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CN 34-1304/R ISSN 1674-3679

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2024, Volume 28,  Issue 11

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Original Articles
Effect of phenol exposure and single nucleotide polymorphisms interaction on renal function
ZHANG Fuwei, WANG Wenzhuo, CAI Xiaomin, WANG Lu, HE Heng, ZHONG Rong, TIAN Jianbo, ZHU Ying, MIAO Xiaoping
2024, 28(11): 1241-1249. doi: 10.16462/j.cnki.zhjbkz.2024.11.001
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  Objective  To investigate of the interaction between exposure to bisphenol A (BPA), bisphenol F (BPF), triclosan (TCS) and gene locus polymorphism on renal function.  Methods  A total of 414 adults were recruited as research subjects from the physical examination population of Tongji Hospital affiliated with Tongji Medical College of Huazhong University of Science and Technology between 2016 and 2021. Population information was collected through questionnaires, and urine samples were obtained for analysis. The internal exposure levels of three phenolic compounds, namely BPA, BPF, and TCS, were subsequently measured in the urine samples of the study subjects. Serum creatinine levels were measured to determine renal function, and eGFR was calculated as an indicator. Blood samples were taken from research subjects to extract DNA for high-throughput genotyping, genome filling, and quality control. Genome-wide association studies (GWAS) were then conducted to analyze gene-environment interactions affecting eGFR levels. Finally, the obtained significant and suggestive genetic loci were annotated by location and function to explore their related biological functions.  Results  Following high-throughput genotyping and genotype filling, 414 samples were obtained with genotype data for 4 135 024 single nucleotide polymorphisms (SNPs) loci. During further identification, three SNPs loci (rs60391380, rs56108314, and rs73082740) were found to have a significant interaction with BPA in relation to renal function. These loci were located in the 4p16.3 chromosome segment, close to the ADRA2C gene. The most significant interaction effect was found for rs60391380, with a beta value of -0.042 (-0.057--0.028) and a P-value of 1.565×10-8. Based on epigenetic modifications, it was speculated that this genetic locus might interact with BPA, activate its regulatory elements, and upregulate the expression of ADRA2C, thereby affecting renal function. Additionally, 844 BPA interaction sites were explored, with suggestive results (P < 5×10-6). In the eGFR genome-wide association analysis, 52 loci were found to interact with BPF in a suggestive manner, but no significant loci were identified. For TCS, no significant or suggestive sites of interaction were found.  Conclusions  The interaction between BPA and SNPs had a joint effect on renal function. However, no statistically significant gene-environment interactions affecting renal function were found for BPF and TCS.
Sleep duration and bedtime in relation to depressive symptoms among older adults
CAO Yi, WU Yu, SU Binbin, ZHENG Xiaoying, GUO Shuai
2024, 28(11): 1250-1256. doi: 10.16462/j.cnki.zhjbkz.2024.11.002
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  Objective  To explore the independent and interactive effects of sleep duration and bedtime on depressive symptoms among middle aged and older adults in China, and provide references for the prevention and intervention measures of depressive symptoms.  Methods  Using data from the 2018 China family panel studies(CFPS), 13 662 individuals aged 50 years and above were selected as the analytical sample. A preliminary exploration of the nonlinear relationships between sleep duration, bedtime, and depressive scores was conducted based on the generalized additive model (GAM). Further analysis of the correlations between sleep duration, bedtime their interaction, and depression symptoms was performed using multivariate logistic regression model, along with subgroup analyses by gender and urban-rural classification.  Results  34.83% of middle-aged and older adults in study had depressive symptoms. Sleep duration < 6 hours and abnormal bedtime (earlier than 21:00 or later than 23:00) were independently associated with depressive symptoms. There was an interaction effect between sleep duration and bedtime on the risk of depressive symptoms. Those with abnormal bedtime and sleep duration < 6 hours had the highest risk (OR=1.32, 95% CI: 1.08-1.60). Further subgroup analyses by gender and residence confirmed the above findings.  Conclusions  Healthcare professionals and caregivers should pay attention to both sleep duration and bedtime among middle-aged and older adults. By implementing effective intervention measures, the occurrence of depressive symptoms can be reduced.
A prospective cohort study on the association of maternal perinatal cigarette smoking, alcohol consumption and their interactions with risk of neonatal low birth weight
PENG Yuan, LUO Manjun, RUAN Xiaorui, LI Liuxuan, LIU Hanjun, TANG Jiapeng, QIN Jiabi
2024, 28(11): 1257-1263. doi: 10.16462/j.cnki.zhjbkz.2024.11.003
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  Objective  To assess the effects of maternal cigarette smoking and alcohol consumption and their interactions during periconceptional pregnancy on the risk of low birth weight (LBW) in newborns.  Methods  Pregnant women attending their initial early prenatal care in Hunan Province were recruited to establish a cohort. Information was collected through questionnaires and medical records, with telephone follow-ups to monitor pregnancy outcomes including LBW. The logistic regression analysis was applied to assess the associations of maternal periconceptional cigarette smoking, alcohol consumption, and their interactions with the risk of LBW. Meanwhile, stratified analysis was conducted to evaluate the stability of the associations.  Results  A total of 34 104 singleton pregnancies and newborns were included in this study. Among these newborns, 3 020 cases were diagnosed with LBW, with an incidence of 8.9% (95% CI: 8.6%-9.2%). The multivariate logistic regression analysis showed that maternal active smoking (OR=1.428, 95% CI: 1.147-1.777), passive smoking (OR=1.128, 95% CI: 1.031-1.235), and alcohol consumption (OR=2.297, 95% CI: 1.949-2.706) during periconceptional pregnancy were significantly associated with risk of LBW (all P < 0.05). Additionally, the interaction analysis revealed an antagonistic effect between active smoking and alcohol consumption (OR=0.117, 95% CI: 0.049-0.278).  Conclusions  Maternal periconceptional active smoking, passive smoking, alcohol consumption and their interactions are significantly associated with neonatal LBW, highlighting the importance of maintaining healthy behaviors during pregnancy to prevent LBW.
The mediating effect of Th1/Th2 balance deviation in the association between B[a]P intrauterine exposure and embryonic arrest
LI Fuxing, LIU Sha, ZHANG Jiayu, JI Jingru, WU Yanfei, Cao Jiuru, WEI Junni
2024, 28(11): 1264-1269. doi: 10.16462/j.cnki.zhjbkz.2024.11.004
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  Objective  To investigate the association between exposure to benzo [a] pyrene (B[a]P) and embryonic arrest, and the mediating effects of helper T cell 1/helper T cell 2(Th1/Th2) balance deviation.  Methods  A total of 245 women with embryonic arrest and women with normal pregnancy who voluntarily induced abortion were selected as the study objects. The levels of 7, 8-dihydroxy-9, 10-epoxy-benzo [a] pyrene (BPDE)-DNA adducts and interleukin (IL)-2, interferon-γ(IFN-γ), IL-4, IL-10 in villus tissues were detected. Logistic regression model was used to analyze the correlation between B[a]P exposure and embryonic arrest, and Bootstrap method was used to analyze the mediating effect of Th1/Th2 balance deviation between them.  Results  After adjusting for covariates, it was found that the risk of embryonic arrest at medium-high exposure level and high exposure level of BPDE-DNA adducts was 5.66 times (aOR=5.66, 95% CI: 2.00-16.01, P < 0.001) and 5.63 times(aOR=5.63, 95% CI: 1.97-16.14, P < 0.001) higher than that at low exposure level, respectively; The results of mediating analysis showed that B[a]P had a total effect of 1.220 (0.501-1.939) on embryonic arrest, with a mediating effect caused by Th1/Th2 balance deviation of 0.328 (0.078-0.716), accounting for 26.89%.  Conclusions  B[a]P exposure is a risk factor for embryonic arrest, and Th1/Th2 imbalance occurring with a Th1-Type deviation is a mediating variable of embryonic arrest caused by B[a]P exposure.
Characterization of hepatitis B virus infection status and amino acid variations in the S region of the virus in a hospital population undergoing physical examination in Tibet
XU Linli, YUAN Xiaojie, ZHANG Weilu, LI Hongyan, JI Zhaohua, WANG Yuhua, LI Yijun, WANG Yuemei, SHAO Zhongjun
2024, 28(11): 1270-1274. doi: 10.16462/j.cnki.zhjbkz.2024.11.005
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  Objective  To probe the status of hepatitis B virus infection in the physical examination population of the Tibet Autonomous Region and to clarify the distribution characteristics of hepatitis B virus genotypes and the amino acid variants in the S region.  Methods  The health check-up population in a hospital in Tibet from May 2022 to July 2023 was selected as the study population, and questionnaires and serologic tests were conducted on the check-up population using random sampling method. According to the results of hepatitis B serologic markers, hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), hepatitis B core antibody (anti-HBc) positive samples were subjected to S region gene amplification and amino acid variation analysis.  Results  A total of 3 970 medical examiners were included, and eight combinations of serum markers were detected for HBsAg, antibody to hepatitis B surface antigen (anti-HBs), and anti-HBc. Differences in the prevalence of HBV infection and the positive rate of single anti-HBc were statistically significant across varing groups including age, gender, occupation, marital status and region (all P < 0.001). The S region sequences were amplified from 48 samples, and the typing results were 39 cases of genotype D, 8 cases of genotype C and 1 case of genotype B, of which 13 cases had amino acid mutations in the major hydrophilic region (MHR) of the S genetic region.  Conclusions  The Tibet Autonomous Region is a highly endemic area for hepatitis B. The HBV genotype is mainly genotype D and the amino acid sequence of the major hydrophilic region in the S region of HBV has mutations at several sites, so it is necessary to actively carry out vaccination measures against hepatitis B in adults.
Serological testing results of hepatitis B virus among the population of childbearing age in Jiangsu Province from 2010 to 2020
LI Menglan, WU Yulin, HUANG Lili, FENG Jie, ZHANG Ruijin, LIU Shuaimei, ZHOU Qing, LIN Ning
2024, 28(11): 1275-1280. doi: 10.16462/j.cnki.zhjbkz.2024.11.006
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  Objective  To investigate the serological testing results of HBV among the population of childbearing age in Jiangsu Province from 2010 to 2020, and to provide reference for scientific prevention and control of HBV infection.  Methods  Serological testing results of HBV were collected from 1 061 396 cases (530 698 pairs) of childbearing age population who participated in the national free pre-pregnancy health examination program from 2010 to 2020, and the HBV infection status and influencing factors were analyzed in Jiangsu Province.  Results  From 2010 to 2020, the total positive rate of HBsAg and HBsAb was 4.49% and 35.82% respectively in Jiangsu Province, and the positive rate of HBsAg and HBsAb showed an downward trend (HBsAg: trend χ2 =542.665, P < 0.001; HBsAb: trend χ2 =727.147, P < 0.001). The positive rate of HBsAg and HBsAb were statistically significant in different testing years, gender, age groups, educational levels and occupations (all P < 0.001). The positive rate of HBsAb was also statistically significant in different ethnic groups, hepatitis B vaccination status and registered permanent residence (all P < 0.001), but there was no significant difference in the positive rate of HBsAg (P>0.05). Among the couples of childbearing age, 8.33% of husbands or wives whose HBsAg test results was positive alone, while 50.67% of their spouses tested negative for HBsAb.  Conclusions  The overall HBV infection rate among the population of childbearing age in Jiangsu Province is at the medium level, and the positive rate of HBsAg decreased gradually from 2010 to 2020. However, the overall positive rate of HBsAb is still low, and most people of the childbearing age are susceptible to HBV, especially in the families whose husbands or wives tested positive for HBsAg alone. Cosidering over half of their spouses tested negative for HBsAb, emphasizing the importance of timely hepatitis B vaccination and improving the protection rate of HBsAb.The positive rate of HBsAg is also related to different gender, age groups, educational level, occupation and other factors, it is necessary to formulate targeted prevention and control measures to further consolidate and strengthen the prevention and control effect of HBV.
Delay on care-seeking and related influencing factors among tuberculosis patients in Zigong, 2013-2022
ZHUO Lingyun, CAO Hong, DU Kenan, ZHANG Yu, ZHANG Yue, LEI Lijian
2024, 28(11): 1281-1286. doi: 10.16462/j.cnki.zhjbkz.2024.11.007
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  Objective  To understand the situation of delay in tuberculosis care-seeking in Zigong, analyze the related influencing factors, and provide a reference for the future formulation of relevant policies and adoption of targeted measures in the region.  Methods  The medical record information of 14 807 tuberculosis patients in Zigong from 2013 to 2022 was collected through the "tuberculosis information management system", a subsystem of the China disease prevention and control information system. The Joinpoint regression model was used to analyze the trend of the delay rates over this period. Additionally, The influencing factors of delayed visits of tuberculosis patients were analyzed using the unconditional multivariate logistic regression model.  Results  The delayed rate of tuberculosis patients in Zigong City showed an overall increasing trend. And the delayed rate of different genders showed an upward trend. And the delay rates for patients aged 20 to 59 and ≥60 also showing an upward trend. Multivariate logistic regression analysis showed that in 2020-2022, the sources of patients include follow-up, direct treatment, promotion, other sources, and tuberculosis pleurisy had a higher risk of delayed TB treatment (all P < 0.05). The risk of delay in care-seeking was lower for patients who were students, domestic workers and unemployed, workers and migrant workers, as well as patients whose sources were actively detected, and whose pathogenetic results were negative, or belonged to areas such as Fushun County and Gongjing District (all P < 0.05).  Conclusions  The delay rate of tuberculosis patients in Zigong City showed an overall upword trend from 2013 to 2022. The delay of tuberculosis patients in Zigong City may be related to occupational type, patient source, diagnosis type, etiology results and registration year. It is crucial to implement effective intervention strategies to address the above factors.
Epidemiological characteristics and related factors of varicella public health emergency events in primary schools of Nanning City from 2014 to 2023
LIANG Xianan, LIANG Changwei, XU Bin, YANG Shixiong, LIANG Xiaoyun, PAN Lihua, XIE Yihong
2024, 28(11): 1287-1294. doi: 10.16462/j.cnki.zhjbkz.2024.11.008
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  Objective  This study aimed to analyze the epidemiological characteristics and related factors of varicella public health emergency events (PHEEs) in primary schools in Nanning City from 2014 to 2023, offering scientific insights for the prevention and control of varicella outbreaks in schools.  Methods  Utilizing the China information system for disease control and prevention, we collected data on varicella cases and PHEEs in primary schools. The moving average warning method identified varicella epidemic periods. Descriptive epidemiology was applied to characterize these PHEEs. We employed stepwise approaches to construct multiple linear regression models, focusing on the factors associated with the duration of varicella outbreaks, the frequency of PHEEs, and the total number of cases during each epidemic period.  Results  Between 2014 and 2023, Nanning City reported 116 varicella PHEEs in primary schools, predominantly occurring during the winter and spring epidemic periods (66.38%). No significant differences were observed in the median duration (H=1.62, P=0.204) and case numbers across various epidemic periods(H=1.69, P=0.194). The overall incidence rate in rural primary schools was significantly higher at 5.82%, compared to other school types (χ2 =646.04, P < 0.001). County-town primary schools experienced the longest epidemic duration (F=4.02, P=0.021), highest average number of cases per outbreak (F=4.54, P=0.013), and the greatest involvement of classes (F=9.36, P < 0.001). Urban primary schools had the highest number of people affected (F=28.06, P < 0.001). The duration of varicella PHEEs was significantly influenced by the initial case numbers reported (β=0.84, P=0.006), the number of cases per outbreak (β=0.16, P=0.048), and the number of classes involved (β=1.21, P=0.004). Furthermore, the total number of PHEEs and total case numbers during an epidemic period were positively associated with the duration of the first outbreak (β=0.08, P=0.029; β=6.16, P=0.001) and negatively with the average interval time between outbreaks (β=-0.21, P < 0.001; β=-8.14, P=0.001).  Conclusions  Heightened focus on varicella prevention and control in primary schools is essential, especially during epidemic periods. Enhancing the sensitivity of school-based varicella outbreak monitoring and reducing transmission between classes can shorten the duration of PHEEs. Strengthening the recognition of abnormal signals during the epidemic, such as the duration of the first outbreak and the interval between outbreaks, is crucial for the timely assessment of the overall outbreak level.
Application of Joinpoint regression analysis in the trend of influenza incidence in Qinghai Province from 2005 to 2023
QIN Shenglin, ZHAO Jinhua, DENG Ping, ZHANG Yang, JIANG Yuqi
2024, 28(11): 1295-1300. doi: 10.16462/j.cnki.zhjbkz.2024.11.009
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  Objective  To analyze the epidemic characteristics and trend characteristics of influenza epidemics in Qinghai Province from 2005 to 2023, provide a reference to the specific prevention and control in the plateau areas.  Methods  The influenza incidence data in Qinghai Province were extracted from the database of China information system for disease control and prevention. The incidence rate of influenza in Qinghai Province was analyzed descriptively from 2005 to 2023. Using the Joinpoint regression model was used to evaluate the time trend of the influenza incidence characteristics in Qinghai Province from 2005 to 2023.  Results  During 2005-2023, we have cumulatively reported 31 156 cases of influenza in Qinghai Province, of which 77.59% cases were in Xining and Haidong City (24 174/31 156). The total incidence rate in Qinghai Province in 2005-2023 showed an upward trend with an average annual percent change(AAPC) of 31.18% (t=4.780, P < 0.001). The annual incidence rate remained stable in terms of the gender trend changes; and the incidence of the age group in 0- < 5, 5- < 15, 15- < 25, 25- < 60, and ≥60 all showed an increasing trend, with AAPC rising at 33.45%, 31.20%, 27.30%, 27.31% and 34.61%, respectively. All age groups showed a turning point in 2021, which slowly rose before the turning point.  Conclusions  From 2005 to 2023, influenza incidence in Qinghai Province as a whole showed a slow-rapid rise and is currently in a high incidence situation, which should optimize the deployment of medical resources; the key prevention and control and control areas are Xining City and Haidong City as the center of the circle radiating in all directions; the groups under 15 years old and over 60 years old are the high incidence groups. It is essential to strengthen influenza monitoring and early warning in key locations such as schools and nursing homes, while actively promoting influenza vaccination for these groups.
The spatio-temporal analysis and prediction model comparison of incidence rate of other infectious diarrhea diseases in Qinghai Province from 2017 to 2023
JIANG Yuqi, LONG Jiang, ZHAO Jinhua, ZHANG Huayi, DENG Ping, JIANG Wenqi
2024, 28(11): 1301-1307. doi: 10.16462/j.cnki.zhjbkz.2024.11.010
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  Objective  To analyze the epidemiological trends and characteristics of other infectious diarrheal diseases(OIDD) in Qinghai Province, and to provide predictions for these diseases in Qinghai Province for 2024.  Methods  Using monthly and annual incidence rates of OIDD in Qinghai Province from January 2017 to December 2023 as primary data, the study employed ArcGIS 10.8 software for map visualization of annual incidence rates in Qinghai Province, and GeoDa 1.16 software for spatial autocorrelation analysis. R 4.3.1 software was used to construct various models for OIDD in Qinghai Province, including seasonal autoregressive integrated moving average (SARIMA) model, triple exponential smoothing (Holt-Winters) model, neural network autoregression (NNAR) model, trigonometric seasonality, Box-Cox transformation (TBATS) model, and Prophet model. The models′ fitting effects were evaluated using root mean square error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE).  Results  All models, except the Holt-Winters model, effectively captured the incidence rate trends. Among them, the NNAR model performed best in the training set, with MAE of 0.90, RMSE of 1.25, and MAPE of 16.43, outperforming models such as TBATS. In the test set, while its RMSE value was higher than those of the SARIMA and TBATS models, its MAE and MAPE values were lower than other models, indicating the best overall predictive performance. Therefore, the NNAR model can be used to forecast the incidence rate of OIDD in Qinghai Province for 2024, providing insights for disease prevention strategies in high-altitude regions.  Conclusions  From 2017 to 2023, Xining City, Haidong City, and Huangnan Tibetan Autonomous Prefecture in Qinghai Province were high-incidence areas for OIDD. Among the predictive models, the NNAR model showed the best performance. However, in practical applications, it is necessary to develop corresponding prevention and control measures by considering the spatiotemporal characteristics and epidemic trends of each region.
Safety analysis of inactivated COVID-19 vaccines in people over 18 years of age in two cites in Anhui Province
LI Tao, TANG Jihai, HOU Lijuan, XUAN Kun, MAO Leijing, XU Haiyang, YAN Jianqiang, REN Zhongjie, WANG Binbing
2024, 28(11): 1308-1315. doi: 10.16462/j.cnki.zhjbkz.2024.11.011
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  Objective  To evaluate the real-world safety of large-scale vaccination of inactivated novel coronavirus vaccine (inactivated vaccine) for adults aged among ≥18-year-old adults in two cities in Anhui Province.  Methods  An open-label study was conducted, with informed consent obtained. From June 2021 to June 2022, we recruited individuals aged ≥18 years from Taihe County, Fuyang City, and Qiaocheng District, Bozhou City, Anhui Province, for large-scale inactivated vaccine administration. The subjects were divided into healthy group and chronic underlying disease (referred to as underlying disease) group, and the incidence and severity of adverse reactions after each dose of vaccine were evaluated in the two groups.  Results  (1) A total of 12 257 subjects over 18 years old were included in this study, including 9 984 healthy subjects and 2 273 subjects with underlying diseases, and 11 874 subjects completed two doses of inactivated vaccine, with a full vaccination rate of 96.88%, and the top three underlying diseases were hypertension (68.28%), diabetes mellitus (18.43%), and cerebral infarction(8.32%). (2) The overall incidence of adverse reaction was 0.42% (51/12 257), all adverse reaction occurred within 28 days, the incidence of adverse reaction in the underlying disease group and the healthy group were 0.40% and 0.42%, respectively, with no statistically significant difference was observed (χ2 =0.028, P=0.868). (3) Except for induration/swelling, there was no significant difference in adverse reaction between the healthy group and the underlying disease group (all P>0.05). The severity was mainly grade 1 (45 cases), and the incidence of grade 1 adverse reaction was 0.37%, there was no significant difference in the incidence of grade 1 and grade 2 adverse reaction between the two groups (all P>0.05). (4) The adverse reaction of the first dose and the second dose in the healthy group and the underlying disease group were mainly grade 1, and there was no significant difference in the grade of adverse reaction between the two doses (all P>0.05).  Conclusions  Adults over the age of 18 who receive the inactivated vaccine against the novel coronavirus have a good safety profile for different ages, different health conditions, and different doses.
A prospective study on the incidence and influencing factors of type 2 diabetes mellitus in rural population in Xinjiang
QIAO Zheng, MA Rulin, GUO Heng, ZHANG Xianghui, HE Jia, WANG Xinping, MULATIBIEKE Keerman, GUO Shuxia
2024, 28(11): 1316-1320. doi: 10.16462/j.cnki.zhjbkz.2024.11.012
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  Objective  This study aims to explore the incidence and influencing factors of type 2 diabetes mellitus (T2DM) among rural populations in Xinjiang, comparing risk factors between the Uyghur and Kazakh ethnic groups and proposing targeted prevention measures.  Methods  Two representative regions in the Xinjiang were selected for questionnaire surveys, physical exams, and blood sample collection from the study subjects in 2010 and 2016, with follow-up studies from 2013 to 2017 (Kazakh) and 2019 to 2022 (Uyghur), Populations with a follow-up period of at least 5 years were selected as the study subjects. The Cox proportional hazards regression model was employed to assess the relationship between influencing factors and the risk of T2DM.  Results  The study included a total of 5 714 participants, including 3 304 Uygur ethnic group participants and 2 410 Kazakh ethnic group participants. During the follow-up period, 428 new cases of T2DM were reported in the Uygur group and 165 new cases in the Kazakh group. The cumulative incidence of new-onset T2DM was 13.0% in the Uyghur population, higher than the 6.8% in the Kazakh population. Common risk factors for both groups include older age, family history of T2DM, obesity, hypertension, and abnormal triglycerides (TG). Additional risk factors specific to the Uyghur group are abnormal LDL-C and HDL-C, while those specific to the Kazakh group include male, being overweight, and abnormal total cholesterol (TC).  Conclusions  T2DM incidence is higher among the Uyghur population than the Kazakh population. There are notable differences in the incidence factors and correlation strengths of T2DM between the two ethnic groups. Given the varying lifestyles and ethnic characteristics, it is essential to implement tailored prevention and control measures for T2DM.
Trend analysis on the disease burden among Chinese elderly population aged 60 and older from 1990 to 2019
WEI Xinyue, ZULIYAER Talifu, ZHONG Panliang, ZHAO Yihao, WANG Yunhe, ZHENG Xiaoying, SU Binbin
2024, 28(11): 1321-1329. doi: 10.16462/j.cnki.zhjbkz.2024.11.013
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  Objective  To analyze the trends in the disease burden among Chinese individuals aged 60 years and older from 1990 to 2019.  Methods  The disability-adjusted life year (DALY) data for Chinese individuals aged 60 and older from the Global Burden of Disease 2019 database, were standardized using world population figures. Long-term trends were assessed using the average annual percent of change calculated by the Joinpoint log-linear regression model to evaluate changes in disease burden among elderly in China over the study period.  Results  Between 1990 and 2019, the disease burden for all level 1 causes among the elderly in China showed a decreasing trend. The most significant decline was observed in communicable diseases, with the burden decreasing from 6 079.32 per 100 000 in 1990 to 2 056.84 per 100 000 in 2019. Non-communicable diseases (NCDs) were the primary contributors to the disease burden among the elderly, with a rate of 71 694.02 per 100 000 in 2019. Among level 3 causes, tuberculosis showed the most substantial decline. In 2019, stroke, ischemic heart disease, and chronic obstructive pulmonary disease were the leading causes of NCDs; lower respiratory infections and tuberculosis were the main causes of communicable diseases; and falls, road injuries, and suicide were the primary causes of injury-related disease burden.  Conclusions  Non-communicable diseases and injuries are increasingly becoming urgent public health issues in China. It is essential to strengthen the prevention and control of key diseases (such as cardiovascular diseases, malignancy, and musculoskeletal diseases) and focus on vulnerable populations (men and ≥85-year-olds). Managing health risk factors and modifying lifestyles are crucial for preventing disease onset and reducing the overall disease burden.
Estimates and trends analysis of under 5 mortality rates by prefecture-level cities in Jiangxi, 2000-2030
ZHANG Xingchao, CHEN Sanqian, MA Jingjie, DENG Yuting, ZHOU Siyu, DING Jing, HU Songbo
2024, 28(11): 1330-1335. doi: 10.16462/j.cnki.zhjbkz.2024.11.014
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  Objective  To analyze the trend and regional differences in the under 5 mortality rate (U5MR) at the level of each prefecture-level cities in Jiangxi from 2000 to 2030 U5MR over this period.  Methods  The U5MR of each prefecture-level city in Jiangxi was calculated based on the U5MR of each district and county in Jiangxi and the birth population from 2000 to 2012, and then based on this data, a linear mixed-effects model was constructed to estimate the U5MR of prefecture-level cities in Jiangxi from 2013 to 2022. GM(1, 1) or equal-dimensional recursive GM(1, 1) model was used to forecast U5MR in Jiangxi prefecture-level cities from 2023 to 2030. Health inequalities among children under 5 years of age in Jiangxi were measured using the concentration index and concentration curve.  Results  In 2000, the U5MR in Jiangxi was 48.842 ‰, with the lowest and highest prefecture-level cities being Nanchang (36.616‰) and Ganzhou (58.729‰), respectively. In 2030, the U5MR in Jiangxi might be 3.472‰, with the lowest and highest prefecture-level cities projected to be Nanchang (1.980‰) and Yichun (4.987‰), respectively. The U5MR of each prefecture-level city in Jiangxi got a rapid decline from 2000 to 2030, and the regional differences were gradually narrowing with the decline of U5MR. The concentration indices of U5MR in Jiangxi in 2000, 2005, 2010, 2015 and 2020 were -0.051, -0.065, -0.090, -0.096 and -0.101, respectively.  Conclusions  From 2000 to 2030, the overall U5MR in Jiangxi shows a decreasing trend, and the regional differences gradually narrows with the decrease of U5MR, and the inequality in the health of children under 5 years of age related to the socio-economic level shows a widening trend.
The predictive value of m6A methylation regulators in chronic kidney disease
CUI Chaoqun, ZHANG Fan, LI Yichun, ZHANG Tieru, ZHOU Han, LEI Lijian
2024, 28(11): 1336-1343. doi: 10.16462/j.cnki.zhjbkz.2024.11.015
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Abstract:
  Objective  To investigate in the expression changes of RNA N6-methyladenosine (m6A) methylation regulators in patients with chronic kidney disease (CKD) and provide novel ideas for disease prevention.  Methods  A community population in a city in North China was selected to compare the baseline characteristics between the case group (151) and control (362) group. The correlation between the expression of the regulators of RNA m6A methylation and renal function-related indexes was analyzed. Screening of relevant variables for the construction of multivariable logistic regression models using LASSO regression, and its validity was assessed using the receiver operating characteristic curve (ROC), calibration curve and decision curve analysis (DCA).  Results  The expression level of methyltransferase like 14 (METTL14) was higher in the case group (P < 0.05). Correlation analysis revealed that METTL14 (rs=-0.110, P < 0.05) and human Alk B homolog 5 (ALKBH5) (rs=-0.218, P < 0.001) were negatively correlated with transforming growth factor (TGF)-β1. Fat mass and obesity-associated protein (FTO) was positively correlated with Urea (rs=0.169, P < 0.001) and TGF-β1 (rs=0.088, P < 0.05). The regression analysis results indicated that gender, age, serum creatinine, METTL14, total cholesterol, and per capita monthly household income were predictors for CKD (all P < 0.05). A risk prediction model was constructed based on this, and the area under the curve (AUC) was 0.796 (95% CI: 0.752-0.840). The average absolute error verified by bootstrap method was 0.036. The Hosmer Lemeshow goodness of fit test showed that the prediction model had good calibration ability (χ2 =12.57, P=0.128).  Conclusions  The expression level of METTL14 is higher in patients with CKD. There is a correlation between METTL14 and the development of CKD.
Review
Systematic review of CRISPR applied to point-of-care nucleic acid detection
WANG Xueqi, HE Na
2024, 28(11): 1344-1348. doi: 10.16462/j.cnki.zhjbkz.2024.11.016
Abstract(55) HTML (27) PDF(4)
Abstract:
  Objective  To understand the current research status of clustered regularly interspaced short palindromic repeats (CRISPR) applied to nucleic acid detection.  Methods  In this study, we systematically reviewed related literatures published on databases of PubMed, BioRxiv, and MedRxiv using the keywords "CRISPR", "nucleic acid detection", "point-of-care testing" or "POCT".  Results  According to the inclusion and exclusion criteria, a total of 17 publications were selected. We summarized and analyzed the information of CRISPR-associated protein, amplification method, sensitivity, specificity, detection time and other aspects. Results suggested that when combined with nucleic acid amplification methods, such as loop-mediated isothermal amplification (LAMP) or recombinase polymerase amplification (RPA), the sensitivity of CRISPR was comparable to real time quantitative polymerase chain reaction (RT-qPCR).  Conclusions  The process of CRISPR can be completed within 30 to 100 minutes, with results that can be read by the naked eye. Additionally, the cost of detection is comparable to the antigen test, making it particularly suitable for large-scale point-of-care (POC) nucleic acid detection in resource limited areas.
Short Reports
Infection status of tick-borne encephalitis virus and Alongshan virus in tick-bite patients in Harbin from 2022 to 2023
LU Yaxian, WANG Wei, ZHANG Lu, PENG Xiaohong, CHEN Denghui, ZHANG Yu, ZHOU Mengchao, TIAN Hang, LI Wanting, LYU Shouxu, WU Wenzhong, HOU Zhijun
2024, 28(11): 1349-1354. doi: 10.16462/j.cnki.zhjbkz.2024.11.017
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Abstract:
  Objective  To explore the infection of tick-borne encephalitis virus (TBEV) and Alongshan virus (ALSV) in tick bites patients in Harbin from 2022 to 2023 in the General Hospital of Forest Industry of Heilongjiang Province.  Methods  Through epidemiological studies and phylogenetic tree construction, the prevalence of TBEV and ALSV was investigated based on the detection data of tick bitten people in Heilongjiang Red Cross Sengong General Hospital from 2022 to 2023.  Results  From 2022 to 2023, there were 159 tick bite patients in Harbin who visited Heilongjiang Red Cross Sengong General Hospital. Acheng District and Bin County had more tick-bite people in Harbin, accounting for 30.19% (48/159) and 16.35% (26/159) of all Harbin tick-bite people, respectively. In Songbei District, Daowai District, Daoli District, Nangang District and Xiangfang District, which are the main urban areas of Harbin, 7, 1, 3, 7 and 7 people were bitten by ticks and went to Heilongjiang Red Cross Sengong General Hospital for treatment, respectively. The prevalence of TBEV and ALSV in these patients was 37.74% (60/159) and 10.06% (16/159), respectively. The subtype of TBEV prevalent in Harbin was TBEV-FE.  Conclusions  There is a risk of tick bites in the Harbin area, both in the city and in the surrounding counties, and can be infected with TBEV and ALSV. In addition to TBE and ALS, other tick-borne diseases, such as Lyme disease and spotted fever, may be prevalent in the Harbin area, and there is a need to strengthen the monitoring of the prevalence of tick-borne diseases in the Harbin and to widely publicize knowledge on the prevention of tick-borne diseases.
The relationship between the incidence of hand, foot and mouth disease and the impact of meteorological factors in a certain city, 2017-2019
LIU Yingying, SU Tong, XUE Weicong, ZHAO Wenna, XIE Yun, WEI Yamei, YU Qiuli, HAN Xu, LI Qi
2024, 28(11): 1355-1360. doi: 10.16462/j.cnki.zhjbkz.2024.11.018
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Abstract:
  Objective  To investigate the influence of meteorological factors on the incidence of hand, foot and mouth disease (HFMD) and their lagged effects.  Methods  Hourly meteorological data for a certain city from 2017 to 2019 were obtained from the China Meteorological Data Network, while daily incidence data for HFMD in a certain city during the same period were retrieved from the China Information System for Disease Control and Prevention. Using these two datasets, a distributed lag non-linear model (DLNM) was constructed.  Results  With reference to the median values of meteorological factors, the cumulative risk of HFMD exhibited a pattern of initial increase followed by decrease as temperature rose, forming an S-shaped curve. Specifically, a protective effect was observed when the daily average temperature was between -8.5 ℃ and -4.0 ℃ with a lag of 6 to 23 days. At a daily average temperature of -8.5 ℃ with a lag of 7 days, the risk of HFMD was at its lowest (RR=0.741, 95% CI: 0.583-0.941). Similarly, a protective effect was noted for daily average atmospheric pressure between 1 015 and 1 038 hPa with a lag of 4 to 25 days. At a daily average pressure of 1 038 hPa with a lag of 25 days, the risk of HFMD was at its minimum (RR=0.706, 95% CI: 0.540-0.924).  Conclusions  HFMD is influenced by meteorological factors. High temperatures increase the risk of HFMD, although their impact on incidence rates is unstable. Conversely, low temperatures and high atmospheric pressures reduce the risk of HFMD, and all three factors exhibit a discernible lagged effect.
Epidemiological trends and spatiotemporal clustering of hepatitis E in Fujian Province, 2014-2023
ZHANG Hairong, LIN Zhiqiang, WU Ruihong, HUANG Lifang
2024, 28(11): 1361-1364. doi: 10.16462/j.cnki.zhjbkz.2024.11.019
Abstract(39) HTML (15) PDF(11)
Abstract:
  Objective  To analyze the epidemic trend and spatiotemporal clustering of hepatitis E in Fujian Province.  Methods  The reported incidence data of hepatitis E in Fujian Province from 2014 to 2023 were collected through the China information system for disease control and prevention. The change trend of the reported incidence rate was described using the Joinpoint 5.1.0.0 model. Spatiotemporal scanning analysis was performed using SaTScan V9.5 software.  Results  A total of 8108 cases of hepatitis E were reported in Fujian Province during 2014-2023, for an average annual reported incidence of 2.05 per 100 000. there was a downward trend (APC=-7.41%, 95% CI: -22.09%-2.25%, P=0.009), while from 2020 to 2023, there was an upward trend (APC=15.95%, 95% CI: 0.94%-42.43%, P=0.034). The main epidemic season was winter and spring. The reported incidence rate of hepatitis E in men was higher than that in women (χ2 =583.42, P < 0.001), and the reported incidence rate showed an over all upward trend with the increase of age (χ2 =4 607.00, P < 0.001). The spatiotemporal scan analysis has revealed seven types of spatial clustering areas for hepatitis E.  Conclusions  From 2014 to 2023, the reported incidence rate of hepatitis E in Fujian Province showed a downward trend and then an upward trend middle aged and elderly men were the main affected population, and the incidence was spatiotemporal clustering. It was necessary to strengthen the monitoring of hepatitis E in high-risk groups and hot spots.

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