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CN 34-1304/R ISSN 1674-3679

2023 Vol. 27, No. 10

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Original Articles
The association between depressive symptoms and metabolic syndrome among the middle-aged and elderly populations in China
YANG Ruonan, HE Shuning, ZHANG Jiahao, YUAN Ping
2023, 27(10): 1117-1121. doi: 10.16462/j.cnki.zhjbkz.2023.10.001
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  Objective  The objective of the study was to analyze the impact of depressive symptoms on metabolic syndrome (MS) in middle-aged and older Chinese adults.  Methods  A total of 6 963 people aged ≥45 years with complete and important variables from the China Health and Retirement Longitudinal Survey (CHARLS) database in 2015 were extracted. Depressive symptoms were assessed using the center for epidemiological studies of depression (CES-D10) scale. MS was defined under the diagnostic criteria proposed by China Diabetes Society (CDS) in 2020. To analyze the association between depressive symptom and MS, propensity score matching was performed to control for potential bias, and the average treatment effect on the treated (ATT) between groups was estimated to verify the effect of depressive symptoms on MS.  Results  Among the 6 963 subjects, 33.10% (95% CI: 32.00%-34.21%) of middle-aged and older adults had depressive symptoms, and the detection rate of MS was 18.44% (95% CI: 17.53%-19.35%). After adjusting for potential confounders by propensity score matching, no significant association was observed between depressive symptoms and MS in middle-aged and older adults (ATT=-0.002-0.002, all P>0.05).  Conclusions  In the middle-aged and elderly population in China, both depressive symptoms and MS were detected at high rates, but having depressive symptoms was not significantly associated with the presence of MS in this population.
Age cohort effect of the change of self-care ability of the elderly population in China under the life course theory
XIE Ruirui, PANG Yue, WANG Qiong, WU Bingyi, LIU Jun, WU Jilei, QIAO Xiaochun
2023, 27(10): 1122-1127. doi: 10.16462/j.cnki.zhjbkz.2023.10.002
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  Objective  To explore various factors affecting the self-care ability of the elderly in China, and to isolate the age and cohort independent effects of the change of self-care ability.  Methods  A layered growth curve model was utilized for statistical analysis of data derived from the Chinese Longitudinal Health Longevity Survey (CLHLS) (2002-2018), a multi-cohort tracking study. Stata14.0 software was used as the analytical tool.  Results  Age and cohort have independent effects on the self-care capacity of the elderly. As age increases, the self-care ability of elderly people in China deteriorates, with differences between urban and rural areas widening. Elderly people born in earlier and later cohorts have poor self-care abilities, while those born in the middle cohorts have better self-care abilities. The difference in self-care ability between urban and rural areas decreases as the cohort becomes younger. Individual behavior and lifestyle, socioeconomic status, gender, and the number of chronic diseases have significant effects on self-care ability.  Conclusions  The influencing factors of the self-care ability of the elderly population in China are multiple and mixed, and the age effect and cohort independent effect are significant. Academic research on the disability of the elderly population should not only pay attention to the changing trend of the age but also pay attention to the differences in the birth cohort of the elderly population. The social prevention strategy of senile disability should not only pay attention to the individual behavior characteristics of the elderly population but also grasp the group characteristics of the cohort.
Urban and rural disparities in the association between physical exercise, cognitive activity, and mild cognitive impairment in community-dwelling older adults
LIAN Pengfei, LIU Zhang, ZENG Yan, LIU Dan, CHENG Guirong, YANG Mengliu, YU Yafu, ZHANG Jingjing, ZHOU Fukai, XU Lang
2023, 27(10): 1128-1132. doi: 10.16462/j.cnki.zhjbkz.2023.10.003
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  Objective  The study aimed to investigate the correlation between physical exercise, cognitive activity, and mild cognitive impairment (MCI) in the community-dwelling older adults, with focus on the disparities between urban and rural areas.  Methods  Based on the Hubei Memory and Aging Cohort Study (HMACS), participants were divided into four groups according to the participation in exercise status: no exercise (NE), physical exercise only (PE), cognitive activity only (CA), and physical exercise and cognitive activity (PE+CA). Multivariate logistic regression model was used to analyze the correlation between the patterns of physical exercise and cognitive activity with MCI and its urban-rural disparities.  Results  A total of 8 365 participants were enrolled, with an average age of (71.67±5.52) years. The prevalence of MCI was 23.22% (95% CI: 22.31%-24.12%), and the MCI prevalence in rural areas was higher than that in urban areas (41.00%∶13.61%). The risk of MCI in the PE, CA, and PE+CA groups were significantly lower than that in the NE group (both P < 0.05). Further, based on the analysis of residence stratification, rural PE group (OR=0.646, 95% CI: 0.542-0.771) and urban CA group (OR=0.684, 95% CI: 0.487-0.961) significantly exhibited a lower risk of MCI (all P < 0.05).  Conclusions  The prevalence of MCI in rural areas is higher than that in urban areas. Physical exercise and cognitive activity will significantly reduce the risk of MCI; the correlation between single exercise patterns and MCI was different between urban and rural areas. Under the goal of healthy aging, we should take into account the cultural background of older adults and urban-rural differences when the intervention strategies for cognitive impairment diseases was formulated.
Disease burden on falls among older adults in Jiangsu Province, 1990-2019
DU Wencong, YU Hao, LUO Pengfei, MENG Na, ZHOU Jinyi
2023, 27(10): 1133-1139. doi: 10.16462/j.cnki.zhjbkz.2023.10.004
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  Objective  To analyze the temporal trends of the disease burden of falls in the elderly in Jiangsu Provincee from 1990 to 2019, and to provide a scientific basis for developing fall prevention and control strategies in the elderly.  Methods  Based on the results of the Global Burden of Disease Study 2019, we analyzed the trends of the mortality, disability-adjusted life year (DALY), DALY rate, years lived with disability loss (YLD), YLD rate, years of life lost (YLL)and YLL rate of falls in the elderly by sex and age in Jiangsu Province from 1990 to 2019. The Joinpoint 4.9.0.0 was used to analyze the time trends from 1990 to 2019 by calculating the average annual percentage of change (AAPC) and corresponding 95% CI.  Results  In 2019, the mortality, DALY rate, YLD rate, and YLL rate contributed by falls among people aged ≥60 years in Jiangsu Province were 54.609/100 000, 1584.374/100 000, 646.922/100 000, and 937.451/100 000, respectively. There was an increase of 93.019%, 27.164%, 46.419%, and 16.584%, respectively, compared with 1990. The mortality, DALY rate, YLD rate, and YLL rate contributed by falls among the elderly in Jiangsu Province from 1990 to 2019 showed an increasing trend, with average annual percent change (AAPC) of 2.235%, 0.837%, 1.647%, and 0.545%, respectively (all P < 0.05). During 1990-2019, the changes in disease burden among the elderly across sex and age groups were different, and the increase of disease burden indicators of falls among elderly women was generally higher than that of elderly men. And the DALY rate of falls among the elderly aged 60- < 65 years showed a significant decreasing trend. However, all disease burden indicators of falls among the elderly aged ≥80 years showed a significant increasing trend.  Conclusions  Falls cause a heavy disease burden for the elderly in Jiangsu Province, especially those aged ≥80 years, and the disease burden is increasing yearly in this age group. Therefore, the prevention of falls among the elderly aged ≥80 should be strengthened to reduce the disease burden.
Dose-response association between lipid profiles and serum urate acid in Chinese adults
GAO Qian, LI Ting, PENG Liuqing, WANG Tong
2023, 27(10): 1140-1145. doi: 10.16462/j.cnki.zhjbkz.2023.10.005
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  Objective  This study aims to estimate dose-response relationship of lipid profiles on serum urate acid (SUA), and to provide evidence for prevention and therapy of Hyperuricemia (HUA).  Methods  Based on China Health and Nutrition Survey (CHNS) in 2009 and China Health and Retirement Longitudinal Study (CHARLS) in 2011-2012, 8 509 and 6 749 participants with no missing key variables were included in this study, respectively. Generalized propensity score based inverse probability weighting (IPW) method was used to adjust for potential confounders, and to estimate dose-response curves of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG) on SUA.  Results  In CHNS, the mean age was (50.32±15.08) years old with 15.3% of individuals having high levels of SUA. In CHARLS, the mean age was (58.52±9.17) years old and, 5.34% of individuals had high levels of SUA. Results of IPW analysis showed that there were statistically significant dose-response relationship between TG, HDL and SUA in both CHNS and CHARLS. The SUA increased as TG increased and HDL decreased.  Conclusions  The abnormality of lipid profiles may lead to an increase in SUA, and the timely lipid-modifying may help to prevent and treat HUA.
Trends of burden on ischemic heart disease and related risk factors among residents in Jiangsu Province, 1990-2019
WANG Weiwei, YU Hao, HONG Xin, YANG Huafeng, ZHOU Hairong, QI Shengxiang, ZHOU Jinyi
2023, 27(10): 1146-1152. doi: 10.16462/j.cnki.zhjbkz.2023.10.006
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  Objective  To examine the trend of burden on ischemic heart disease (IHD) and related risk factors among residents in Jiangsu Province from 1990 to 2019.  Methods  Based on open access data from the Global Burden of Disease (GBD) 2019 Study, years of life lost (YLD), years lived with disability (YLL), disability-adjusted of life years (DALY), and population attributable fraction (PAF) were used to describe the temporal trend burden of IHD and its attributable risk factors from 1990 to 2019. A decomposition method established by Das Gupta P was applied to quantify the burden related to population growth, population age, age-specific prevalence, and the severity of the disease.  Results  The burden of IHD, in number of prevalence, deaths, and DALYs showed increasing trends from 1990 to 2019. During the same period, age-standardized rates of IHD YLL and DALY showed decreased trends, and the annual decreased rates of change of both YLL and DALY were much higher from 2010 to 2019 than those from 1990 to 2010. The DALY of IHD in 2019 increased by 75.78% compared with 1990, the proportions attributable to age-specific prevalence, population growth, population age and the severity of the disease were 52.06%, 46.12%, 23.52%, and -45.92, respectively. In 2019, DALY attributable to the 26 modifiable risk factors accounted for 92.75% of the total IHD DALY, and the proportion of environmental/occupational, behavioral and metabolic risk factors was 38.21%, 68.03% and 79.07%, respectively. The top five of age-standardized attributable DALY rate in 2019 were high blood pressure, high LDL cholesterol, tobacco, ambient particulate matter pollution, and diet high in sodium. From 1990 to 2019, DALYs attributed to ambient particulate matter pollution (ARC=1.29%), high body-mass index (ARC=1.76%), diet high in red meat (ARC=0.36%), diet high in processed meat (ARC=0.32%), and alcohol use (ARC=4.19%) exhibited the greatest increase. From 2010 to 2019, the age-standardized DALY rate ranking for 10 risk factors for IHD increased, and the age-standardized DALY rate ranking for 8 risk factors decreased.  Conclusions  The burden of IHD continues to increase in Jiangsu residents. Population age and age-specific prevalence are responsible for the considerable increase in the burden of IHD among Jiangsu residents. It is important to strengthen programs on prevention and control for hypertension, dyslipidemia and obesity. Behavior risk factors such as smoking, drinking and unreasonable diet habits should be reduced. Outdoor environment should be improved.
A nested case-control study on the influencing factors of sudden cardiac death
ZHANG Lizhen, YIN Chun, LI Siyu, WU Xijiang, CHEN Yarong, SHEN Shujuan, WANG Zhongge, CHEN Ruirui, LI Jing, XU Lulu, HU Yujia, BAI Yana
2023, 27(10): 1153-1160. doi: 10.16462/j.cnki.zhjbkz.2023.10.007
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  Objective  To study the influencing factors of sudden cardiac death (SCD) based on the cohort population, and to provide basic data for the prevention and etiological research of SCD.  Methods  A nested case-control study was conducted, involving 52 newly diagnosed cases of SCD during three follow-up visits from 2011 to 2019 in Jinchang cohort. And 208 participants without SCD during the same period of follow-up were selected as the control group according to the matching method of age (±2 years) and 1∶4 individuals of the same sex. Conditional logistic regression model was used to analyze the influencing factors of SCD in Jinchang cohort, and the dose-response relationship of SCD risk was fitted by restricted cubic spline (RCS) models.  Results  Multivariate conditional logistic regression analysis showed that triglycerides (TG) (OR=2.94, 95% CI: 1.15-7.51), low density lipoprotein cholesterol (LDL-C) (OR=2.70, 95% CI: 1.18-6.22), diabetes (OR=5.59, 95% CI: 1.79-17.46) and abnormal electrocardiogram (OR=5.54, 95% CI: 2.11-14.56) were risk factors for SCD. Education level in high school and above (OR=0.33, 95% CI: 0.12-0.88) was a protective factor for SCD. RCS analysis showed that there was a positive linear dose-response relationship between fasting plasma glucose (FPG), TG and the risk of SCD (general trend P<0.05, non-linear P>0.05).  Conclusions  TG, LDL-C, diabetes, abnormal electrocardiogram and education level were related to the occurrence of SCD, and there was a dose-response relationship between FPG, TG and the risk of SCD.
Development and validation of a risk prediction model for venous thromboembolism in stroke patients
WANG Rongrong, ZHOU Qianyu, GUO Yuanli, WANG Panpan, HE Wenqian, ZHAO Mingyang, ZHANG Peijia, HU Bo, WU Tiantian, YAO Zihui, WANG Yu, SUN Changqing
2023, 27(10): 1161-1166. doi: 10.16462/j.cnki.zhjbkz.2023.10.008
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  Objective  To develop and validate the risk prediction model of venous thromboembolism (VTE) in stroke patients, so as to provide a scientific basis for the prevention and control of VTE.  Methods  A total of 675 stroke patients were enrolled from our stroke cohort of Henan Province. The data were randomly divided into a training (473 patients) and a testing dataset (202 patients) by a ratio of 7∶3. Then, we used a random forest algorithm for variable selection and logistic regression analysis to construct the model, and a nomogram was drawn. The prediction efficiency of the model was evaluated by the area under the receiver operating characteristic curve and Hosmer-Lemeshow test. Decision curve analysis (DCA) was used to evaluate the clinical application value of the model and the five-fold cross-validation was utilized to verify the model internally.  Results  The predictors that ultimately entered the prediction model were age, hospital stays, ADL, myodynamia, uric acid, D-dimer, fibrinogen, and total cholesterol. In the training dataset, the Hosmer-Lemeshow test yielded P=0.872 and the AUC was 0.924 (95% CI: 0.898-0.950). The testing dataset showed that the Hosmer-Lemeshow test yielded P=0.597 and the AUC was 0.902 (95% CI: 0.852-0.951). DCA curves indicated that the model had high clinical net benefits in both datasets. Internal verification presented that the average AUCs of the model in the training and testing datasets were 0.913 and 0.929, respectively.  Conclusions  The risk prediction model developed in this study can effectively predict VTE occurrence in stroke patients, offering a valuable tool for identifying high-risk individuals and implementing early preventive measures.
A prospective cohort study on the association between oral hygiene behaviors and the incidence of stroke
LONG Mengya, WANG Huiqun, ZHOU Jie, WU Yanli, YU Lisha, LIU Tao
2023, 27(10): 1167-1174. doi: 10.16462/j.cnki.zhjbkz.2023.10.009
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  Objective  To explore the relationship between oral health behavior and the incidence of stroke in Guizhou Province, and to provide reference for the prevention and control of stroke.  Methods  A total of 9 280 permanent residents aged 18 years and above were selected using stratified random cluster sampling across 12 counties (cities and districts) in Guizhou Province in 2010. The cohort was followed up from 2016 to 2020. SPSS 21.0 software was used to analyze the data. The measured data were expressed as mean±standard deviation (x±s). One-way variance analysis was used for comparison among multiple groups. The count data were expressed as constituent ratio or rate. Chi-square test was used for comparison between groups. Cox proportional hazards regression model was used to analyze the relationship between oral hygiene behavior and stroke incidence. The Graphpad Prism 10.0.2 software was utilized for plotting stroke incidence risk.  Results  Of the 7 970 individuals included in the analysis, 204 experienced a stroke, with an incidence density of 3.62/1 000 person-years. The results of Cox regression analysis showed that compared with the individuals who brushed their teeth less than once a day, the risk of stroke decreased by 34.3% (HR=0.657, 95% CI: 0.459-0.941) for those brushing teeth once a day, and by 50.8% (HR=0.492, 95% CI: 0.307-0.789) for those brushing twice a day or more. The risk of ischemic stroke was 0.515-fold higher in those who brushed their teeth twice or more per day than in those who brushed less than once (HR=0.515, 95% CI: 0.298-0.891). However, no correlation was found between oral hygiene behavior and hemorrhagic stroke.  Conclusions  Brushing teeth is a protective factor for stroke. Brushing teeth twice or more every day can effectively reduce the risk of ischemic stroke.
Epidemiological characteristics of fund-raising cases of cardiovascular and cerebrovascular diseases among low-income population in China
YANG Haiming, SONG Mingyu, XIAO Meng, ZHAO Yuxuan, WANG Yueqing, LIANG Yuqin, HU Yao, SHEN Peng, YU Canqing, LYU Jun, LI Liming, SUN Dianjianyi
2023, 27(10): 1175-1181. doi: 10.16462/j.cnki.zhjbkz.2023.10.010
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  Objective  To describe the characteristics of epidemiology and health economics of fund-raising cases of cardiovascular and cerebrovascular diseases among low-income population in China from 2018 to 2020.  Methods  The study used data of 251 629 cardiovascular and cerebrovascular diseases fund-raising cases posted on "Waterdrop" online service platform from year 2018 to 2020 in China. The χ2 test, χ2 test for trend and general linear regression were used to describe the distribution of fund-raising cases and the difference of amount of money raised.  Results  A total of 251 629 fund-raising cases were included in the study, of which 80.9% was of cerebrovascular diseases, 19.1% was of cardiovascular diseases. There were 51 292 cases in 2018, 92 123 in 2019 and 108 214 in 2020. The number of male patients was more than that of female patients, and the proportion of patients over 65 years old increased faster during the three years (Ptrend<0.001). Fund-raising cases was mostly initiated in economically underdeveloped and populous provinces. The total fund-raising amount of "Waterdrop" platform for cardiovascular and cerebrovascular diseases was 1.24 billion yuan, 2.04 billion yuan, and 2.05 billion yuan for 2018, 2019, and 2020, respectively, but money raised for each case decreased over the years. The average money raised for each case decreased from 25 248.2 yuan to 19 792.4 yuan for cerebrovascular diseases, 19 386.3 yuan to 15 220.5 yuan for cardiovascular diseases from 2018 to 2020. The amount of money raised had regional differences, with higher amount for cases in economically developed provinces.  Conclusions  Significant differences in gender, age and region were observed for the distribution of cardiovascular and cerebrovascular diseases fund-raising cases. Targeted assist of cardiovascular and cerebrovascular diseases treatment is needed for women, the elderly, and patients from western and northeastern provinces in China.
A Study of the association between husband′s smoking and wife′s risk of hypertension
ZENG Shuai, DUAN Xinyun, MU Rongwei, HAN Chunying, LIU Fangchao, WANG Long, YANG Ying, MA Xu
2023, 27(10): 1182-1187. doi: 10.16462/j.cnki.zhjbkz.2023.10.011
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  Objective  This study aimed to analyze the potential association between a husband′s smoking habits and the risk of hypertension in their wives.  Methods  The study included 2 612 479 women with planned pregnancies who participated in the National Free Pre-pregnancy Checkups Project twice between 2010 and 2019.The mean daily and cumulative smoking of their husbands at the time of the two examinations were used as the exposure. And the wives′ hypertensive disease at the time of the two examinations were used as the outcome. The ratio of husband′s smoking to wife′s risk of hypertension and its 95% confidence interval were estimated using logistic regression models and restricted cubic spline models, and the stability of the results was tested using sensitivity analysis.  Results  The risk of hypertension for wives whose husbands smoked > 5-10, > 10-15, > 15-20, and >20 cigarettes per day was 1.20(95% CI: 1.12-1.28), 1.27(95% CI: 1.16-1.40), 1.69(95% CI: 1.54-1.86) and 2.07(95% CI: 1.68-2.54) times higher (all P<0.05), respectively, and the risk of hypertension was 24%(95% CI: 11%-39%), 60%(95% CI: 39%-84%), and 66%(95% CI: 48%-87%) higher for wives whose husbands were with cumulatively exposed to smoking of > 2.0-4.0, > 4.0-6.0, and >6.0 pack×years, respectively, compared to those whose husbands were nonsmokers (all P<0.05). The risk increased with increasing escalating exposure to husbands′ smoking (Ptrend<0.01).  Conclusions  A husband′s smoking is associated with an increased risk of hypertension in his wife. Strengthening family-based tobacco control and hypertension management could improve the health of women of childbearing age.
Association between sleep status and diabetes mellitus among adults in Shaanxi Province
WU Meng, WANG Yanping, WANG Weihua, SA Rina, HU Zhiping, LIU Rong, XU Yalong, QIU Lin
2023, 27(10): 1188-1192. doi: 10.16462/j.cnki.zhjbkz.2023.10.012
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  Objective  To explore the associations of sleep duration and sleep quality with diabetes mellitus among adults in Shaanxi Province, thus providing evidence for diabetes prevention and control.  Methods  Through multi-stage stratified cluster random sampling method, 6 202 permanent residents aged 18 years and older were selected as research subjects from Shaanxi Adult Chronic Disease and Risk Factor Surveillance Program in 2018. Questionnaire survey, physical examination and laboratory test were conducted. Multivariate logistic regression analysis model analysis was used to analyze the independent and combined associations between sleep duration, sleep quality and diabetes mellitus.  Results  A total of 6 062 subjects were enrolled in this analysis, and the prevalence of diabetes was 8.17%. The results of multivariate logistic regression analysis model analysis showed that after adjusting for relevant confounding factors, compared with the sleep duration of 6 to<8 h/d group, the risk of diabetes increased in the sleep duration<6 h/d group (OR=1.38, 95% CI: 1.07-1.78, P=0.014) and the >8 h/d group (OR=1.26, 95% CI: 1.05-1.52, P=0.015). Compared with the group with good sleep quality, the group with poor sleep quality (OR=1.32, 95% CI: 1.09-1.61, P=0.005). had an increased risk of diabetes. Further analysis of the combination of sleep duration and quality showed that compared with the group with sleep duration of 6-<8 h/d and good sleep quality, those with sleep duration<6 h/d and poor sleep quality (OR=1.55, 95% CI: 1.14-2.10, P=0.005) and those with sleep duration >8 h/d and poor sleep quality (OR=1.53, 95% CI: 1.18-1.99, P=0.002) had an increased risk of diabetes.  Conclusions  Both abnormal sleep duration and poor sleep quality are associated with diabetes mellitus, and a joint effect exists between them.
Screening signature genes for primary Sjögren′s syndrome based on bioinformatics analysis
KONG Teng, CHENG Lingjing, SUN Xiangfei, ZHENG Chaoyue, FENG Shuang, TAI Yangfang, WU Shengnan, HE Peifeng, YU Qi
2023, 27(10): 1193-1203. doi: 10.16462/j.cnki.zhjbkz.2023.10.013
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  Objective  This study employed bioinformatics methods to identify signature genes in patients with primary Sjögren′s syndrome (pSS) compared to healthy controls, offering insights and a theoretical foundation for exploring the pathogenesis of pSS at the transcriptome level.  Methods  The microarray data containing the information of pSS patients and healthy controls was screened and obtained from the GEO database, with data sets GSE84844 and GSE66795 used to analyze and obtain target genes and GSE40611 used for validation. Differential analysis, weighted gene co-expression network analysis (WGCNA) and other bioinformatics analyses were used to obtain hub genes. The least absolute shrinkage and selection operator (LASSO) regression was used to obtain signature genes closely related to the pathogenesis of pSS, and the area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of signature genes for pSS.  Results  Compared with healthy controls, pSS patients had 55 differential expression genes. GO enrichment analysis showed that DEGs were mainly involved in biological processes such as defense response to virus, positive regulation of type Ⅰ interferon production and antiviral innate immune response. Furthermore, KEGG signal pathway enrichment analysis found that DEGs were enriched in influenza A, RIG-I-like receptor signaling pathway, necroptosis and hepatitis B. Four signature genes, DDX60, EPSTI1, IFI27 and IFI44, were screened by WGCNA combined with LASSO regression, and their AUC values in the validation data set were 0.807, 0.866, 0.804 and 0.892, respectively.  Conclusions  The signature genes DDX60, EPSTI1, IFI27, and IFI44 hold significant diagnostic value for pSS, providing a theoretical foundation for further exploration of the pathogenesis and progression mechanisms of pSS.
The mediating effect of school life maladjustment on the relationship between autistic traits and depression in vocational college students
CHENG Shaogui, GAO Peng, LI Jiping, TIAN Zhenshang, CHENG Si, YE Dongqing, FANG Xinyu
2023, 27(10): 1204-1211. doi: 10.16462/j.cnki.zhjbkz.2023.10.014
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  Objective  To investigate the impact of autistic traits on depression and to understand the role of maladaptation to school life in the relationship chain, providing clues for the intervention of depression symptoms.  Methods  The study included all first and second grade students from two vocational colleges in Lu′an and Anqing cities. Demographic characteristics, levels of autistic traits, maladaptation to school life, and depression status were investigated. A multiple logistic regression model was used to analyze the effect of autistic traits on maladaptation to school life and depression. The mediating effect of maladaptation on school life was studied using Bootstrap.  Results  A total of 3 316 subjects were included, among whom 1 667 (50.3%) had no depression, 1 071 (32.3%) had mild depression, 542 (16.3%) had moderate depression, and 36 (1.1%) had severe depression. The multiple logistic regression models showed that high levels of autistic traits were risk factors for maladaptation to school life and depression (OR=1.810, 95% CI: 1.260-2.601, P=0.001; OR=4.940, 95% CI: 3.429-7.119, P < 0.001). The mediating effect analysis showed that maladaptation to school life partially mediated the relationship chain between autistic traits and depression, with an indirect effect accounting for 44.07% of the total effect.  Conclusions  The level of autistic traits can not only directly affect depression but also indirectly affect it through maladaptation to school life. Positive adaptation to school life can alleviate the adverse effects of high autistic traits on depression. Therefore, to reduce the incidence of depression among vocational college students, attention should be paid to their adaptation to school life.
Dynamic changes of metabolic profile in mice exposed to polystyrene nanoparticles
PAN Xueyan, ZHAO Yi, ZHENG Xueting, LI Shangjie, WU Liang, XU Jiahao, ZHANG Xiaoxia, LIAO Shaobing, YIN Mingjuan, NI Jindong
2023, 27(10): 1212-1220. doi: 10.16462/j.cnki.zhjbkz.2023.10.015
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  Objective  To exposure the dynamic effects of nano-plastics on the body′s metabolism during long-term exposure based on the method of metabolomics.  Methods  Male C57BL/6J mice, aged 13 months, were exposed to polystyrene nanoparticles (PS-NPs) at doses of 0, 1 and 10 mg/kg over a period of 9 months via gastric lavage. After one, three, six, and nine months intervals post-exposure, random selected mice from each group were killed and their blood samples collected. Subsequently, the technique of TM wide-target metabolomics was utilized for the classification of serum differential metabolites.  Results  The sample points of different exposure time nodes (first, third, sixth, and ninth months) within the same dose group were distinguishable. It was discovered that the urobilin content decreased as exposure time increased and was closely related to the metabolic pathways of porphyrin and chlorophyll. After long-term exposure (nine months), 135 distinct metabolites were identified in the comparison between the control group and groups with varying exposure doses. Out of these, 50 metabolites were upregulated and 85 metabolites were downregulated. Cluster analysis revealed that arachidonic acid metabolism and purine metabolism pathway were the most perturbed. The contents of differential metabolites associated with these pathways (e.g., 2,3-dinor-8-iso Prostaglandin F2α, Xanthine, 2′-Deoxyinosine, 3′-Aenylic Acid, Hypoxanthine) were markedly upregulated.  Conclusions  The serum metabolic profile of mice changed exposed to PS-NPs for extended exposure was altered (from middle age to old age). Among the altered differential metabolites, urobilin is linked to the duration of PS-NPs exposure and is a potential sensitive marker. In addition, 2,3-dinor-8-iso Prostaglandin F2α and Xanthine are potential specific markers. These metabolites suggest the pathways for the metabolism of arachidonic acid and purines are potential mechanisms for studying PS-NPs exposure damage.
Short Reports
Incidence and mortality trends of hepatitis B virus infection-related liver cancer in Jiangsu Province from 1990 to 2019
LIU De, CHEN Peipei, LOU Peian, QIAO Cheng, LI Ting, ZHANG Pan, JIANG Yixue, DONG Zongmei, ZHU Xuan, YU Hao
2023, 27(10): 1221-1227. doi: 10.16462/j.cnki.zhjbkz.2023.10.016
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Abstract:
  Objective  To analyze the current status and the temporal trend of hepatitis B virus (HBV) infection-related liver cancer incidence and mortality in Jiangsu Province from 1990 to 2019 based on the Global Health Data Exchange (GHDx) database.  Methods  The incidence and mortality data of HBV infection-related liver cancer in Jiangsu Province from 1990 to 2019 were collected from the GHDx database. The temporal trend of age-standardized incidence/mortality rates was analyzed by Joinpoint software. The effect of age, period and cohort factors on age-specific incidence/mortality changes was assessed using an age-period-cohort model.  Results  From 1990 to 2019, the age-standardized incidence and mortality of HBV infection-related liver cancer in Jiangsu Province showed fluctuations. The overall trend showed a significant downward trend, with the average annual percent change decreasing by -4.7% and -5.3% (all P < 0.001), respectively. The results of the age-period-cohort model indicated that the age-standardized incidence and mortality of HBV infection-related liver cancer decreased with the increase of the birth cohort (P < 0.001), and showed a trend of increasing and then decreasing with the increase of age and period (P < 0.001).  Conclusions  From 1990 to 2019, the incidence and mortality of HBV infection-related liver cancer in Jiangsu Province showed a significant downward trend. The risk of incidence and mortality decreased with the growth of the birth cohort and showed a trend of increasing followed by decreasing with age and period. Vaccinating hepatitis B among high-risk adults and strengthening health education for the elderly population, could further reduce the future disease burden of liver cancer in Jiangsu Province.
Effects of exposure to neonicotinoids on estrogen homeostasis in pregnant women
WANG Yi, WU Linying, XUAN Dongliang, TIAN Jing, WANG Yuanping, YANG Zichen, HAN Minghui, WANG Hexing, PENG Qian, JIANG Qingwu
2023, 27(10): 1228-1233. doi: 10.16462/j.cnki.zhjbkz.2023.10.017
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Abstract:
  Objective  To investigate the effect of neonicotinoids (NEOs) on estrogen homeostasis during pregnancy.  Methods  A total of 151 pregnant women in one administrative district of Shanghai were selected as study participants. A questionnaire survey was used and urine samples were collected. The concentrations of eight NEOs (thiamethoxam, clothianidin, imidacloprid, acetamiprid, thiacloprid, nitenpyram, midaclothiz and dinotefuran), four metabolites (N-desmethyl-thiamethoxam, N-desmethyl-clothianidin, 5-hydroxy-imidacloprid and N-desmethyl-acetamiprid) and three estrogens (estrone, estradiol and estriol) in their urine were determined by ultra-performance liquid chromatography-tandem quadrupole time-of-flight mass spectrometry. ANOVA and multiple linear regression were used to analyze the effect of NEOs exposure levels on estrogen levels in pregnant women.  Results  The detection rate of NEOs and their metabolites in urine samples of pregnant women was 93.38%, with a median urinary NEOs concentration of 2.66 μg/g. The acetamiprid and N-desmethyl-acetamiprid had the highest detection rate (78.15%), while the imidacloprid and 5-hydroxy-imidacloprid had the lowest. ANOVA found that higher urinary estrone levels in pregnant women with detectable thiamethoxam and N-desmethyl-thiamethoxam, while lower urinary estradiol and estriol levels in pregnant women with detectable clothianidin and N-desmethyl-clothianidin. Multiple linear regression analysis showed a positive association between urinary all NEOs levels and estrone levels in pregnant women regression coefficient (β=0.137, 95% CI: 0.019-0.256). Urinary thiamethoxam and N-desmethyl-thiamethoxam levels, and urinary acetamiprid and N-desmethyl-acetamiprid levels were positively correlated with estrone levels in pregnant women (β=0.154, 95% CI: 0.032-0.275; β=0.157, 95% CI: 0.028-0.286).  Conclusions  Pregnant women in Shanghai may be generally exposed to NEOs, and the exposure level of NEOs during pregnancy may affect estrogen homeostasis.
Analysis of the spatiotemporal distribution and clustering on newly reported pneumoconiosis cases in Bijie City, Guizhou Province from 2017 to 2021
YANG Shaofang, YANG Junhong, HE Wenlei, HE Yaoyao, TANG Biao
2023, 27(10): 1234-1240. doi: 10.16462/j.cnki.zhjbkz.2023.10.018
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Abstract:
  Objective  To analyze the spatial and temporal characteristics of newly reported pneumoconiosis cases in Bijie City, Guizhou Province, aiming to provide references for the prevention and control of occupational disease.  Methods  The spatial and temporal distribution analysis, spatial autocorrelation analysis, hot spot analysis and spatial autoregressive analysis between four impact factors and newly reported pneumoconiosis cases (2017-2021) in Bijie City were conducted using ArcGIS 10.2, Matlab R2011a and GeoDa 0.9.5-i software.  Results  From 2017 to 2021, a total of 1 487 new cases of pneumoconiosis were reported in Bijie City, with an annual decrease in the number of cases (Rs < 0). The global spatial autocorrelation analysis showed a non-random spatial distribution and spatial clustering pattern for the newly reported pneumoconiosis cases. Hotspot analysis revealed that the hotspot area of the number of newly reported pneumoconiosis cases from 2017 to 2020 located in Jinsha County, and in Zhijin County at 2021, and the hotspot area of the cumulative number of newly reported pneumoconiosis cases from 2017 to 2021 located in Jinsha County. All hotspot areas were statistically significant (P < 0.05). There was a high-high adjacent distribution pattern of newly reported pneumoconiosis cases in Jinsha County, Zhijin County and surrounding areas. The results of spatial autoregressive model showed that the industrial added value, secondary sector of the economy added value and the number of coal mining enterprises were statistically significant related to the occurrence of newly reported pneumoconiosis cases in Bijie City, and the most statistically significant influencing factor was the industrial added value(Z=2.574, P=0.010).  Conclusion  The number of newly reported pneumoconiosis cases in Bijie City, Guizhou Province, has been decreasing annually. Jinsha, Zhijin County and the adjacent areas can be taken as the key prevention and control areas of pneumoconiosis, and the industrial sector should be the focus of pneumoconiosis prevention and control efforts.

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