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 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.

Objective To analyze the variation trends in the death level and disease burden of road traffic injuries among Chinese residents from 1990 to 2019, and to provide a scientific reference basis for the prevention and control. Methods The data regarding road traffic injuries in Chinese residents from 1990 to 2019 were obtained from the Global Burden of Disease Study 2019 (GBD 2019) database. Indicators like the incidence rate, the mortality rate, the rate of disability adjusted life years (DALY), the rate of years lived with disability (YLD) and the rate of years of life lost due to premature death (YLL) were analyzed, and the changing trends were analyzed by Joinpoint regression model. Results The standardized incidence rates of road traffic injuries in Chinese residents during 1990-2019 showed an increasing trend (P<0.001), but the standardized mortality rates showed a fluctuating downward trend (P<0.001). The incidence and death level of road traffic injuries in each year were higher in males than in females, the incidence rates were 1.4-1.6 times higher than those of females, and the mortality rates were 2.3-3.0 times higher than those of females. The standardized DALY rates and the standardized YLL rates showed fluctuating downward trends (both P<0.001), while the standardized YLD rates showed a fluctuating upward trend (P<0.001). The disease burden of road traffic injuries in each year was significantly higher in males than in females, and the standardized DALY, YLD and YLL rates were 2.0-2.7 times, 1.3-1.6 times and 2.1-3.0 times higher than those of females respectively. The mortality rates increased with advancing age. Compared with those in 1990, the mortality rate of the group aged ≥70 years in 2019 increased, while the mortality rates of other age groups decreased. The DALY and YLL rates first increased and then decreased with advancing age, with the peak age of 35-45 years. Compared with those in 1990, the DALY rate in the group aged ≥60 years and the YLL rate in the group aged ≥70 years in 2019 increased, whereas those in the other age groups decreased. The YLD rate increased with advancing age. The YLD rates of all age groups in 2019 increased compared with those in 1990, with the largest increase in the group aged 75-79 years. Conclusion The death and disease burden caused by road traffic injuries in China show overall decreasing trends, but they are still at high levels, especially in males and the elderly. Targeted effective measures should be continuously taken to reduce the disease burden caused by road traffic injuries.

Objective To explore the effects of a low-calorie diet combined with high-intensity interval training (HIIT) on body composition, glucose-lipid metabolism and cardiopulmonary function among female college students with overweight, and to provide a basis for developing more effective weight loss and health improvement strategies. Methods Eighty-five female overweight college students were recruited. With a random number table method, they were randomly divided into the low-calorie diet (LCD) group (n=43) and the control group (n=42). The diets for both groups were customized by a clinical nutritionist, with the LCD group receiving a daily caloric intake of 1,000-1,200 kCal and the control group receiving 1,400-1,800 kCal per day. On the basis of controlled diets, both groups underwent HIIT three times a week for an intervention duration of 12 weeks. We detected and compared the changes in body composition (including weight, body mass index, total body fat percentage, muscle mass, upper body fat, lower body fat and total body water), glycolipid metabolism (including glycated hemoglobin, fasting blood glucose, 2-hour postprandial blood glucose, insulin resistance index, insulin function index, total cholesterol, triacylglycerol, low-density lipoprotein cholestrol and high-density lipoprotein cholestrol) and cardiopulmonary function (heart rate, vital capacity index, systolic and diastolic blood pressures) before and after the intervention between the two groups. Results Before the intervention, there were no statistically significant differences in the indicators related to body composition, glycolipid metabolism and cardiopulmonary function between the two groups (P>0.05). After the intervention, changes in body composition indicators revealed that the LCD group showed significantly decreases in weight (62.15±5.22)kg, body mass index (24.51±2.35)kg/m², total body fat percentage (30.65±3.41%), upper body fat (2.33±0.42)kg and lower body fat (3.01±0.99)kg compared with the control group, with statistically significant differences (P<0.05). After the intervention, changes in glycolipid metabolism indicators displayed that the LCD group had lower levels of glycated hemoglobin (6.43±0.73%), fasting blood glucose (6.32±1.04) mmol/L, 2-hour postprandial blood glucose (9.03±1.21) mmol/L, total cholesterol (4.21±0.67) mmol/L, triacylglycerol (1.46±0.38) mmol/L, low-density lipoprotein cholestrol (2.56±0.59) mmol/L, and a lower insulin resistance index (2.81±0.46) than the control group, but had a higher insulin function index compared with the control group, with all differences being statistically significant (P<0.05). After the intervention, cardiopulmonary function indicators of the LCD group showed that the vital capacity index significantly increased, while the systolic and diastolic blood pressures significantly decreased, with statistically significant differences compared with the control group (P<0.05). Conclusion Implementing a 12-week intervention involving a low-calorie diet combined with HIIT for the female overweight college students can significantly improve their body composition, glycolipid metabolism and cardiopulmonary function.

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 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。

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 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.

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 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。

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。

Objective To explore the prevention and control measures against tuberculosis in communities through analyzing the family clusters of pulmonary tuberculosis (PTB) among patients with PTB in a district of Tianjin City. Methods The family clusters of PTB in PTB patients registered in a district of Tianjin City from 2009 to 2022 were retrospectively analyzed, and the results were described. Results A total of 55 families were involved in the family clusters of PTB in a district of Tianjin City during 2009-2022, with 2-4 cases in one family and 126 confirmed cases. 60.56% of the family close contacts were diagnosed in the previous two years after the diagnosis of the first case in the family, and 58.73% were housekeepers, house workers and the unemployed. 6.35% were active patients. Among patients with secondary PTB, the proportion of active patients was higher than that of passive patients, showing a statistically significant difference (P=0.04). 72.22% were newly treated patients, and the delay rates of clinic visiting and confirmed diagnosis were 38.89% and 43.65% respectively. Passive patients were more prone to clinic visiting delay. Compared with patients with negative results of pathogenic detection and tuberculous pleurisy, patients with positive results of pathogenic detection were less likely to have a delayed confirmed diagnosis. Conclusion Standardized management and follow-up in the course of treatment should be enhanced for patients with confirmed tuberculosis. Tuberculosis health education and active screening for PTB should be carried out regularly for family close contacts so as to timely detect potential active patients and reduce the occurrence of family clusters.

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 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。

Objective To evaluate the immunogenicity and safety of a quadrivalent influenza virus split vaccine among population aged ≥ 3 years. Methods A total of 2,700 subjects were enrolled in this randomized, blinded, positive-controlled, non-inferiority trial, and randomly assigned to the trial group or the control group at a ratio of 2:1. The immunogenicity at 28 days after vaccination was evaluated by using indicators like geometric mean titers (GMTs), seroconversion (SC) rates and seroprotection (SP) rates of hemagglutination inhibition (HI) antibodies against different influenza viruses. We collected the adverse events within 28 days after vaccination and serious adverse events within 6 months, and evaluated the safety of the vaccine. Results Among the population aged ≥ 3 years after vaccination, the antibody GMTs against H1N1, H3N2, B/Yamagata and B/Victoria in the trial group were 382.68, 463.22, 209.27 and 133.79 respectively, with the GMT ratios (95%CI) being 0.98 (0.90-1.07), 1.30 (1.18-1.42), 1.26 (1.16-1.35) and 1.16 (1.08-1.24) respectively. The SC rates were 81.11%, 92.23%,83.72% and 88.49% respectively, and the differences (95%CI) in the SC rates were 4.48% (1.20%-7.87%), 4.42% (2.02%-7.02%), 8.33% (5.07%-11.71%) and 5.64% (2.82%-8.62%) respectively. The SP rates were 96.65%, 97.79%, 94.67% and 92.23% respectively. All study hypotheses about immunogenicity were achieved. The incidence rates of adverse reactions after vaccination in the trial group and the control group were 15.75% and 16.48% respectively (P=0.656), the incidence rates of solicited systemic adverse reactions after vaccination were 3.51% and 3.45% respectively (P=1.000), and the incidence rates of solicited local adverse reactions after vaccination were 12.63% and 13.36% respectively (P=0.626). No vaccine-related serious adverse events occurred. Conclusion The immunogenicity of one dose of the trial vaccine is non-inferior to that of the control vaccine, and the vaccine also shows good safety after vaccination.

目的 分析维持性血液透析(maintenance hemodialysis,MHD)尿毒症患者营养不良影响因素,同时建立列线图模型,为临床诊疗及改善患者营养状况提供依据。 方法 回顾性选取2022年1月—2024年6月亳州市人民医院收治的126例MHD尿毒症患者为研究对象,根据MHD尿毒症患者营养评估结果分为营养不良组和营养正常组,比较两组患者基本情况及临床特征差异,并采用多因素logistic回归分析筛选MHD尿毒症患者营养不良的独立危险因素,构建列线图并评估其区分度、一致性。 结果 共纳入126例MHD尿毒症患者,其中营养不良组67例(占53.17%),营养正常组59例(占46.83%)。两组在不同性别、体质指数、原发病、透析龄、MHD频率、MHD期间体重增长量、超滤量、是否合并高血压、是否合并冠心病、有无吸烟史方面比较差异无统计学意义(P＞0.05),在不同年龄、尿素清除指数(urea clearance index,Kt/V)、白细胞计数、C反应蛋白、血钙、血磷、甲状旁腺激素、是否合并糖尿病、有无并发肾性贫血方面比较差异有统计学意义(P＜0.05)。进一步多因素logistic回归分析结果显示,MHD尿毒症患者营养不良的独立危险因素包括年龄≥60岁(OR=5.151,P=0.001)、合并糖尿病(OR=5.317,P=0.005)、有并发肾性贫血(OR=12.362,P＜0.001)、Kt/V＜1.2(OR=5.606,P=0.005)。列线图预测MHD尿毒症患者营养不良的ROC曲线下面积0.829(95%CI:0.758～0.899)。列线图预测MHD尿毒症患者营养不良的校准曲线接近理想曲线。Hosmer-Lemeshow拟合优度检验χ²=7.924,P=0.339。 结论 MHD尿毒症患者的营养不良影响因素主要包括年龄≥60岁、合并糖尿病、有并发肾性贫血、Kt/V＜1.2,基于这些因素建立的列线图对MHD尿毒症患者的营养不良预测区分度与一致性较好。

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.

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 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 analyze the factors influencing low-birth-weight infants (LBWI), and to enhance the accuracy of analysis of the influencing factors based on decision tree algorithm combined with logistic regression models. Methods In this study, 12,686 women with singleton pregnancies and live births in the birth cohort constructed in the Maternal and Child Health Care Hospital of Guangxi Zhuang Autonomous Region from May 2019 to December 2021 were taken as the research subjects, and their demographic data, pregnancy examination data and neonatal related indicators were collected. Univariate analysis, classification and regression tree (CART) algorithm and logistic regression model were used to construct models, and the factors influencing LBWI were analyzed. Results The average age of the pregnant women was (31.69±4.48) years, and the average gestational age of delivery was (38.64±1.59) weeks. There were 777 cases of LBWI, accounting for 6.1%, and 11,909 cases of normal birth weight, accounting for 93.9%. The decision tree model displayed that the top three most important factors affecting LBWI were gestational age, gestational weight gain, and pre-pregnancy body mass index (BMI), and the sensitivity and specificity of the model were 80.9% of 96.5% respectively. Logistic regression revealed that gestational age less than 37 weeks (OR=35.215), insufficient gestational weight gain (OR=1.974), low pre-pregnancy BMI (OR=1.460) and gestational hypertension (OR=2.025) were risk factors for the occurrence of low body weight, with the sensitivity and specificity being 66.5% and 94.9% respectively. There were differences in the outcome indicators and presentation forms of the two models, and the decision tree algorithm could provide more intuitive and interpretable results, while the logistic regression model could better analyze the relationship between variables. Conclusion Gestational age, pre-pregnancy BMI, gestational weight gain, parity, gestational hypertension, household registration, and newborns' gender can all affect the newborns' body weight. The method of decision tree algorithm combined with logistic regression model can improve the accuracy and interpretability of influencing factor analysis, and has certain guiding significance for decision-making in clinical care and public health departments.

Objective To analyze the exposure level and distribution characteristics of risk factors for stroke among high-risk population in Hunan Province, and to provide a scientific basis for intervention management of high-risk population of stroke. Methods Based on the Screening and Intervention Project for People at High Risk of Stroke in 2020, a questionnaire survey, physical examination and laboratory tests were conducted on permanent residents aged 40 years and aboveselectedby a cluster sampling in 14 project implementation hospitals in 10 cities and prefectures in Hunan Province. χ² test and logistic regression were used for comparative analysis. Results A total of 49,587 residents were accumulatively screened in 2020, and 12,327 residents were at high risk of stroke, with the detection rate of 24.86%. The high-risk detection rate was higher in males than in females (31.82% vs. 19.77%, χ²=968.638, P<0.001), and showed statistically significant differences among different ages, marriage status, education levels, occupations and incomes. The top four exposure rates of risk factors in the high-risk populationof stroke were hypertension (81.43%), dyslipidemia (73.77%), lack of exercise (49.15%) and diabetes mellitus (43.80%). The rate of cumulative exposure to hypertension, dyslipidemia, lack of exercise, diabetes mellitus and smoking history was 82.17%. Apart from the exposure rate of smoking history being higher in males (59.92%) than in females (2.58%), the exposure rates of the remaining risk factors were all higher in females than in males. The exposure rate of hypertension increased with age. The exposure rates of hypertension (90.43%) and lack of exercise (65.87%) were found to be the highest among the group aged 80 years andabove. The exposure rate of abnormal blood lipids was observed to be the highest in the group aged 40-49 years (78.61%). Theexposure rate of diabetes mellitus in the group aged 60-69 years was the highest (49.00%). Conclusion The situation of stroke prevention and treatment in Hunan Province is still severe. The high risk factors for stroke mainly include hypertension, dyslipidemia, lack of exercise and diabetes mellitus. It is necessary to strengthen the intervention and management of these risk factors and further improve the ability and level of stroke prevention and treatment.

目的 对深圳市龙岗区一起因餐饮店误用亚硝酸盐导致食物中毒的调查和分析,探讨预防控制措施,防范类似事件的发生。方法 采用现场流行病学、食品卫生学调查、实验室检验等方法,调查分析食物污染的环节和原因。结果 患者最初临床症状为头晕、冒冷汗、恶心、呕吐,后出现嘴唇发绀、意识不清、昏迷,潜伏期约为92 min,经使用亚甲蓝治疗后病情改善。患者胃内容物、外卖剩余食品、餐饮店后厨外环境样品、焯水肉汤检出亚硝酸盐。经调查,涉事餐饮店经营模式为线上外卖和线下经营,在制作食物过程中存在添加亚硝酸盐,亚硝酸盐的购进途径为市场的商店购买。结论 该起事件为误用亚硝酸盐引起的外卖食物中毒事件,应加强对亚硝酸盐的生产、销售、使用等环节的监管,加大对餐饮店违规使用亚硝酸盐的监管力度,以及采用综合措施加强外卖食品的监管。

After the SARS-CoV-2 pandemic, how to use disease surveillance data to establish prediction and early warning is an important research topic in the field of disease surveillance. With the rapid development of computer technology, various emerging time series models have been rapidly increasing in recent years, but there is still a lack of an overview of various disease monitoring time series prediction models. This study reviews the main disease monitoring time series prediction models both domestically and internationally in recent years and provides readers with a basic understanding of the principles, classification methods, implementation steps, and model evaluation indicators of various disease monitoring time series prediction models. At the same time, this study introduces the main software commonly used for modeling, provides readers with a detailed and comprehensive introduction to the current application progress in disease monitoring time series prediction models both domestically and internationally, and provides important references for better establishing prediction and early warning models.

目的 了解云南省养老机构消毒工作现状及消毒质量状况,为做好养老机构消毒与感染控制工作提供依据。 方法 通过现场问卷调查和采样检测,2022年10月—2023年4月选择云南省62家养老机构开展基本情况调查及消毒质量监测,对调查结果进行统计分析。 结果 对比公办养老机构和民办养老机构的基本调查总体情况,除消毒效果评价执行率和紫外线灯管强度监测有差异外(P＜0.05),其余各项差异均无统计学意义(P＞0.05)。共监测样品6 095件,合格5 203件,合格率为85.37%,环境物体表面、餐(饮)具和工作人员手的监测合格率分别为86.06%、83.88%、83.93%;公办养老机构总体合格率为87.15%,民办养老机构总体合格率为82.53%,两类机构消毒质量合格率差异有统计学意义(χ²=24.673,P＜0.001),其中公办养老机构的环境物体表面、餐(饮)具和工作人员手合格率为87.14%、86.78%、87.67%,均高于民办养老机构(χ²=6.886,P=0.009; χ²=8.353,P=0.004; χ²=14.767,P＜0.001)。 结论 云南省养老机构卫生消毒状况存在薄弱环节,建议加强消毒工作管理和监督,不断提高消毒质量。

Objective To analyze the changing trends in fall mortality rates and disease burden of death among the elderly in Chongqing Municipality during 2012-2023, and to provide suggestions for implementing targeted interventions. Methods Based on death cases with fall as the underlying cause of death (ICD-10: W00-W19) from the data about death cause surveillance in 2012-2023, SPSS 26.0 software was used to analyze the mortality rate, age-standardized mortality rate, years of life lost (YLL) rate due to premature death, average years of life lost (AYLL) and constituent ratio of death cause. χ² test was employed for mortality rate comparisons. Trend changes in the rates were represented by the average annual percentage change (AAPC). Results The fall mortality rate and age-standardized mortality rate among the elderly in Chongqing Municipality increased from 30.74/100,000 and 31.60/100,000 in 2012 to 52.95/100,000 and 44.36/100,000 in 2023, with the AAPC being 5.27% and 3.09% respectively, showing statistically significant differences in the changing trends (P<0.05). The fall mortality rates were consistently higher in males than in females, with statistically significant differences (P<0.05). The fall mortality rates from 2012 to 2019 were all higher in the urban elderly than in the rural ones except that in 2016, but the fall mortality rates from 2020 to 2023 were higher in the rural elderly than in the urban ones, showing statistically significant differences (P<0.05). The基金项目:重庆市科卫联合项目(2022MSXM138);重庆第一批公共卫生重点学科(渝卫办发〔2022〕72 号)作者简介:丁贤彬(1970-),男,重庆江津区人,主任医师,公共卫生硕士,研究方向:慢性病与伤害防控。通信作者:杨弦弦,E-mail: xxyang_cqcdc@163.com。YLL rate due to falls in Chongqing Municipality increased from 4.68‰ in 2012 to 7.18‰ in 2023, with the AAPC being 4.24%, showing a statistically significant difference in the changing trend (P<0.05). The AYLL due to falls decreased from 15.23 years in 2012 to 13.56 years, with the AAPC being -1.18%, showing a statistically significant difference in the changing trend (P<0.05). Conclusion The fall mortality rates among the elderly in Chongqing Municipality are higher than the national average and show upward trends. Special attention should be paid to comprehensive interventions for falls prevention in the elderly.

Objective To explore the changing trends in newly-born population and maternal and infant perinatal period outcomes in Changsha Hospital for Maternal & Child Health Care from 2015 to 2023, and to provide a basis for maternal and child health care services and policy formulation. Methods We collected the data about puerperae and live births in Changsha Hospital for Maternal & Child Health Care from 2015 to 2023, and then analyzed the changing trends in maternal fertility characteristics and perinatal outcomes by using descriptive statistical analysis method. Results From 2015 to 2023, the number of live births in this hospital showed an overall fluctuating downward trend. After the adjustment of birth policies, the birth population showed a short-term increase, with a year-on-year increase of 23.30% in 2016 and that of 5.33% in 2022. The average age of first childbirth of the puerperae increased from (27.60±3.27) years to (28.93±3.69) years. The proportion of elderly puerperae gradually increased over the years. The proportion of puerperae with a second child increased first and then decreased, reaching a peak of 46.12% (6,481/14,052) in 2017 and then decreasing to 37.77% (4,194/11,104). The proportion of puerperae with a third child showed an upward trend, increasing from 1.47% (169/11,508) to 5.30% (588/11,104). The main childbearing age group was puerperae aged 25-＜30 years, accounting for 42.33%, followed by those aged 30-＜35 years, accounting for 36.40%. There were statistically significant differences in delivery methods, adverse pregnancy outcomes and neonatal birthweights among puerperae of different age groups, while no statistically significant difference was found in neonatal birth defects among puerperae of different age groups. The cesarean section rate for first births showed an upward trend year by year (χ²_trend=602.101, P<0.001), while the cesarean section rate for second and higher order births showed a downward trend (χ²_trend=14.899, P<0.001). The incidence rate of macrosomia showed an overall downward trend, and the incidence rate of low birth weight infants showed a slow decreasing trend. Conclusion Newly-born population in Changsha Hospital for Maternal & Child Health Care during 2015-2023 showed a temporary fluctuating upward trend with the adjustment of birth policies. The proportions of elderly puerperae and multiparas increased, and the incidence rate of adverse perinatal outcomes also increased. It is necessary to continue to strengthen perinatal health care so as to reduce the occurrence of adverse perinatal outcomes.

Objective To analyze the burden of premature death due to four main types of chronic diseases and its changing trend among household-registered residents in Lishui District, Nanjing City from 2010 to 2020, and to explore the possibility of realizing the goals ofreduction of burden of premature death fromHealthy China 2030. Methods We collected and sorted out the monitoring data about causes of deaths among household-registered residents in Lishui District, Nanjing City from 2010 to 2020, and then calculated the indicators like the crude premature death rate, the age-standardized premature death rate, the years of life lost (YLL) from premature death and the probability of premature death. Joinpoint software was used to analyze the changing trends in the above-mentioned indicators, and the burden of premature death from four main types of chronic diseases was further stratified and analyzed according to genders and disease types. Results The crude premature death rate, the age-standardized premature death rate, the YLL rate, the age-standardized YLL rate and the probability of premature death from four main types of chronic diseases among household-registered residents in Lishui District, Nanjing City during 2010-2020 were 270.41/100,000, 223.31/100,000, 107.64‰, 79.93‰ and 11.95% respectively. The crude premature death rate, the age-standardized premature death rate, the age-standardized YLL rate and the probability of premature death all showed decreasing trends (P<0.05), and the above-mentioned indicators were higher in males than in females. Among four main types of chronic diseases, the age-standardized premature death rate, the age-standardized YLL rate and the probability of premature death from malignant tumors and cardiovascular diseases showed downward trends (P<0.05). The YLL rate and the crude premature death rate from malignant tumors were 50.56‰ and 7.47% respectively, which were found to be the highest among four main types of chronic diseases. The decreases in the probabilities of premature death of four main types of chronic diseases were arranged in the following order: cardiovascular and cerebrovascular diseases, malignant tumors, chronic respiratory diseases and diabetes. By 2030, the probabilities of premature death of four main types of chronic diseases can all reach the reduction goals from Healthy China 2030 according to the prediction based on the average growth speed. Conclusion The burden of premature death from four main types of chronic diseases among household-registered residents in Lishui District, Nanjing City showed downward trends, suggesting that the goals of Healthy China 2030 can be achieved. However, the baseline value is relatively low, and it is still difficult to further reduce the burden. Intervention measures should be taken continuously, and it is suggested that special attention should be paid to males and patients with malignant tumors or diabetes in chronic disease prevention and treatment.

目的 了解广东省狂犬病暴露预防处置门诊建设现状,为全省门诊的规范化建设提供依据。方法 采用统一设计的问卷对广东省所有狂犬病暴露预防处置门诊的基本情况、硬件设施及人员情况、预防接种服务及管理制度情况进行调查。结果 广东省人均狂犬病暴露预防处置门诊数为0.94个/10万人,1 184个门诊中42.6%为独立设置的门诊,88.1%的门诊按要求设置了伤口处置区、疫苗接种区、留观区和疑似异常反应处置区四大区域;＞80%的门诊配有扫码设备、冷链设备、急救药物,≤62%的门诊配有冲洗设备;每个门诊预防接种人员中位数为8人,外科医生人数中位数为2人;80%以上的门诊公示了暴露处置规范等内容,但只有49.7%和56.8%的门诊能公示接种后异常反应补偿政策、相关法律法规;75.2%的门诊开展5针法接种程序,应对严重异常反应43.3%的门诊选择更换其他疫苗,分别有47.6%和52.6%的门诊能提供被动免疫制剂、破伤风疫苗注射服务;不同地区间门诊场地设置、设备配置、人员配置、服务与管理情况差异有统计学意义(P＜0.05)。结论 广东省狂犬病暴露预防处置门诊设置和分区、冲洗设备配置、外科医生配备、疫苗种类配备、被动免疫制剂和破伤风疫苗注射服务方面建设有待加强,珠三角地区狂犬病暴露预防处置门诊服务能力优于其他地区。

目的 探究廊坊地区成年居民无偿献血认知情况及影响因素,为改进献血宣传服务、提高人群的无偿献血认知提供依据。方法 采取分层随机抽样法,在廊坊市行政区划县市中随机抽取2个县10个街头献血点、2个站内献血点展开调查,以不记名方式,一对一询问方式开展调查,调查其个人信息、家庭情况与无偿献血认知情况,多元线性回归分析廊坊地区成年居民无偿献血认知情况及其相关的影响因素。结果 本研究共发放问卷1 236份,回收有效问卷1 200份,问卷有效率为97.09%。1 200名成年居民无偿献血认知情况总得分为(10.90±2.42)分,其中不适应献血的情况(2.26±0.63)分、无偿献血免费用血政策(2.28±0.64)分,得分相对较高,两次献血时间间隔(2.04±0.65)分,得分相对较低。不同年龄、性别的成年居民对无偿献血认知情况的得分差异无统计学意义(P>0.05),月收入≥5 000元的成年居民其无偿献血认知得分高于月收入<5 000元的成年居民,大专及以上学历的成年居民其无偿献血认知得分高于中学及以下学历,献血次数2次及以上的成年居民其无偿献血认知得分高于1次或0次的成年居民,医学相关工作者的成年居民其无偿献血认知情况高于非医学工作者(P<0.05)。是否是独生子女、不同户籍地、不同父母文化情况、家庭人均年收入不同的成年居民其对无偿献血认知情况的得分差异无统计学意义(P>0.05),家人支持献血的成年居民其无偿献血认知得分高于家中不支持献血的成年居民,家中有无偿献血的成年居民其无偿献血认知得分高于家中没有无偿献血的成年居民(P<0.05)。多元线性回归分析显示个人月收入、学历、献血次数、职业、家人是否支持献血、家人中无偿献血情况均是成年居民无偿献血认知情况的影响因素(P<0.05)。结论 廊坊地区成年居民无偿献血认知水平还有待提升,个人月收入、学历、献血次数、职业、家人是否支持献血、家人中无偿献血情况均会影响居民对无偿献血的认知水平。

Objective To understand the prevalence of and time changing trend in wasting, overweight and obesity amongst children and adolescents in Wuhan City from 2019 to 2022. Methods Based on the data regarding the Monitoring and Intervention Project of Common Diseases and Health Influencing Factors among Students in Wuhan City from 2019 to 2022, body mass index (BMI) was calculated by height and weight among 18,330 children and adolescents. Cochran-Armigtage trend test was used to explore the time changing trend, and χ² test was employed to compare the differences among groups. Results The detection rate of wasting decreased from 5.20% in 2019 to 3.40% in 2022, showing a decreasing trend (Z=-3.080, P<0.05). The detection rate of obesity increased from 13.73% in 2019 to 18.07% in 2022, showing an increasing trend (Z=-4.536, P<0.05). The total detection rates of wasting, overweight and obesity were 4.10%, 17.14% and 16.36% respectively. The detection rates of wasting, overweight and obesity were all higher in male students than in female ones. The detection rates of overweight and obesity were higher in the main urban area than in the area far from the main urban area. The detection rates of wasting and overweight were found to be the highest in the group aged 15-17 years, while the detection rate of obesity was found to be the highest in the group aged 6-8 years, showing statistically significant differences in the different age groups (P<0.05). Conclusion The prevalence of wasting among children and adolescents aged 6-17 years in Wuhan City has been alleviated. The prevalence of obesity is increasing year by year, and the situation is grim.

Objective To analyze the long-term epidemic features of measles, mumps and rubella in Huai’an City, Jiangsu Province after the expansion of the immunization program in 2008, and to provide a scientific basis for prevention and control of local infectious diseases. Methods The reported data about measles, mumps and rubella cases in Huai’an City during 2008-2023 were described and analyzed through the China Information System for Disease Control and Prevention. The annual percent change (APC) and average annual percent change (AAPC) based on a Joinpoint regression model were used to analyze the trend changes in the incidence rates. Results A total of 569 cases of measles, 7,821 cases of mumps, and 463 cases of rubella were reported in Huai’an City from 2008 to 2023, with the average annual incidence rates being 0.71/100,000, 10.05/100,000 and 0.57/100,000 respectively. The time trend of mumps showed a turning point in 2012. From 2008 to 2012, the APC was 75.05%, without statistically significant difference in the increasing trend. From 2012 to 2023, the APC was -20.11%, and the decreasing trend was statistically significant (P=0.005). The incidence of measles and rubella showed an overall increasing and decreasing trend respectively, with the APC=AAPC being 2.81% and -8.26% respectively, showing no statistically significant difference. Seasonal indices indicated that the incidence peaks of measles, mumps and rubella were in February-May, April-July and March-June respectively. The male cases reported outnumbered the female, and students, nursery children and scattered children were the main high-incidence groups. Conclusion From 2008 to 2023, the incidence of measles, mumpsand rubella in Huai’an City fluctuated in different years. Vaccination strategy should continue to be implemented in future.Moreover, schools and kindergartens should be regarded as key prevention and control venues, and comprehensive prevention and control measures should be taken to effectively control the epidemic of measles, mumps and rubella.

Objective To understand the current status of human papillomavirus (HPV) infection among females in Neijiang area, and to establish an infection prediction model. Methods A retrospective analysis was conducted on 1,510 qualified clinical cases undergoing HPV screening in a large-scale comprehensive tertiary Class A hospital in Neijiang from May 2021 to November 2022. Univariate and multivariate logistic regression analyses were performed to identify risk factors for HPV infection, and then the results were employed to construct a prediction model for the training group. Data from January to February 2024 were used as the validation group for internal validation of the model. Results Among the screened females in this hospital, the total HPV infection rate was 39.00% (589/1,510), among which single infection accounted for 77.25% (455/589) and multiple infections 22.75% (134/589). The top five most common subtypes of HPV infection were as follows: HPV52 (8.21%, 124/1,510), HPV16 (6.69%, 101/1,510), HPV58 (6.16%, 93/1,510), HPV53 (4.57%, 69/1,510), and HPV39 (3.97%, 60/1,510). The results of multivariate logistic regression analysis displayed that age (>30 years old), education level below junior college, sexual frequency (≥2 times per week), and non-normative contraceptive methods were independent risk factors for HPV infection (P<0.05). As for the training group, the area under the curve (AUC) was 0.766 (95%CI: 0.740-0.792), with the sensitivity and specificity being 55.3% and 91.9% respectively. As for the verification group, the AUC was 0.797 (95%CI: 0.736-0.859), with the sensitivity and specificity being 68.8% and 78.1% respectively. The P-values based on the Hosmer-Lemeshow test in the two groups were both greater than 0.05, and the predicted curve of the calibration curves was basically consistent with the standard curve. The clinical decision curve analysis revealed that there was a good clinical net benefit when the threshold was greater than 18% in the training group as well as greater than 13% in the validation group. Conclusion Female HPV infection in Neijiang area was mainly dominated by HPV52, HPV16 and HPV58, and mainly affected by age (> 30 years old), education level below junior college, sexual frequency (≥2 times per week), and non-normative contraceptive methods. The model has good predictive performance and can be available for analyzing the risk of HPV infection in patients.

目的 深入了解新报告HIV异性性传播感染者的感染原因,分析我国艾滋病经异性性途径传播的危险因素,为干预策略调整提供参考。 方法 在HIV异性性传播疫情较重的福州市、柳州市、青岛市等6个地市,招募2022年12月—2023年5月间新报告的经异性性传播途径感染HIV的病例开展深入访谈并进行分析。 结果 本次访谈共招募75人,实际纳入分析的感染者为67人。其中男性36人,女性31人,平均年龄(48.2±11.7)岁。感染途径构成比例为非婚非商业性传播(44.8%,30/67)、商业性传播(26.9%,18/67)及婚内性传播(25.4%,17/67),余2例疑似遭遇性伤害/性暴力感染。分析结果显示,异性性传播感染者人群艾滋病相关知识缺乏、感染风险意识缺失、安全套使用率低,男性与低档场所卖淫妇女发生商业性无保护性行为,夫妻常年分居的女性与阳性配偶发生无保护性行为,阳性感染者发现晚等为异性性传播病例主要的感染风险因素。 结论 未来干预工作应加强重点地区重点人群的艾滋病宣传干预,如在农村中加强卖淫妇女、嫖客人群的干预,特别是加强中老年人群的干预,重视检测和配偶告知等工作。

Objective To explore the changing trends in the mortality rates of colorectal cancer in Beijing from 1992 to 2021, and to provide a basis for colorectal cancer prevention and treatment. Methods Based on the surveillance data about causes of deaths in Beijing from 1992 to 2021, Joinpoint regression model was used to analyze the changing trends in the mortality rates of colorectal cancer, and the age-period-cohort model was employed to estimate the effects of age, period and cohort on colorectal cancer mortality in Beijing. Results Overall, the crude mortality rate of colorectal cancer among residents in Beijing during 1992-2021 showed an upward trend, increasing from 7.18/100,000 in 1992 to 22.00/100,000 in 2021. The standardized mortality rate increased from 9.70/100,000 in 1992 to 10.86/100,000 in 2021. The average annual percentage change in the standardized mortality rate was 0.43% in the whole population, 0.92% in males and -0.15% in females. Estimation based on the age-period-cohort model displayed that the risk of death in the group aged 80- years based on age effect was 143.74 times that of the group aged 20- years. In terms of period effect, the risk of death in 2017-2021 was 1.94 times that of 1992-1996. As for the birth cohort effect, the risk of death in population born in 1997-2001 decreased by 0.09 times compared with those born in 1912-1916. Conclusion Overall, the mortality rates of colorectal cancer among residents in Beijing from 1992 to 2021 were on the rise, and the mortality rate was higher in males than in females. The risk of death due to colorectal cancer showed an upward trend with age and period. Males and the elderly are the key groups of concern.

Objective To analyze the current status of screening for high-risk population with theChronic Obstructive Pulmonary Disease Population Screener Questionnaire (COPD-PS) in a community, and to explore the validity of the questionnaire. Methods A random cluster sampling method was used to select 1,306 residents aged ≥35 years in a community in Shanghai in March-May 2023. COPD-PS was employed to perform the screening, and the contents included 5 scoring items like shortness of breath frequency, production of sputum, functional limitations due to breathing problems, smoking history and age. Demographic information, personal and family respiratory system disease histories were also investigated simultaneously. And residents with the score ≥5 points were defined as the population at high risk of COPD. Cronbach model, correlation analysis and factor analysis were applied to analyzing the reliability and validity of the scale.χ²test and logistic regression analysis were performed to analyze the distribution of high-risk population and risk factors. Results Analysis results based on the COPD-PS revealed that Cronbach’s α was 0.72, and KMO was 0.76. The confirmatory factor analysis model had good fitting results for all indicators. The high-risk proportion of COPD among the surveyed population was 16.54% (95%CI:14.56%-18.67%). The proportion of high-risk population was relatively high among males, residents aged 60 years and above, residents with low education, the retired, residents having a history of smoking, residents having a previous history of respiratory system disease and residents having a family history of respiratory system disease (all P<0.001). Logistic regression analysis displayed that advanced age (OR_{60-69 years old}=103.825, 95%CI:40.417-266.710; OR_{≥70 years old}=110.634, 95%CI:41.263-296.625), having a history of smoking (OR=3.272, 95%CI:2.657-4.029) and having a previous history of respiratory system disease (OR=2.598, 95%CI: 1.737-3.885) were independent risk factors for high-risk COPD. Conclusion The COPD-PS is a brief and effective questionnaire which can identify individuals who are likely to have COPD in the general population, and it is suitable for community screening applications. Community screening for high-risk COPD should focus on people aged 60 years and above, having a history of smoking and having a previous history of respiratory system disease.

目的 评估一起小学水痘暴发期间应急接种的疫苗保护效果(vaccine effectiveness, VE),为学校水痘疫情防控提供依据。方法 通过问卷调查表收集2023年5月衢州市发生的一起小学水痘暴发疫情的水痘病例信息和疫苗接种信息,采用流行病学曲线描述疫情期间水痘病例的分布,采用回顾性研究评估水痘减毒活疫苗(varicella attenuated live vaccine, VarV)的保护效果及不同免疫状态下应急接种效果。结果 本研究纳入该小学1 175名学生,共发现28例病例,总体罹患率为2.38%。597名学生参与应急接种,应急接种后,无免疫史学生、1剂次免疫史学生、无免疫史+应急接种学生、1剂次免疫史+应急接种学生的罹患率分别为6.67%(10/150)、5.34%(15/278)、1.67%(1/60)、0.37%(2/537),4组对象水痘罹患率差异有统计学意义(χ²=27.672,P＜0.001)。相较于未参加应急接种病例,参加应急接种病例的皮疹严重程度更轻、未出现发热症状、病程更短(P＜0.05)。与无免疫史的学生相比,1剂次免疫史的VE为33%(95%CI:-152%～82%),无免疫史+应急接种的VE为41%(95%CI:-442%～93%),1剂次免疫史+应急接种的VE为87%(95%CI:28%～98%)。结论 暴露后接种1剂次VarV能有效预防中度和重度水痘,缩短病程;既往1剂次疫苗接种并不能提供足够的群体免疫力来阻断水痘疫情的暴发,在2剂次VarV全程接种率较低的地区,应急接种是控制疫情的有效措施。

Objective To establish a high performance liquid chromatography for simultaneous determination of many hypoglycemic components in hypoglycemic healthcare products. Methods In this study, 18 kinds of main hypoglycemic components (including acarbose, acetohexamide, metformin, pioglitazone hydrochloride, glibenclamide, glipizide, glipazone, glimepiride, gliclazide, tolbutamide, rosiglitazone, chloropropylurea, nateglinide, troglitazone, repaglinide, tolazamide, phenformin hydrochloride and buformin hydrochloride) in 5 kinds of hypoglycemic health products were extracted by methanol ultrasonic extraction. The hypoglycemic components were determined by Agilent Eclipse Plus C18 liquid chromatography column (250 mm×4.6 mm, 5 μm) on Shimadzu Lc-2010AHT high performance liquid chromatograph. The mobile phase A was methanol, and the mobile phase B was 50 mmol/L ammonium acetate aqueous solution. Gradient elution conditions were as follows: 0-5 min, 20%A+80%B; 5-10 min, 20%-45%A+80%-55%B; 10-30 min, 45%-65%A+55%-35%B; 30-40 min, 65%-85%A+35%-15%B; 40-50 min, 85%-20%A+15%-80%B; and 50-60 min, 20%A+80%B. The column temperature was 35℃, the volume flow rate 0.8 ml/min, the injection volume 10 μl, and the detection wavelength 230 nm. Results The method showed good precision, stability and repeatability in the determination of 18 kinds of hypoglycemic components, with the relative standard deviation < 3.0%. In this study, the contents of 18 kinds of hypoglycemic components in 5 kinds of hypoglycemic healthcare products were determined by the detection method, and a total of 8 kinds of hypoglycemic components were detected, with the content range of (0.68-91.76) mg/kg. Conclusion The method is simple and easy to operate, can simultaneously determine 18 kinds ofhypoglycemic components, and is suitable for rapid screening and detection of illegal-added hypoglycemic components in hypoglycemic healthcare products.

目的 了解南京地区学龄前儿童的睡眠状况及屏幕暴露情况,探讨屏幕暴露对睡眠的影响。 方法 采用整群随机抽样法,于2024年3—5月在南京地区抽取1 864名3～＜6岁学龄前儿童的父母或主要监护人作为调查对象,采用一般情况量表、儿童睡眠习惯量表(Children’s Sleep Habits Questionnaire,CSHQ)、屏幕暴露量表进行调查,并对数据进行分析。 结果 1 864名学龄前期儿童日平均屏幕暴露时间为(1.56±0.62)h/d,工作日平均屏幕暴露时间为(1.48±0.52)h/d,周末屏幕暴露时间为(1.75±0.68)h/d,日平均屏幕暴露时间＜1 h为868名,占46.57%;日平均屏幕暴露时间≥1 h为996名,占53.43%;日平均睡眠时间为(9.53±1.04)h/d,工作日平均睡眠时间为(9.25±1.11)h/d,周末平均睡眠时间为(10.24±1.52)h/d。CSHQ得分为(46.72±8.24)分,CSHQ得分＜41分为329名,占17.65%,CSHQ得分≥41分为1 535名,占82.35%,不同年龄、家庭人均月收入、父母或监护人文化程度、独生子女、居住地区的学龄前儿童屏幕暴露时间比较,差异均有统计学意义(P＜0.05);不同年龄、家庭人均月收入、父母或监护人文化程度、独生子女、居住地区、不同日平均屏幕暴露时间的学龄前儿童CSHQ得分比较,差异均有统计学意义(P＜0.05);屏幕暴露是学龄前儿童睡眠不良的独立危险因素(OR=5.083,P＜0.001)。 结论 屏幕暴露是学龄前儿童睡眠不良的独立危险因素,家长需限制学龄前儿童屏幕使用时间,减少屏幕使用对学龄前儿童睡眠质量的影响。