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1.
BMC Health Serv Res ; 22(1): 424, 2022 Mar 31.
Article in English | MEDLINE | ID: mdl-35361211

ABSTRACT

BACKGROUND: The "4 + 7" volume-based procurement is a "large group purchase" led by the Chinese government, with the aim of reducing the price of medicines by trading volume for price. Although the "4 + 7" drugs had passed the national consistency evaluation, the adverse drug reactions need to be further evaluated to ensure the safety of the "4 + 7" drugs with low prices. We aimed to analyze the occurrence characteristics and related influencing factors of adverse reactions of psychiatric drugs under the chinese drug volume-based procurement policy(4 + 7 policy), and provide references for clinical medication. METHODS: 137 cases of adverse drug reactions of four psychotropic drugs reported under the "4 + 7" policy in Wuxi Mental Health Center in 2020 were collected. The gender and age of patients, related "4 + 7" drugs, involving organs / systems, clinical manifestations, distribution of new / serious adverse reactions, clinic outcomes were analyzed. RESULTS: Among the 137 cases of adverse drug reactions, the incidence of adverse drug reactions was the highest in patients aged 61-70 (25.38%). Mainly involved 4 "4 + 7" psychiatric drugs, of which olanzapine tablets caused the most adverse reactions (54, 39.24%). The adverse reactions mainly involved the digestive system, nervous system, cardiovascular system, blood and lymphatic system, among which the digestive system was the most common (61, 44.53%). A total of 8 cases (6.16%) of new and 26 cases of serious adverse reactions were reported, all of which led to the prolongation of disease course. Except for the transient side effects, most of that were improved or cured with no death, disability or teratogenicity after stopping or reducing the dose with symptomatic treatment. CONCLUSION: Since more and more drugs will be included in "4 + 7" for clinic, clinical pharmacists should strengthen the publicity and training of the knowledge of "4 + 7" drugs, strengthen the monitoring of adverse drug reactions, and provide timely feedback to the clinic, in order to achieve early prevention, early identification, timely diagnosis and reasonable intervention of the adverse drug reactions under the context of "4 + 7" policy.


Subject(s)
Drug-Related Side Effects and Adverse Reactions , Aged , China/epidemiology , Drug-Related Side Effects and Adverse Reactions/epidemiology , Humans , Incidence , Middle Aged , Psychotropic Drugs/adverse effects , Public Policy
2.
Front Endocrinol (Lausanne) ; 13: 935905, 2022.
Article in English | MEDLINE | ID: mdl-35909573

ABSTRACT

Purpose: Nearly 85%-90% of osteogenesis imperfecta (OI) cases are caused by autosome dominant mutations of COL1A1 and COL1A2 genes, of which de novo mutations cover a large proportion, whereas their characteristics remain to be elucidated. This study aims to compare the differences in clinical and genetic characteristics of de novo and inherited COL1A1/COL1A2 mutations of OI, assess the average paternal and maternal age at conception in de novo mutations, and research the rate of nonpenetrance in inherited mutations. Materials and Methods: A retrospective comparison between de novo and inherited mutations was performed among 135 OI probands with COL1A1/COL1A2 mutations. Mutational analyses of all probands and their family members were completed by Sanger sequencing. A new clinical scoring system was developed to assess the clinical severity of OI quantitatively. Results: A total of 51 probands (37.78%) with de novo mutations and 84 probands (62.22%) with inherited mutations were grouped by the results of the parental gene verification. The proportion of clinical type III (P<0.001) and clinical scores (P<0.001) were significantly higher in de novo mutations. Missense mutations covered a slightly higher proportion of de novo COL1A1 mutations (46.34%) compared with inherited COL1A1 mutations (33.33%), however, lacking a significant difference (P=0.1923). The mean BMD Z/T-score at the lumbar spine in de novo mutations was -2.3 ± 1.5, lower than inherited mutations (-1.7 ± 1.8), but lacking statistical significance (P=0.0742). There was no significant difference between the two groups in OI-related phenotypes (like fracture frequency, blue sclera, and hearing loss) and biochemical indexes. In de novo mutations, the average paternal and maternal age at conception was 29.2 (P<0.05) and 26.8 (P<0.0001), respectively, which were significantly younger than the average gestational age of the population. Additionally, 98.04% of pedigrees (50/51) with de novo mutations were spontaneous conception. The rate of nonpenetrance of parents with pathogenic variants in the inherited mutation group was 25.64% (20/78). Conclusions: Our data revealed that the proportion of clinical type III and clinical scores were significantly higher in de novo mutations than in inherited mutations, demonstrating that de novo mutations are more damaging because they have not undergone purifying selection.


Subject(s)
Collagen Type I, alpha 1 Chain , Collagen Type I , Osteogenesis Imperfecta , China/epidemiology , Collagen Type I/genetics , Collagen Type I, alpha 1 Chain/genetics , Humans , Osteogenesis Imperfecta/genetics , Retrospective Studies
3.
Front Public Health ; 10: 874993, 2022.
Article in English | MEDLINE | ID: mdl-35910877

ABSTRACT

Objectives: Health-related physical-fitness (HRPF) involves multi-components of physical functional tests and is reported to be associated with the risk of fall. The study sought to determine whether specific physical fitness components were stronger predictors of falls among elderly people. Methods: This prospective cohort study involved 299 community residents age ≥60 years from Shanghai, China. The baseline data included comprehensive assessment of sociodemographic, clinical, and HRPF test. Subjects were followed for 1 year and were contacted by telephone to report falls. LASSO regression and Multivariate regression analysis were used to identify risk predictors of fall. In addition, we used receiver operating characteristic (ROC) curve analyses to determine whether the predictors have diagnostic. Results: During the 1-year prospective fall assessment, 11.7% of these subjects experienced one or frequent falls. LASSO models revealed that age (=0.01) and 8-ft up-and-go test score (=0.06) were positively associated with falls, while activity-specific balance confidence (ABC; = -0.007) and 2-min step test score (= -0.005) were inversely related. The Area Under roc Curve (AUC) for a linear combination of age, ABC scale score, 2-min step test and 8-ft up-and-go test was 0.778 (95% confidence interval: 0. 700-0.857), which was superior to any of the variables taken alone. Conclusion: Age, activity-specific balance confidence and fitness abnormalities were determined to contribute to the incident of falls. The value of 2-min step test score, and 8-ft up-and-go test score were the key HRPF components in predicting falls among elderly people.


Subject(s)
Geriatric Assessment , Physical Fitness , Aged , China/epidemiology , Humans , Middle Aged , Prospective Studies , Risk Factors
4.
BMC Infect Dis ; 22(1): 663, 2022 Aug 01.
Article in English | MEDLINE | ID: mdl-35915398

ABSTRACT

BACKGROUND: China has experienced a continuous decreasing trend in the incidence of hepatitis A in recent years. Temporal trend analyses are helpful in exploring the reasons for the changing trend. Thus, this study aims to analyse the incidence trend of viral hepatitis A by region and age group in mainland China from 2004 to 2017 to evaluate the effectiveness of prevention and control measures. METHODS: Data on hepatitis A and population information were collected and analysed with a joinpoint regression model. Annual percentage changes (APCs) and average annual percentage changes (AAPCs) were estimated for the whole country and for each region and age group. RESULTS: From 2004 to 2017, the seasonality and periodicity of hepatitis A case numbers were obvious before 2008 but gradually diminished from 2008 to 2011 and disappeared from 2012-2017. The national incidence of hepatitis A (AAPC = - 12.1%) and the incidence rates for regions and age groups showed decreasing trends, with differences in the joinpoints and segments. Regarding regions, the hepatitis A incidence in the western region was always the highest among all regions, while a nonsignificant rebound was observed in the northeastern region from 2011 to 2017 (APC = 14.2%). Regarding age groups, the hepatitis A incidence showed the fastest decrease among children (AAPC = - 15.3%) and the slowest decrease among elderly individuals (AAPC = - 6.6%). Among all segments, the hepatitis A incidence among children had the largest APC value in 2007-2017, at - 20.4%. CONCLUSION: The national annual incidence of hepatitis A continually declined from 2004 to 2017 and the gaps in hepatitis A incidence rates across different regions and age groups were greatly narrowed. Comprehensive hepatitis A prevention and control strategies, including the use of routine vaccination during childhood in mainland China, especially the implementation of the national Expanded Program on Immunization (EPI) in 2008, resulted in substantial progress from 2004 to 2017. However, gaps remain. Regular monitoring and analysis of hepatitis A epidemic data and prompt adjustment of hepatitis A prevention and control strategies focusing on children, elderly individuals and those living in certain regions are recommended.


Subject(s)
Hepatitis A , Adenomatous Polyposis Coli , Aged , Child , China/epidemiology , Hepatitis A/epidemiology , Humans , Immunization Programs , Incidence , Regression Analysis
5.
Parasit Vectors ; 15(1): 275, 2022 Aug 01.
Article in English | MEDLINE | ID: mdl-35915463

ABSTRACT

BACKGROUND: Avian haemosporidia infect both domestic and wild birds, causing anemia, acute tissue degeneration, and depopulation in wild birds. Poultry and wild birds have been reported as common reservoirs of haemosporidia, but limited information is available for red junglefowl (Gallus gallus) in China. The present study investigated the prevalence and molecular characterization of haemosporidia in red junglefowl. METHODS: Blood samples were collected from 234 red junglefowl from Jinghong City of Yunnan Province, and genomic DNA was extracted from these samples. The prevalence of haemosporidia was determined by nested PCR targeting the mitochondrial cytochrome b (cytb) gene. Molecular characterization was investigated based on phylogenetic analysis of cytb sequences, and associated risk factors were analyzed using the Chi-square (χ2) test. RESULTS: The overall prevalence of haemosporidia was 74.8% (175/234), and three species were identified, namely Haemoproteus enucleator, Leucocytozoon californicus, and Plasmodium juxtanucleare. The prevalence of haemosporidia in adult fowl (81.1%, 107/132) was significantly higher (χ2 = 6.32, df = 1, P = 0.012) than that in juveniles (66.7%, 68/102). Three novel haemosporidian lineages were revealed. CONCLUSIONS: This study examined the prevalence and identified species of avian haemosporidians in red junglefowl, providing new information on the molecular epidemiology and geographical distribution of haemosporidian parasites. Our results indicated high prevalence and diverse species distribution of these haemosporidians in red junglefowl. To the best of our knowledge, this is the first record of haemosporidian infection in red junglefowl in China.


Subject(s)
Bird Diseases , Haemosporida , Animals , Animals, Wild , Bird Diseases/epidemiology , Bird Diseases/parasitology , Chickens , China/epidemiology , Cytochromes b/genetics , Haemosporida/genetics , Phylogeny , Risk Factors
6.
PLoS One ; 17(8): e0272458, 2022.
Article in English | MEDLINE | ID: mdl-35917292

ABSTRACT

Medical facility equality is a critical metric for determining equal access to medical care. Their spatial distribution is important for effective pandemic treatment and daily prevention in cities. This paper used the Kernel Density Two-Step Floating Catchment Area (KD2SFCA) and shortest distance methods to calculate the accessibility of designated COVID-19 Fangcang hospitals and fever clinics in the Wuhan Metropolitan Development Zone. Their equality was evaluated by the Gini coefficient and Lorentz curve. Several results were obtained: (1) The facilities' accessibility declines radial from the central to peripheral areas. (2) Most of the demand points in the study area can reach the medical facilities for COVID-19 pandemic treatment within 60 minutes. (3) For the spatial distribution of these facilities, the equality evaluated for different time thresholds differed significantly, with long time thresholds having better equality than for short time thresholds. (4) While the distances distribution of fever clinics is balanced, the equality gap in various areas remains enormous when considering population distribution. Suggestions for optimizing the spatial distribution of pandemic treatment medical facilities in Wuhan are proposed, and which will serve as references for the planning of Wuhan's pandemic medical facilities in the future.


Subject(s)
COVID-19 , COVID-19/epidemiology , Catchment Area, Health , China/epidemiology , Cities , Health Services Accessibility , Humans , Pandemics/prevention & control
7.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(8): 1095-1100, 2022 Aug 06.
Article in Chinese | MEDLINE | ID: mdl-35922237

ABSTRACT

Objective: To determine IgG antibody levels of measles, rubella, mumps in healthy population in Shanghai from 2010 to 2020 and analyze the trend of antibody changes in different age groups. Methods: 10 828 healthy people without measles, rubella and mumps in Shanghai were included in the study from 2010 to 2020. Serum samples were collected from 12 age groups, and the serum IgG antibody of measles, rubella and mumps were detected by ELISA. The difference of antibody positive rates and antibody levels were analyzed. Results: The median age M (Q1, Q3) of 10 828 objects were 8 years old (9 months old, 20 years old). Males accounted for 48.34% (5 234/10 828) and females accounted for 50.92% (5 514/10 828). Unknown gender information accounted for 0.74% (80/10 828), and 27.03% (2 927/10 828) of participants had unknown MMR immunization history. The total positive rates of measles, rubella and mumps IgG antibody were 76.78%, 64.46% and 64.29% and their GMCs were 541.45 mIU/ml, 31.76 IU/ml and 133.73 U/ml respectively. There were significant differences in serum IgG antibody GMC of measles, rubella and mumps in each year (Fmeasles=180.74, P<0.001; Frubella=189.95, P<0.001; Fmumps=122.40, P<0.001). The positive rate of measles antibody was higher than that of rubella and mumps, and the difference was statistically significant (χ²=518.09, P<0.001). Conclusion: The level of measles IgG antibody in healthy people in Shanghai is higher, while the level of rubella and mumps IgG antibody is slightly lower.


Subject(s)
Measles , Mumps , Rubella , Adult , Antibodies, Viral , Child , China/epidemiology , Female , Humans , Immunoglobulin G , Infant , Male , Measles/prevention & control , Measles-Mumps-Rubella Vaccine , Mumps/epidemiology , Mumps/prevention & control , Mumps virus , Rubella/epidemiology , Rubella/prevention & control , Young Adult
8.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(8): 1101-1106, 2022 Aug 06.
Article in Chinese | MEDLINE | ID: mdl-35922238

ABSTRACT

Objective: To understand the prevalence of HIV, hepatitis C virus (HCV) and syphilis and related factors among cross-border couples in Mangshi county, Dehong autonomous prefecture, Yunnan province. Methods: From May, 2017 to April, 2019, 2 500 couples with 5 000 cross-border marriages were selected by using cluster sampling method. The demographic characteristics, AIDS-related health services, HIV, HCV, syphilis infection and other information were collected through questionnaires and laboratory tests. The influencing factors of HIV, HCV and syphilis infection were analyzed by multivariate logistic regression model. Results: A total of 2 500 couples with cross-border marriage were investigated, among which 2 438 (97.5%) couples were Chinese men with Myanmar women. The average age of 5 000 participants was (34.16±9.00) years. Most of them were minority groups (59.9%), farmers (98.5%), education years ≤6 years (81.4%), marriage years>3 years (80.0%), and from mountainous areas (61.7%). The HIV prevalence of Chinese and Myanmar populations was 1.7% (43/2 500) and 2.0% (49/2 500), respectively. The HCV infection rates were 2.0% (49/2 500) and 1.3% (32/2 500), respectively and the infection rates of syphilis were 0.4% (10/2 500) and 0.2% (4/2 500), respectively. There were no statistically significant differences in the prevalence of three diseases among Chinese and Myanmar populations (P>0.05). The multivariate analysis showed that compared with those aged ≤ 30 years, having lower AIDS awareness, never receiving HIV testing, without HCV and syphilis infection, HIV prevalence was higher among those aged>30 years (OR=3.21, 95%CI: 1.80-5.73), having higher AIDS awareness (OR=17.41, 95%CI: 4.27-70.91), receiving HIV testing (OR=4.93, 95%CI: 2.72-8.92), with HCV infection (OR=5.64, 95%CI: 2.72-11.70) and syphilis infection (OR=8.37, 95%CI: 1.63-43.08). Compared with those aged ≤ 30 years, having marriage years ≤ 3 years, and with HIV negatives, HCV infection rate was higher among those age>30 years (OR=3.02, 95%CI: 1.69-5.38), having marriage years>3 years (OR=2.24, 95%CI: 1.34-3.74), and with HIV positives (OR=6.69, 95%CI: 3.29-13.59). Compared with those having HIV negatives, the syphilis infection rate was relatively higher among participants with HIV positives (OR=9.07, 95%CI: 2.00-41.10). Conclusion: The prevalence of HIV, HCV, and syphilis among cross-border couples in Mangshi county, Dehong autonomous prefecture of Yunnan province is relatively high. Age, AIDS awareness, HIV testing history, and the length of marriage are associated with the HIV, HCV, and syphilis infection.


Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , Hepatitis C , Syphilis , China/epidemiology , Female , HIV Infections/epidemiology , Hepacivirus , Hepatitis C/epidemiology , Humans , Male , Prevalence , Risk Factors , Syphilis/epidemiology
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(8): 1136-1141, 2022 Aug 06.
Article in Chinese | MEDLINE | ID: mdl-35922244

ABSTRACT

Obesity has become a global public health problem that seriously threatens population health. The Chinese government has attached great importance to prevent and control the negative impacts of obesity on individuals, families and society. China has established a policy system for obesity, and made certain achievements in behavioral intervention, drug treatment, traditional Chinese medicine treatment, and surgical treatment. This study summarizes the prevention and treatment experience of obesity in China in order to provide reference for African countries to better formulate prevention and treatment strategies for obesity in line with their local context.


Subject(s)
Obesity , Public Health , Asians , China/epidemiology , Government , Humans , Obesity/prevention & control
10.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(8): 1142-1149, 2022 Aug 06.
Article in Chinese | MEDLINE | ID: mdl-35922245

ABSTRACT

Over the past two decades, with the improvement of living standards and the change of lifestyle, the incidence of stroke in young adults had been increasing year by year. Compared with elderly patients, young patients had a higher proportion of intracranial and subarachnoid hemorrhage. The etiologies of ischemic stroke in young patients were more diverse, with increasing risk factors such as hypertension, diabetes, smoking, alcoholism, and oral contraceptives. Due to the atypical clinical symptoms, various etiologies, the clinical inertia of the receiving physicians and the concerns about the use of statins in young stroke patients, timely diagnosis and standardized treatment are still challenging. China has been providing medical assistance to African countries for nearly 60 years. Considering the regional differences in medical level between China and Africa, in order to help Chinese medical teams to have a deep understanding of the current situation of stroke in young African adults, this paper comprehensively analyzed the epidemiology, etiology, risk factors and prevention measures of stroke in young adults, especially in Chinese and African, which could provide corresponding reference for early identification, treatment, prevention and education of stroke in young people.


Subject(s)
Stroke , Adolescent , Aged , China/epidemiology , Humans , Incidence , Risk Assessment , Risk Factors , Stroke/epidemiology , Stroke/prevention & control , Young Adult
11.
Dis Markers ; 2022: 9717510, 2022.
Article in English | MEDLINE | ID: mdl-35923246

ABSTRACT

Objective: To investigate the association between thromboxane A synthase 1 (TBXAS1) gene polymorphism and metabolic syndrome (MS) and explore whether gene polymorphism could act as biomarkers in MS and its components or whether it could play a role in MS-related damage. Methods: A total of 3072 eligible subjects were obtained, of which 1079 cases were controls and 1993 cases were MS patients. Subjects were followed up for 5 years, and the endpoint were recorded. The gene polymorphism of TBXAS1 was detected by using the Sequenom MassArray method. Results: Significant differences were observed in ischemic stroke and NC_000007.14: g.139985896C>T (P < 0.05). The incidence of ischemic stroke was significantly higher in T allele carriers than in C (P < 0.05). C allele was the protective factor of the onset of ischemic stroke. There were negative interactions between C allele and waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and fasting plasma glucose (FPG). Conclusion: These findings suggest that NC_000007.14: g.139985896C>T was related to the incidence of ischemic stroke in the whole and MS population, and individuals who carry the C allele have a reduced risk of ischemic stroke, which may be used as a promising biomarker of disease risk in patients with MS.


Subject(s)
Ischemic Stroke , Metabolic Syndrome , Thromboxane-A Synthase/genetics , China/epidemiology , Humans , Polymorphism, Genetic , Risk Factors , Waist Circumference
12.
Int J Chron Obstruct Pulmon Dis ; 17: 1671-1683, 2022.
Article in English | MEDLINE | ID: mdl-35923356

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) is the most common chronic inflammatory airway disease. Il-12r beta 2 (IL-12Rß2) is important for the production of pathogenic Th1 cells. We aimed to explore the association between IL-12Rß2 genetic variants and COPD risk among southern Chinese Han population. Methods: We recruited 996 participants to perform an association analysis through SNPStats online software. We used false-positive report probability analysis to detect whether the positive findings were noteworthy. Haploview 4.2 software and SNPStats were used to conduct the haplotype analysis and linkage disequilibrium. Finally, the interaction of SNP-SNP in COPD risk was evaluated by multi-factor dimensionality reduction. Results: The study found evidence that genetic loci in IL-12Rß2 (rs2201584, rs1874791, rs6679356, and rs3790567) were potentially associated with the COPD susceptibility. In particular, IL-12Rß2-rs2201584 and -rs1874791 showed close associations with COPD risk in both overall and several stratified analyses. Overall analysis or several stratified analyses indicated that allele A or homozygous genotype AA of IL-12Rß2-rs2201584 were risk factors for COPD (Allele A: OR (95% CI) = 1.23 (1.02-1.48), p = 0.033; genotype AA: OR (95% CI) = 1.76 (1.15-2.69), p = 0.009). The allele A or homozygous genotype AA of IL-12Rß2- rs1874791 were also risk factors for COPD (Allele A: OR (95% CI) = 1.36 (1.10-1.68), p = 0.004; genotype AA: OR (95% CI) = 2.17 (1.18-3.99), p = 0.013). Conclusion: Intronic variants in IL-12Rß2 (rs2201584, rs1874791, rs6679356, and rs3790567) were associated with the COPD susceptibility. In particular, there were sufficient evidences that IL-12Rß2-rs2201584 and -rs1874791 were associated with the increasing risk of COPD.


Subject(s)
Pulmonary Disease, Chronic Obstructive , Receptors, Interleukin-12/genetics , Case-Control Studies , China/epidemiology , Gene Frequency , Genetic Predisposition to Disease , Genotype , Humans , Polymorphism, Single Nucleotide , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/genetics
13.
Front Public Health ; 10: 922587, 2022.
Article in English | MEDLINE | ID: mdl-35923957

ABSTRACT

Human Papillomavirus (HPV) infection is one of the most common sexually transmitted infections worldwide. The current study aimed to investigate the prevalence and genotype distribution of HPV infection among outpatient-based populations. A total of 40,613 women were recruited from the First People's Hospital of the Yunnan Province. Our study retrospectively analyzed the results of cervical HPV screening among 40,613 women. The results of study showed the prevalence and genotype distribution of HPV infection was different among various outpatient-based populations, and the prevalence of HPV infection was the highest in the gynecological outpatients (26.59%), followed by reproductive gynecological outpatients (18.51%), and the prevalence of physically examined population was the lowest (8.15%). The outpatient-based population was facing a huge threat of HPV infection, especially women from the gynecology clinic. The three most common HPV genotypes were HPV-52 (4.79%), 16 (2.95%) and 58 (2.83%). However, the distribution of HPV genotype varied by populations, especially in physically examined population, the infection rate of HPV-81 ranked third among all infections with various genotypes. Two peaks of prevalence of HPV infection were observed among women under 25 years (31.93%) and over 55 years (28.55%), while the prevalence in women aged 46-55 years (20.18%) was the lowest. Our study on the prevalence and genotype distribution of HPV infection among various outpatient-based populations will provide scientific evidence for vaccination strategies of HPV and prevention and control plans of cervical cancer in Kunming area.


Subject(s)
Papillomavirus Infections , China/epidemiology , Female , Genotype , Humans , Outpatients , Papillomaviridae/genetics , Papillomavirus Infections/epidemiology , Prevalence , Retrospective Studies
14.
Front Public Health ; 10: 923324, 2022.
Article in English | MEDLINE | ID: mdl-35923970

ABSTRACT

Introduction: The coronavirus disease 2019 (COVID-19) pandemic have significantly affected health care systems and daily wellbeing. However, the indirect impacts of the pandemic on birth outcomes are not fully understood. We aimed to examine whether the pandemic altered risk of adverse birth outcomes. Methods: This retrospective cohort study included all singleton births during 2016-2020 identified in Women's Hospital of Nanjing Medical University. We compared birth outcomes during COVID-19 pandemic (January-December 2020) with before the pandemic (January-December 2016-2019) using Logstic regression adjusted for confounders. Results: A total of 19,792 and 92,750 births occurred during and before the pandemic, respectively. Maternal characteristics were similar between groups, except maternal age was higher in pandemic cohort. We observed a reduction in preterm birth (PTB, <37 weeks) during the pandemic [5.9 vs. 5.1%, OR (95%CI) = 0.86 (0.80, 0.92)], but the difference disappeared after multivariable adjustment [adjusted OR (95%CI) = 1.02 (0.94, 1.11)]. Moreover, full term infants born during the pandemic had lower birth weights than those born before the pandemic [adjusted ß (95% CI) = -17.4 (-23.9, -10.8)]. Consistently, the risks of low birthweight (LBW, <2,500 g) and small for gestational age (SGA, < P10) were increased [LBW: adjusted OR (95%CI) = 1.13 (1.02, 1.24); SGA: adjusted OR (95%CI) = 1.11 (1.02, 1.21)], and the risks of macrosomia (≥4,000 g) and large for gestational age (LGA, ≥P90) were decreased in the pandemic cohort [macrosomia: adjusted OR (95%CI) = 0.82 (0.77, 0.88); LGA: adjusted OR (95%CI) = 0.73 (0.69, 0.77)]. Conclusion: In this study, we observed no change in preterm birth and a decrease in birth weight of full term infants during the pandemic in Nanjing, China.


Subject(s)
COVID-19 , Premature Birth , COVID-19/epidemiology , China/epidemiology , Cohort Studies , Female , Fetal Macrosomia , Humans , Infant , Infant, Newborn , Pandemics , Premature Birth/epidemiology , Retrospective Studies
15.
Front Public Health ; 10: 917732, 2022.
Article in English | MEDLINE | ID: mdl-35928479

ABSTRACT

Objective: This study aimed to determine the efficacy, effectiveness, and cost-effectiveness of inactivated COVID-19 vaccines (CoronaVac and BBIBP-CorV) in China using existing international clinical trials and real-world evidence. Methods: Through a search of PubMed, Embase, Web of Science, and CNKI, studies investigating the effectiveness of inactivated COVID-19 vaccines were identified, and a meta-analysis was undertaken to synthesize the vaccine efficacy and effectiveness data. Moreover, a decision-analytic model was developed to estimate the cost-effectiveness of inactivated vaccines for combating the COVID-19 pandemic in the Chinese context from a societal perspective. Results of the meta-analysis, along with cost data from official websites and works of literature were used to populate the model. Sensitivity analysis was performed to test the robustness of the model results. Results: A total of 24 studies were included in the meta-analysis. In comparison to no immunization, the effectiveness of inactivated vaccine against COVID-19 infection, hospitalization, ICU admission and death were 65.18% (95% CI 62.62, 67.75), 79.10% (95% CI 71.69, 86.51), 90.46% (95% CI 89.42, 91.50), and 86.69% (95% CI 85.68, 87.70); and the efficacy against COVID-19 infection and hospitalization were 70.56% (95% CI 57.87, 83.24) and 100% (95% CI 61.72, 100). Inactivated vaccine vaccination prevented more infections, hospitalizations, ICU admissions, and deaths with lower total costs, thus was cost-saving from a societal perspective in China. Base-case analysis results were robust in the one-way sensitivity analysis, and the percentage of ICU admission or death and direct medical cost ranked the top influential factors in our models. In the probabilistic sensitivity analysis, vaccination had a 100% probability of being cost-effective. Conclusion: Inactivated vaccine is effective in preventing COVID-19 infection, hospitalization, ICU admission and avoiding COVID-19 related death, and COVID-19 vaccination program is cost-saving from societal perspective in China.


Subject(s)
COVID-19 Vaccines , COVID-19 , Cost-Benefit Analysis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , China/epidemiology , Humans , Pandemics/prevention & control , Randomized Controlled Trials as Topic , Vaccines, Inactivated/therapeutic use
16.
Front Public Health ; 10: 917119, 2022.
Article in English | MEDLINE | ID: mdl-35928495

ABSTRACT

Objective: This study aimed to describe the economic burden of Chinese patients with melanoma in Hunan province of China, and to investigate the factors for hospitalization spending and length of stay (LOS) in patients undergoing melanoma surgery. Methods: Data was extracted from the Chinese National Health Statistics Network Reporting System database in Hunan province during 2017-2019. Population and individual statistics were presented, and nonparametric tests and quantile regression were used to analyze the factors for spending and LOS. Result: A total of 2,644 hospitalized patients with melanoma in Hunan were identified. During 2017-2019, the total hospitalization spending was $5,247,972, and out-of-pocket payment (OOP) was $1,817,869, accounting for 34.6% of the total expenditure. The median spending was $1,123 [interquartile range (IQR): $555-2,411] per capita, and the median LOS was 10 days (IQR: 5-18). A total of 1,104 patients who underwent surgery were further analyzed. The non-parametric tests and quantile regression showed that women were associated with less spending and LOS than men. In general, patients aged 46-65 and those with lesions on the limbs had higher hospitalization costs and LOS than other subgroups. Conclusion: Melanoma causes heavy economic burdens on patients in Hunan, such that the median spending is close to 60% of the averagely annual disposable income. Middle-aged men patients with melanoma on the limbs present the highest financial burden of melanoma.


Subject(s)
Health Expenditures , Melanoma , China/epidemiology , Female , Hospitalization , Humans , Length of Stay , Male , Melanoma/surgery , Middle Aged
17.
Front Public Health ; 10: 919190, 2022.
Article in English | MEDLINE | ID: mdl-35937249

ABSTRACT

High vaccination coverage is essential to prevent and control the spread of the COVID-19 epidemic. Currently, the real-world acceptance of COVID-19 vaccines among adolescents aged 12-17 years in China has not been reported. We aimed to assess the acceptance rate of COVID-19 vaccination among adolescents in eastern China and to identify factors associated with the intention to get vaccinated against COVID-19. We conduct a cross-sectional questionnaire survey among adolescents from three provinces in the eastern part of China from 16 August to 28 October 2021. The questionnaires were distributed to 2,100 students, and 2,048 students completed the questionnaires. The results showed that 98.4% (2,016/2,048) of adolescents had received at least one dose of the COVID-19 vaccine and 1.6% (32/2,048) declined the vaccination. The participants from rural districts, or whose parents were vaccinated, were more likely to accept the vaccine. The main reason for declining vaccination was worry about vaccine safety (25%). The main adverse event after the vaccination was pain at the injection site. In conclusion, the vaccine coverage rate reached 98.4% among the adolescents in this study, which met the criteria for herd immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The high vaccination rate is beneficial to the prevention and control of the COVID-19 pandemic.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Cross-Sectional Studies , Humans , Pandemics/prevention & control , SARS-CoV-2 , Vaccination , Vaccination Coverage
18.
Parasit Vectors ; 15(1): 286, 2022 Aug 07.
Article in English | MEDLINE | ID: mdl-35934699

ABSTRACT

BACKGROUND: The genus Rickettsia contains the lineages spotted fever group (SFG), typhus group (TG), and transitional group (TRG). The spotted fever group Rickettsia (SFGR) is transmitted by ticks. The tick species Dermacentor nuttalli is considered the main vector carrying SFGR in Inner Mongolia. Studying the genetic diversity and population structure of Rickettsia is essential for developing effective control strategies and predicting evolutionary trends of Rickettsia. METHODS: In 2019 we collected 408 D. nuttalli in the Inner Mongolia Autonomous Region, detected the percentage of Rickettsia-positive specimens, and characterized the haplotypes. From the Rickettsia-positive ticks, the gltA and ompA genes were extracted, amplified, and sequenced. RESULTS: Ten haplotypes of the gltA gene and 22 haplotypes of the ompA gene were obtained. The phylogenetic analysis showed that the haplotypes G1-G7 and G9 of the gltA gene cluster with Rickettsia raoultii, while G8 and G10 cluster with Rickettsia sibirica. Haplotypes O1-O15, O18 and O20-O22 of the ompA gene cluster with R. raoultii, while O16 and O19 cluster with R. sibirica. The average haplotype diversity was 0.3 for gltA and 0.7 for ompA. The average nucleotide diversity was greater than 0.05. Neutrality tests were nonsignificant for Tajima's D results and Fu's Fs results. The fixation index values (FST) showed that the degree of genetic differentiation between most sampled populations was small (FST < 0.05), whereas some populations showed a medium (FST > 0.05) or large (FST > 0.15) degree of differentiation. Analysis of molecular variance (AMOVA) revealed that the variation within populations was greater than that between populations. The mismatch analysis of Rickettsia showed double peaks. CONCLUSIONS: We found two Rickettsia spp. (R. raoultii and R. sibirica). The high genetic disparity of Rickettsia allows for easy adaption to different environments. Genetic differentiation between populations is small, and Rickettsia populations do not show a geographically differentiated structure. The high rates of retention and infection of Rickettsia in D. nuttalli together with the animal husbandry exchange in Inner Mongolia gradually led to the harmonization of genetic characteristics of Rickettsia across various regions. Overall, the significant genetic diversity and geographical structure of Rickettsia in D. nuttalli are critical for SFGR control.


Subject(s)
Dermacentor , Ixodidae , Rickettsia , Spotted Fever Group Rickettsiosis , Animals , China/epidemiology , Dermacentor/genetics , Genetic Variation , Ixodidae/microbiology , Phylogeny , Rickettsia/genetics , Spotted Fever Group Rickettsiosis/epidemiology
19.
Global Health ; 18(1): 76, 2022 Aug 08.
Article in English | MEDLINE | ID: mdl-35941625

ABSTRACT

BACKGROUND: SARS-CoV-2, a new coronavirus first reported by China on December 31st, 2019, has led to a global health crisis that continues to challenge governments and public health organizations. Understanding COVID-19 knowledge, attitudes, and practices (KAP) is key for informing messaging strategies to contain the pandemic. Cross-national studies (e.g.: comparing China to the U.S.) are needed to better understand how trans-cultural differences may drive differences in pandemic response and behaviors. The goal of the study is to compare knowledge and perceptions of COVID-19 between adults in China and the U.S. These data will provide insight into challenges these nations may face in coordinating pandemic response. METHODS: This is a convergent mixed methods study comparing responses from China and the U.S. to a multinational COVID-19 KAP online survey. The survey included five quantitative constructs and five open-ended questions. Chinese respondents (n = 56) were matched for gender, age, education, perceived social standing, and time of survey completion with a U.S. cohort (n = 57) drawn from 10,620 U.S. RESPONDENTS: Quantitative responses were compared using T-test & Fisher-Exact tests. Inductive thematic analysis was applied to open-ended questions. RESULTS: Both U.S. and Chinese samples had relatively high intention to follow preventive behaviors overall. Differences in intended compliance with a specific recommendation appear to be driven by the different cultural norms in U.S. and China. Both groups expressed trepidation about the speed of COVID-19 vaccine development, driven by concern for safety among Chinese respondents, and concern for efficacy among U.S. RESPONDENTS: The Chinese cohort expressed worries about other countries' passive handling of the pandemic while the U.S. cohort focused on domestic responses from individuals and government. U.S. participants appeared more knowledgeable on some aspects of COVID-19. Different perspectives regarding COVID-19 origins were identified among the two groups. Participants from both samples reported high trust in health professionals and international health organizations. CONCLUSIONS: Mixed methods data from this cross-national analysis suggests sociocultural differences likely influence perceptions and knowledge of COVID-19 and its related public health policies. Discovering and addressing these culturally-based differences and perceptions are essential to coordinate a global pandemic response.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , China/epidemiology , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Humans , Pandemics/prevention & control , SARS-CoV-2 , Surveys and Questionnaires
20.
BMC Endocr Disord ; 22(1): 198, 2022 Aug 08.
Article in English | MEDLINE | ID: mdl-35941681

ABSTRACT

PURPOSE: The aim of this study is to explore the factors associated with the fall risk in type 2 diabetes (T2D) patients with a lacunar stroke. MATERIALS AND METHODS: We compiled data of 146 T2D patients (mean age 68 years), including the Morse fall scale data (MFS), nutrition score, self-care scale, laboratory data, and data from continuous glucose monitoring system (CGMS) from 2019 to 2021 in Shanghai Pudong Hospital. Thereby, we evaluated the associations between MFS and other clinical parameters. RESULTS: The analyses showed that there were significantly increased size and numbers of lacunar infarction (p < 0.05). Furthermore, the greater risk group had an older mean age (p < 0.05), and significant decreased estimated glomerular filtration rate (eGFR), total triglyceride (TG), while increased microalbuminuria, magnesium, lipoprotein A (LP(a)), anti-thyroid peroxidase antibody (TPOAb) (p < 0.05). However, the time in range (TIR) was very comparable (p > 0.05). The correlational study revealed the higher score of MFS was associated with the age (r = 0.41), number of lacunar infarction (r = 0.18), nutrition score (r = 0.20), self-care score (r = - 0.43), serum creatine level (r = 0.19), eGFR (r = - 0.26) (p < 0.05). The total numbers of lacunar infarction were associated with age (r = 0.36), eGFR (r = - 0.40), homocysteine level (r = 0.33) (p < 0.05). CONCLUSIONS: Age, nutrition, self-care ability, and renal function are all critical factors associated with the risk of fall in T2D with lacunar infarction. The age, eGFR, and homocysteine are closely associated with lacunar infarction, suggesting that in T2D, evaluation of kidney dysfunction, homocysteine level in the elderly can predict lacunar infarcts and falls.


Subject(s)
Diabetes Mellitus, Type 2 , Stroke, Lacunar , Accidental Falls , Aged , Blood Glucose , Blood Glucose Self-Monitoring , China/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Disease Susceptibility , Homocysteine , Humans , Risk Factors , Stroke, Lacunar/epidemiology , Stroke, Lacunar/etiology
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