ObjectiveTo genotype the specimens from hand-foot-and-mouth disease (HFMD) cases in Dehong Prefecture, Yunnan Province in 2023 by gene sequencing, and to analyze the genetic characteristics of Coxsackievirus A4 (CVA4), CVA6, CVA10, CVA16 and enterovirus A71 (EV-A71), so as to clarify the serotypes of enteroviruses causing endemic HFMD and the genotype composition of CVA4, CVA6, CVA10, CVA16 and EV-A71 prevalent in HFMD, and to provide baseline genotype data for monitoring the dynamic changes of the five virus genotypes.MethodsStool specimens from HFMD cases in Dehong Prefecture in 2023 that tested positive for EV-A71, CVA16 and other enteroviruses by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) were first subjected to gene sequencing and typing of the VP4/VP2 junction region to determine the viral types. Subsequently, the complete VP1 gene of each virus was amplified in two segments using group-specific VP1 gene primers corresponding to enterovirus groups (i.e., enterovirus group A, B, and C) and sequenced (group A virus: primers 486/488 and 487/489, group B virus: primers 490/492 and 491/493, group C virus: primers 494/496 and 495/497). The representative reference sequences of VP1 genes for CVA4, CVA6, CVA10, CVA16 and EV-A71 were downloaded from the literature, and the VP1 gene phylogenetic tree was constructed using MEGA 6.0 software for genetic characterization.ResultsA total of 256 stool specimens were collected from HFMD cases in Dehong Prefecture in 2023, of which 94 tested positive for nucleic acid by RT-qPCR, yielding a positive rate of 36.72%. Of the 94 positive specimens, 83 were identified as group A viruses, and were classified into 5 serotypes (17 strains of CVA4, 3 of CVA6, 6 of CVA10, 49 of CVA16, and 8 of EV-A71). Nine strains were group B viruses, comprising 2 serotypes: 2 strains of echovirus type 3 (E3) and 7 strains of Coxsackievirus B type 5 (CVB5). The remaining 2 strains were group C viruses, both identified as poliovirus type 3 (PV3). Genetic analyses of the VP1 region showed that all 17 CVA4 strains were identified as subgenotype C2, all 3 CVA6 strains as subgenotype D3a, all 6 CVA10 strains as genotype C. Among the 49 CVA16 strains, 46 were identified as subgenotype B1a and 3 as subgenotype B1b, and all 8 EV-A71 strains were identified as subgenotype C4a.ConclusionIn 2023, group A viruses dominated the pathogenic spectrum of HFMD in Dehong Prefecture. Among them, CVA16 had the highest positivity rate. Genetic characteristic analyses showed that CVA4, CVA6, CVA10 and EV-A71 were each composed of a single genotype (subgenotype), while CVA16 was composed of two subgenotypes (B1a and B1b), with B1a being the predominant one. It is recommended that molecular epidemiological surveillance of HFMD pathogens, particularly group A viruses, be continuously strengthened in Dehong Prefecture.
[Objective]To investigate the associations of multiple glycolipid metabolic indicators and their cumulative abnormality burden with incident colorectal cancer risk in a general population-based prospective cohort,and to examine the mediating role of glycolipid metabolic abnormalities in the relationships between smoking,alcohol consumption,physical activity,and colorectal cancer incidence.[Methods]A total of 17 897 eligible participants recruited from the Taizhou Cohort between 2011 and 2014 were included.Cox proportional hazards regression models were used to assess the associations of conventional and derived glycolipid indicators,as well as a glycolipid abnormality index constructed from total cholesterol,triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,fasting plasma glucose,and insulin,with incident colorectal cancer risk.Restricted cubic spline models were applied to evaluate dose-response relationships for major indicators.Receiver operating characteristic curves were generated to compare predictive performance across indicators.Mediation analyses were conducted to assess the mediating effects of the glycolipid abnormality index on the associations of smoking,alcohol consumption,and physical activity with colorectal cancer incidence.[Results]During a median follow-up of 11.2 years,102 incident colorectal cancer cases were identified,with an incidence density of 51.2 per 100 000 person-years.After adjustment for potential confounders,Cox proportional hazards regression analyses showed that decreased high-density lipoprotein cholesterol was associated with a 1.74-fold higher risk of colorectal cancer(HR=1.74,95%CI:1.03-2.95),elevated low-density lipoprotein cholesterol was associated with a 1.78-fold higher risk(HR=1.78,95%CI:1.05-3.02),and abnormal fasting plasma glucose was associated with a 1.86-fold higher risk(HR=1.86,95%CI:1.15-3.02).Triglycerides and fasting plasma glucose showed an approximately linear increasing association with colorectal cancer risk in multivariable restricted cubic spline models.The glycolipid abnormality index showed a clear gradient association with colorectal cancer risk;participants with three or more abnormal indicators had a 3.08-fold higher risk than those without abnormalities(HR=3.08,95%CI:1.60-5.92).The area under the curve was 0.795,higher than that of individual glycolipid indicators and other combined indices,and gender-stratified analyses showed generally consistent patterns.Glycolipid metabolic abnormalities partially mediated the associations of smoking,alcohol consumption,and physical activity with colorectal cancer incidence,with mediation proportions of 8.33%,9.45%,and 9.04%,respectively.[Conclusion]Glycolipid metabolic abnormalities are associated with an increased risk of incident colorectal cancer.The glycolipid abnormality index shows an increasing relationship with colorectal cancer risk and demonstrates better discrimination,and it partially mediates the associations of smoking,alcohol consumption,and physical activity with colorectal cancer incidence in the overall population.
[Objective]To investigate the status and influencing factors of latent tuberculosis infection(LTBI)among close contacts of patients with bacteriologically confirmed pulmonary tuberculosis in Jing'an District,Shanghai,and to provide scientific evidence for the development of tuberculosis infection testing and preventive intervention strategies for close contacts of bacteriologically positive patients.[Methods]From October 2022 to October 2023,patients with bacteriological confirmed pulmonary tuberculosis registered in Jing'an District,Shanghai,and their close contacts were enrolled as the research subjects.The close contacts were screened for tuberculosis infection using the interferon-γ release assay(IGRA).The chi-square test and binary logistic regression model were used to analyze factors influencing LTBI.[Results]A total of 112 close contacts were included,of whom 30(26.79%)were male and 82(73.21%)were female.The age ranged from 1 to 86 years,with a median(25th,75th percentiles)of 47.50(32.25,61.00)years.The infection rate of LTBI was 21.43%(24/112),and the incidence of active pulmonary tuberculosis was 2.68%(3/112).Univariate analyses showed that a positive sputum smear of the index case,being a direct relative of the index case,co-living,and not wearing a mask were significantly associated with LTBI(all P<0.05).Multivariate logistic regression analyses showed that the risk of latent infection in close contacts of the index case with a positive sputum smear was 6.50 times higher than in those with a negative sputum smear(95%CI:1.82-23.25,P=0.004).[Conclusion]The infection rate of LTBI in close contacts of patients with bacteriologically confirmed pulmonary tuberculosis in Jing'an District,Shanghai,is relatively high,and close contacts of sputum smear-positive patients face an even higher risk of infection.Therefore,tuberculosis infection screening and follow-up management should be strengthened for this population.
[Objective]To investigate the detection status of scoliosis and its influencing factors among primary and secondary school students in Jiangqiao Town in Jiading District of Shanghai,thereby providing evidence for the prevention and management of scoliosis in children and adolescents.[Methods]A stratified cluster random sampling was conducted in March 2025.Three primary schools and two secondary schools in Jiangqiao Town were randomly selected;within each school,3-4 entire classes were randomly chosen.Screening was performed in accordance with the criteria specified in GB/T 16133-2014 Screening for Abnormal Spinal Curvature in Children and Adolescents,and a self-designed structured questionnaire was administered to conduct face-to-face surveys(Cronbach's α=0.730).[Results]A total of 772 valid questionnaires were collected on-site,representing a 100%response rate.The sample consisted of 413 males(53.50%)and 359 females(46.50%),including 385 primary school students(49.87%)and 387 secondary school students(50.13%).The detection rate of scoliosis in primary and secondary school students was 12.05%.The detection rates were 8.72%for males and 15.88%for females,with the female rate being significantly higher than the male rate(χ²=9.29,P=0.002).For primary and secondary school students,the detection rates were 6.75%and 17.31%,respectively,with the secondary school student rate being significantly higher(χ²=20.31,P<0.001).The results of univariate analysis revealed that students with sufficient sleep and standard sitting postures during reading/writing had a significantly lower scoliosis detection rate compared to those with insufficient sleep and non-standard sitting postures(χ²=5.90,P=0.015 and χ²=5.09,P=0.024).Multivariate logistic regression analyses revealed that the detection rate of scoliosis was significantly higher in females than in males(OR=1.846,95%CI:1.156-2.984),and significantly higher in secondary school students than in primary school students(OR=2.722,95%CI:1.656-4.472).[Conclusion]The scoliosis detection rate among primary and secondary school students in Jiangqiao Town in Jiading District is relatively high.Females and secondary school students are key populations requiring targeted prevention and control efforts.It is imperative to strengthen health education on scoliosis,promote early screening and diagnosis,and implement timely targeted interventions.
ObjectiveTo examine factors associated with breast cancer among adult women in suburban Shanghai and develop a risk stratification model, and to provide a basis for the identification of high-risk populations.MethodsA cross-sectional study was conducted using baseline data from the Shanghai Suburban Adult Cohort and Biobank. A total of 39 683 women aged 20-74 years, comprising 249 breast cancer cases and 39 434 non-breast cancer cases, were included. Information on demographic characteristics, reproductive health, lifestyle, chronic diseases, and psychological status was collected. Missing data were handled using multiple imputation. Multivariable Firth logistic regression analyses were used to identify factors associated with breast cancer, and restricted cubic spline analyses were performed to assess the dose-response relationship between glycated hemoglobin and breast cancer. With breast cancer as the outcome variable, the data were randomly split into a training set and a test set at a ratio of 7∶3. A logistic regression model was developed for risk stratification and further calibrated using Platt scaling. Model performance was evaluated using the area under receiver operating characteristic curve (ROC-AUC), area under the precision-recall curve (PR-AUC), Brier score, calibration intercept, and calibration slope, to assess discrimination, overall prediction error, and calibration. Given that breast cancer was a low-prevalence outcome, the model’s precision, recall, and lift for the top 5% and top 10% of high-risk individuals were further calculated, to evaluate the model’s ability to identify and stratify risk in high-risk screening scenarios.ResultsIn the fully adjusted multivariable Firth logistic regression model, increasing age was associated with a higher risk of breast cancer (OR=1.050, 95%CI: 1.033-1.067), whereas older age at menarche (OR=0.921, 95%CI: 0.859-0.987) and a greater number of pregnancies (OR=0.875, 95%CI: 0.770-0.986) were associated with a lower risk of breast cancer. Women with a history of estrogen use had a higher risk of breast cancer than those without such a history (OR=3.098, 95%CI: 1.481-5.728). Hyperglycemia was associated with an increased risk of breast cancer (OR=1.754, 95%CI: 1.305-2.334). Compared with women without anxiety or depression, those with mild (OR=2.239, 95%CI: 1.484-3.266) or severe (OR=10.104, 95%CI: 1.106-32.798) anxiety or depression had a higher risk of breast cancer. Restricted cubic spline analyses showed a nonlinear association between glycated hemoglobin and breast cancer (P=0.003). The logistic regression-based risk stratification model showed moderate discriminative ability (ROC-AUC=0.730, 95%CI: 0.673-0.784) and a low overall prediction error (Brier score=0.006, 95%CI: 0.006-0.006). The lift values were 4.261 for the top 5% high-risk group and 3.199 for the top 10% high-risk group, identifying 21.3% and 32.0% of breast cancer cases, respectively.ConclusionBreast cancer among adult women in suburban Shanghai is associated with older age, earlier age at menarche, fewer pregnancies, history of estrogen use, hyperglycemia, and mild and severe anxiety or depression, suggesting that greater attention should be paid to reproductive hormone-related factors, metabolic abnormalities, and psychological health in community-based women’s health management. The logistic regression-based model using routine epidemiological indicators shows moderate discriminative ability and potential for enriching high-risk populations and might help support initial screening and stratified management of women at high risk of breast cancer in resource-limited community settings.
ObjectiveTo conduct an epidemiological investigation and analysis of a clustered scabies outbreak in a middle school, so as to provide evidence for developing targeted prevention and control strategies.MethodsCase data on a clustered scabies outbreak occurring in a middle school of Shaanxi Province in 2025 were collected. Field epidemiological approaches were adopted to define cases, search for infected individuals, and describe the temporal, spatial, and population distribution. Specimens were collected from individuals and surrounding environments for laboratory testing.ResultsA total of 25 scabies cases were identified in 4 classes and 9 dormitories of the school. All cases were first-year high school students. The overall attack rate was 6.00% (25/414); the attack rate was 10.53% (22/209) among male students and 1.46% (3/205) among female students. The disease course ranged from 10 to 30 days, with a median duration of 14 days, and 3 students (12.00%) continued attending classes with ongoing infection. Skin scrapings collected from lesion sites of 3 patients were examined under microscopy, all of which were positive for Sarcoptes scabiei; no laboratory testing was performed for the remaining cases. This clustered scabies infection outbreak lasted for one month. All affected students recovered completely without severe complications or deaths, and the outbreak was effectively contained.ConclusionThis scabies infection is a clustered school-based scabies outbreak caused by Sarcoptes scabiei. Affected patients present relatively severe symptoms and a prolonged disease course. Scientific and standardized preventive systems should be established to enable timely early warning and emergency response.
[Objective]To investigate the current awareness and optimization recommendations on pneumonia with unknown etiology(PUE)surveillance among Shanghai healthcare professionals,and to provide evidence for the improvement of the surveillance system.[Methods]In December 2024,healthcare professional participants from diverse medical and health institutions were randomly selected within each stratum using a stratified cluster sampling method in all 16 districts of Shanghai for questionnaire surveys on their knowledge and suggestions for optimization of the PUE surveillance system.Descriptive statistics analyses,multivariate logistic regressions,and content analyses were used for data analyses.[Results]A total of 385 survey subjects were involved in the study,including 119 professional staffs from disease prevention and control centers and 266 from medical institutions.Those who understood the case definition for PUE correctly accounted for 67.01%(258/385).Multivariate regression model analyses showed that female gender(aOR=2.22,95%CI:1.36-3.66),professionals from disease control institutions(aOR=2.02,95%CI:1.12-3.72),and those who self-assessed as being familiar with the monitoring system(aOR=2.18,95%CI:1.23-3.89)had better understanding of the definition.Overall,89.61%(345/385)of the survey subjects acknowledged the necessity of the surveillance system.Small number of cases meeting the case definition(54.46%,214/379),insufficient diagnostic awareness(39.84%,151/379),and lack of incentives for case reporting(29.29%,111/379)were major problems for the current surveillance system,with variations observed across different types of institutions.Suggested segments for optimizing the surveillance system included monitoring purpose,case definition,form of monitoring and reporting procedure,organization mechanism,and epidemiological investigation and response.[Conclusion]The necessity of PUE surveillance is commonly recognized among healthcare workers.However,the existing system falls short in terms of mastery of case definition and overall surveillance adaptability.There is an urgent need for optimization and improvement to enhance the capacity for preventing and controlling emerging and sudden respiratory infectious diseases.
[Objective]To investigate the screen exposure situation and its determinants among children aged 0-3 years,so as to offer insights for intervening in children's screen exposure.[Methods]A total of 1 797 children who received routine physical examinations in Shaoxing Maternal and Child Health Care Hospital from January 2024 to December 2024 were enrolled.A self-designed screen exposure questionnaire was used to collect demographic information for children,educational attainment of parents and main caregivers,contents of video screen exposure,and video devices.The screen exposure rate among children was analyzed,and a multivariable logistic regression model was used to analyze its influencing factors.[Results]Among the 1 797 children aged 0-3 years,935 were boys(52.03%),and 862 were girls(47.97%).The mean age was(21.81±9.97)months old.A total of 335 infants and toddlers had an average daily cumulative screen exposure>1 hour over the past week,with a screen exposure rate of 18.64%.Multivariable logistic regression analyses showed that the risk of screen exposure was higher with each one-year increase in the child's age(OR=1.90,95%CI:1.58-2.28),with cartoons or nursery rhymes as the main video content(OR=2.09,95%CI:1.27-3.44;OR=1.75,95%CI:1.02-2.97,respectively),and with watching videos during the period for meals or for parents doing housework,or before bedtime(OR=3.51,95%CI:2.08-5.92;OR=2.92,95%CI:1.75-4.88;OR=2.01,95%CI:1.16-3.49,respectively).In contrast,higher maternal educational levels(OR=0.67,95%CI:0.49-0.92)were associated with a reduced rate of screen exposure.[Conclusion]Among children aged 0-3 years,their screen exposure is associated with their age,maternal educational level,screen content,and time of video watching.The departments should strengthen the education on screen exposure for older children and the mothers with lower education,while advocating for parents to scientifically and normatively manage screen content and time.
[Objective]To describe the prevalence and dynamic pain characteristics of dysmenorrhea among female medical students through a menstrual diary-based observational study.[Methods]From April to June 2021,female students were recruited from a medical college in Shanghai to complete menstrual diaries and record dysmenorrhea-related characteristics for two menstrual cycles.Dysmenorrhea severity was assessed using the visual analogue scale(VAS)(no pain:0;mild:1-3;moderate:4-6;severe:7-10).A total of 323 diaries were collected,of which 303 were 93.81%valid(valid response rate:93.81%),covering 596 complete menstrual cycles.Among them,293 participants completed diaries for two cycles and were included in the analysis of persistent dysmenorrhea.Period,point,and persistent prevalence of dysmenorrhea were calculated using the number of participants as the denominator.Paired comparisons were performed using Cochran's Q test and Bonferroni-adjusted McNemar tests.Using menstrual cycles with dysmenorrhea as the unit of analysis,the distributions of pain onset,peak timing,and pain duration across different severities were compared using the χ² tests or Fisher's precision probability tests.[Results]Among 303 female college students,269 experienced dysmenorrhea during the first recorded cycle,and 288 had dysmenorrhea in any cycle.Among 596 complete menstrual cycles recorded,527 were associated with dysmenorrhea(88.42%),and among 293 students who completed 2 complete recorded cycles,239 had persistent dysmenorrhea.The period,point,and persistent prevalence of dysmenorrhea among female college students were 95.05%(288/303),88.78%(269/303),and 81.57%(239/293),respectively(Q=61.61,P<0.001).The prevalence of persistently severe dysmenorrhea was 5.12%(15/293).Among the 527 dysmenorrheic cycles,there were statistically significant differences in the distribution of pain onset time(P=0.003)and pain duration(P<0.001)among different degrees of dysmenorrhea;mild dysmenorrhea mostly started on the first day of menstruation(52.83%),and moderate dysmenorrhea mostly started before menstruation(50.19%).Pain duration increased with severity;the proportions of cycles with pain lasting≥4 days were 13.20%,43.03%,and 51.56%for mild,moderate,and severe dysmenorrhea cycles,respectively.For all severity groups,mean pain scores peaked on the first day of menstruation and then decreased day by day to a stable level.[Conclusion]Dysmenorrhea is highly prevalent among female medical students,and differences exist across pain severity levels in onset time,duration,and dynamic changes in pain.Identification and health guidance for those with persistently moderate-to-severe dysmenorrhea should be strengthened,and medical evaluation should be conducted when necessary.
[Objective]To analyze the epidemiological status,serotypes,and drug resistance characteristics of Vibrio parahaemolyticus in foodborne disease surveillance in Wenzhou from 2016 to 2024,and to provide scientific evidence and data support for the prevention and control of Vibrio parahaemolyticus infections.[Methods]A total of 45 980 stool or anal swab samples were collected from patients with vomiting and diarrhea as the main symptoms and a history of consuming suspicious food at medical institutions at all levels in Wenzhou from 2016 to 2024.Isolation,identification,and drug susceptibility testing were performed.Case information was collected through the National Foodborne Disease Surveillance Reporting System.The Cochran-Mantel-Haenszel(CMH)chi-square test was used to analyze the detection rates among groups.[Results]Among the 45 980 suspected samples,2 821 were positive for Vibrio parahaemolyticus,with an overall detection rate of 6.14%.A comparison of detection rates across different population groups revealed that the highest rates were found among adults aged 20-39(8.57%,1 603/18 697)and among farmers and workers(7.93%,994/12 537).A comparison of detection rates across different seasons revealed that the detection rates were higher from June to October(5.12%,9.04%,15.04%,14.68%,and 7.80%,respectively),peaking in August.Analyses of the sampling results for suspect foodstuffs revealed that aquatic products and their derivatives accounted for the highest proportion(42.86%).Regarding the setting of food consumption,the household accounted for 44.53%(1 257/2 821).From 2016 to 2020,the predominant serotype was O3:K6(28.82%,813/2 821),followed by O10:K4(28.25%,797/2 821)and O4:KUT(23.61%,666/2 821).In terms of drug resistance,the resistance rate to cefazolin was the highest at 84.15%(393/467),and the multi-drug resistance rate was 6.21%(29/467).[Conclusion]From 2016 to 2024,patients with suspected foodborne illnesses in Wenzhou City experienced a peak in Vibrio parahaemolyticus infections during the summer and autumn months(June to October).Young adults aged 20-39,as well as farmers and manual workers,were the key target groups for the prevention and control of Vibrio parahaemolyticus infections.The predominant serotype of Vibrio parahaemolyticus shifted from O3:K6 to O10:K4.Vibrio parahaemolyticus exhibited a high level of resistance to cefazolin.It is essential to strengthen surveillance of the epidemiological trends of the predominant serotype,monitor changes in the antibiotic resistance of Vibrio parahaemolyticus,enhance health education for key populations,and intensify regulatory inspections of high-risk foods such as aquatic products and their derivatives.
ObjectiveTo analyze the composition of respiratory virus pathogen spectrum and epidemiological characteristics among adult influenza-like illness (ILI) cases in Putuo District of Shanghai from 2015 to 2024, to summarize the epidemic patterns of respiratory viruses across different time periods and populations, and to provide scientific evidence for the prevention and control of adult respiratory virus infections in Putuo District of Shanghai.MethodsSurveillance data of 2 273 adult ILI cases from sentinel hospitals under the comprehensive surveillance system for acute respiratory infections in Putuo District of Shanghai from 2015 to 2024 were retrospectively collected. Descriptive epidemiological methods were adopted to analyze the temporal and population distribution characteristics of respiratory viruses, including influenza virus (IFV), respiratory syncytial virus (RSV), adenovirus (ADV), and human metapneumovirus (HMPV). The mixed infection status among different age groups was compared, and the distribution of influenza virus subtypes was described. SPSS 22.0 and WPS Office software were used for statistical analyses.ResultsThe overall detection rate of respiratory viruses in 2 273 adult ILI cases was 43.51%. The detection rate in females (45.48%) was significantly higher than that in males (41.25%), with statistical significance (χ2=4.113, P=0.043). Individuals aged 60 years old and above had the highest detection rate (47.41%) (χ2=8.430, P=0.014). The detection rates in winter (50.41%) and summer (48.42%) were higher than those in other seasons (χ2=47.028, P<0.001). The overall viral detection rate decreased after 2020 (χ2=208.411, P<0.001). Detection rates of various viruses varied by year, with IFV and ADV showing high rates from 2015 to 2019 (all P<0.001), while human coronavirus (HCoV) and rhinovirus/enterovirus (HRV/EV) exhibited higher rates from 2020 to 2022 (all P<0.001). Co-infection with IFV and HCoV was the most common, followed by co-infection with IFV and ADV, together accounting for 50.00% of all mixed infections. During the surveillance period, the detection rate of IFV was significantly higher than that of other respiratory viruses. Influenza B/Victoria lineage predominated in 2021, followed by successive predominance of influenza A(H1N1), A(H3N2), and the co-circulation of the two subtypes from 2022 to 2023. Influenza A(H1N1) re-emerged as the predominant subtype in the first half of 2024.ConclusionFrom 2015 to 2024, respiratory virus infections in adults prevailed in winter and summer, and people aged 60 years old and above were the key high-risk population. The detection rates of respiratory viruses declined after 2020. IFV was the predominant pathogen detected, and different influenza virus subtypes circulated alternately each year.
[Objective]To investigate the physical fitness status and associated factors among preschool children aged 3 to 6 years in Tongzhou District of Beijing,and to provide evidence for promoting physical development in this population.[Methods]Based on the 2020 National Physical Fitness Surveillance data for Tongzhou District of Beijing,a total of 416 children were included for standardized physical tests,including morphological,physiological,and fitness indicators,and questionnaire surveys.Independent sample t-tests and ANOVA were used to compare differences in physical indicators across groups,while multivariate linear regression models were applied to analyze influencing factors.[Results]The comprehensive fitness score of children aged 3 to 6 years old in Tongzhou District of Beijing was(79.98±6.97)points,with an overall physical fitness pass rate of 99.52%.The proportions of excellent,good,and pass grades were 37.50%,39.90%,and 22.12%,respectively.The average heights for the 3-years-old,4-years-old,5-years-old,and 6-years-old groups in Tongzhou District were(102.13±4.24)cm,(107.92±4.66)cm,(115.43±4.70)cm,and(119.16±4.33)cm,respectively.The corresponding average body weights were(16.63±2.46)kg,(18.66±2.54)kg,(21.60±4.02)kg,and(23.46±4.64)kg,respectively.Among children aged 3 to 6 years,the average BMI was(15.95±1.79)kg·m-2,body fat percentage was(21.92±4.77)%,resting pulse rate was(95.24±9.70)beats per minute,grip strength was(5.74±2.07)kg,standing long jump distance was(78.12±19.95)cm,sit-and-reach flexibility was(12.25±4.65)cm,continuous two-foot jump time was(6.29±2.55)seconds,15-meter obstacle shuttle run time was(7.94±1.30)seconds,and balance beam walking time was(5.11±2.25)seconds.Multiple linear regression analyses showed that higher composite fitness scores were significantly positively associated with female gender(b=1.72,95%CI:0.42-3.01),aged 4 years old and above(b=2.97,95%CI:1.35-4.59),mixed feeding(b=4.16,95%CI:1.60-6.72)or breastfeeding(b=3.23,95%CI:0.36-6.10)during infancy,taller paternal(b=0.16,95%CI:0.02-0.30)and maternal(b=0.25,95%CI:0.11-0.39)height(all P<0.05).[Conclusion]The physical fitness of children aged 3 to 6 years in Tongzhou District of Beijing is generally favorable,with gender,age,feeding patterns,and genetic factors identified as key correlating factors.Comprehensive strategies are recommended to improve early childhood physical health.
[Objective]To analyze the correlation between family nurturing care environment and children with autism spectrum disorder(ASD)or at high risk,and to provide scientific evidence for the tertiary prevention of ASD in children at high risk.[Methods]A case-control study,enrolling 30 children with ASD or at high risk for ASD as the case group,and 113 normal children who underwent routine physical examinations at the community health service centers and district maternal and child health care hospital during the same period as the control group,was conducted.The information for maternal pregnancy and childbirth,children,and family nurturing care was collected through the child healthcare system and a self-designed questionnaire survey.Multivariate logistic regression analyses were used to identify the relevant factors for ASD or high-risk status in children.[Results]Multivariate logistic regression analyses showed that among maternal and child factors,maternal adverse conditions during the 3 months before pregnancy and throughout pregnancy(OR=6.026,95%CI:1.575-23.062),and male gender(OR=4.064,95%CI:1.046-15.784)were positively correlated with ASD or high risk status in children(P<0.05).Among family nurturing care factors,unbalanced dietary structure(OR=7.281,95%CI:1.819-29.148)was positively correlated with ASD or high-risk status in children(P<0.05),while paternal companionship>2 h·d-1(OR=0.025,95%CI:0.001-0.426)and parent-child interaction with responsive care(OR=0.824,95%CI:0.704-0.963)were negatively correlated with ASD or high-risk status in children(P<0.05).[Conclusion]Factors positively correlated with ASD or high-risk status in children include maternal adverse conditions during the 3 months before pregnancy and throughout pregnancy,male gender,and unbalanced dietary structure.Factors negatively correlated with it include paternal companionship and parent-child interaction with responsive care.Clinically,comprehensively management of maternal pre-pregnancy and prenatal health,children's diet and family nurturing care,along with focused developmental monitoring of boys,and efforts toward early detection,early diagnosis and early intervention should be strengthened.
[Objective]To analyze the association between sleep chronotypes and myopia among junior high school students in Changning District of Shanghai,and to provide scientific basis for myopia intervention in this population.[Methods]This study was conducted as a cross-sectional survey using stratified cluster sampling.Four junior high schools in Changning District were selected as the research sites.Two methods were used to assess chronotypes,including the sleep-wake pattern calculated based on sleep duration and the sleep chronotype evaluated by the Morningness-Eveningness Questionnaire-5 items(MEQ-5).Myopia status of students was determined through distant visual acuity examination combined with non-cycloplegic computerized refraction.The χ2 test or t test was used to compare the distribution differences of sleep chronotypes between the myopic and non-myopic groups.Furthermore,a multivariate logistic regression model was used to analyze the association between sleep chronotypes and myopia.Statistical analyses were performed using SPSS 27.0 software.[Results]A total of 801 middle school students participated in this survey,with a screening-based prevalence of myopia of 81.77%.Univariate analyses showed that both the sleep chronotype calculated based on the sleep-wake pattern(χ2=4.54,P=0.033)and the sleep chronotype assessed by the MEQ-5(χ2=12.75,P=0.013)were statistically associated with myopia.After adjusting for grade,maternal age at birth,parental myopia,frequency of weekend outdoor activities,and sleep duration,multivariate analyses indicated that a higher grade(e.g.,grade 9:OR=3.63,95%CI=1.92-6.87)and myopia in both parents(OR=2.73,95%CI=1.23-6.06)were associated with a higher risk of myopia.In contrast,older maternal age at birth(OR=0.64,95%CI=0.49-0.85)and more frequent weekend outdoor activities(e.g.,1-2 times per week:OR=0.21,95%CI=0.05-0.88;≥5 times per week:OR=0.16,95%CI=0.04-0.71)were associated with a lower risk of myopia.The association between MEQ-5 chronotype and myopia was not statistically significant after multivariate adjustment(P=0.124).However,compared with the"absolute evening type",the odds ratios(ORs)for myopia risk across sleep chronotypes decreased from 3.22(moderate evening type)to 0.57(absolute morning type),with fluctuations in between(0.95 for the"intermediate type"and 0.98 for the"moderate morning type").[Conclusion]A sleep chronotype tending toward the"evening type"in junior high school students may be associated with an increased risk of myopia,and this association requires further prospective studies to validate.
[Objective]To analyze the epidemiological and clinical characteristics of pertussis in Taizhou City,Zhejiang Province,2024,and to provide a scientific basis for formulating local prevention and control strategies.[Methods]Case data and population data were obtained from the China Disease Prevention and Control Information System.Epidemiological case investigation data were collected from the Zhejiang Vaccine Clinical Research and Application Effectiveness Evaluation System and the Immunization Service Information System.Descriptive epidemiological methods were used to analyze the temporal,spatial and demographic distributions,and SaTScan 9.7 software was applied for spatiotemporal cluster scanning.[Results]In 2024,a total of 3 090 pertussis cases were reported in Taizhou City,with no deaths.The number of reported cases increased significantly compared with those in previous years,and the peak occurred in April.Spatiotemporal scanning identified three clusters:a most likely cluster centered around Tantou Town in Tiantai County,covering 16 streets/towns,a second most likely cluster centered around Taiping Subdistrict in Wenling City,covering 11 streets/towns,and a third most likely cluster centered around Ganjiang Town in Yuhuan City,covering 6 streets/towns.The three clusters together accounted for 31.04%of the total scanned cases.The majority of cases were in the 6-10 years age group(55.02%),and students accounted for the highest proportion by occupation(44.17%).Among 2 929 epidemiological investigation cases,the most common clinical manifestations were cough(97.58%)and aggravated nocturnal cough(52.10%),while typical symptoms(including paroxysmal spasmodic cough and post-tussive vomiting,etc.)were less frequent.Among the cases,82.49%had completed the full 4-dose vaccination schedule,and their complication rate(10.47%)was lower than that of the unvaccinated group(20.56%).[Conclusion]The number of reported pertussis cases surged in Taizhou City in 2024,showing significant spatiotemporal clustering,with school-aged children being the high-risk group.Vaccination could reduce the risk of complications.It is recommended to further enhance surveillance sensitivity,with a focus on strengthening immunization strategies for high-risk groups such as school-aged children aged 6-10 years,and to reinforce targeted protection for infants under 1 year old who have not completed primary vaccination,along with their families.In addition,prevention and control resources should be deployed in advance for the cluster areas identified through spatiotemporal analysis and for the spring peak season,to interrupt local transmission chains.
ObjectiveTo analyze the potential risk of infection sources during the consolidation phase of schistosomiasis elimination in Lushan County (a mountainous region) of Sichuan Province, and to provide prevention and control strategies for the consolidation of schistosomiasis elimination achievements in mountainous areas.MethodsIn 2024, one to two villages with historically severe epidemics were selected in the heavily endemic townships of Lushan County as monitoring sites to carry out monitoring for wild animal feces, domestic animals, wild rats, free-roaming dogs, local residents, and mobile populations. Follow-up monitoring for previously infected individuals was carried out in Caoping Village of Siyan Town. Statistical analyses were performed to assess the risks associated with infection sources.ResultsA total of 115 fecal samples from 13 species of wildlife were incubated, with all negative. Blood tests were conducted on 492 cattle, 34 sheep, and 261 dogs, with all negative. A total of 2 520 rodent traps were set, capturing 67 wild rats with a capture rate of 2.66%, and no positive wild rats were found upon dissection. The activity track of 25 loose dogs was 2 212 meters at the farthest, 236 meters at the nearest, and 744 meters on average. a total of 68 wild droppings (all dog feces) were picked up along the way, with all negative. Blood tests were performed on 3 540 local population, yielding 39 blood-positive cases with a blood positive rate of 1.1%. Fecal examinations were conducted on 193 individuals, with all negative. A total of 315 blood tests were performed on the mobile population, identifying 1 positive case with a blood-positive rate of 0.32%. One person received a fecal examination, with zero positive. A follow-up survey of 505 previously infected individuals revealed 5 blood-positive cases, with a positive rate of 0.99%. Fecal examinations were conducted on 15 individuals, with all negative.ConclusionIn this investigation, no local or imported sources of schistosomiasis transmission were found. However, there was a wide variety and a large number of potential sources of infection in the local area. It is necessary to actively explore regional monitoring models for schistosomiasis elimination flexibly adjust prevention and control strategies according to local conditions, achieve precise prevention and control, and consolidate the achievements of elimination.
[Objective]To understand the epidemiological characteristics and post-exposure prophylaxis of rabies exposure cases in Suqian City of Jiangsu Province from 2021 to 2024,providing a reference for optimizing the allocation of health resources and formulating scientific prevention and control measures.[Methods]Data on individuals exposed to rabies and treated at Suqian's rabies post-exposure prophylaxis(PEP)clinics from 2021 to 2024 were collected.Descriptive epidemiological methods were used to analyze patient characteristics,exposure classification,animal species responsible for injuries,wound management,and vaccination status.[Results]Between 2021 and 2024,the number of outpatient visits for rabies PEP clinics in Suqian City totaled 333 450.The median age and the 25th and 75th percentiles of exposed individuals was 23(9,47)years.The highest proportion of exposed individuals was recorded in 2023(27.09%);the majority were female(52.22%),aged 5-9 years(17.49%),and in other occupations(37.05%).The rabies exposure rate in Suqian City from 2021 to 2024 was 16.75‰.The overall rabies exposure rate showed an upward trend(χ2trend=1 994.80,P<0.001).The exposure rate among males was lower than that among females(χ2=890.43,P<0.001).The highest exposure rate was observed in the 5 - 9 age group(χ2=67 063.20,P<0.001).The number of individuals seeking medical care for rabies exposure exhibited a weak bimodal distribution,with the primary peak occurring in August and the secondary peak in January.The primary animal responsible for injuries was the cat(53.70%),and the source of these animals was predominantly domestic pets(88.90%).The proportion of exposed individuals bitten by cats showed an upward trend from 2021 to 2024(χ2trend=548.44,P<0.001).Grade Ⅲ exposure accounted for the highest proportion(53.53%),and 301 652 cases(90.46%)presented within 24 hours of exposure.The coverage rate of rabies vaccine was 98.18%(13 625/13 877)for those with Grade Ⅰ exposure and 99.95%(319 413/319 573)for those with Grade Ⅱ and Ⅲ exposures;64 042 individuals received rabies immunoglobulin or anti-rabies serum;8 360 exposed individuals received tetanus vaccine,with the usage rate of tetanus vaccine among exposed individuals was only 2.51%,though the rate was on the rise(χ2trend=618.26,P<0.001).[Conclusion]Between 2021 and 2024,the overall incidence of rabies exposure in Suqian City showed an upward trend,with a higher incidence among women than men.The incidence was particularly high among children and adolescents aged 14 and under,with the majority of injuries caused by cats;most injuries were inflicted by domestic animals.The overall uptake of tetanus vaccines showed an upward trend.Suqian City should step up health education on rabies exposure during January and August each year,with a particular focus on raising awareness of rabies exposure prevention among people aged 14 and under and women.It should also strengthen the management of domestic animals and ensure that they receive regular rabies vaccinations,particularly for pet cats.Preventive measures against tetanus should be strengthened for individuals exposed to rabies.Medical staff at rabies PEP clinics should receive enhanced training on the management of rabies exposures and the completion of information system reports to ensure the standardized operation of these clinics.
ObjectiveTo analyze the trend of stroke mortality among residents in Handan City of Hebei Province from 2017 to 2023, to evaluate the impact of this mortality on life expectancy, and to provide data support for formulating stroke prevention and control strategies.MethodsStroke mortality surveillance data were collected in Handan City from 2017 to 2023. The crude mortality rate, standardized mortality rate, gender-specific mortality rate, and subtype-specific mortality rate of stroke were calculated. The average annual percentage change (AAPC) was used to analyze the trend of stroke mortality. Arriaga’s decomposition method was used to estimate the influence of stroke mortality on life expectancy across all age groups and different stroke subtypes.ResultsThe standardized mortality rate of stroke in Handan City fluctuated from 63.51/ 100 000 to 103.54/100 000 from 2017 to 2023, showing a significant decreasing trend (AAPC=-7.46%, P<0.001). The changes in stroke mortality positively contributed 0.94 years to life expectancy growth. The positive contribution from the 65 to 69 years old group was the greatest, with a contribution of 0.23 years. The declines in the mortality rates of hemorrhagic stroke, ischemic stroke and unclassified stroke contributed 19.94%, 14.61% and 0.44% to life expectancy, respectively. The positive contribution in the 65 to 69 years old group was the greatest, with a contribution of 4.90% and 3.57% for hemorrhagic stroke and ischemic stroke, respectively. The 85 years old and above group made the greatest positive contribution to life expectancy for unclassified stroke, with a contribution of 0.08%.ConclusionThe standardized mortality rate of stroke in Handan City showed a declining trend from 2017 to 2023, which positively contributed to the increase of life expectancy. However, it is still recommended to strengthen the prevention and control of stroke, especially for men and people aged 60 years old and above. At the same time, attention should also be paid to the impact of different factors influencing hemorrhagic stroke and ischemic stroke on life expectancy.
[Objective]To analyze the output and efficiency of chronic disease management services for hypertension and diabetes in community health service institutions in Shanghai,to evaluate the allocation and efficiency of chronic disease management resources,and to provide references for improving the efficiency of chronic disease management in Shanghai's communities.[Methods]A total of 73 community health institutions from 15 districts of Shanghai were selected.Based on the chronic disease management resource data of community health institutions in 2019,2021,and 2023,descriptive methods and the BCC model in Data Envelopment Analysis(DEA)were used to analyze the resource allocation,service output,and the efficiency of chronic disease management services in community health institutions in Shanghai.[Results]From 2019 to 2023,the indicators of resource allocation and service output of community health service institutions in Shanghai all showed upward trends.In terms of service efficiency,the average number of chronic disease patients managed by each health technician decreased from 237 to 231,and the number of patients served per 1 000 working hours decreased from 54 to 44.DEA efficiency analyses showed that the average overall efficiency increased from 0.867 in 2019 to 0.886 in 2021 and then decreased to 0.811 in 2023.The average technical efficiency decreased from 0.901 to 0.847,which was the main reason for the decline in overall efficiency.The average scale efficiency showed an initial increase followed by a decrease,rising from 0.961 in 2019 to 0.977 in 2021 and dropping back to 0.955 in 2023.The number of strong effective districts(overall efficiency=1.000)decreased from 6 in 2019 to 3 in 2023,and the efficiency differences between districts expanded.The range of overall efficiency widened from 0.622 - 1.000 to 0.513 - 1.000,indicating a decline in overall efficiency and an increase in inter-district heterogeneity.[Conclusion]From 2019 to 2023,the total volume of resource allocation and service output for chronic disease management in community health service institutions in Shanghai increased continuously.However,both the service output efficiency and the overall resource allocation efficiency declined,driven primarily by a decrease in technical efficiency,and accompanied by widening inter-district disparities.
[Objective]To investigate the relationship between fasting plasma glucose(FPG)and age/sex,to further analyze the appropriate cutoff age for detecting fasting hyperglycemia(FHG),and to provide a reference for blood glucose screening and health management.[Methods]In this cross-sectional study,a total of 50 607 examinees from the Health Management Center of a Shanghai-based Medical Consortium in 2023 were included.The age and sex distributions of FPG levels and the detection rate of FHG(FPG≥6.1 mmol·L-1)were analyzed.A non-parametric method was used to plot the receiver operating characteristic(ROC)curve of age for predicting hyperglycemia.The area under the ROC curve(AUC)reflected the predictive value of age for FHG,and the appropriate cutoff age for hyperglycemia detection was determined by the maximum Youden index.[Results]The median and the 25th and 75th percentiles of FPG in the study population was 5.00(4.68,5.41)mmol·L -1,with levels systematically higher in males[5.06(4.73,5.53)mmol·L -1]than in females[4.93(4.64,5.28)mmol·L -1].Both FPG levels and the abnormal detection rate increased non-linearly with age,plateauing approximately at 80 years of age.ROC curve analyses showed that age had good discriminatory value for hyperglycemia status(AUC=0.778 for the total population),with the appropriate predictive age threshold being 48 years old(48 years old for males,49 years old for females).[Conclusion]The present study found that both FPG levels and the risk of abnormal glucose regulation were increased at 48 - 49 years old among the hospital-based physical examination population,with risk remaining consistently higher in males than in females.The appropriate cutoff age for FPG was 48 years old.Specifically,the period of 45-50 years of age should be set as an intensified screening phase for blood glucose screening,with particular emphasis on earlier intervention for males.Furthermore,glycemic management targets for the elderly population require individualized consideration.
