Knowledge and determinants regarding tuberculosis among medical students in Hunan, China: a cross-sectional study.

BACKGROUND: Tuberculosis (TB) is one of the most common infectious diseases worldwide. Insufficient TB knowledge may increase the risk of contracting the disease among medical students. The purpose of this study was to assess the level of TB knowledge and analyse related determinants among medical students. METHODS: A cross-sectional study was performed among final-year medical students from three main undergraduate medical universities in Hunan Province. TB knowledge, attitude and practice were assessed using a questionnaire. A t-test and multiple linear regression analysis were conducted to explore the association between TB knowledge and influencing factors. RESULTS: The total mean percentage of correct answers for TB knowledge was 44.4% (SD 13.5%), including 52.5% (SD 16.8%) for epidemiology and prevention, 35.7% (SD 16.1%) for diagnosis, and 47.5% (SD 22.7%) for treatment. Medical students who reported observing at least one TB case and an X-ray of a TB patient had a higher percentage of correct answers for epidemiology and prevention (54.4% vs 43.9%, p < 0.001; 54.3% vs 42.1%, p < 0.001), diagnosis (37.2% vs 29.0%, p < 0.001; 37.1% vs 27.5%, p < 0.001), treatment (50.0% vs 36.0%, p < 0.001; 49.5% vs 35.7%, p < 0.001) and total score (46.2% vs 36.2, p < 0.001; 46.0% vs 34.7%, p < 0.001). Older medical students (≥23 years) had greater knowledge than younger medical students (< 23 years) regarding diagnosis (37.2% vs 31.7%, p < 0.001). The multivariable linear regression analysis determined an association between observing at least one TB case and an X-ray of a TB patient and greater knowledge of epidemiology and prevention (ß = 5.6, 95% CI: 2.3, 8.9; ß = 8.2, 95% CI: 4.6, 11.8), diagnosis (ß = 3.9, 95% CI: 0.8, 7.1; ß = 5.7, 95% CI: 2.2, 9.2) and treatment (ß = 10.1, 95% CI: 5.6, 14.5; ß = 7.0, 95% CI: 2.2, 11.8) and a higher total score (ß = 5.5, 95% CI: 2.9, 8.1; ß = 6.6, 95% CI: 3.8, 9.5). Moreover, an older age (≥23 years) was associated with more accurate knowledge of diagnosis (ß = 3.9, 95% CI: 1.8, 6.1) and a higher total score (ß = 2.8, 95% CI: 1.1, 4.6). CONCLUSION: Poor TB knowledge was observed among medical students, which implied a need to innovate our current infectious disease curriculum to promote TB knowledge and practices among medical students.

The Association Between Anemia and Depressive Symptoms in Non-White Male Adults: National Health and Nutrition Examination Survey (2005-2018).

BACKGROUND: The relationship between anemia and depression remains controversial. This study aimed to investigate the association between hemoglobin (Hb) levels and depressive symptoms. Study Design: A cross-sectional study. METHODS: This study was conducted using National Health and Nutrition Examination Survey data from 2005-2018. Hb levels were obtained from laboratory files, and depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Multivariable logistic regression analysis and smoothing plots were performed to examine the relationship between anemia and depression, including potential nonlinear associations. RESULTS: The study included 6008 male adults. Multivariable analysis revealed that anemia was associated with an increased odds ratio for mild (OR=1.49, 95% CI: 1.06, 2.10) and moderate (OR=2.05, 95% CI: 1.14-3.70) anemia. Additionally, each additional g/dL of Hb was significantly inversely associated with developing depression (OR=0.91, 95% CI: 0.85, 0.96). A nonlinear relationship was detected between Hb and depression, with an inflection point at 15 g/dL. Below this threshold, there was a significantly negative association between Hb and depression (OR=0.88, 95% CI: 0.79, 0.98); no significant relationship was observed above it (OR=1.05, 95% CI: 0.84, 1.31). CONCLUSION: Anemia was positively associated with depression in non-White American men. A nonlinear relationship between Hb and depression was detected, and it had a saturation effect. A significant negative correlation with depression was observed when the Hb level was below 15 g/dL.

A Case-Control Study of the Factors Associated with Anemia in Chinese Children Aged 3-7 years Old.

Background: Anemia in children is still an important public problem in China and can have a profound impact on the physical and mental health of children. The purpose of this study was to explore the risk factors for anemia among Chinese children aged 3-7 years old and to provide some basis for the prevention and control of anemia. Methods: A matched case-control study was conducted and 1104 children (552 cases and 552 controls) were recruited in this study. Cases were children who were diagnosed with anemia by the doctor of physical examination and checked by one deputy chief physician of pediatrics, and controls were healthy children without anemia. Data were collected using a self-designed structured questionnaire. Univariable and multivariable analyses were used to identify independent determinants of anemia. P values less than 0.05 were used to declare statistical significance. Results: In the multivariable analyses, maternal anemia before or during pregnancy and lactation (OR = 2.14, 95% CI: 1.10∼4.15; OR = 2.86, 95% CI: 1.66∼4.94; OR = 2.51, 95% CI: 1.13∼5.60), gestational weeks (OR = 0.72, 95% CI: 0.53∼0.96), having G6PD deficiency or thalassemia (OR = 8.12, 95% CI: 2.00∼33.04; OR = 36.25, 95% CI: 10.40∼126.43), having cold and cough in previous two weeks (OR = 1.56, 95% CI: 1.04∼2.34), family income (OR = 0.80, 95% CI: 0.65∼0.97), and being a picky eater (OR = 1.80, 95% CI: 1.20∼2.71) were determinants of anemia in children aged 3-7 years old. Conclusions: Some of the identified factors are modifiable and could be targeted to reduce childhood anemia. More emphasis should be given by the concerned bodies to intervene in the anemia problem by improving the maternal health education, screening for disease-related anemia, requesting medical services in a timely manner, improving the economic status of households, promoting dietary habits, and improving sanitation and hygiene practices.

Predictors of serological cure after penicillin therapy in HIV-negative patients with early syphilis in Shenzhen, China.

BACKGROUND: Syphilis is a common infectious disease worldwide. Serological monitoring is important for syphilis management. We currently know little about the characteristics of this seronegative response. The aim of this study was to explore the factors associated with serological cure after treatment of early syphilis. METHODS: A retrospective cohort study was conducted and the data of patients with early syphilis in a clinic in Shenzhen from 2011 to 2019 were retrieved. Univariable and multiple Cox proportional hazard regression models were utilized to identify factors associated with a serological cure state among syphilis patients with early syphilis two years after treatment. RESULTS: A total of 346 (85.9%) syphilis patients achieved serological cure. The multivariate analysis results revealed that having a baseline TRUST titer >1:8 was associated with an increased probability of serological cure, compared with having a baseline TRUST titer ≤1:8 (HR = 1.43, 95% CI = 1.10-1.85, P<0.01); primary syphilis was positively associated with serological cure, compared with participants with latent early syphilis (HR = 1.72, 95% CI = 1.27-2.33, P<0.001). CONCLUSIONS: Two years after treatment, a higher percentage of early syphilis patients achieved serological cure. The study indicated that the syphilis stage and baseline serum titer were crucial factors associated with serological cure.

Predictors of Seronegative Conversion After Centralized Management of Syphilis Patients in Shenzhen, China.

Objective: The aim of this study was to explore the seronegative conversion status of syphilis patients after centralized management and to analyze potential determinants. Materials and Methods: A retrospective population-based cohort study was conducted, and data for individuals who had been diagnosed with syphilis between 2011 and 2019 were retrieved from the Shenzhen Nanshan Center for Chronic Disease Control. Seroconversion statuses were summarized as percentages. Univariable and multiple Cox proportional hazard regression models were used to analyze the factors associated with seronegative conversion among syphilis patients. Results: During the study period, 1,545 patients with syphilis participated in the syphilis convergence case management program on a voluntary basis, of whom 290 were excluded due to missing follow-up data. A total of 27.6% (346/1255) of patients with syphilis showed seronegative conversion. Multivariable analysis revealed that the following significantly determined syphilis seroconversion from positive to negative: younger age (15-19 years vs. ≥30 years: HR = 2.18), male gender (HR = 1.45), lower baseline toluidine red unheated serum test (TRUST) titer of ≤ 1:8 (HR = 2.23), and different disease stages, including latent syphilis (HR = 1.98), primary syphilis (HR = 7.67), and secondary syphilis (HR = 4.83). Conclusions: Few patients with syphilis tested negative after treatment at the end of the study. Seronegative conversion in the patients was associated with age, sex, baseline TRUST titer, and syphilis stage.

Nutrition knowledge, attitudes, behaviours and the influencing factors among non-parent caregivers of rural left-behind children under 7 years old in China.

OBJECTIVE: To explore and compare nutrition knowledge, attitudes and behaviours (KAB) between non-parent and parent caregivers of children under 7 years old in Chinese rural areas, and to identify the factors influencing their nutrition KAB. DESIGN: Face-to-face interviews were carried out with 1691 non-parent caregivers and 1670 parent caregivers in the selected study areas; multivariate logistic regression models were used to identify the factors influencing nutrition KAB in caregivers. RESULTS: The awareness rate of nutrition knowledge, the rate of positive attitudes and the rate of optimal behaviours in non-parent caregivers (52.2 %, 56.9 % and 37.7 %, respectively) were significantly lower than in the parent group (63.8 %, 62.1 % and 42.8 %, respectively). Multivariate logistic regression modelling showed that caregivers' family income and care will, and children's age and gender, were associated with caregivers' nutrition KAB after controlling the possible confounding variables (caregivers' age, gender, education and occupation). CONCLUSIONS: Non-parent caregivers had relatively poor nutrition KAB. Extra efforts and targeted education programmes aimed to improve rural non-parent caregivers' nutrition KAB are wanted and need to be emphasized.

Femoral head epiphysis growth and development among Chinese children aged 0-5 years.

The aim of this study was to examine the pattern of femoral head epiphysis growth and development among Chinese children. Between January and December, 2007, we randomly sampled 1,450 healthy Chinese children (0-5 years old) from Hunan Provincial Children's Hospital in Changsha, Hunan, China. The diameter of femoral head epiphysis was measured by pelvic X-ray photography and processed by medical image processing software. The growth of femoral head epiphysis in girls was 2-3 months earlier than that in boys. The diameter of femoral head epiphysis increased with advancing age in both girls and boys, but the diameter of femoral head epiphysis in 2, 3, 4, 6, and 10-month-old girls was significantly larger than that in boys. Cubic regression equations between the diameter of femoral head epiphysis and age were created for boys and girls that could be used to predict the diameter of femoral head epiphysis. In conclusion, there was gender difference in femoral head epiphysis growth and development among Chinese children, and our prediction models will provide the guidance for early diagnosis of diseases related to the growth and development of the femoral head epiphysis.

Curative versus palliative treatments for colorectal cancer with peritoneal carcinomatosis: a systematic review and meta-analysis.

The objective of this study was to provide an up-to-date summary of the current evidence that may be useful for updating guidelines. We comprehensively searched the published literatures and conferences for studies that compared curative with palliative treatments in colorectal cancer patients with peritoneal metastasis. The primary outcomes considered in this study were three- and five-year overall survival rates. We pooled data across studies and estimated summary effect sizes. Overall, patients who received curative treatments had improved three-year survival (hazard ratio (HR), 2.19 [95% CI, 1.83 to 2.62]) and five-year survival (HR, 2.22 [95% CI, 1.83 to 2.69]) compared with those who received palliative treatments. Patients who received curative treatments had an increased risk of treatment-related morbidity (odds ratio (OR), 2.90 [95% CI, 2.02 to 4.17]), but there was no significant difference in treatment-related mortality between patients who received curative treatments and those who received palliative treatments (OR, 1.46 [CI, 0.62 to 3.47]). Curative treatments improved overall survival in colorectal cancer patients with peritoneal metastasis and did not increase the risk of treatment-related mortality. Curative treatments were associated with a higher risk of treatment-related morbidity. These data highlight the importance for further investigation aimed at prevention of treatment-associated morbidity.

[Mutual interaction between hepatitis C virus core protein and translin, a recombination hotspot binding protein].

OBJECTIVE: To study the role of the core protein of hepatitis C virus (HCV) in HCV pathogenesis and investigate the molecular mechanism of this protein in tumorigenesis. METHODS: By using the yeast two hybrid system 3, the bait plasmids of the gene of the core protein of HCV was constructed and transfected into AH109 yeast strain. Then this transfected AH109 yeast was mated with Y187 yeast containing liver cDNA library plasmids and cultured on quadropledropout (QDO) medium covered with x-alpha-gal and assayed for alpha-gal activity. The blue colonies growing on QOD were collected to extract the plasmids to transform Escherichia coli. Plasmids were extracted from the bacterium and sequenced. After bioinformatic analysis translin, a recombination hotspot binding protein interacting with HCV core protein was found. To further prove the interaction between translin protein and HCV core protein translation was performed by using reticulocyte lysate and immunoprecipitation in vitro. RESULTS: Among the 30 positive colonies, a colony was translin. The interaction between HCV core protein and translin protein could be proved not only in yeast, but also in vitro. CONCLUSION: The core protein of HCV can interact with translin protein, this can explain partly the tumorigenesis of HCV.

[Influence of mediating/moderating effects of health skills on the relation between knowledge and behaviors in health, among college students].

OBJECTIVE: To study the influence of mediating/moderating effects of health skills on the relations between health knowledge and health behaviors in college students. METHODS: Stratified cluster random sampling was used among 2 181 students, selected in several colleges in Changsha, Hunan province. EpiData 3.0 was adopted to establish the database. Correlation and regression analyses were performed by SPSS 17.0. RESULTS: Positive correlations were seen on: 1) Knowledge and skills on health (r = 0.592, P < 0.01), 2) Knowledge and behaviors on health (r = 0.647, P < 0.01), 3) Health skills and health behaviors(r = 0.629, P < 0.01). The mediating effect of health skills on the relations between health knowledge and health behaviors was significant (34.55%). The interaction effect of "health skill × (times) related knowledge" was significant (ß = -0.093, t = - 5.212, P = 0.000). New variables that were produced by the interaction also reached significant level (Δ R(2) = 0.006, P = 0.000), resulted in increasing the explanation function to health behaviors by 0.6%. CONCLUSION: Health skills could partially mediate the effects and moderate the relationship between health knowledge and health behaviors among college students.

[Study on the nutritional status and determinants among rural stranded children in China].

OBJECTIVE: To explore the nutritional status and determinants among rural stranded children under 7 years of age. METHODS: The group of stranded children (n=7585) and the children for control (n=7557) were identified by multi-stage stratified cluster sampling. The ascertainment methods mainly included questionnaire, anthropometric measurements and laboratory examination. RESULTS: In this study, there were three groups, including the group of stranded children whose single parent left home to look for better job somewhere, the group of stranded children whose parent both left home and the third group serving as control. Prevalent rates on the following items were: stunting--14.9%, 17.9% and 16.3%, underweight--7.2%, 8.3% and 7.6%, wasting--3.1%, 3.4% and 3.3% and anemia--18.9%,20.6%, 18.7% respectively. The prevalent rate of stunting in the group of children with both parents away from home was significantly higher than that those with only one parent did. The prevalence rate of anemia in the group with both parents away from home was significantly higher than that in the control group. Based on multivariate non-conditional logistic regression analysis, the determinants of stunting among the stranded children were: age, with low birth weight, living alone, being the only child in the family, mother's education level, frequency of eating breakfast and snacks every week, motives of caretakers and the relationship between children and the caretakers. The determinants of underweight among those stranded children were: age of child, with low birth weight, the frequency of eating snacks every week, motives of the caretakers and having rickets. CONCLUSION: The nutritional status among rural stranded children was relatively poor, especially in those whose parents were both away from home, which calls for urgent improvement.

[Knowledge, attitude, practice and related determinants on nutrition among caregivers of rural stranded children under 7-year-olds in China].

OBJECTIVE: To explore knowledge, attitude, practice (KAP) and related determinants on nutrition among caregivers of those rural stranded children under 7 years of age in China and to provide evidence for setting up relevant health education program. METHODS: 1691 caregivers of the stranded children randomly selected were surveyed by a standard questionnaire. Logistic regression models were used to screen the determinants on KAP regarding nutrition. RESULTS: Rates on awareness, positive attitude and approprite behavior were lower in caregivers of children whose parents both left (47.8%, 55.4%, 41.8%, respectively) the countryside, when compared with those only one parent was away from home (59.9%, 59.5%, 38.0%, respectively). Data from multivariable logistic regression models showed that caregivers' KAP on nutrition was related to age, educational background, average family income, and willingness on the job as well as the age of the child. CONCLUSION: Improving caregivers' KAP on nutrition and setting up appropriate health education program were in urgent need.

[Retrospective study of liver failure complicated with bacterium and fungous infection].

OBJECTIVE: To study clinic character of liver failure complicated with bacterium and fungous infection. METHODS: The patients with liver failure complicated with bacterial and fungous infection who were treated in our hospital from January 1986 to June 2006 were studied. All patients had clinical manifestation and positive of bacterium. The data were statistical analysis. RESULTS: 507 patients diagnosed with fungous infection were found from January 1986 to June 2006 in which 132 patients were diagnosed with bacterial and fungous infection. There were 85 patients (64.39%) with chronic severe hepatitis and 40 patients (30.3%) with decompensation cirrhosis. Bacterial infection happened in 153 cases in which the rate of nosocomial infections was 54.90%. 204 bacterial strains were separated in which 143 strains (70.10%) were gram-negative bacterium and 61 (29.90%) strains were gram-positive bacterium. The main sites of bacterial infection were abdominal cavity (122 cases) and lung (30 cases). Fungous infection happened in 143 cases in which the rate of nosocomial infections was 86.71%. 155 fungous strains were separated in which 90 strains (58.06%) were Candida albicans, 17 strains (10.97%) were Aspergillus fumigatus and 25 (16.13%) strains were non-Candida albicans. The main sites of fouguns infection were lung (94 cases) and mouth (53 cases). 84 patients (63.64%) were ineffective and died after treatment. CONCLUSION: The patients with decompensation cirrhosis and chronic severe liver hepatitis were easy to be infected by bacterial and fungous. the rate of fungous nosocomial infections is higher than that of bacterium. The prognosis is bad in patients who had secondary fungous infection.