Objective To analyze the epidemiological characteristics and trends of cases of HIV/AIDS transmitted via same-sex sexual behavior in Jilin Province from 2014 to 2023, and to provide a scientific basis for formulating targeted prevention and control strategies. Methods Descriptive epidemiological methods were used to analyze the epidemic data about homosexual sexual transmission HIV/AIDS cases with current addresses in Jilin Province reported through the China Information System for Disease Prevention and Control from 2014 to 2023. Joinpoint software was employed to construct a linear regression model with the year as the independent variable and the number of reported cases/composition ratio as the dependent variable, and then the prevalence trend was explored. Results A total of 8,867 cases of HIV/AIDS transmitted via same-sex sexual behavior were cumulatively reported in Jilin Province from 2014 to 2023, showing a decreasing trend from 2016 to 2023 (APC=-6.42%, P=0.030). There were reports about cases of HIV/AIDS transmitted via same-sex sexual behavior in 9 cities (prefectures) of Jilin Province in each year. The top two cities with cumulatively-reported cases were Changchun City (4,890 cases, accounting for 55.15%) and Jilin City (1,001 cases, accounting for 11.29%). The changing trend in the number of reported cases was different among all cities (prefectures). The cases were mainly distributed in the group aged 25-49 years (5,364 cases, accounting for 60.49%), and the age composition ratio of the group aged ≥50 years showed a monotonically increasing trend (APC=5.66%, P<0.001). Most of the cases had received college education or above (3,541 cases, accounting for 39.93%), and the composition ratio showed a slight upward trend from 2014 to 2018 (APC=4.77%, P=0.043). The marital status was mainly unmarried (5,754 cases, accounting for 64.89%), and the proportion of the divorced or widowed showed a slight monotonously increasing trend (APC=2.20%, P=0.002). The proportion of the first CD4 < 200 cells/μl accounted for 31.23% (2,558/8,192), showing a monotonically increasing trend (APC=3.70%, P=0.001). Conclusion Although the HIV/AIDS epidemic due to homosexual sexual transmission in Jilin Province during 2016-2023 showed a downward trend, the proportion of late detection was high. Special attention should be paid to the group aged ≥50 years and the divorced and widowed men who have sex with men (MSM) whose incidence are on the rise in recent years, and comprehensive prevention and control of HIV/AIDS should be carried out in a targeted manner.

Objective To analyze the current status of awareness of AIDS knowledge and sexual behavior characteristics among university students in Hunan Province, and to provide data support for improving AIDS prevention and control in universities in Hunan Province. Methods We conducted a network questionnaire survey on awareness of AIDS knowledge and sexual behavior characteristics among 10,011 students from 5 universities in Hunan Province. The awareness status of AIDS knowledge and its influencing factors among the university students were analyzed. Results A total of 9,991 valid questionnaires were retrieved, with the effective rate of 99.80%. The total awareness rate of AIDS knowledge was 86.34%. The awareness rates of male homosexual behavior as the main mode of AIDS transmission among young students in China and AIDS as an incurable disease were 73.15% and 70.36% respectively. There were statistically significant differences in the awareness rates of AIDS knowledge among university students of different genders (χ²=10.210, P=0.001), grades (χ²=109.836, P<0.001) and specialties (χ²=75.533, P<0.001). Multivariate analysis revealed that the awareness rate of AIDS knowledge was higher in female students than in male students (OR=1.16, 95%CI: 1.02-1.32), higher in sophomores (OR=1.98, 95%CI: 1.70-2.31) and juniors (OR=1.61, 95%CI: 1.33-1.95) than in seniors (OR=2.48, 95%CI: 1.70-3.63), and higher in students majoring in literature and history (OR=2.02, 95%CI: 1.60-2.56), science and technology (OR=2.18, 95%CI: 1.73-2.75) and medicine (OR=3.35, 95%CI: 2.31-4.84) than in students majoring in sports and arts. The awareness rate of AIDS knowledge was lower in students acquiring AIDS knowledge through other means (OR=0.70, 95%CI: 0.57-0.84) than in students acquiring the knowledge through school education. The awareness rates of pre-exposure and post-exposure prophylactic drug use were 55.90% and 45.56% respectively. In this study, 885 university students had sex (8.86%). The consistent condom use rate in premarital sex was lower in male students than in female ones (60.49% vs. 68.26%, χ²=5.546, P=0.019). The consistent condom use rate was higher in students with single sex partner than in students with multiple sex partners (69.17% vs. 36.84%, χ²=56.836, P<0.001) as well as higher in students with heterosexual behavior than in male students who had sex with men (64.68% vs. 52.56%, χ²=4.514, P=0.034). Conclusion The awareness rate of AIDS knowledge among the university students in Hunan Province needs to be further improved, the condom use rate in high-risk sexual behavior is low, and there is an obvious separation between knowledge and practice. Attention should be paid to improving the university students’ concept and awareness of safe sex behavior and enhancing the publicity and education on prevention and control knowledge before and after exposure.

Objective To understand the current status of cognitive impairment among the elderly population in Shenzhen City, to explore its potential influencing factors, and to provide a basis for dementia prevention among the elderly in Shenzhen City. Methods A total of 2,112 senior citizens aged ≥65 years in Shenzhen City were selected. One-on-one questionnaire interviews were conducted by trained investigators, and theAlzheimer’s Disease-8(AD8) was used to screen the senior citizens’ cognitive function. At the same time, demographic characteristics, lifestyle habits, and health status of the respondents were collected. AD8 score ≥2 served as the criterion for identifying cognitive impairment. Multivariate logistic regression analysis was performed to identify the factors influencing cognitive impairment among the elderly in Shenzhen City. Results The detection rate of cognitive impairment among the elderly in Shenzhen City was 30.35% (641/2,112), and the median AD8 score (P₂₅-P₇₅) was 1 (0-2). Chi-square analysis revealed that 12 factors like age, gender, educational level, marital status, income and pre-retirement occupation had significantly impacted on cognitive impairment among the elderly. Further multivariate logistic regression analysis displayed that lifestyle and history of chronic diseases had impacts on cognitive impairment among the elderly. Among them, the detection rate of cognitive impairment in smokers was 80% higher than that in non-smokers (OR=1.800, 95%CI:1.261-2.568), and high-frequency exercise (OR=0.640, 95%CI:0.459-0.891) was a protective factor. Having a history ofhyperlipidemia (OR=1.371, 95%CI:1.108-1.696) andhaving a history ofcoronary heart disease (OR=1.304,95%CI:1.041-1.634) were identified as risk factors for cognitive impairment among the elderly. In addition, age, gender, educational level and income were found to have impacts on cognitive impairment. Conclusions Cognitive impairment is common among the elderly in Shenzhen City, which is related to their ages, socio-economic status, lifestyle habits and history of chronic diseases. Physical and mental health services should be provided for elderly high-risk groups, which are conducive to reducing the risk of cognitive impairment, promoting their mental health, and enhancing their sense of happiness.

Objective To analyze the epidemic features of newly reported HIV/AIDS cases in Hubei Province from 2010 to 2022, and to provide a basis for developing HIV/AIDS prevention and treatment strategies. Methods We collected the information about newly reported cases with current address in Hubei from January 1, 2010 to December 31, 2022. WPS2019 software was used to organize the data, and SPSS25.0 software was employed to statistically analyze the prevalence of the cases as well as the distribution of time, region and population. Results A total of 33,385 newly reported HIV/AIDS cases were reported in Hubei from 2010 to 2022, and the newly reported rate of cases showed an increasing trend year by year (χ²=4.637, P<0.05). The top five cities with the largest number of cases were Wuhan City, Jingzhou City, Huanggang City, Huangshi City and Xiaogan City. The newly reported cases were mainly transmitted by sexual intercourse, with 59.32% of heterosexual transmission and 39.11% of homosexual transmission. 74.16% of males in heterosexual transmission had a history of non-marital heterosexual contact. Non-sexual transmission accounted for 1.57%. There were statistically significant differences in the proportions of newly reported sexually- and non-sexually-transmitted HIV/AIDS cases in Hubei Province in different years (χ²=1,450.417, P<0.001). The male-to-female ratio of the newly reported cases was about 4.2∶1, with male cases increasing from 73.01% in 2010 to 81.16% in 2022, and female cases decreasing from 26.99% in 2010 to 18.84% in 2022, with statistically significant differences in the ratio of male and female gendercompositionin different years (χ²=141.408, P<0.001). Among the newly reported cases, the number of cases aged 15-24 and ≥ 50 years increased significantly. 37.90% of the newly reported cases were married with a spouse, and heterosexual contact was the major route for their transmission, accounting for 79.07%. Homosexual contact was the main route for transmission in unmarried cases, accounting for 70.95%. The differences in the proportions of different marital statuses in different years were statistically significant (χ²=334.093, P<0.001). Most of the newly reported cases had junior middle school education or below, and there were statistically significant differences in the proportions of different literacy levels among different years (χ²=219.259, P<0.001). The newly reported cases mainly came from medical institution examination, accounting for 56.62%, followed by self-consultation and testing services, accounting for 19.32%. The differences in the proportions of different sample sources in different years were statistically significant (χ²=559.309, P<0.001). Conclusion The increase in the newly reported HIV/AIDS cases in Hubei Province from 2010 to 2022 was obvious, with heterosexual contact as the main transmission route. The numbers of young cases aged 15-24 years and elderly cases aged≥50 years increased obviously. It is necessary to carry out targeted publicity and education, expand the coverage of monitoring and testing, and strengthen the comprehensive prevention and control efforts.

目的 分析2014—2023年永州市东安县狂犬病监测数据,探讨其狂犬病高发因素,为狂犬病防控提供参考依据。方法 对2014—2023年东安县狂犬病疫情资料进行描述性流行病学分析。结果 2014—2023年东安县累计报告狂犬病病例26例,年均发病率为0.48/10万,呈周期性波动小幅上升趋势。报告病例全部在乡镇农村,夏秋季高发;40岁以上中老年农民占88.46%;26例病例中,Ⅲ级暴露占50.00%,暴露后没有进行规范处置病例占92.31%;有明确暴露史的病例19例,犬伤暴露占94.74%。2016—2022年东安县狂犬病暴露预防处置门诊就诊者37 069人,年均暴露率为0.99/100人年,具有夏秋冬季高暴露特征。暴露后就诊者中全程接种率为99.85%,Ⅲ级暴露就诊者中被动免疫制剂注射率为39.53%;暴露后就诊者中由犬致伤占85.98%,所有暴露后就诊者经规范处置后无一人发病。结论 2014—2023年东安县狂犬病报告病例数呈周期性波动小幅上升趋势。加强农村地区宣传教育,规范犬只管理,减少人群暴露机会,强化疫点处置,规范暴露后伤口处置、全程接种狂犬疫苗,必要时注射狂犬病被动免疫制剂是防制狂犬病的有效措施。

Objective To explore the potential relationship between exposure to perfluoroalkyl substances (PFAS) and the risk of post-stroke depression, and to provide a basis for post-stroke depression prevention and management. Methods Statistical data during 2011-2020 based on the US National Health and Nutrition Examination Survey (NHANES) database were used to select 3,411 post-stroke survivors as the study subjects. We collected four types of PFAS, namely, perfluorooctanoic acid (PFOA), perfluorooctane sulfonates (PFOS), perfluorohexane sulfonate (PFHxS) and perfluorononanoic acid (PFNA). Multifactor logistic regression analysis was performed to identify the correlation between PFAS and post-stroke depression. Results Six hundred and sixteen patients with stroke were finally enrolled in the study, and the prevalence rate of post-stroke depression was 16.72%. The levels of PFOA, PFOS, PFHxS and PFNA exposure in the depression group were lower than those in the non-depression group, with statistically significant differences (Z=-4.901--3.488, P<0.05). The results of multifactor logistic regression analysis revealed that after adjusting for demographic characteristics like gender, age, race and body mass index as well as covariates like educational background, combined hypertension, diabetes, history of alcohol consumption, marital status, family income level and history of smoking, the higher the exposure levels of PFOA (OR=0.573, 95%CI:0.428-0.769), PFOS (OR=0.832, 95%CI:0.759-0.912), PFHxS (OR=0.710, 95%CI:0.559-0.901) and PFNA (OR=0.210, 95%CI:0.098-0.452), the lower the prevalence rate of depression in the post-stroke survivors (all P<0.05). Conclusions Exposure to PFOA, PFOS, PFHxS and PFNA is negatively associated with the risk of developing post-stroke depression. Further prospective cohort study is needed to validate these findings.

目的 了解老年2型糖尿病患者流感疫苗接种犹豫状况及影响因素,为降低患者流感疫苗接种犹豫提供参考。方法 采用方便抽样法,选取丽水地区3家医院就诊的364名老年2型糖尿病患者作为调查对象。采用一般情况量表、流感疫苗接种犹豫量表、流感防治知识量表进行调查分析。结果 老年2型糖尿病患者流感疫苗接种犹豫得分为(75.68±12.84)分,流感防治知识得分为(5.22±1.82)分;不同性别、文化程度及流感疫苗接种史的老年2型糖尿病患者流感疫苗接种犹豫得分比较,差异均有统计学意义(P<0.05);老年2型糖尿病患者流感疫苗接种犹豫得分与流感防治知识得分呈负相关(r=-0.584,P<0.01);多元线性回归分析结果显示,老年2型糖尿病患者流感疫苗接种犹豫影响因素为性别、文化程度、流感疫苗接种史、流感防治知识得分(P<0.05)。结论 老年2型糖尿病患者流感疫苗接种犹豫水平较高,应针对患者的性别、文化程度、流感疫苗接种史、流感防治知识等因素采取相应的干预措施,降低流感疫苗接种犹豫,提高疫苗接种率。

目的 分析老年女性骨质疏松患者认知功能情况及危险因素,为提高老年人群生活质量,减少认知功能障碍发生提供依据。方法 选择2018年12月—2023年12月新疆某三甲医院收治的506例老年女性骨质疏松患者作为调查对象,调查其基本情况,通过简易精神状况量表(Mini Mental State Examination,MMSE)、匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)、焦虑自评量表(Self-Rating Anxiety Scale,SAS)、老年抑郁量表(Geriatric Depression Scale,GDS)评估其认知功能、睡眠质量和心理状态。采用多因素logistic回归分析探讨老年女性骨质疏松患者认知功能的影响因素。结果 506例老年女性骨质疏松患者MMSE总分为(26.11±1.26)分,且认知功能障碍发生率为79.45%(402/506)。不同年龄、文化程度、有无记忆力下降、参加社区活动情况、是否经常体育锻炼、是否补钙、有无骨折史、高血压史、冠心病史、睡眠障碍、焦虑、抑郁的老年女性骨质疏松患者其认知功能障碍发生率差异有统计学意义(P<0.05)。多因素logistic回归分析显示,年龄越大[OR(95%CI):3.781(2.015~7.093)]、文化程度越低[OR(95%CI):2.008 (1.397~2.885)]、记忆力下降[OR(95%CI):2.396(1.572~3.652)]、参加社区活动少[OR(95%CI):2.776(1.711~4.505)]、有高血压史[OR(95%CI):3.543(1.926~6.518)]、有睡眠障碍[OR(95%CI):2.096(1.439~3.054)]、焦虑[OR(95%CI):3.504(1.943~6.322)]、抑郁[OR(95%CI):3.804(2.024~7.150)]均为老年女性骨质疏松患者认知功能障碍发生的危险因素(P<0.05)。结论 老年女性骨质疏松患者认知功能障碍发生率较高,并且与年龄、文化程度、记忆力下降、社区活动、高血压史、睡眠障碍、焦虑状态、抑郁状态等因素相关。因此,临床尽早对老年女性骨质疏松患者认知功能进行筛查,同时根据其危险因素做好预防工作,从而提高生活质量,减少认知功能障碍发生率。

Objective To explore the current status of oral health-related quality of life (OHRQOL) and its affecting factors among patients with type 2 diabetes mellitus (T2DM) in Nanjing City, and to provide a basis for improving T2DM patients’ oral quality of life. Methods A multi-stage stratified cluster random sampling method was used to select 1,373 patients with T2DM in 2022, and their demographic and social characteristics, general health status, behavior, lifestyle and other information were investigated. These patients’ OHRQOL was evaluated using the Oral Health Impact Profile-14 (OHIP-14). Multivariate logistic regression was used to analyze the factors influencing OHRQOL in patients with T2DM. Results This study enrolled a total of 1,373 patients with T2DM, with the mean age of (65.14±7.67) years, including 589 (42.90%) males and 784 (57.10%) females. The T2DM patients’ OHRQOL score was 2.00 (0.00-9.00). The results of multivariate logistic regression analysis indicated that the factors influencing the T2DM patients’ OHRQOL included age (OR=1.151), education level (OR=0.603), area (OR=1.443), glycosylated hemoglobin control status (OR=1.428), each brushing time ≥ 3 minutes (OR=1.609), periodontitis (OR=2.429), gum bleeding (OR=1.415), gum swelling (OR=1.843), loose teeth (OR=2.027), bad breath (OR=2.252), weak chewing (OR=1.531) and depression (OR=2.759). Conclusion The T2DM patients’ OHRQOL is affected by multiplefactors. Therefore, intervention measures should be actively developed and taken so as to improve the T2DM patients’ OHRQOL.

Objective To analyze the epidemiological features of other infectious diarrhea and long-term changing trends of their incidence rates in Fuling District of Chongqing Municipality from 2013 to 2022, and to provide a scientific basis for other infectious diarrhea prevention and control in Fuling District. Methods Data about other infectious diarrhea cases in Fuling District from 2013 to 2022 were collected from the China Information System for Disease Prevention and Control, and the time, regional and population distribution was analyzed through descriptive research. ArcMap 10.7 was used to draw point density map to visualize the regional distribution of the incidence. Excel 2019 and SPSS 20.0 were applied to calculating the age-standardized incidence rate of the Chinese population. Joinpoint regression model was employed to calculate annual percent of change (APC) and average annual percent change (AAPC), and then the long-term changing trends of the incidence rates were analyzed. Results A total of 11,380 cases ofother infectious diarrhea were reported in Fuling District from 2013 to 2022, with the average annual reported incidence of 1,138cases and the average annual reported incidence rate of 100.87/100,000. There were two incidence peaks in winter and summer. In the population distribution, the number of reported cases in males (n=6,359) was higher than that in females (n=5,021), the number of reported cases in 0-3 years old was 9,995 (accounting for 87.83%). As for the population classification, most of the cases were scattered children (n=9,797, 86.09%). As for the regional distribution, the cases were mainly distributed in Lizhi Street (n=2,485, 21.84%), Chongyi Street (n=2,355, 20.69%), Dunren Street (n=2,119, 18.62%), Ma’an Street (n=1,313, 11.54%) and Jiangdong Street (n=380, 3.34%). One outbreak was reported, whichoccurred in a primary school. Joinpoint regression analysis revealed that the overall trend of the age-standardized incidence rates in Fuling District from 2013 to 2022 showed an increasing trend, with statistical significant differences in the trend (AAPC=8.50%, 95%CI:3.98-13.22, P=0.002). The crude incidence rates of other infectious diarrhea in Fuling District from 2013 to 2018 presented an upward trend, with statistical significant differences in the trend (APC=16.75%, 95%CI:2.73-32.69, P=0.026), but the crude incidence rates from 2018 to 2022 showed a decreasing trend, without statistical significant differences in the trend (APC=-9.89%, 95%CI:-24.81-7.98, P=0.199). Conclusions Other infectious diarrhea in Fuling District during 2013-2022 mainly affected scattered children, and the incidence peak in winter was higher than that in summer. Most of the cases were scattered in the urban areas like Lizhi Street, Chongyi Street and Dunren Street, and schools (primary schools) were the high incidence places. The overall trend in the incidence of other infectious diarrhea in Fuling District from 2013 to 2022 showed a significant increasing trend, but the crude incidence rates from 2018 to 2022 showed a certain decreasing trend under the influence of the SARS-CoV-2 pandemic.Based on the epidemiological characteristics of other infectious diarrhea in Fuling District,targeted prevention and control measures should be taken for high incidence populations in different seasons and regions.

目的 探究深圳市南山区医务人员流感疫苗接种的影响因素和接种意愿,为深圳市南山区制定医务人员流感疫苗接种策略提供参考。方法 随机抽取深圳市南山区7家医院医护人员进行问卷调查,采用χ²检验进行单因素分析,使用多因素logistic回归分析流感疫苗接种的相关因素。结果 2022—2023年深圳市南山区医护人员流感疫苗接种率为66.01%,logistic回归分析显示,40~＜50岁(OR=0.678,95%CI:0.508~0.906)、学历为本科(OR=1.350,95%CI:1.045~1.744)和研究生及以上(OR=1.850,95%CI:1.373~2.492)、护士(OR=0.809,95%CI:0.689~0.949)、同意医务人员更容易将流感传播给病人(OR=1.345,95%CI:1.172~1.543)、2021—2022年出现过流感症状(OR=1.673,95%CI:1.462~1.914)、2021—2022年接种过流感疫苗(OR=7.801,95%CI:6.843~8.893)、工作单位要求接种流感疫苗(OR=1.441,95%CI:1.257~1.652)的医务人员更愿意接种流感疫苗。结论 深圳市南山区医务人员流感疫苗接种率在新冠疫情及实施干预后有所提高,其接种率与多种因素有关,应继续实行当前政策、加大宣传力度,尤其是对流感的危害和接种流感疫苗不良反应的正确认识,可能对接种率的提高更有帮助。

Objective To evaluate the health economic benefits of the strategy for free vaccination of 23-valent pneumococcal polysaccharide vaccine (PPSV23) among the elderly aged 60 years and above in Pudong New Area, ShanghaiMunicipality, and to provide a scientific basis for government agencies to formulate prevention and control strategies. Methods The elderly population aged 60 years and above in Shanghai Municipality in 2021 served as the study cohort. A decision tree-Markov model was used to evaluate the cost-effectiveness and effectiveness of the strategy for free vaccination of PPSV23 among the elderly aged 60 years and above in Pudong New Area from the perspective of the whole society, and a sensitivity analysis of the model was performed. Results The vaccination rate of PPSV23 among the elderly aged 60 years and above in Pudong New Area, ShanghaiMunicipality was 29.39%, the per capita benefit of receiving PPSV23 212.97 yuan, the per capita net benefit -182.76 yuan, and the benefit-cost ratio 0.54 yuan. It cost 25,711.04 yuan to obtain one additional life year, which was lower than the per capita gross domestic product (GDP) in Shanghai Municipality (173,756.71 yuan) and far lower than the threshold of three times the per capita GDP. Conclusion The strategy for free vaccination of PPSV23 among the elderly aged 60 years and above is highly cost-effective, suggesting that implementation of this vaccination strategy should be continuously intensified.

Objective To investigate the fluoride levels, distribution characteristics and influencing factors in drinking water in Hefei City, and to evaluate the potential health risks for different populations. Methods The fluoride concentration in drinking water during 2020-2022 was monitored. R 4.2.2 software was used for stratification and correlation analysis. The health risk assessment model recommended by the US EPA was applied to health risk assessment. Results The fluoride concentration in drinking water in Hefei City ranged from 0.03 mg/L to 1.35 mg/L, and the median was 0.29 mg/L, of which <0.5 mg/L accounted for 95.97%, 0.5-<0.7 mg/L 3.90%, 0.7-<1.0 mg/L 0.09%, and ≥1.0 mg/L 0.04%. There were statistically significantdifferences in the fluoride concentration among different years, water periods, water sample types, sampling types, disinfection modes, water source types, water supply scales and areas (all P<0.05). The fluoride concentration during 2020-2022 showed a downward trend, and it was higher in the high water period than in the low water period. The fluoride concentration in tap water was found to be the highest, followed by factory-treated water and secondary water supply. As for water treated with different disinfection methods, the fluoride concentration was higher in non-disinfected water, but lower in liquid chlorine disinfected water. The fluoride concentration was higher in rural water than in urban water. As for different water sources, the fluoride concentration was higher in water from lakes, but lower in water from reservoirs, showing an obvious regional difference. The fluoride in drinking water was positively correlated with 16 indexes like chloride, sulfate, total hardness, oxygen consumption, total dissolved solids and pH, and the largest correlation coefficient was chloride (r=0.533). The fluoride in drinking water was weakly and negatively correlated with chroma and nitrate nitrogen. The medians of non-carcinogenic risk (hazard quotient, HQ) of fluoride intake from drinking water in residents were between 0.086 and 0.201, all of which were less than 1. The non-carcinogenic risk of fluoride was significantly higher in infants aged 1-2 years than in children aged 4-5 and 6-9 years and adults, and also higher in male adults than in female adults. As for children aged 1-2, 4-5 and 6-9 years, the non-carcinogenic risk of fluoride was higher in girls than in boys. Conclusions The fluoride concentration in drinking water in Hefei City is relatively low. Many factors of water supply, such as water period and disinfection method, affect fluoride concentration. Moreover, fluoride concentration is related to chloride, total hardness and pH in water. The non-carcinogenic risk of drinking tap water is at an acceptable level, and the risk degree is related to age.

目的 了解老年医院患者医疗卫生服务需求,为完善老年医疗服务体系提供建议。方法 自制老年医疗服务需求调查问卷,于2022年8—10月采用方便抽样方法,对天津市老年医院≥65岁的门诊及住院老年患者开展问卷调查,采用χ²检验进行比较不同特征老年患者对医疗服务需求的差异。结果 共发放调查问卷400份,有效回收问卷396份,有效率99.0%。老年患者医疗需求各项目平均得分(3.85±0.89)分,其中健康管理与指导维度需求最高,为(4.16±0.75)分,其次为助老文化维度(4.11±0.76)分。χ²检验分析结果显示,不同特征老年患者,对适老设施、助老文化、健康管理与指导和老年诊疗特色4个维度需求,差异均有统计学意义(P＜0.05)。结论 老年患者对健康管理与指导需求尤为迫切,医疗服务需求呈现多元化;针对不同特征的老年患者,应提供可选择的医疗服务,以满足个体化需求。

目的 分析无乳链球菌(Streptococcus agalactiae, GBS)多位点序列分型(multi-locus sequence typing, MLST)与毒力基因、耐药性的相关性,为预防和临床治疗无乳链球菌提供参考依据。方法 对2021—2022年珠海市金湾中心医院产前门诊及产科患者中分离出的无乳链球菌30株,通过聚合酶链式反应对MLST基因和毒力基因扩增,并对菌株耐药性进行检测。结果 2021—2022年30株GBS中共分离出10种ST型, 分别为ST12 (7株,23.3%),ST19(5株,16.7%),ST529(5株,16.7%), ST862(4株,13.3%),ST651(3株,10.0%),ST27(2株,6.7%),ST2(1株,3.3%),ST10(1株,3.3%),ST1964(1株,3.3%),1株新ST型(3.3%)。毒力基因检出率为hylB(93.3%),cfb(90.0%),lmb(76.7%),cylE(73.3%), fbsA(46.7%),bac(10.0%)。hylB和cfb基本存在于所有ST型。lmb、 cylE分布于ST10、ST651、ST862外其余检出ST型中。fbsA检出于ST2、ST27、ST529和ST19中。bac在各型中检出率最低。30株GBS对青霉素、氨苄西林、利奈唑胺、万古霉素均未检出耐药,对红霉素、克林霉素耐药率分为76.7%,80.0%,左旋氧氟沙星、莫西沙星的耐药率为20.0%,红霉素和克林霉素耐药普遍存在于各ST型,氟喹诺酮类耐药仅检出于ST19,ST651和新ST型中。结论 该院GBS以ST12、ST19、ST529为主,发现1例新ST型无乳链球菌。6种毒力基因中hylB、cfb、lmb、cylE携带率较高。GBS对青霉素、氨苄西林、利奈唑胺、万古霉素均未检出耐药,红霉素、克林霉素耐药率较高。不同型别间毒力基因和耐药性分布存在差异。临床应加强对孕妇GBS的毒力基因及耐药性监测。

目的 分析老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者用药依从性现状及影响因素。方法 采取便利抽样法于2021年1月—2022年11月在南通妇幼保健院筛选120例老年T2DM患者,采用问卷调查方式评估患者用药依从性现状及各项临床资料指标,并采用多因素logistic回归分析评估用药依从性的影响因素。结果 120例老年T2DM患者MMAS-8平均评分为(4.91±1.64)分,其中MMAS-8评分＜6分患者共49例,用药依从性不良发生率为40.83%。不同性别、年龄、学历、健康素养水平、自我效能感得分率、用药种类、不良反应发生情况、疾病认知程度、用药信念、自我护理能力水平、是否合并症的老年T2DM患者其用药依从性不良发生率差异均有统计学意义(P<0.05)。多因素logistic分析结果表明年龄、学历、健康素养、自我效能感得分率、用药种类、疾病认知程度、用药信念、自我护理能力为老年T2DM患者用药依从性的独立影响因素(P<0.05)。结论 老年T2DM患者的用药依从性目前仍处于较低水平,受其年龄、学历、健康素养、自我效能感得分率、用药种类、疾病认知程度、用药信念、自我护理能力等多种因素影响,临床可采取针对性干预措施,以提升其用药依从性。

目的 了解消毒供应室工作人员职业暴露情况及影响因素,为提高其防护意识、降低职业暴露提供参考。方法 以六安市中医院148名消毒供应室工作人员为研究对象,根据医院感染管理信息资料,统计2022年1—12月1年内职业暴露情况,并采用自制职业防护知识评估量表和职业防护行为评估量表对工作人员职业防护知识、职业防护行为进行评估,采用多因素logistic回归分析消毒供应室工作人员职业暴露发生的影响因素。结果 纳入的148名消毒供应室工作人员发生职业暴露106例共171例次,发生过职业暴露人员占比71.62%。171例次的职业暴露类型包括锐器伤、高温烫伤及化学制剂损伤,分别为85例次、61例次、25例次,占比分比为49.71%、35.67%、14.62%。多因素logistic回归分析结果显示,年龄<33岁(OR=1.960,95%CI:1.043~3.684)、职称为初级(OR=2.098,95%CI:1.101~3.998)、距最近一次参加培训的时间≥10个月(OR=1.857,95%CI:1.021~3.376)均为消毒供应室工作人员发生职业暴露的独立危险因素(P<0.05),职业防护知识(OR=0.543,95%CI:0.299~0.987)及职业防护行为(OR=0.489,95%CI:0.256~0.931)得分较高为消毒供应室工作人员发生职业暴露的保护因素(P<0.05)。结论 消毒供应室工作人员发生职业暴露的风险较高,其危险因素包括年龄<33岁、职称为初级、距最近一次参加培训的时间≥10个月,而职业防护知识和职业防护行为得分越高其职业暴露的风险越低,临床可根据上述因素通过加强培训,培养工作人员职业防护意识,建立良好的职业安全行为,降低其职业暴露发生的风险。

目的 探讨某地小学生用眼行为习惯和户外活动情况及与近视发生的关系,为小学生近视预防提供依据。方法 2023年1—7月对1 306例小学生开展用眼行为习惯和户外活动情况调查,并进行近视检查,分析近视发生与用眼行为习惯和户外活动的关系。结果 1 306例小学生中每日看电视、使用手机时间≥2 h比例分别占31.85%和42.11%;眼书距离＜20 cm比例占60.26%;偶尔或很少走路、乘车、趴桌或卧位看书比例占44.95%;持续用眼时间≥40 min比例占69.75%。每日户外活动时间＞1 h比例占39.51%;户外活动类型主要以玩耍游戏、球类活动和跑步为主,分别占75.96%、41.58%和27.87%。1～3年级和4～6年级小学生每日看电视时间,每日玩手机时间,眼书距离,走路、乘车、趴桌或卧位看书,持续用眼时间,每日户外活动时间比较差异有统计学意义(P＜0.05)。1 306例小学生中近视发生率为31.55%,单因素分析显示其近视发生与所处年级,父母是否近视,睡眠时间,每日看电视时间,每日玩手机时间,眼书距离,走路、乘车、趴桌或卧位看书,持续用眼时间,每日户外活动时间有关(P＜0.05)。在调整年级,父母是否近视等因素后,多因素logistic回归分析显示:每日看电视时间,每日玩手机时间,眼书距离,走路、乘车、趴桌或卧位看书,持续用眼时间,每日户外活动时间是小学生发生近视的影响因素(P＜0.05)。结论 小学生用眼不良行为习惯比例较高,户外活动比例较低,尤其在4～6年级小学生最明显,用眼行为习惯和户外活动是近视发生的影响因素,应加强小学生不良用眼行为习惯的干预,增加户外活动。

Objective Five different diagnostic criteria for metabolic syndrome (MetS) were used to describe the differences in the detection rates of MetS among Chinese adolescents so as to provide references for MetS preventionand controlin the adolescents. Methods Based on the China Health and Nutrition Survey, the detection rates of MetS among Chinese adolescents aged 12-17 years were calculated separately using the Chinese definition (abbreviated as the CHN2012 definition) recommended by the Pediatric Academy of Chinese Medical Association, the International Diabetes Federation criterion (abbreviated as the IDF criterion), the Cook criterion, the Noubiap criterion andthe modified definition of MetS based on IDF criteria(the MetS-IDFm criterion). Kappa test was used to evaluate the consistency. Results The overall detection rate of MetS under the Noubiap criterion was found to be the highest (5.61%), followed by the Cook criterion (4.76%), the MetS-IDFm criterion (3.27%), the CHN2012 definition (2.56%) and the IDF criterion (1.35%). Under the five diagnostic criteria, the detection rates of MetS were all higher in males than in females, and the detection rates of hypertension and high triglyceride were the highest among all components. Among the total population and males, the consistency was found to be the strongest between the Cook and Noubiap criteria, with the Kappa values being 0.913 and 0.923 respectively. Among females, the consistency was found to be the strongest between the CHN2012 definition and the MetS-IDFm criterion, with the Kappa value being 0.956. Conclusions Overall, the detection rate of MetS under the Noubiap criterion is found to be the highest in the adolescents, and it is in good agreement with that under the Cook criterion. The detection rate of MetS under the IDF criterion is found to be the lowest in the adolescents, and it is in poor agreement with those under the other criteria.

Objective To evaluate the immunogenicity and immune persistence of recombinant novel coronavirus protein vaccine (CHO cells), ZF2001, at different doses and immunization procedures in healthy people aged 18-59 years. Methods We conducted a randomized, blind, placebo-controlled and phase II clinical trial. A total of 900 healthy participants aged 18-59 years were randomly assigned to two-doses of low-dose group, two-doses of high-dose group, two-doses of placebo group, three-doses of low-dose group, three-doses of high-dose group, and three-doses of placebo group at a ratio of 1:1:1:1:1:1 and received ZF2001 or placebo. All the participants’ blood samples were collected for SARS-CoV-2 neutralizing and receptor binding domain (RBD) protein-binding antibodies detection before vaccination, 14 days, six months, and 12 months after full vaccination. Results The geometric mean titers (GMTs) of neutralizing antibodies of two-doses of low-dose group, two-doses of high-dose group, two-doses of placebo group at 14 days after full vaccination were 17.7, 14.1 and 2.0 respectively, and those at 6 months after full vaccination were 3.6, 3.7 and 2.0 respectively. The GMTs of RBD protein-binding antibodies of the above-mentioned three groups at 14 days after full vaccination were 439.82, 338.04 and 5.98 respectively, and those at 6 months after full vaccination were 63.62, 50.42, and 5.67 respectively. The GMTs of neutralizing antibodies of three-doses of low-dose group, three-doses of high-dose group, and three-doses of placebo group at 14 days after full vaccination were 97.3, 68.4 and 2.0 respectively, those at 6 months after full vaccination were 19.3, 16.7 and 2.0 respectively, and those at 12 months after full vaccination were 7.4, 7.3 and 2.0 respectively. The GMTs of RBD protein-binding antibodies of the above-mentioned three groups at 14 days after full vaccination were 1,745.67, 1,107.36 and 5.84 respectively, and those at 6 months after full vaccination were 281.31, 212.41 and 5.80 respectively. Conclusions ZF2001 can induce high levels of neutralizing and RBD protein-binding antibodies in the healthy participants. The immune persistence of three doses is better than that of two doses, and the immunogenicity and immune persistence of low doses are superior to those of high doses. The neutralizing antibodies at 6 months after full vaccination show a decreasing trend. A low-dose and three-dose vaccination program is recommended, and booster vaccination at 6 months after full vaccination should be considered.

Objective To understand the contamination status of foodborne pathogens in commercially sold foods in Changsha City, and to provide a scientific basis for food safety risk assessment and early warning monitoring of foodborne diseases. Methods According to the requirements of the Manual for National Food Contamination and Hazardous Factors Risk Monitoring, we monitored and analyzed foodborne pathogens in 622 food samples across 11 categories in Changsha City from 2020 to 2023. Results Among the 622 food samples, 346 strains of foodborne pathogens were detected, of which there were 37 strains ofBurkholderia cepacia (49.33%), with only one strain carrying the bon gene, 125 strains of Salmonella (24.65%), with 21 serotypes, predominantly Salmonella enteritidis, 22 strains of Yersinia enterocolitica (10.68%), mainly characterized byail-virF-yadA-ystA-rfbC-ystB+virulence genes, 68 strains of Campylobacter (33.01%), 32 strains of Cronobacter (26.67%), 25 strains ofClostridium perfringens (13.59%), 33 strains of Listeria monocytogenes (7.25%), 3 strains of Bacillus cereus (3.75%) and 1 strain of Clostridium sordellii (2.86%). A total of 257 positive samples were identified, with an overall positivity rate of 41.31%. The positive detection rate in 2022 was the highest (66.67%), and that in 2023 was the lowest (24.21%). The positive detection rate indicated that raw poultry meat was the most contaminated (81.06%), followed by raw livestock meat (68.27%), spices and powders (62.50%), fresh tremella and wet Auricularia auricula (49.33%), and processed meat products (31.82%). Bulk samples had a higher positive detection rate (57.11%) compared with pre-packaged ones (12.67%). The positive detection rate was found to be the highest in farmers’ markets (63.86%), followed by retail stores (35.14%), supermarkets (33.58%), and online stores (22.22%). Conclusions The contamination of foodborne pathogens in commercially sold foods in Changsha City is relatively severe. It is necessary to strengthen supervision and monitoring of high-risk food categories, enhance food safety monitoring and early warning systems, reduce the occurrence of foodborne diseases, and effectively safeguard public health.

目的 通过美国国家健康与营养调查(National Health and Nutrition Examination Survey,NHANES)数据库探究高尿酸血症患者肾结石的发病影响因素,为肾结石预防提供依据。方法 采用横断面研究,纳入NHANES数据库2011—2018年收录的551例高尿酸血症患者资料,基于#KIQ026判定肾结石。采用多因素logistic回归分析高尿酸血症患者并发肾结石的影响因素,构建限制性立方样条模型以明确剂量-反应关系,并采用受试者工作特征(receiver operating characteristic,ROC)曲线评价影响因素对高尿酸血症患者并发肾结石的综合预测价值。结果 551例高尿酸血症患者中共发现肾结石65例,肾结石并发率为11.80%。多因素logistic回归分析结果提示,高尿酸血症患者并发肾结石受到合并高血压(OR=2.220,95%CI:1.213~4.065)、血总钙(OR=0.036,95%CI:0.002~0.660)、血尿素氮(OR=1.114,95%CI:1.037~1.196)等因素的影响。剂量-反应分析结果显示,高尿酸血症患者并发肾结石风险与血总钙呈负向线性相关(非线性P=0.175),与血尿素氮呈正向线性相关(非线性P=0.676),差异均有统计学意义(P<0.05)。基于合并高血压、血总钙、血尿素氮等建立ROC,曲线下面积为0.685(95%CI:0.644~0.724),灵敏度为81.54%,特异度为50.41%。结论 高尿酸血症患者并发肾结石受到合并高血压、血总钙、血尿素氮等因素的影响,对高尿酸血症患者实行控制血压、均衡钙饮食、优化蛋白摄入水平等措施有利于预防肾结石的发生,上述研究结论还需进一步验证。

Objective To analyze the factors influencing willingness to receive HIV self-testing among college students, and to provide theoretical support for promoting HIV/AIDS prevention and control in universities. Methods A stratified cluster random sampling method was employed to select 1,015 college students from Xiangnan University in July-August 2022, and then a cross-sectional study was conducted. A questionnaire based on the health belief model (HBM) theory was developed to investigate the status of willingness to receive HIV self-testing, and structural equation modeling was applied to further analyzing its influencing factors. Results Among the 1,015 study participants, 688 (67.8%) reported having engaged in sexual activity, and 154 (15.2%) admitted to having had unprotected sex, with only 27 (2.7%) of them being willing to undergo HIV self-testing. The results of univariate analysis showed that males (χ²=7.904, P=0.005), participants who had not got relevant knowledge about HIV prevention and treatment (χ²=4.272, P=0.039), the married (χ²=29.935, P<0.001), homosexuals (χ²=16.983, P=0.001), participants who had more than 3 sexual partners (χ²=35.109, P<0.001), perception of disease threat (t=-3.127, P=0.002) and action cues (t=1.791, P=0.007) were related to intention of HIV self-testing. The results of structural equation modeling revealed that cues to action directly and positively influenced the willingness to receive HIV self-testing, with the path coefficient being 0.08, while perception of disease threat had a direct and negative impact on thewillingness to receive HIV self-testing, with the path coefficient being -0.13. Perception of benefits indirectly and positivelyinfluenced the willingness to receive HIV self-testing, with the total effect being 0.025. Conclusion As for health education about HIV/AIDS prevention and control, it is necessary to enhance the awareness and publicity of HIV/AIDS knowledge and HIV self-testing, improve the awareness and acceptance of HIV self-testing, and promote the implementation of work regarding HIV/AIDS prevention and control.

目的 分析老年冠心病住院患者睡眠障碍的危险因素及预防措施,为预防老年冠心病住院患者睡眠障碍提供依据。方法 选取2021年11月—2023年3月杭州市临平区第一人民医院收治的345例老年冠心病住院患者为研究对象,根据患者睡眠障碍情况,以匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)>7分为存在睡眠障碍,分为睡眠障碍组、无睡眠障碍组,通过问卷调查及医院电子病例系统回顾性收集研究对象临床资料。采用单因素χ²检验及多因素logistic回归分析老年冠心病患者合并睡眠障碍的相关因素。结果 345例老年冠心病住院患者,睡眠障碍发生72例,发生率为20.87%。睡眠障碍组与无睡眠障碍组年龄、性别、冠心病病程、是否合并焦虑情绪、抑郁情绪及胃炎比较,差异均有统计学意义(P<0.05),多因素logistic分析结果显示,女性(OR=1.874,95%CI:1.121~3.132)、冠心病病程≥3年(OR=2.119,95%CI:1.234~3.640)、合并焦虑情绪(OR=2.335,95%CI:1.532~3.559)、合并抑郁情绪(OR=1.855,95%CI:1.047~3.288)、合并胃炎(OR=1.876,95%CI:1.193~2.950)为老年冠心病患者合并睡眠障碍发生的危险因素(P<0.05)。结论 老年冠心病患者合并睡眠障碍发生率较高,危险因素较多,临床可据此筛选老年冠心病合并睡眠障碍的高危患者,采取相应干预对策。

目的 探讨肺癌患者术后并发肺部感染情况及影响因素,为其感染的防控提供参考。方法 回顾性分析2020年3月—2023年6月杭州市中医院收治498例肺癌患者的临床特征,根据所选患者术后是否并发肺部感染将其分为感染组和未感染组。分析感染组患者致病菌分布特点,比较两组临床特征,并采用多因素logistic回归分析法分析肺癌患者术后并发肺部感染的影响因素。结果 498例肺癌患者术后并发肺部感染40例,发生率8.03%。40例感染组患者中共分离出病原菌株75株,革兰氏阳性菌、革兰氏阴性菌及真菌的占比分别为26.67%、65.33%、8.00%,其中革兰氏阴性菌的占比较高,主要为肺炎克雷伯杆菌(57.33%)。两组临床特征比较,感染组年龄≥60岁、手术时间≥3 h、术中出血量≥200 ml、机械通气时间≥12 h、胸腔引流持续时间≥7 d、术后有侵入性操作、糖尿病、血清白蛋白水平<30 g/L的患者占比分别为65.00%、77.50%、52.50%、85.00%、37.50%、67.50%、72.50%、72.50%,高于未感染组的48.91%、58.08%、32.53%、57.86%、21.83%、48.91%、55.90%、48.69%,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,年龄≥60岁(OR=3.102,95%CI:1.157~8.313)、机械通气时间≥12 h(OR=2.221,95%CI:1.175~4.200)、胸腔引流持续时间≥7 d(OR=2.869,95%CI:1.107~7.438)、术后有侵入性操作(OR=2.450,95%C:1.147~5.231)、糖尿病(OR=1.610,95%CI:1.512~1.714)、血清白蛋白水平<30 g/L(OR=2.683,95%CI:1.144~6.294)是肺癌患者术后并发肺部感染的独立危险因素(P<0.05)。结论 肺癌患者术后易并发肺部感染,致病菌中占比较高的为革兰氏阴性菌,主要为肺炎克雷伯杆菌,而年龄≥60岁、机械通气时间≥12 h、胸腔引流持续时间≥7 d、术后有侵入性操作、糖尿病、血清白蛋白水平<30 g/L是肺癌患者术后并发肺部感染的独立危险因素,临床可据此给予高危患者针对性地预防及抗菌治疗措施,以减少术后肺部感染的发生。

目的 了解2型糖尿病患者合并睡眠障碍的现状,探讨其影响因素,为制定针对性干预措施提供依据。方法 采用便利抽样法,于2022年12月1日—2023年12月31日在湖州市第一人民医院,抽取220名2型糖尿病患者作为调查对象,采用一般情况量表、匹兹堡睡眠质量指数量表进行调查,并检测患者糖化血红蛋白、胰岛素抵抗指数、体质量指数和空腹血糖,采用单因素χ²检验和多因素logistic回归分析2型糖尿病患者睡眠障碍发生的影响因素。结果 本研究共纳入220例2型糖尿病患者,合并睡眠障碍102人,发生率为46.36%。单因素及多因素分析结果显示,女性(OR=1.415,95%CI:1.071～1.868)、年龄≥50岁(OR=1.468,95%CI:1.170～1.842)、无配偶(OR=1.361,95%CI:1.112～1.665)、有吸烟史(OR=1.513,95%CI:1.191～1.921)、有糖尿病家族史(OR=1.696,95%CI:1.281～2.243)、有糖尿病并发症(OR=1.714,95%CI:1.267～2.319)、糖化血红蛋白＞7.0%(OR=1.531,95%CI:1.170～2.004)、病程(3～5年OR=1.483,95%CI:1.119～1.966;＞5年OR=1.529,95%CI:1.168～2.004)、治疗方案为药物治疗(OR=1.425,95%CI:1.138～1.784)、胰岛素抵抗指数≥2.69(OR=1.153,95%CI:1.175～1.948)、超重或肥胖(OR=1.475,95%CI:1.070～2.033)、有心血管疾病史(OR=1.679,95%CI:1.165～2.418)、空腹血糖未达标(OR=1.525,95%CI:1.080～2.153)的2型糖尿病患者易合并睡眠障碍的影响因素(P<0.05)。结论 2型糖尿病患者合并睡眠障碍的发生率较高,临床可对2型糖尿病患者进行针对性干预措施,以降低睡眠障碍发生率。

目的 探讨安徽省某精神专科医院的医院感染现状,为精神科医院感染的防控提供参考依据。方法 利用医院感染实时监控系统、调阅电子病例、现场核查等方式统计调查2020年1月—2023年12月安徽省某精神专科医院的医院感染情况,描述性分析该院医院感染(例次)患病率以及患者医院感染部位和抗菌药物使用情况。结果 2020年1月—2023年12月期间住院患者43 550名,发生医院感染 761例次,感染例次率 1.75%,呈逐年下降趋势(χ²=37.437,P<0.001)。男性患者医院感染例次率(2.20%)高于女性患者(1.31%);≥60岁患者医院感染例次率(2.59%)远高于其他各年龄组;封闭病房患者医院感染例次率(2.16%)高于开放病房(0.87%),差异均有统计学意义(P<0.001)。患者感染部位构成比排前三位的是:下呼吸道(77.40%),皮肤(8.41%),上呼吸道(5.65%)。不同年份间抗菌药物治疗前标本送检率逐年增加,差异有统计学意义(χ²=253.956,P<0.05)。结论 该精神专科医院医院感染率相对较低,但医院感染仍需高度重视并加以防控,同时应进一步加强抗菌药物治疗前送检,依据病原学检测及药敏实验规范临床用药。

Objective To investigate the willingness to have a second child and a third child among professional women in childbearing age, and to analyze the factors influencing their willingness to bear a second child and a third child respectively. Methods A questionnaire was used to survey professional women of childbearing age who bore a child in the physical examination center of a tertiary grade-A hospital in Hefei City. Univariate analysis was conducted by χ² test, and multivariate analysis was performed using logistic regression analysis. Results A total of 988 subjects were investigated in this study. They were mainly concentrated in the age group of 31-40 years (70.55%), and 87.65% of them hold a bachelor’s degree or above. Among them, there were 691 professional women of childbearing age who had given birth to a child, and their intention to give birth to a second child accounted for 20.84%. There were 297 professional women of childbearing age who had given birth to a second child, and their willingness to give birth to a third child accounted for 20.88%. According to the research findings, the difference between the desires to have a second child anda third child was statistically significant (χ²=23.249, P<0.001), and the proportion of those who did not want to have a second child (64.69%) was lower than that of those who did not want to have a third child (75.08%). Professional women of childbearing age who were younger (OR=0.225, P=0.002) and had a single-parent family structure (OR=2.076, P=0.017) had a higher desire to have a second child, while professional women of childbearing age who had a poor family function (OR=2.931, P=0.030) had a lower desire to have a second child. Professional women of childbearing age who had a lower educational level (OR=0.269, P=0.004) had a higher willingness to have a third child, while professional women of childbearing age who had job changes (OR=2.362, P=0.048) and complications during pregnancy (OR=5.564, P=0.022) had a lower willingness to have a third child. Conclusions The willingness of professional women of childbearing age to have a second or third child may be affected by age, family structure, job changes, pregnancy complications and other factors; hence it is necessary to further develop corresponding measures to improve the willingness of professional women of childbearing age to have a second or third child.

Human papillomavirus (HPV) is a common genital tract infection virus, which is divided into high-risk and low-risk types according to its carcinogenicity. Persistent HPV infection with high-risk types is the main cause of cervical cancer. The integration of the HPV viral genome into the human (host) genome is thought to be the molecular basis of persistent HPV infection as well as a key step in the development of cervical cancer. The HPV integrated detection method began with the Southern blot in 1987, and then a series of PCR-based classical methods appeared. With the development of high-throughput sequencing technology at present, HPV integrated detection methods have also been further developed. However, clinical transformation has not yet been realized due to the limitations of the current technology. This study reviews the current relevant methods for HPV integration detection.

Objective To establish the synthetical index of influenza in Shanxi Province, to predict the epidemic thresholds and intensity thresholds of influenza, and to evaluate the model applied to prediction. Methods The surveillance data about epidemic seasons of influenza from 2010/2011 to 2021/2022 were selected. Three indexes like the weekly percentage of influenza-like illness (ILI) cases, the positive rate of nucleic acid detection of influenza virus and the outbreaks of ILI cases were integrated into the form of synthetical index. The epidemic thresholds and intensity thresholds of influenza in Shanxi Province were assessed by the synthetical index combined with the moving epidemic method (MEM). The cross-validation method was applied to analyzing and evaluating the fitting effect of the model, and the evaluation indexes were sensitivity, specificity, Youden index, etc. Early warning analysis was performed for the 2022/2023 influenza epidemic season. Results The MEM model was established based on the synthetical index value. The cross-validation results revealed that the fitting effect of the data about the 2010/2011 influenza epidemic season was poor, so they were deleted. And the influenza early warning model was re-established by using the data about the 2011/2012-2021/2022 influenza epidemic season. The sensitivity, specificity and Youden index were 0.91, 0.93 and 0.86 respectively. The estimated pre-pandemic threshold, the moderate-intensity threshold, the high-intensity threshold and the extremely high-intensity threshold for the 2022/2023 influenza epidemic season were 0.87, 1.41, 3.13 and 4.46 respectively, with the sensitivity, specificity and Youden index being 0.92, 0.94 and 0.86 respectively. Conclusion The MEM model based on the synthetical index value has high sensitivity and specificity in formulating the epidemic thresholds of influenza in Shanxi Province, and can timely and accurately forecast the beginning and epidemic intensity of the influenza season.

Objective To conduct an umbrella review of systematic reviews or meta-analyses on the effects of breastfeeding on child health outcomes, and to analyze the associations between breastfeeding and various child health-related outcomes. Methods Databases such as CNKI, Wanfang Data, VIP Chinese Database, PubMed, Web of Science, the Cochrane Library, and Embase were searched for systematic reviews or meta-analyses on the effects of breastfeeding on child health outcomes from inception to June 30, 2023. The qualities of the studies were assessed using a measurement tool to assess systematic reviews version 2 (AMSTAR 2). Two researchers independently screened the literatures and extracted outcome data for the analysis. Results A total of 21 meta-analyses were enrolled in this review, and the methodological quality evaluation by AMSTAR-2 tool found that there were 4 moderate-quality, 6 low-quality, and 11 very low-quality studies. A total of 24 child health-related outcome indicators were reported, and breastfeeding was significantly associated with 18 indicators like nutritional status, psychological status, gingival health, allergy, inflammation, cancer risk, cardiopulmonary health, etc., all showing a significant improvement trend. However, breastfeeding for less than one month might lead to childhood obesity. Conclusions Breastfeeding can significantly improve most of the child health indicators, but attention should also be paid to the risk of childhood obesity caused by short-term breastfeeding. The methodological quality and evidence quality of the meta-analyses enrolled in this umbrella review need to be improved, and the potential dose-dependent relationship between some indicators and breastfeeding needs to be further verified.

Objective To investigate the current status of electronic cigarette (e-cigarette) use, secondhand smoke exposure and the factors influencing e-cigarette tries and current e-cigarette use among university students in Wenzhou City, and to provide a basis for tobacco control interventions among university students in Wenzhou City. Methods A random cluster sampling method was used to select 2,118 students from 3 universities in Wenzhou City, and then an anonymous self-filling questionnaire survey on behaviors related to e-cigarette use was conducted through scanning a QR code with a smartphone camera. We descriptively analyzed the status of university students who had used e-cigarettes and ones who were using e-cigarettes. Multivariate logistic regression analysis was employed to analyze the factors affecting the university students who had used e-cigarettes and ones who were using e-cigarettes. Results A total of 2,116 valid questionnaires were retrieved, with the effective response rate of 99.90%. Of all the university students surveyed, 95.27% had heard about e-cigarettes, 6.71%% reported that they had used e-cigarettes, and 1.65% reported that they were using e-cigarettes. There were statistically significant differences in the rates of e-cigarette tries and current e-cigarette use among student groups with different characteristics, and the two rates were higher in male students (11.11%, 3.19%) than in female students (2.97%, 0.35%), higher in junior college students (11.86%, 3.28%) than in undergraduates (4.91%, 1.08%), and higher in non-medical students (8.97%, 2.57%) than in medical students (3.73%, 0.44%). The rates of e-cigarette tries and current e-cigarette use were different among university students with different grades, and showed upward trends with the increase of grades. As for the e-cigarette sources, 50.77% of the respondents reported that they used e-cigarettes from classmates or friends in the last time, 23.08% bought from e-cigarette experience stores or e-cigarette retail stores, and 12.31% from online stores. The causes for e-cigarette use were to like certain flavors (27.69%), consider e-cigarettes with less harmfulness (15.38%) and quit smoking (13.85%). As for current e-cigarette users, fruit flavors were the most popular (50.00%), followed by tobacco flavor (22.22%) and herbal flavor (11.11%), and the average cost of the current e-cigarette users was 100 Yuan per month. Multivariate logistic regression analysis revealed that female students and having no teachers smoking on campus were the common protective factors for e-cigarette tries and current e-cigarette use. Undergraduates were the protective factor for e-cigarette tries compared with junior college students, while freshmen, sophomores and medical students were the protective factors for current e-cigarette use. 34.69% of the surveyed students reported seeing teachers smoking on campus, of which 3.17% reported seeing teachers smoking on campus almoston a daily basis. Among the surveyed students, the proportions of having the awareness about adults’ lung cancer (92.53%) and children’ pulmonary diseases (91.12%) caused by secondhand smoke were higher than that of having the awareness about adults’ cardiopathy (80.29%) caused by secondhand smoke. Conclusions The proportion of current e-cigarette use in the university students surveyed in Wenzhou City increased. Junior colleges and non-medical colleges are the key units for tobacco control, and senior male students the key group for tobacco control. Active promoting the legislation of smoking ban in public places in Wenzhou City can effectively reduce the harmfulness of secondhand smoke. It is conducive to reducing the generation of new smokers through strengthening the construction of smoke-free campuses, enhancing the publicity regarding harmfulness of e-cigarettes, and prohibiting or delaying the teenagers’ attempt of e-cigarettes.

Objective To analyze the incidence and characteristics of adverse events following immunization (AEFI) of the National and non-National Immunization Program vaccines in Hebei Province during 2020-2022, and to evaluate the safety of the vaccines so as to put forward opinions and suggestions for work in future. Methods Descriptive epidemiological methods were used to analyze the distribution characteristics of AEFI in Hebei Province from 2020 to 2022. Results A total of 36,390 cases of AEFI were reported in Hebei Province during 2020-2022, with the average annual reported incidence rate of 14.18 per 100,000 doses. The male-to-female ratio was 0.90∶1. The age was concentrated in the range of ≥18 years old, and the reporting time in the second and third quarters. 94.48% of the AEFI cases had recovered or improved, and 87.21% of the AEFI cases occurred within one day after vaccination. General reactions and abnormal reactions accounted for 91.59% and 3.21% of the AEFI cases respectively. The top three categories of vaccines with the highest reported incidence rates of AEFI were herpes zoster vaccine (HZV) (285.19/100,000 doses), diphtheria, tetanus and acellular pertussis combined vaccine (DTaP) (119.22/100,000 doses) and 23-valent pneumococcal polysaccharide vaccine (PPV23) (52.21/100,000 doses). Anaphylaxis was a category of reactions with the highest proportion in the clinical diagnosis of abnormal reactions, accounting for 50.09%, with the reported incidence rate of 0.23/100,000. Conclusion The National and non-National Immunization Program vaccines in Hebei Province during 2020-2022 showed good safety.

Objective To understand the incidence situation and vaccination effect of hand, foot and mouth disease (HFMD) since it was brought into legal management, and to provide a basis for formulating effective prevention and control strategies. Methods Descriptive epidemiological methods were used to analyze the data regarding HFMD incidence, etiology monitoring and vaccination in Kunshan City from 2008 to 2022. Results A total of 25,759 HFMD cases were cumulatively reported in Kunshan City from 2008 to 2022, and the average annual reported incidence rate was 70.80/100,000, which was lower than the national level of the same period. The proportion of severe cases decreased significantly. The incidence peak occurred every other year. Two incidence peaks were observed each year, one in May-July, and another in September-November. The incidence rate was higher in males than in females. The age-at-onset in HFMD was concentrated in children under 5 years old, and most of the cases were children below the age of 3 years. The incidence rate was higher in townships than in urban areas. The main pathogens were EVG and CoxA16 in 2014-2016, and CoxA6 was predominant in 2017-2022. After the wide use of EV71 vaccine, the proportion of severe cases was lower than that before the promotion (P<0.001). Conclusions HFMD in Kunshan City during 2008-2022 showed a trend of high incidence, and EV71 vaccine had better effect on preventing severe HFMD. It is necessary to actively develop a multivalent vaccine and improve the vaccination rate, strengthen health education and intervention, and take comprehensive measures to reduce the incidence of HFMD.

目的 了解高水碘地区学龄儿童、成人及孕妇的碘营养状况,讨论高水碘环境下三类人群碘营养状况的差异。方法 采用现况调查的方法,抽取高水碘地区5个行政村的200例儿童、200例成人及64例孕妇作为研究对象,采集调查对象随机尿,测定尿碘水平;采集当地饮用水和家庭食用盐,测定水碘和盐碘含量。结果 调查地区水碘范围为391.50～424.10 μg/L。共采集食用盐200份,未加碘食盐占45.00%,成人食用加碘食盐组(110人)与未加碘食盐组(90人)尿碘中位数分别为495.50 μg/L和581.50 μg/L,两组尿碘水平差异无统计学意义(H=-1.434,P=0.152)。所调查儿童、成人及孕妇的尿碘中位数分别为668.01、529.00和410.75 μg/L,其中儿童和成人尿碘水平≥300 μg/L分别占88.0%和78.5%,孕妇尿碘水平≥500 μg/L的占37.5%。不同年龄组成人间的尿碘水平差异有统计学意义(χ²=15.769,P＜0.001),老年人尿碘水平低于青中年人。结论 调查数据表明该地区为水源性高碘地区。学龄儿童和成人碘营养处于碘过量状态,孕妇碘营养处于碘超足量状态,高水碘地区停供碘盐不足以保护当地居民免受高水碘的危害,应即时改水降碘以控制高碘地区的人群碘摄入达到适宜水平。

Objective To investigate the potential categories of career anxiety among higher vocational nursing interns, to explore their influencing factors, and to provide a reference basis for adjusting higher vocational nursing interns’ direction of core literacy training and optimizing their clinical practice management mode. Methods Eight hundred and fifty-one higher vocational nursing interns from 3 tertiary Grade-A hospitals and 7 higher vocational colleges in Anhui Province were selected as the research subjects by convenient sampling method. The general information questionnaire and career anxiety scale were used to conduct a questionnaire survey. The potential types of career anxiety were identified by potential profile analysis, and the influencing factors were analyzed by ordered multi-classification logistic regression. Results The higher vocational nursing interns’ career anxiety were divided into three potential categories, which were defined as low career anxiety type, medium career anxiety type and high career anxiety type, accounting for 22.91% (195/851), 51.12% (435/851) and 25.97% (221/851) of the respondents respectively. The total scores of career anxiety scale were (31.98±7.59), (45.66±8.16) and (55.53±8.55) respectively. There were statistically significant differences in internship time(χ²=47.247, P<0.001), monthly family income (χ²=58.259, P<0.001) and family members engaged in related occupations (χ²=17.832, P<0.001) among the higher vocational nursing interns with different potential categories of career anxiety. The results of ordered multi-classification logistics analysis displayed that monthly family income(OR=0.427,95%CI:0.297-0.612) and family members engaged in related occupations(OR=0.066,95%CI:0.045-0.950) were related to the higher vocational nursing interns’ career anxiety levels. Conclusions The higher vocational nursing interns’ career anxiety can be divided into three types, namely, low career anxiety type, medium career anxiety type and high career anxiety type. Targeted interventions should be conducted for those with low monthly family income and without family members engaged in related occupations so as to reduce their career anxiety levels.

Objective To analyze the epidemiological and spatial-temporal distribution features of pertussis in Hefei City, to explore its key incidence areas, and to provide references for pertussis prevention and control. Methods The data about pertussis incidence in Hefei City during 2012-2022 were collected from the China Disease Prevention and Control Information System, and then descriptively analyzed by using spatial analysis and spatiotemporal scanning statistics. Results A total of 693 pertussis cases were reported in Hefei City from 2012 to 2022, with the average annual reported incidence rate of 0.21/100,000. The cases' distribution was seasonal (in May-September). The cases were mainly concentrated in children under 1 year old, and most of them were scattered children, students and children in kindergarten (87.31%), with a male to female sex ratio of 1.10:1. Shushan District, Luyang District and Yaohai District were the major high incidence areas of pertussis in Hefei City. The results of global spatial autocorrelation analysis revealed that there was spatial aggregation of pertussis incidence in all counties (urban areas) of Hefei City during 2021-2022 (P<0.01). Local spatial autocorrelation analysis displayed that hot spots (high-high clusters) appeared in the incidence of pertussis during 2021-2022 (P<0.01). A total of 2 clusters were detected by spatiotemporal scanning analysis, and the first cluster was from January 1, 2021 to December 30, 2022, with Luyang District and Yaohai District as the center. The second cluster was from January 1 to December 30, 2019, with Shushan District as the center. Conclusions The incidence of pertussis in Hefei City in 2012-2022 was characterized by a low-high fluctuation, of which the incidence of pertussis during 2020-2022 showed an upward trend, with a phenomenon of pertussis recurrence. Luyang District and Yaohai District were the high incidence areas in 2022, with a spatiotemporal aggregation, and mainly in the young age. It is necessary to strengthen the publicity, education, monitoring and training among the key population in the key areas.

目的 通过对肥胖合并中枢性性早熟(central precocious puberty,CPP)儿童体质量指数、空腹胰岛素、尿酸等临床资料分析,探讨肥胖儿童合并CPP的危险因素,并建立预测模型。方法 以2021年5月—2023年7月就诊于徐州医科大学淮安临床学院儿科的112例6～11岁肥胖儿童为研究对象,其中合并CPP儿童49例纳入观察组,其余63例纳入对照组。收集患儿年龄、性别、身高、体重、性激素水平、血生化、骨龄、盆腔彩超等资料,采用多因素logistic回归分析肥胖合并CPP的影响因素并建立联合预测模型,受试者工作特征(receiver operating characteristic,ROC) 曲线评估预测模型的预测效能。结果 ①观察组女童构成比高于对照组[39/49(79.6%),38/63(60.3%)],差异有统计学意义(P＜0.05)。观察组的尿酸、空腹胰岛素、促肾上腺皮质激素水平均高于对照组(P＜0.05),而丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、游离甲状腺素、总胆固醇、血尿素氮水平均低于对照组(P＜0.05)。两组间BMIz、血清微量营养素水平及外周血白细胞等比较差异均无统计学意义(P＞0.05)。②多因素logistic回归分析,发现女童[OR(95%CI):12.989(3.167～53.270)]、空腹胰岛素升高[OR(95%CI):1.018(1.007～1.029)]、促肾上腺皮质激素升高[OR(95%CI):1.044(1.008～1.080)]、尿酸升高[OR(95%CI):1.013(1.005～1.022)]是肥胖合并CPP的独立危险因素。以上述各危险因素建立联合预测模型,logit P=-9.475+2.564×女童+0.018×空腹胰岛素+0.043×促肾上腺皮质激素+0.014×尿酸,并绘制 ROC 曲线,显示该预测模型的AUC为 0.879(95%CI: 0.812～0.947),表明其对肥胖儿童合并CPP具有较好的预测能力。结论 女童及空腹胰岛素、促肾上腺皮质激素、尿酸升高是肥胖儿童合并CPP的独立危险因素,其联合预测模型对预测肥胖儿童合并CPP具有一定的临床应用价值。

Objective To understand the status quo of scientific research in the field of infectious diseases in Hunan Province from 2013 to 2022 and evaluate the hotspots, advantages and shortcomings of infectious diseases research in the province through analyzing scientific research achievements in the field of infectious diseases in the province. Methods We retrieved the data about scientific research achievements (including papers, treatises, projects, patents and awards) in the field of infectious diseases in relevant scientific research institutions in Hunan Province from 2013 to 2022 through Chinese databases like CNKI, Wanfang and Weipu as well as foreign databases such as Medline, PubMed and Web of Science. Excel, SPSS and other software were used to sort out and analyze the data. The principal component analysis model was employed to comprehensively evaluate the core institutions, hotspots, annual changing trends, advantaged projects and shortcomings of infectious diseases research in Hunan Province. Results This study collected 2,671 published Chinese and English papers on infectious diseases in Hunan Province from 2013 to 2022, including 2,091 Chinese papers and 580 English papers. In the field of infectious diseases, 52 projectssupported by the National Natural Science Foundation of China and 98 projects supported by Hunan Natural Science Foundation were obtained. A total of 35 related monographs were published. The number of published patents was 217. 23 projects had been awarded scientific research awards. Principal component analysis of the data revealed that the top five institutions based on the scientific research levels during 2013-2022 were Central South University, University of South China, Hunan University of Traditional Chinese Medicine, Hunan Normal University and Hunan Institute of Schistosomiasis Prevention and Control. The top three hotspots based on research directions were viral hepatitis, AIDS and influenza, and the top three years based on the number of published papers were 2020, 2019 and 2014. Conclusions The hotspot institutions in the field of infectious diseases in Hunan Province from 2013 to 2022 were four medical universities, namely, Central South University, University of South China, Hunan University of Traditional Chinese Medicine and Hunan Normal University. The research hotspots in the field of infectious diseases in Hunan Province during 2013-2022 were viral hepatitis, AIDS, influenza and SARS-CoV-2 infection, while the weak directions were measles, hand, foot and mouth disease, human infection with H7N9 avian influenza and other types.It is necessary to cooperate with universities, disease control institutions and hospitals for development, concentrate scientific and technological resources to support the study on hotspots of infectious diseases, highlight core research institutions from point to point, and comprehensively improve the level of infectious diseases research in Hunan Province.

Objective To explore the influence of perceived social support on maternal depression and the mediating role of anxiety and insomnia between perceived social support and maternal depression. Methods We selected 6,833 pregnant women and puerperae in western Anhui in May-November 2022 to serve as the surveyed subjects. Questionnaire surveys were conducted by using the general information questionnaire, Edinburgh Postpartum Depression, Generalized Anxiety Disorder-7, Athens Insomnia Scale and Perceive Social Support Scale. Spearman correlation analysis was used to identify the relationship among the variables. AMOS23.0 was employed to analyze the mediating role of anxiety and insomnia between perceived social support and maternal depression. Results The detection rate of depressive symptoms was 52.83% among the 6,833 pregnant women and puerperae in western Anhui, showing statistically significant differences in the detection rates of depressive symptoms among pregnant women and puerperae with different ages, pregnancy stages, education levels, family monthly incomes, pregnancy conditions, and having or having no anxiety and insomnia (χ²=6.972, χ²=90.156, χ²=9.919, χ²=62.409, χ²=61.156, χ²=1,770.936, χ²=960.153, all P<0.05). The results of Spearman correlation analysis displayed that the scores of Maternal Depression Scale were positively correlated with the scores of Anxiety Scale and Insomnia Scale, but negatively correlated with the score of Perceived Social Support Scale (r=0.598, r=0.464, r=-0.457, all P<0.01). The score of Anxiety Scale was positively correlated with the score of Insomnia Scale, but negatively correlated with the score of Perceived Social Support Scale (r=0.499, r=-0.293, P<0.01). The score of Insomnia Scale was negatively correlated with the score of Perceptive Social Support Scale (r=-0.278, P<0.01). Perceived social support of the pregnant women and puerperae significantly negatively predicted depressive mood (β=-0.292, t=-27.266, P<0.01). The mediating effects of anxiety and insomniain the relationship between perceived social support and maternal depression in the pregnant women and puerperae were 23.19% and 7.44% respectively. Anxiety and insomnia played a chain mediating role between perceived social support and maternal depression, and the mediating effects were both 5.25%. Conclusion The detection rate of maternal depression in western Anhui was at a high level. Perceived social support can affect the occurrence of depressive mood in the pregnant women and puerperae through the mediating and chain mediating effects of anxiety and insomnia respectively.