10.16462/j.cnki.zhjbkz.2021.09.007
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  Objective  To analyze the mortality trends and epidemiological characteristics of kidney cancer in China from the Global Health Data Exchange (GHDx) database.   Methods  We collected the kidney cancer mortality data in China among adults aged 20- < 90 years in GHDx database from 1990 to 2019. Joinpoint regression model was used to estimate the mortality trends. Age-period-cohort model was used to explore the age effect, period effect and cohort effect.   Results  The standardized mortality of kidney cancer from 1990 to 2019 showed a fluctuating growth trend in the whole population and the subgroups of male and female, with the average annual change percentage of 2.04%, 2.92% and 0.70% respectively; For both male and female, the relative risk of kidney cancer mortality increased with advancing age and time period, but decreased from earlier birth cohorts to more recent birth cohorts.   Conclusions  The overall trends of the mortality of kidney cancer in China increased from 1990 to 2019. People who born earlier, being older, and living in modern times have a higher risk of kidney cancer mortality. The disease burden caused by kidney cancer is still a serious public problem.
Interaction between genetic variation and Helicobacter pylori infection in the occurrence of gastric cancer
REN Shuai, Li Qian, ZHU Meng-yi, ZHANG Yan, YAN Cai-wang, WEI Li-qin, JIN Guang-fu
2021, 25(9): 1034-1041. doi: 10.16462/j.cnki.zhjbkz.2021.09.008
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  Objective  To investigate the interaction between known genetic variation of gastric cancer and Helicobacter pylori (H. pylori) in the occurrence of gastric cancer, and its effect on tumor site and the age at onset of gastric cancer.   Methods  With a case-only design, the interaction between genetic variation and H. pylori was analyzed by binary Logistic regression analysis in 2 426 patients with gastric cancer.   Results  After adjusting confounding factors, the interactions of genetic variation NSUN 3 rs7624041 and DEFB rs 2376549 with H. pylori infection in gastric cancer were statistically significant (OR=1.257, 95% CI: 1.006-1.571, P=0.044; OR=0.845, 95% CI: 0.715-0.999, P=0.048). Based on the hierarchical analysis of tumor location, there was no interaction between genetic variation and H. pylori infection. Hierarchical analysis based on tumor stage showed that the interaction between lnc-POLR3G-4 rs7712641 and H. pylori infection was statistically significant in patient with early gastric cancer (OR=1.757, 95% CI: 1.060-2.915, P=0.029). The age-based stratified analysis results showed that the interactions between ASHIL rs80142782, NSUN 3 rs7624041, DEFB rs2376549 and H. pylori infection were statistically significant in people aged < 60 years (OR=1.602, 95% CI: 1.006-2.551, P=0.047; OR=1.811, 95% CI: 1.247-2.632, P=0.002; OR=0.688, 95% CI: 0.520-0.910, P=0.009). And the interactions between PSCA rs2294008, CUX 2 rs6490061 and H. pylori infection were statistically significant in people over 60 years old (OR=0.775, 95% CI: 0.630-0.954, P=0.016; OR=0.790, 95% CI: 0.635-0.982, P=0.034).   Conclusions  The occurrence and development of gastric cancer is complex. It is helpful to prevent the occurrence and development of gastric cancer by integrating genetic factors and environmental factors and taking targeted H. pylori eradication measures for susceptible and high-risk groups.
Development of a risk model for colon adenocarcinoma based on 3 methylation-regulated long non-coding RNA
ZHU Liang-yu, ZHOU Qian, SUN Hong-yu, TANG Xue-jiao, SHI Xin-rui, LIU Pu, YANG Lei
2021, 25(9): 1042-1047. doi: 10.16462/j.cnki.zhjbkz.2021.09.009
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  Objective  The purpose of this study is to identify the methylation-regulated long non-coding RNA (lncRNA) in patients with colon adenocarcinoma (COAD) and its prognostic value by mining the cancer genome atlas (TCGA) and gene expression omnibus (GEO).   Methods  Gene expression profile data, DNA methylation data and corresponding clinical data were obtained from the TCGA. The expression profile data of GSE39582 array was downloaded from the GEO. The edgeR and limma packages were used to screen differentially expressed genes. Spearman rank correlation was used to determine the correlation between gene expression values and methylation values. Cox regression model was used to construct risk model.   Results  Through joint analysis of TCGA and GEO databases, 23 methylation-regulated lncRNA were identified. Univariate Cox analysis identified 4 methylation-regulated lncRNA (LINC00675, LINC01082, LINC01207, and RP1-170O19.14) associated with overall survival (OS) in COAD patients. A risk model was constructed based on stepwise Cox regression analysis, risk score=(-0.148 19×expression valueLINC01082)+(-0.120 50×expression valueLINC01207)+(-0.120 46×expression valueRP1-170O19.14).   Conclusion  In this study, the risk model of COAD patients are constructed based on methylation-regulated lncRNA, which could promote the individual prediction of OS in COAD patients.
Prediction of disease burden of esophageal cancer in China based on ARIMA and NNAR models
MA Qian-qian, HE Xian-ying, CUI Fang-fang, SUN Dong-xun, ZHAI Yun-kai, GAO Jing-hong, WANG Lin, ZHAO Jie
2021, 25(9): 1048-1053. doi: 10.16462/j.cnki.zhjbkz.2021.09.010
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  Objective  To explore the time series characteristics of the disease burden of esophageal cancer in China and predict the disease burden of esophageal cancer.   Methods  The incidence, mortality, and disability adjusted life year (DALY) of esophageal cancer in China from 1990 to 2019 were collected. autoregressive integrated moving average (ARIMA) model and neural network autoregression (NNAR) model were established based on the data from 1990 to 2016, and model prediction performance was verified by comparing 2017-2019 forecast data with actual data through mean absolute percentage error (MAPE), modulation error ratio (MER), mean absolute error (MAE) and root mean squared error (RMSE). The better model was applied to predict the disease burden of esophageal cancer from 2020 to 2024.   Results  From 1990 to 2019, the overall disease burden of esophageal cancer in China showed a fluctuating upward trend, with the incidence rate rising by 33.26%, the mortality rate rising by 21.26%, and the DALY rate rising by 6.66%. The predicted values of disease burden by ARIMA model and NNAR model were basically consistent with the actual dynamic trend. The incidence rate of esophageal cancer in China from 2020 to 2024 would be 20.375/100 000, 21.057/100 000, 21.380/100 000, 21.341/100 000, 21.080/100 000, and mortality rate would be 18.834/100 000, 19.647/100 000, 20.407/100 000, 20.889/100 000, 20.988/100 000, and the DALY rate would be 418.192/100 000, 431.123/100 000, 442.780/100 000, 452.376/100 000, and 459.358/100 000.   Conclusions  The disease burden of esophageal cancer in China will increase slightly from 2020 to 2024. The NNAR model demonstrates good prediction performance and accuracy in simulating the disease burden of esophageal cancer in China, and provides a reference method for short-term prediction of the disease burden.
Association between sleep duration and the prevalence of hypertension in middle-aged and elderly Chinese——Based on the data of CHARLS 2018
DUAN Si-yu, YANG Zhan-ji, SUN Jian, LI Jiang-ping, WANG Kai-rong, WANG Rui, YANG Hui-fang
2021, 25(9): 1054-1059. doi: 10.16462/j.cnki.zhjbkz.2021.09.011
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  Objective  To explore the relationship between sleep duration and the prevalence of hypertension in middle-aged and elderly Chinese.  Methods  The cross-sectional study method was applied to analyze the data from the China Health and Retirement Longitudinal Study (CHARLS) of Peking University. A total of 7 885 subjects were included in this study. According to nocturnal sleep duration, the subjects were divided into 5 groups: ≤5 h, > 5- < 6 h, 6- < 7 h(reference), 7- < 8 h, ≥8 h. Using binary Logistic regression analysis, we established three models to explore the association between nocturnal sleep duration and the prevalence of hypertension by adjusting different covariates and odds ratio (OR) and 95% confidence interval (95% CI) were obtained.  Results  Taking nocturnal sleep duration 6- < 7 h as reference, the risk of hypertension among nocturnal sleep duration ≤5 h was 1.37 times higher(95% CI: 1.12-1.69, P=0.002). Further, subjects were classified according to gender. After adjusting for confounders with step-by-step method, the risk of hypertension in males with nocturnal sleep duration ≤5 h group was 1.72 times higher than with nocturnal sleep duration 6- < 7 h (95% CI: 1.14-2.59, P=0.009). However, no association was found in females after adjusting for confounders (OR=1.26, 95% CI: 0.99-1.59, P=0.055).  Conclusions  In Chinese middle aged and elderly people, nocturnal sleep duration ≤5 h may be an independent risk factor for hypertension. And for males, nocturnal sleep duration ≤5 h can increase the risk of hypertension.
Prospective cohort of chronic diseases among urban residents in Guangdong Province: design and baseline characteristics of subjects from 2018 to 2019
LUO Shi-yun, YE Yong-xin, CHEN Ni-xuan, JIA Sheng, ZUO Zhi-gang, YU Zhen, CHEN Wu-nong, SUN Min-ying, SHEN Ji-chuan, LIN Jin-chun, WANG Jian, YUAN Qian, LUO Yan-fang, ZHU Yao-wen, LI Liu-qing, LI Xue-yan, LIU Yuan-hua, ZHI Miao, QIU Zhi-cheng, XIA Min, ZHU Wei
2021, 25(9): 1060-1066. doi: 10.16462/j.cnki.zhjbkz.2021.09.012
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  Objective  To explore the distribution of health relative factors and further reveal the epidemic characteristics and incidence of chronic diseases among urban residents in Guangdong Province.  Methods  From March 1, 2018 to October 30, 2019, a baseline survey was conducted in Guangzhou, Dongguan and Shenzhen of Guangdong Province, including questionnaire, physical examination, biological sample collection and laboratory test. A cohort baseline database and a biobank of 34 764 subjects aged 30 to 84 were established.  Results  34 764 participants with age of (53.31±12.61) years including 41.1% males, were recruited in this study. The prevalence of current smoking was 34.4% in men and 0.4% in women. The prevalence of current regular alcohol drinking was 16.7% in men and 1.9% in women. The proportion of participants whose BMI ≥24 kg/m2 was 54.4% in men and 44.4% in women. 35.8% of males had a waist circumference greater than 90 cm, while 34.0% of females had a waist cir-cumference greater than 85 cm. The proportion of participants who were hypertensive (SBP ≥140 mm Hg or DBP ≥90 mm Hg) was 34.8% in men and 28.8% in women.  Conclusions  The factors related to chronic diseases, such as diet, smoking, drinking and obesity, showed different distribution of characteristics among urban residents in Guangdong Province of different genders and ages.
Association between abnormal renal function and sleep among male coal workers in Xingtai City
WANG Han, QIN Sheng, LI Qing-lin, XUE Chao, ZHAO Hai-xia, ZHANG Sheng-kui, YUAN Ju-xiang
2021, 25(9): 1067-1072. doi: 10.16462/j.cnki.zhjbkz.2021.09.013
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  Objective  To explore the relationship between sleep duration, insomnia, shift work and kidney function among male coal workers in Xingtai City, and to provide a theoretical basis for the prevention and treatment of kidney diseases in male coal workers.  Methods  A cross-sectional study was uesd. Relevant information was collected through questionnaires and blood biochemical analysis. Mutiple Logistic regression model was used to explore the relationship between abnormal renal function and sleep, night shift work.  Results  The prevalence of abnormal renal function among male workers in coal enterprises was 5.3%. The proportion of individuals with night shift work, sleep duration ≤5 h and insomnia were 63.2%, 4.0%, and 10.0% respectively. After adjusting for age, sleep duration, shift work and and insomnia, the results of multivariate Logistic regression analysis model showed that the relationship between shift work (OR=1.557, 95% CI: 1.078-2.250, P=0.018), sleep duration ≤ 5 h (OR=1.886, 95% CI: 1.005-3.540, P=0.048), group with sleep problems (OR=1.810, 95% CI: 1.286-2.546, P=0.001) and abnormal renal function was attenuated. The relationship between insomnia and abnormal renal function was not statistically significant (P=0.279). According to the stratified analysis of the shift work, after adjusting the related abnormal renal function among shift workers (Ptrend=0.001).  Conclusions  Sleep and shift work independently associate with abnormal renal function in male coal workers. The risk of abnormal kidney function increases with the severity of sleep problems.
Analysis of comprehensive surveillance results of respiratory tract infectious diseases in Taizhou, 2012-2019
HE Yi-lin, ZHANG Xuan, GUAN Yun-hao, LI Chen, DAI Wen-jun, ZHA Jie, ZHANG Xiang
2021, 25(9): 1073-1077, 1101. doi: 10.16462/j.cnki.zhjbkz.2021.09.014
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  Objective  To understand the epidemiological characteristics of influenza-like illness (ILI) cases and severe acute respiratory infection (SARI) cases in Taizhou, so as to provide a basis for scientific prevention and control strategies.  Methods  The basic information of ILI and SARI cases and throat swab specimens were collected from the sentinel hospital and 13 respiratory pathogens were detected by RT-PCR method.χ2 test was used as statistical analysis method.  Results  From April 2012 to December 2019, with epidemic peaks in autumn and winter, the percentages of ILI visits (ILI%) and SARI visits (SARI%) were 7.27% and 2.44%, respectively. Finally, 956 ILI case specimens and 557 SARI case specimens were detected. The positive detection rates of the two types of cases were 50.84% (486/956) and 39.14% (218/557), separately. Streptococcus pneumoniae (SP), influenza virus (Flu), Haemophilus influenzae (HI) and Human rhinovirus (HRV) were the dominant pathogens in Taizhou city from April 2012 to December 2019, and their detection rates were 14.81%, 9.25%, 9.39% and 7.73%, respectively. The total mixed infection rate was 30.11% (212/704), which was mainly caused by SP complicated with other pathogenic infections. The positive rate of pathogen detection in the low-age group was higher than that in the high-age group, and the detection rate of children under 5 years old was 34.83% (χ2=54.47, P < 0.001). The detection rate of human coronavirus (HCoV) was 2.12%, with HCoV-OC43 subtype mainly (46.88%), and each subtype has no obvious seasonal distribution characteristics.  Conclusions  The incidence of comprehensive respiratory tract surveillance in sentinel hospitals in Taizhou City showed that the peak of the epidemic was in autumn and winter, and SP, Flu, HI, and HRV were main pathogens in this area. In the age group under 15 years old, the detection rate was higher. Comprehensive respiratory disease prevention and control measures should be taken for key populations.
Analysis of the temporal and spatial distribution characteristics of hand-foot-and-mouth disease in Zhongshan City from 2013 to 2018
WU Yan-jia, LIU Xin-xia, LI Lei, WANG Bo-yuan, WANG De-quan
2021, 25(9): 1078-1084. doi: 10.16462/j.cnki.zhjbkz.2021.09.015
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  Objective  To analyze the temporal-spatial clustering of hand-foot-and-mouth disease (HFMD) in Zhongshan City from 2013 to 2018, so as to provide a theoretical basis for prevention and control of HFMD.  Methods  The epidemic data of HFMD in Zhongshan City from 2013 to 2018 was collected. Combining spatial autocorrelation analysis and spatial-temporal scanning to realize spatial-temporal analysis, and visualize the analysis results.  Results  A total of 97 214 cases of HFMD were reported in Zhongshan City from 2013 to 2018, with an average annual incidence of 493.40/100 000. Children aged 0-5 years old accounted for 95.38% of the total cases. The distribution over time was obviously bimodal. Spatial autocorrelation analysis results showed that there was an obvious positive spatial correlation in HFMD incidence from 2015 to 2016. High risk clusterings were detect by year-by-year time-space scanning from 2013 to 2018, mainly in the suburban border towns on the west side of the central city. The high-incidence aggregation period was basically consistent with the trend of the incidence curve.  Conclusions  A certain characteristic of spatiotemporal clustering is shown in the HFMD incidence in Zhongshan City from 2013 to 2018. The clustering degree is higher at the turn of spring and summer, summer and autumn. And future prevention and control work should be strengthen at that time..
Research on the direct financial burden on families with 2-6 years old children having autism spectrum disorder in China
ZHAO Ya-nan, LUO Ya-nan, WANG Xiang-yu, FAN Hui-yun, ZHANG Rong, ZHENG Xiao-ying
2021, 25(9): 1085-1090. doi: 10.16462/j.cnki.zhjbkz.2021.09.016
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  Objective  To investigate and explore the direct expenditures on health care and intervention of the families of 2-6 years old children with autism spectrum disorder (ASD).  Methods  Using the questionnaire to investigate the financial cost on Chinese families of 2-6 years old ASD children. Chi square analysis and ANOVA analysis were used to compare the mean values of various expenditures.  Results  Caregivers of 3 880 ASD children were recruited in 33 Provinces of China.The direct expenditure of intervention is average 7 339.48 Yuan per month (88 073.76 Yuan per year), which accounts for 85.56% of the total household income. The total direct expenditure of intervention is average 9 677.87 Yuan per month (116 134.44 Yuan per year), which accounts for 127.38% of the total household income. To the low-income families, their intervention expenditure's percentage can high up to 210%, along with the middle-income families 97% and the high-income families 56%. The statistical difference is obviously significant (all P < 0.05). Taking the severity of ASD into consideration, the lower the function is, the more the direct intervention exist (97%) (χ2 =8.297, P < 0.001).  Conclusion    The cost of intervention of ASD children has caused a serious financial burden on their families, especially to the poor and the families with low functioning children.
Prevalence and influencing factors of hearing status for workers with different subjective perception of hearing in Wuhan City from 2017 to 2019
LI Wen-zhen, FENG Xiao-bing, XIAO Yang, CHEN Zhen-long, YI Gui-lin, CHEN Wei-hong, WANG Dong-ming
2021, 25(9): 1091-1096. doi: 10.16462/j.cnki.zhjbkz.2021.09.017
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  Objective  To investigate the hearing status and influencing factors of hearing among people with different subjective perception of hearing in Wuhan City from 2017 to 2019.  Methods  A cross-sectional survey was conducted to select some automobile manufacturing workers who underwent physical examination in Wuhan Prevention and Treatment Center for Occupational Disease from Jan 2017 to Dec 2019 as the research subjects. Questionnaire survey and pure tone threshold test were conducted. After excluding individuals with missing information, a total of 15 594 individuals were finally included for analysis and research. Logistic regression analysis was used to explore the influencing factors of hearing status for workers with different subjective perception of hearing.  Results  Among the 15 594 male workers in automobile manufacturing industry, the proportion of subjective feeling of hearing for good, general and poor was 45.86% (7 152/15 594), 51.75% (8 070/15 594) and 2.39% (372/15 594), respectively. In terms of speech frequency, the proportion of hearing loss of the workers with good subjective hearing was 3.45%. In terms of high frequency, the proportion of hearing loss of workers with good subjective hearing was 18.47%. Age≥40 (OR=4.53, 95% CI=3.34-6.14, P < 0.001) and military service or shooting behavior (OR=1.55, 95% CI=1.01-2.41, P < 0.001) were risk factors for high-frequency bilateral hearing loss among people with good subjective perception of hearing. Age ≥40, occupational noise exposure, temporary tinnitus, sudden change of hearing and current smoking were risk factors for high frequency bilateral hearing loss among people with general and poor subjective perception of hearing.  Conclusion  Some people with good subjective perception of hearing still have hearing loss, and risk factors of hearing loss among people with different subjective perception of hearing are different.
Short Report
Monitoring results of drinking water-borne endemic fluorosis in Fuzhou from 2017 to 2019
CAO Xiang-yu, XU You-qiong, LIAO Dong-dong
2021, 25(9): 1097-1101. doi: 10.16462/j.cnki.zhjbkz.2021.09.018
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Abstract:
  Objective  To understand the effect of the prevention measures and the trend of drinking water-borne endemic fluorosis in Fuzhou, so as to provide basis for the timely adjustment of the prevention measures.  Methods  To investigate the situation of water improvement and the operation of water improvement projects in allepidemic villages of the city, and to determine the fluorine content in water. Three villages were randomly selected as fixed monitoring villages in each monitored county. All children aged 8- < 13 in the villages were examined for dental fluorosis. Urinary fluoride in adults aged over 25 were detected in 2019.  Results  A total of 11 water improvement projects were investigated from June 2017 to June 2019. All water improvement projects were in normal operation. The range of fluoride in water was 0.05-0.76 mg/L, and the qualified rate of fluorine in water was 100%. A total of 1 346 children (times) aged 8- < 13 years were examined from 2017 to 2019. The detection rate of dental fluorosis was 1.26% and fluorosis community index was 0.03. From 2017 to 2019, the detection rate of dental fluorosis were 1.75%, 1.40% and 0.67% respectively, and the difference between different years was not statistically significant (χ2 =2.062, P=0.357). The cases of dental fluorosis in children from 2017 to 2019 were all concentrated in Minhou County, with the detection rates of 21.21%, 17.95% and 13.04%, respectively, and the difference between different years was not statistically significant (χ2 =0.616, P=0.700). The detection rate of dental fluorosis among children aged from 8- < 13 were 4.55%, 18.18%, 20.00%, 20.00% and 27.27%, respectively, and the difference was not statistically significant (χ2 =4.499, P=0.346). The detection rate of dental fluorosis between boys and girls were 27.66% and 8.33% respectively, and the difference was statistically significant (χ2 =6.037, P=0.014). A total of 450 samples of adult urine fluoride were detected in 2019, with a range of 0.04-3.76 mg/L and a geometric mean of 0.80 mg/L.  Conclusions  The effect of changing water supply and reducing fluorine in Fuzhou to prevent drinking water endemic fluorosis is good. Dynamic monitoring should be strengthened to continuously consolidate the effectiveness.
The epidemiological characteristics of rash and fever syndrome in Gansu Province from 2009 to 2019
WANG Li-juan, LIU Xin-feng, ZHOU Jian-hun, JIANG Xiao-juan, YUAN Yan, LI Juan-sheng, MENG Lei
2021, 25(9): 1102-1106. doi: 10.16462/j.cnki.zhjbkz.2021.09.019
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Abstract:
  Objective  To understand the compositions of pathogens and seasonal distribution characteristics of rash and fever syndrome (RFS) in Gansu Province from 2009 to 2019, so as to provide references for further disease surveillance and scientific prevention and control.  Methods    Descriptive epidemiological methods were used to analyze the composition of pathogens of RFS in Gansu Province from 2009 to 2019 and the seasonal variation characteristics of the main pathogens.  Results    The compositions of pathogens of RFS in Gansu Province were dominated by viruses, mainly enterovirus (56.04%), measles virus (19.14%), varicella-zoster virus (16.85%) and rubella virus (7.33%). The differences of positive rate of the main pathogens in different age groups and different seasons were statistically significant (all P < 0.05). The positive rate of enterovirus was higher in the 0-year-old and 5-year-old groups (χ2 =393.04, P < 0.001). The positive rate of measles virus was the highest in the 35-year-old group (χ2 =150.13, P < 0.001). The positive rate of rubella virus was the highest in the 15-year-old group (χ2 =327.89, P < 0.001), while the varicella-zoster virus had the lowest positive rate in the 0-year-old group (χ2 =221.53, P < 0.001). The positive rate of enterovirus in winter was lower than those in other seasons (χ2 =173.97, P < 0.001). The positive rate of measles virus (χ2 =164.46, P < 0.001) and rubella virus (χ2 =68.90, P < 0.001) were higher in spring, and the positive rate of varicella-zoster virus in winter was higher than those in other seasons (χ2 =32.90, P < 0.001).  Conclusions  From 2009 to 2019, the compositions of pathogens of RFS in Gansu Province were mainly viruses and the main pathogens have obvious seasonal characteristics. Seasonal and targeted proventive methods should be adopted for high-risk populations.
The association between hypertriglyceridemia-waist and hyperuricemia
ZHANG Kai-xuan, LIN Hai, LUO Dan, HU Kuan, ZOU Pin-ang, LUO Fang, CHEN Yue, PENG Wen-hui, WANG Bao-guo
2021, 25(9): 1107-1111. doi: 10.16462/j.cnki.zhjbkz.2021.09.020
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Abstract:
  Objective  To study the relationship between hypertriglyceridemia-waist (HTGW) phenotype and high uric acidemia (HUA) and provide a basis for early identification of high-risk individuals of HUA.   Methods  Adults from 24 townships in Zhongshan City were selected by multi-stage random sampling method to conduct on-site questionnaires, physical examinations and biochemical index detection. The relationship between HTGW phenotype and HUA was analyzed using Logistic regression model, Goodman-Kruskal method and multivariate linear stepwise regression.   Results  A total of 7 173 subjects were included. The detectable rate was 15.2% for the HTGW phenotype population and 2 332 for HUA patients, with a detectable rate of 32.5%. The multi-factor Logistic regression analysis showed that the HTGW phenotype was an important risk factor for HUA (OR=2.689, 95% CI: 2.249-3.215, P <0.001). The results of the Goodman-Kruskal correlation analysis and Multiple linear regression modol showed that there was a significant positive correlation between the HTGW phenotype and HUA (P < 0.001).   Conclusions  HTGW phenotype is an important risk factor of HUA. In daily prevention and treatment of HUA, we should focus on monitoring people with HTGW phenotype.
Clinical epidemiological study on the association between neutrophil extracellular traps and acute myocardial infarction among coronary atherosclerotic heart disease
SHUAI Zi-qiang, ZHANG Cheng-xin, AN Cheng, GE Sheng-lin
2021, 25(9): 1112-1116. doi: 10.16462/j.cnki.zhjbkz.2021.09.021
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Abstract:
  Objective  To investigate the change and its roles of neutrophil extracellular traps (NETs) in peripheral blood from patients with coronary atherosclerotic heart disease (CAHD) during their acute myocardial infarction (AMI) and post operation of coronary artery bypass graft (CABG), and to proride effective prevention and control of CAHD and AMI.   Methods  A total of 52 patients with AMI and 52 healthy controls (HCs) were involved in this study. The levels of NETs, fragment a of the factor B (Ba), fragment a of the 5th complement (C5a) and myeloperoxidase (MPO) in peripheral blood were detected by enzyme linked immunosorbent assay (ELISA) at the onset of AMI [pre-treatment (PRT) group], post-operative treatment group (POT group) and in HC group. Their differences between the groups were detected by t test while the relationships between the parameters in PRT group were tested by Pearson correlation analysis.   Results  All the parameters from PRT and POT group were higher than those in the HC group, respectively. The levels of cardiac troponin I (cTnI), NETs, Ba, C5a and MPO in PRT group were higher than those in POT group [(0.279±0.132) ng/ml vs.(0.016±0.008) ng/ml, P < 0.001; OD value: (0.466±0.143) vs. (0.378±0.151), P=0.002; (72.812±30.144) pg/ml vs. (60.491±28.323) pg/ml, P=0.001; (327.112±203.228) ng/ml vs. (260.411±135.984) ng/ml, P=0.025; (75.782±33.596) ng/ml vs. (58.462±29.647) ng/ml, P=0.008, respectively]. In PRT group, NETs was positively correlated with Ba, C5a and MPO (r=0.394, P=0.001; r=0.324, P=0.030 and r=0.406, P < 0.001), respectively, and Ba had positive correlation with C5a (r=0.436, P < 0.001) while cTnI was only correlated with NETs (r=0.352, P=0.008). The cTnI level, though recovered to normal range in POT group, was still higher than that in HC group [(0.016±0.008) pg/ml vs. (0.012±0.007) pg/ml, P=0.016].   Conclusions  The persistent high level of NETs and its related high activity of complement alternative pathway in CAHD during the onset of AMI and post-treatment of CABG might contribute to the progression of the disease and the recurrence of myocardial infarction. Intervention on the formation of NETs might be one of the potential pathways to prevent the progression of CHAD and the occurrence of AMI.

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