Effects of meteorological factors on the incidence of mumps and models for prediction, China.

BACKGROUND: Mumps is an acute respiratory infectious disease with obvious regional and seasonal differences. Exploring the impact of climate factors on the incidence of mumps and predicting its incidence trend on this basis could effectively control the outbreak and epidemic of mumps. METHODS: Considering the great differences of climate in the vast territory of China, this study divided the Chinese mainland into seven regions according to the administrative planning criteria, data of Mumps were collected from the China Disease Prevention and Control Information System, ARIMA model and ARIMAX model with meteorological factors were established to predict the incidence of mumps. RESULTS: In this study, we found that precipitation, air pressure, temperature, and wind speed had an impact on the incidence of mumps in most regions of China and the incidence of mumps in the north and southwest China was more susceptible to climate factors. Considering meteorological factors, the average relative error of ARIMAX model was 10.87%, which was lower than ARIMA model (15.57%). CONCLUSIONS: Meteorology factors were the important factors which can affect the incidence of mumps, ARIMAX model with meteorological factors could better simulate and predict the incidence of mumps in China, which has certain reference value for the prevention and control of mumps.

[Equity of outpatient service utilization for hypertensive patients in community].

OBJECTIVE: To analyze the equity of outpatient service utilization for hypertensive patients (HPs) under 3 kinds of social medical insurance, and to explore its influential factors.
 Methods: A total of 8 670 HPs (aged at 15 years old from 28 sub-centers) in 14 provinces were selected. Indirectly standardized method and concentration index were used to analyze the equity of outpatient utilization in HPs, and decomposition analysis was used to explore the impact factors of outpatient treatment among the whole sample population, population with urban employees' basic medical insurance (UEBMI), and population with urban residents' basic medical insurance (URBMI) and new rural cooperative medical systems (NCMS).
 Results: The overall concentration index (CI) for the whole sample population was 0.2378. After the standardizing "need" variable, horizontal inequity (HI) was 0.2360, indicating that the outpatient service of HPs was inequity and that the higher economic level, the more outpatient services received. The decomposition of overall CI results showed that the positive factors for contribution were gross domestic product (GDP) level, retired, UEBMI and URBMI, and the negative factors for contribution were NCMS. The CI of UEBMI, URBMI and NCMS was 0.2017, 0.1208 and 0.0288, respectively; the HI was 0.1889, 0.1215 and 0.0219, respectively. The inequity in UEBMI is the most serious, followed by NRCMS and URBMI. The economic level was the main factor that caused inequity in the outpatient services utilization in three social medical insurance. In addition to the economic level, a common positive factor for the contribution to UEBMI and URBMI was district of residence, and the age was the positive factor to UEBMI as well.
 Conclusion: There are different levels of inequity in the HPs covered by 3 kinds of social medical insurance, and the inequity of UEBMI is the highest one among 3 kinds social medical insurance. The economic level is the main factor that affects the equity of outpatient in the HPs under 3 kinds of social medical insurance.

[Empirical research of the relationship between related knowledge, attitude and behavior of hypertension patients based on the structural equation model].

OBJECTIVE: To analyze the relationship among hypertension-relevant knowledge, attitude and behavior and to provide evidence for prevention of hypertension.
 Methods: A total of 5 861 employees with hypertension from 10 provinces were selected, and their data were collected by uniform questionnaires. The structural equation model was established by using LISREL version 8.7. Knowledge, attitude and behavior was set as latent variables, and the observed variables corresponding to latent variables served as explicit variables. The parametric estimation of the structural equation model is based on polyserial correlation coefficients and asymptotical covariance matrix.
 Results: Knowledge directly affected attitude, and the impact coefficient was 0.84; attitude directly affect behavior, and the impact coefficient was 0.38; knowledge showed indirect effect on behavior; the structural equation model fitted the data well.
 Conclusion: Hypertension-related knowledge significantly affect attitude, while knowledge and attitude showed slight effect on behavior. There were other factors that affected the patient's behavior. It was suggested that we should fully consider the factors for behavior in health education, and adopt more appropriate measures in hypertension control.

Older age at first birth is a risk factor for pancreatic cancer: a meta-analysis.

BACKGROUND: Some studies found that age at first birth is associated with pancreatic cancer; others did not. The present meta-analysis was to evaluate the relationship between age at first birth and pancreatic cancer in women. DATA SOURCES: We searched PubMed, Embase, and the Cochrane Library for relevant publications on age at first birth and pancreatic cancer up to April, 2014. The eligible studies (six cohorts and five case-controls) were independently selected by two authors. Pooled relative risk (RR) estimates and corresponding 95% confidence interval (95% CI) were calculated using the inverse-variance method. RESULTS: The pooled RR of pancreatic cancer risk for the highest versus lowest categories of age at first birth was 1.21 (95% CI: 1.01-1.45, P=0.314, I2=13.7%). Consistent relationships were also observed within subgroup analyses stratified by study design, geographic region, and whether the studies included adjustment for cigarette smoking, diabetes, or all of the confounders. In this meta-analysis, no publication bias among studies was observed using Egger's test (P=0.383) or Begg's test (P=0.436). CONCLUSION: Our findings suggest that older age at first birth is associated with an increased risk of pancreatic cancer in women and the exact functional mechanism needs further investigation.

[Influential factors of treatment cost of antihypertensive drugs for hypertensive patient in community].

OBJECTIVE: To explore the influential factors of treatment cost of antihypertensive drugs for hypertensive patient in community. METHODS: A total of 220 community health centers (CHCs) from 15 provinces were selected across China in view of geographical location, economic level and previous cooperative experience to implement standardized blood pressure management for hypertensive patients for 1 year, based on guidelines for prevention and control for hypertension in China (2009 Community-based revision). Baseline and follow-up information for each hypertensive patient under the care of these CHCs was collected. A total of 22 683 hypertensive patients in hypertension community standardization management were enrolled in this study. We used multivariate linear regression model to analyze the influential factors of treatment cost of antihypertensive drugs. RESULTS: Cultural degree, regional distribution, medical security system, the blood pressure classification, complications, and treatment options were statistically significant independent variables. CONCLUSION: In hypertension community standardization management, the blood pressure of hypertensive patients should be controlled in advance to reduce the economic burden, , the occurrence of complications should be reduced, and economic factors should also be considered when selecting a treatment option.

[Correlations of IL-4R gene polymorphism and serum IgE levels with asthma predictive index].

OBJECTIVE: To study the correlations of IL-4R gene polymorphism and serum IgE levels with asthma predictive index (API) in children. METHODS: One hundred and sixty-seven children with positive API, 187 children with negative API and 203 healthy children (control group) were enrolled. PCR and DNA sequencing were used to identify genotypes of the Arg551Gln locus in IL-4R gene. Serum IgE levels were measured using ELISA. RESULTS: There was no significant difference in the genotype frequencies of the Arg551Gln locus in IL-4R gene among the positive API, negative API and control groups. Serum IgE levels in the positive API group were significantly higher than in the negative API and control groups (P<0.01). In the positive API group, the children aged less than 2 years had significantly lower serum IgE levels than those aged over 2 years (P<0.01). CONCLUSIONS: There is no correlation between the Arg551Gln polymorphism in IL-4R gene and API results. API positivity is correlated with elevated serum IgE levels. An older age (>2 years) may be a risk factor for increased serum IgE levels in children with positive API.

Efficacy and Prognosis of Hyperbaric Oxygen as Adjuvant Therapy for Neonatal Hypoxic-Ischemic Encephalopathy: A Meta-Analysis Study.

Background: Preclinical and clinical evidence suggests that hyperbaric oxygen therapy (HBOT) may benefit newborns. The effectiveness of HBOT for neonatal hypoxic-ischemic encephalopathy (HIE) remains controversial. We conducted a meta-analysis to evaluate the efficacy and prognosis of HBOT in neonates with HIE. Methods: A systematic search of eight databases was performed for available articles published between January 1, 2015, and September 30, 2020, to identify randomized controlled clinical trials (RCTs) on HBOT for neonatal HIE. Methodological quality assessment was performed by applying the simple procedure detailed by the Cochrane collaboration. Afterward, quality assessment and data analysis were performed using Revman 5.3 software. STATA 15 software was used to detect publication bias as well as for sensitivity analysis. Results: A total of 46 clinical RCTs were selected for the study and included 4,199 patients with neonatal HIE. The results indicated that HBOT significantly improved the total efficiency (TEF) of treatment for neonatal HIE patients [odds ratio (OR) = 4.61, 95% confidence interval (CI) (3.70, 5.75), P < 0.00001] and reduced the risk of sequelae (OR = 0.23, 95% CI (0.16, 0.33), P < 0.00001) and the neonatal behavioral neurological assessment (NBNA) scores [mean difference (MD) = 4.51, 95%CI (3.83,5.19, P < 0.00001)]. Conclusion: In light of the effectiveness of HBOT neonatal HIE, this meta-analysis suggested that HBOT can be a potential therapy for the treatment of neonatal HIE. Due to the heterogeneity of studies protocol and patient selection being only from China, more research is needed before this therapy can be widely implemented in the clinic. Protocol Registration: PROSPERO (ID: CRD42020210639). Available online at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020210639.

Complete genome sequence of Paenibacillus polymyxa SC2, a strain of plant growth-promoting Rhizobacterium with broad-spectrum antimicrobial activity.

Paenibacillus polymyxa SC2 is an important plant growth-promoting rhizobacterium (PGPR). Here, we report the complete genome sequence of P. polymyxa SC2. Multiple sets of functional genes have been found in the genome. As far as we know, this is the first complete genome sequence of Paenibacillus polymyxa.

[Genetic diversity and phylogeny of soybean rhizobia isolated from the regions of Loess Plateau in China].

OBJECTIVE: We investigated the genetic diversity and phylogeny of soybean rhizobia isolated from the regions of Loess Plateau in China. METHODS: We analyzed 130 soybean rhizobia isolated from 15 regions in 4 provinces of Loess Plateau through BOX-PCR, 16S rDNA PCR- RFLP, 16S-23S IGS PCR-RFLP and 16S rRNA gene sequencing. RESULTS: BOX-PCR, 16S rDNA PCR- RFLP and 16S-23S IGS PCR-RFLP were in good agreement with the results which showed that all strains tested ascribed to two groups: the genus of Sinorhizobium and Bradyrhizobium phylogenetically. The analysis of 16S rRNA gene of 5 representative strains indicated that they were related to type strains S. fredii, B. japonicum and B. liaoningense, homology coefficient with type strains was 100% respectively. CONCLUSION: Soybean rhizobia isolated from the regions of Loess Plateau in China showed rich genetic diversity. S. fredii was the dominant species. Bradyrhizobium accounted for 10% of the strains tested only, of which, two strains were B. liaoningense.

[Meta-analysis of the curative effect of low molecular weight heparin on acute respiratory distress syndrome].

OBJECTIVE: To observe the clinical effect of low molecular weight heparin on the curative effect of acute respiratory distress syndrome (ARDS) patients through a systematic evaluation method. METHODS: Databases such as PubMed, Cochrane Library database, Web of Science, CNKI, China Biological Medical Literature Database (CBM), VIP, Wanfang database were searched to retrieve randomized controlled trials (RCTs) on low molecular weight heparin and conventional treatment on the efficacy and prognosis of patients with acute lung injury (ALI)/ARDS from the establishment of the database to September 2020. The conventional treatment group was given conventional treatment, and the low molecular heparin group was given low molecular heparin based on conventional treatment. Outcome indicators were oxygenation index (PaO2/FiO2), acute physiology and chronic health evaluation II (APACHE II), activated partial thromboplastin time (APTT), prothrombin time (PT), platelet count (PLT), interleukin-6 (IL-6) and the mortality at 7 days and 28 days. The literature was screened according to the proposed inclusion and exclusion criteria; the Cochrane collaboration evaluation tool was used to evaluate the quality of literature; Meta analysis used RevMan 5.3 software to perform funnel plot analysis on the outcome indicators of the included ≥ 11 literatures, and to evaluate the publication bias. RESULTS: A total of 12 RCTs and 623 patients were included. The results of Meta analysis showed that PaO2/FiO2 increased in the low molecular weight heparin group compared with the conventional treatment group [mean difference (MD) = 72.08, 95% confidence interval (95%CI) was 56.92-87.24, P < 0.000 01], APACHE II (MD = -4.34, 95%CI was -5.73 to -2.96, P < 0.000 01), IL-6 [standardized mean difference (SMD) = -2.13, 95%CI was -2.71 to -1.56, P < 0.000 01] and 7-day mortality [relative risk (RR) = 0.52, 95%CI was 0.30-0.90, P = 0.02] and 28-day mortality (RR = 0.55, 95%CI was 0.34-0.90, P = 0.02) were significantly reduced, APTT was significantly shortened (MD = -0.88, 95%CI was -1.51 to -0.26, P = 0.006); but PT (MD = -0.44, 95%CI was -1.23 to 0.36, P = 0.28) and PLT (MD = -0.08, 95%CI was -18.81 to 18.65, P = 0.99) between the two groups had no statistically significant differences. A funnel chart analysis of PaO2/FiO2 with 11 included papers showed that there might be publication bias. CONCLUSIONS: Low molecular weight heparin can improve the poor oxygenation of ARDS patients, reduce the mortality of ARDS patients in the acute stage and the inflammatory reaction, but it may increase the bleeding risk of ARDS patients.

Occupational Stress and Mental Health: A Comparison Between Frontline Medical Staff and Non-frontline Medical Staff During the 2019 Novel Coronavirus Disease Outbreak.

Background: During an epidemic, both frontline and non-frontline medical staff endure stressful work circumstances that render their mental health a major public health concern. This study aims at investigating and comparing the prevalence and severity of mental health symptoms (i.e., anxiety, depression and insomnia) between frontline medical staff and non-frontline medical staff during the coronavirus disease 2019 (COVID-19) outbreak. It also seeks to evaluate the association of their mental health with occupational stress. Methods: A cross-sectional study was conducted in Wenzhou, China from 2020 February 16th to 2020 March 2th. A total of 524 medical staff responded to the Generalized Anxiety Disorder Scale, the Patient Health Questionnaire, the Insomnia Severity Index, the Occupational stress Questionnaire, and a demographic data form. Data were principally analyzed with logistic regression. Results: Of the 524 participants, 31.3% reported depression, 41.2% reported anxiety, and 39.3% reported insomnia. Compared with the citizens during the COVID-19 epidemic, medical staff experienced higher level of anxiety, depression and insomnia, especially the frontline medical staff. Furthermore, male, married medical staff with poorer physical health reported lower mental health. Frontline medical staff endorsed higher self-reported occupational stress, especially higher occupational hazards, than non-frontline medical staff. In addition, four indicators on occupational stress (working intensity, working time, working difficulty and working risk) were correlated positively with mental health symptoms. Regression analyses found a significant association between occupational stress and mental health symptoms in both frontline and non-frontline medical staff during COVID-19 outbreak. Conclusion: The results indicated that during the COVID-19 epidemic, medical staff experienced higher levels of anxiety, depression and insomnia than citizens, and their occupational stress had positive effects on their psychological distress. These findings emphasize the importance of occupational stress management interventions to decrease the risk of developing mental health problems among the medical staff during a biological disaster.

Spatial-temporal analysis and visualization of scarlet fever in mainland China from 2004 to 2017.

This study retrospectively analyzed the spatio-temporal distribution and spatial clustering of scarlet fever in mainland China from 2004 to 2017. In recent years, the incidence of scarlet fever is increasing. Previous studies on the spatial distribution of scarlet fever in China are mainly focused at the provincial and municipal levels, and there is few systematic report on the spatial and temporal distribution characteristics of scarlet fever on the national level. Based on the incidence information of scarlet fever in mainland China between 2004 and 2017 collected from the China Center for Disease Control, this paper systematically explored the Spatio-temporal distribution of scarlet fever by three methods, contains spatial autocorrelation analysis, Spatio-temporal scanning analysis, and trend surface analysis. The results demonstrate that the incidence of scarlet fever varies by seasons, which is in line with double-peak distribution.The first peak generally occurs from May to June and the second one from November to December, while February and August is the lowest period of incidence. Trend surface analysis indicates that the incidence of scarlet fever in northern China is higher than the south, slightly higher in western compared to the east, and lower in the central part. Additionally, the results show that the clustering regions of scarlet fever centrally distributed in the northeast, northwest, north china and some provinces in the east, such as Zhejiang, Shanghai, Shandong, and Jiangsu.

[Multiplex-PCR approach to identify Bacillus species applied in microbial fertilizers].

OBJECTIVE: To discriminate the strains of Bacillus subtilis group including B. subtilis, B. amyloliquefaciens, B. licheniformis, and B. pumilus, a rapid and accurate distinguishing method is essential for the identification of the target strains to ensure the quality and safety of microbial fertilizers. METHODS: By analyzing unique nucleotide sequences of the rpoA, gyrA and 16S rDNA genes, 4 pairs of species-specific primers were optimized and the multiplex PCR was developed to discriminate and identify B. subtilis, B. amyloliquefaciens, B. licheniformis and B. pumilus. RESULTS: Thirty-three reference strains belonging to three genera of Bacillus, Paenibacillus and Brevibacillus were tested and the anticipated results appeared except for four species with cross amplification results with the primers of B. pumilus. However, the four species can be easily discriminated by morphology characters. In addition, the multiplex-PCR results of 23 strains of B. subtilis group isolated from MF products were identical with the biochemical assay. CONCLUSION: The newly constructed multiplex-PCR assay is species-specific and effective. This method can be used to detect and identify the strains of B. subtilis group from microbial fertilizers products.

The association between health information attitudes and skills in patients with chronic disease in China.

OBJECTIVES: To assess and explore the relationship between the health information (HI)-related attitudes and skills of patients with chronic disease in China. METHODS: A questionnaire was developed to measure the participants' HI-related attitudes and skills. The study included all participants (N = 1671) undergoing routine physical examinations at the Health Management Centre, Third Xiangya Hospital of Central South University, Changsha, Hunan province, from September to November 2013. The Kruskal-Wallis test was used to assess the impacts of social demographic factors and chronic disease conditions on the patients' HI-related attitudes and skills. Multiple linear regression and bivariate correlation analyses were adopted to explain the relationship between attitudes and skills. RESULTS: The chronic disease patients clearly know that HI was valuable for their health, but their general HI-related skills were inadequate, particularly for elderly and undereducated patients. Additionally, the participants' HI attitudes positively correlated with their HI-related skills (r = 0.47, p < 0.001). Because the attitudes ascended by grade (i.e. negative, moderate, and active), the HI-related evaluation, expression and comprehension, and seeking skills categories increased by 11%, 5.3%, and 8.4%, respectively. CONCLUSIONS: Although the chronic disease patients held explicit and active attitudes towards HI, their skills were unsatisfactory. Attitudes and skills, however, present a positive relationship. These results suggest that training in HI-related skills should be the main goal of health literacy promotion in patients who suffer from long-term chronic diseases, particularly elderly and undereducated patients. However, cultivating an active attitude towards HI is important to improve HI-related skills.

Novel PEG-grafted nanostructured lipid carrier for systematic delivery of a poorly soluble anti-leukemia agent Tamibarotene: characterization and evaluation.

Tamibarotene (Am80), a poorly water-soluble drug for the treatment of acute promyelocytic leukemia (APL), loaded nanostructured lipid carrier (Am80-NLC) was developed and characterized previously. The purpose of the present work was to develop PEGylated nanostructured lipid carrier (PEG-NLC) for intravenous delivery of Am80, with the aim to further extend the circulation in blood and decrease the adverse events. Am80-loaded PEG-NLC (Am80-PEG-NLC) modified with PEG-40 stearate (PEG40-SA, molecular weight 2000 Da) was formulated by the method of melt-emulsification and low temperature-solidification technique. Am80-NLC was developed as well as control. Based on the optimized results of single-factor screening experiment, the average drug entrapment efficiency, the mean particle size, and zeta potential of Am80-NLC and Am80-PEG-NLC were found to be 89.8-94.3%, 178.9-201.6 nm, and -37.74 to -20.1 mV, respectively. In vitro drug release of Am80-NLC and Am80-PEG-NLC possessed a sustained release characteristic and their release behavior was in accordance with the Ritger-Peppas equation. In vivo, after intravenous (i.v.) injection to rats, the mean residence time (MRT) of Am80-PEG-NLC group was significantly prolonged and the AUC value was improved as well compared with the Am80-NLC group. Furthermore, the biodistribution in mice showed that Am80-PEG-NLC preferentially decreased the accumulation of Am80 in kidney and increased the drug concentration in brain after i.v. injection. In conclusion, Am80-PEG-NLC may be a potential delivery system for Am80 in the treatment of APL.

Preparation and in vitro evaluation of etoposide-loaded PLGA microspheres for pulmonary drug delivery.

Pulmonary drug delivery has become a promising route in the treatment of lung diseases because of better local retention and lower systemic penetration. In this study, etoposide-loaded poly(lactic-co-glycolic acid) (PLGA) microspheres were designed with potential pulmonary delivery properties. The microspheres were prepared via improved emulsion-solvent evaporation method. Physicochemical characteristics, micromeritics properties and in vitro drug release behavior of the microspheres were then evaluated. Results showed that etoposide-loaded PLGA microspheres were spherical in shape with smooth surface with size (11.8 ± 1.25) µm. Particles remained stable without any changing in size and morphology after dried by the freeze-drying method. Etoposide was loaded into PLGA microspheres in an amorphous state with high drug loading ((7.7 ± 0.3)%) and encapsulation efficiency ((84.2 ± 2.9)%). Results of micromeritics properties also demonstrated that etoposide-loaded PLGA microspheres were very suitable for pulmonary delivery. In addition, in vitro drug release study indicated a sustained release profile fitted with the Ritger-Peppas equation for up to 20 days. In conclusion, the etoposide-loaded PLGA microspheres were promising for pulmonary delivery, and etoposide could be sustained released from the PLGA microspheres.

A novel approach for systematic delivery of a hydrophobic anti-leukemia agent tamibarotene mediated by nanostructured lipid carrier.

The present work evaluated the feasibility of nanostructured lipid carriers (NLC) for the intravenous delivery of tamibarotene (Am80), a poorly water-soluble drug for the treatment of acute promyelocytic leukemia (APL). The objective of this research was to develop a suitable drug delivery system in vivo which could improve therapeutic efficacy and decrease side effects. The tamibarotene-loaded-NLC (Am80-NLC) nanosuspension was formulated by the method of melt-emulsification at a high temperature and solidified by ice bath. Based on the optimized results of single-factor screening experiment, the Am80-NLC was found to be relatively uniform in size (189.38+/- 8.07 nm) with a narrow poly-dispersity index (PI) (0.27+/-0.02) and a negative zeta potential (-34.69+/-3.05 mV). The average drug entrapment efficiency and loading capacity was 90.85+/- 1.03% and 9.08+/- 0.10%, respectively. The differential scanning calorimetry (DSC) analysis indicated that Am80 was not in crystalline state in Am80-NLC. The in vitro release profile of Am80-NLC possessed a sustained release characteristic and the release behavior was in accordance with the Ritger-Peppas equation. In vivo, after intravenous injection to mice, Am80-NLC showed a longer retention time and higher AUC values compared with the Am80 solution. In addition, biodistribution results clearly demonstrated that Am80-NLC preferentially decreased the drug distribution in kidney and liver of mice after intravenous injection. These results revealed that injectable Am80-NLC may serve as a promising carrier for Am80 to increase therapeutic efficacy on APL and reduce adverse events.