ObjectiveTo analyze epidemiological features of scrub typhus from 2006 to 2015 in Guangdong Province and explore characteristics of its spatial and temporal distributions, so as to provide scientific basis for developing effective strategies and measures for control of scrub typhus.MethodsEpidemic data of scrub typhus from 2006 to 2015 in Guangdong Province were collected from the China information System for Disease Prevention and Control. The data of incidences of scrub typhus were analyzed by using spatial autocorrelation analysis and spatiotemporal scan statistics, and geographical information system.ResultsFrom 2006 to 2015, a total of 20 178 cases of scrub typhus were reported in Guangdong Province, including 24 deaths. The annual incidence was 2.02/100,000, with an increasing trend annually (P<0.01). Two peaks in incidence were observed, the first as the highest one during June to July and the second during September to October. The spatial positive correlation at county (district) level was found and showed significant spatial clustering (Moran's I index =0.256, P<0.01). Local spatial association analysis indicated that 21 counties, including Deqing, Huaiji, Yangshan, and Guangning, were hotspots (GiZ =1.69-5.77, both P<0.01), forming high incidence areas of scrub typhus. Whereas with the low incidence, Fengshun county was the only cold spot area of scrub typhus in Guangdong Province (GiZ=-1.72, P>0.05). Four clustering areas were found by time-space scanning during 2006 to 2015, and 46 counties (districts) were classified as Class 1 clustering area (LLR=8 640.82, RR=7.10, P<0.01), taking the cities of Qingyuan and Lianzhou as the center, with a radius of 243.31 km, including 46 counties (districts) of Guangning, Yunan, and Huaiji, accounting for 35.66% (46/129) of all counties (districts) in Guangdong Province.ConclusionThe incidence of scrub typhus increased yearly from 2016 to 2015 in Guangdong Province, with a significant feature of spatiotemporal clustering. Effective measures should be taken for target population to decrease the incidence of scrub typhus in the high-risk areas during the high occurrence seasons.

ObjectiveTo analyze etiologic characteristics of hand, foot, and mouth disease (HFMD) and genetic features of EV 71 in Weinan City in 2016.MethodsSpecimens of suspected HFMD cases in Weinan in 2016 were collected for determination of enterovirus types by using real-time quantitative PCR (RT-qPCR). Meanwhile, nucleotide sequence, homology and phylogenetic analysis of VP1 encoding gene were performed in two strains of EV 71.ResultsA total of 1 019 throat swabs specimens of HFMD were detected and 689 specimens were found to be positive for EV, with a total positive rate of 67.62%. The positive rates of viruses ranging from high to low were 26.89% for the other human enteroviruses (HEV), 24.63% for EV 71, and 16.09% for Cox A16 (P<0.01). The nucleic acid positive cases of EV were mainly occurred from May to October, accounting for 91.04%（549/603）of the total positive cases. The male to female sex ratio of the nucleic acid positive cases was 1.26∶1. The nucleic acid positive cases were mainly the children aged under five years (93.90%, 647/689), then scattered children(67.94%) and the children in kindergarten (32.06%). The positive rate of EV 71 was highest in severe cases (72.22%) and that of other HEV was highest in common cases (29.04%; P<0.01). The sequence of VP1 region of two strains of EV 71 had high homology with C4a gene subtype (96.6%-96.7%) and amino acids (99.3%). Phylogenetic tree analysis showed that the two strains of EV 71 had very high homology with the epidemic strain of Fujian（KU595899.1）.ConclusionThe other HEV was major virus causing HFMD in Weinan in 2016. EV 71 was the predominant virus subtype causing severe cases of HFMD in Weinan City and belonged to C4a genotype.

ObjectiveTo investigate the possible effects of environmental lead and cadmium co-exposure on intelligence and psychomotor function of children.MethodsA town near an industrialized area in southern China was selected as the exposed area, and an adjacent town on the windward side as the control area. Stratified by age, children aged 9–11 years at the town level primary school were selected as the subjects of the survey from both areas. Combined Raven’s Test in China Revision 2 (CRT-C2) was applied to test children’s intelligence and Jinyi Psychomotor test Battery (JPB) was used to test their psychomotor function. Simultaneously lead and cadmium contents in blood were analyzed by ICP-MS.ResultsA total of 530 pupils aged 9-11 years were surveyed, including 266 living in the exposed area and 264 in the control area. The geometric means of lead and cadmium in blood of children in the exposed area were 65.89 μg/L and 1.93 μg/L, and those in the control area were 37.21 μg/L and 1.07 μg/L, respectively (all P<0.01). The IQ scores of the children in the exposed area and control area were (103.38±10.76) and (106.23±12.84), respectively (P<0.01). The scores of number scratching, numeral connection, and target tracking of the children in the exposed area were significantly lower than those in the control area (all P<0.01). Multivariate linear regression analysis showed that blood lead was negatively correlated with IQ score (β=-4.16，P<0.01), numbers scratching(β=-0.96，P<0.05), numeral connection(β=-1.54，P<0.01), and target tracking(β=-11.85，P<0.01); but blood cadmium was only negatively related with target tracking (β=-31.21，P<0.01). There were no significant interactions between blood lead and cadmium on IQ and five psychomotor function tests (all P＞0.05).ConclusionEnvironmental lead and cadmium exposures could impact children's neurological development separately, but the effect of lead and cadmium co-exposure on children's neurological development was not observed.

ObjectiveTo investigate the effect of family doctor signing service on the health of the elderly in the community.MethodsElderly people aged 65 years and over, who participated in free medical examination in a community health service center in Huadu District, Guangzhou in March 2016, were recruited as study subjects. Among them, those who signed family doctor services voluntarily were taken as the signing group, and those who did not sign family doctor services were classified as the control group. The signing group was managed by family doctor service team, and the control group, by public health doctors for routine follow-up. Body mass index (BMI), blood pressure (BP), fasting blood glucose (FBG), total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDLC), and high-density lipoprotein cholesterol (HDLC) were tested and compared before and after intervention for one year between two groups. Logistic regression analysis was used to analyze the related factors.ResultsA total of 304 people were investigated, including 170 in the signing group and 134 in the control group. Before intervention, there were no statistical differences in abnormal rates of BMI, BP, FBG, TC, triglyceride, LDLC, and HDLC between the 2 groups (all P>0.05). After intervention, except for the BMI, the abnormal rates of BP, FBG, TC, triglyceride, LDLC, and HDLC in the signing group were lower than those in the control group (all P<0.05). Logistic regression analysis showed that family doctor signing service was the influencing factor of BP, FBG, triglyceride, and HDLC.ConclusionFamily doctor signing service could improve the normal rate of BP, FBG, triglyceride, and HDLC in the elderly, and effectively improve their health status.

ObjectiveTo understand the current situation of job burnout and social support of higher vocational teachers and analyze the relationship between the job burnout and social support.MethodsTeachers were selected from a vocational college in Baoji City for the survey by using stratified random sampling method. The Maslach Burnout Inventory (MBI-GS), social support rating scale (SSRS), and self-designed general population questionnaire were used for investigation. The data were analyzed by descriptive epidemiological method.ResultsA total of 118 teachers were surveyed and their average scores of the three dimensions of emotional exhaustion, cynicism, and low sense of achievement were （3.44±0.90）,（3.02±0.98), and（3.24±0.79), respectively. The positive rates of job burnout in three dimensions were 50.85%, 32.20%, and 29.66%, respectively. The score of emotional exhaustion in male teachers was higher than that in female ones（P＜0.01）；the average scores of emotional exhaustion and cynicism in different age groups were statistically significant (both P＜0.01）. Compared with teachers engaged in non-medical teaching, teachers engaged in medical teaching had higher scores in emotional exhaustion and cynicism (both P＜0.01）, but lower score of low sense of achievement（P＜0.01）；different job titles, different working years and average teaching hours per year were all statistically significant（P＜0.05 or P＜0.01）. Teachers aged 50 years and over, with higher job titles, and having over 20-year working experience had more social supports than other corresponding groups（P＜0.05 or P＜0.01）. Teachers' job burnout and their social support were negatively correlated (r =-0.348--0.298，P＜0.01).ConclusionThe professional burnout of higher vocational college teachers in Baoji City was more serious and they obtained less social support. It is necessary to strengthen health education and take measures to improve the social support for higher vocational teachers.

ObjectiveTo explore the acute oral toxicity and 30-day toxicity of Wanglaoji herbal tea, so as to provide scientific basis for evaluating its edible safety.MethodsAcute oral toxicity test：Wanglaoji herbal tea extract was administered to the NIH mice via oral gavage at doses of 15.0 g/(kg?BW)［equivalent to herbal crude drugs 99.9 g/(kg?BW）］，and symptoms and deaths of NIH mice were observed for 14 days. Thirty-day oral toxicity test: Wanglaoji herbal tea extract was administered to the male and female Sprague Dawley rats via oral gavage at doses of 1.88, 3.75, and 7.50 g/(kg?BW)［equivalent to herbal crude drugs 12.5, 25.0, and 50.0 g/(kg?BW)］, and the same volume of purified water was given to rats in control group, for 30 consecutive days. Hematologic and biochemistry tests were performed, and organs were weighed at the end of the experiment. Histopathological examination was conducted in the control group and 7.50 g/(kg?BW) group.ResultsIn the acute oral toxicity test, no adverse reactions or deaths were observed during the observation period. The LD50 of the acute toxicity was above 15.0 g/(kg?BW). In the 30-day oral toxicity, all dose groups had no obvious effect on body weight, weight gain, food intake, food utilization rate, hematologic tests, biochemical tests, organ weight and the ratios of organs in male and female rats. Histopathological examination did not show any changes associated withWang Laoji herbal tea extract.ConclusionWanglaoji herbal tea extract belongs to non-toxic level, and 7.50 g/(kg?BW) ［equivalent to herbal crude drugs 50.0 g/(kg?BW)］ Wanglaoji herbal tea extract would not cause obvious toxic reaction in rats.

ObjectiveTo investigate the nutritional status of children with chronic kidney disease (CKD） and the influencing factors of malnutrition.MethodsAccording to the US National Kidney Foundation practice guidelines for CKD in 2002, children diagnosed with CKD in Yongxing Hospital, Zhoukou were recruited from September 2012 to October 2015 to participate in a nutritional survey. Their body height, body mass and other parameters were mearured. The nutritional status of CKD children was evaluated using the WHO generic Z value standard. Questionnaire survey of the knowledge related nutrition was conducted among parents of the children. The incidence of malnutrition in children with CKD and factors influencing the malnutrition were analyzed.ResultsA total of 1 500 children with CKD were enrolled in the study. Their age ranged from 3 to 14 years and the average age was (8.7 ± 3.5) years. Of all the children with CKD, 810 were male and 690 female, with a male to female ratio of 1.17∶1. Average duration of CKD was (2.8 ± 1.3) years, and there were 375 cases in Stage 1 CKD, 420 in Stage 2 CKD, 300 in Stage 3 CKD, and 405 in Stage 4 CKD. There were 878 CKD cases with malnutrition and the incidence of malnutrition was 58.5%. Of them, 230 cases were growth retardation, 182 were low body mass, and 466 were emaciated. Multivariate logistic regression analysis showed that CKD children with longer duration(OR=1.773) and higher CKD stages (OR=1.598）were more likely to have malnutrition. The children with CKD, whose parents understood malnutrition knowledge (OR=0.598), received nutrition knowledge guidance (OR=0.472), knew the concept of nutrients (OR=0.603), had their children nutritional status checked (OR=0.617), and concerned about the children's diet (OR=0.392), were less likely to suffer from malnutrition.ConclusionThe incidence of malnutrition in children with CKD was high. The higher the CKD stage and the longer the course of disease, the higher the risk of malnutrition in children. Parents knowing more about the knowledge of malnutrition can help to reduce the occurrence of malnutrition in children.

ObjectiveTo analyze expression levels of differentially expressed miRNAs in sera of patients with occupational medicamentosa-like dermatitis induced by trichloroethylene (OMLDT) and establish diagnostic model for OMLDT using support vector machines (SVMs).MethodsSerum samples of patients with OMLDT and contacts were collected from January 1, 2009 to December 30, 2014. miRNAs were extracted and analyzed by microarrays. miR-21 and miR-193b were verified using qRT-PCR. From all the samples, 60% was randomly selected and used as a test set to establish the OMLDT diagnostic model by SVM algorithm, and the remaining 40% was used as verification set to evaluate the specificity and sensitivity of the model. ResultsThere were 34 patients in the OMLDT case group, including 23 males and 11 females, with an average age of (27.29 ± 10.43) years. There were 34 patients in the control group, including 26 males and 8 females, with an average age of (25.00 ± 6.14) years. There was no significant difference in gender composition or mean age between the two groups (both P> 0.05). The expression levels of miR-21 and miR-193b in the OMLDT case group were higher than those in the control group (both P< 0.01). The recognition rate of cross validation for the diagnostic model was 95%. The sensitivity, specificity and accuracy of SVM diagnostic model were 81.82%, 100.00%, and 92.86% respectively. ConclusionmiR-21 and miR-193b could be candidate serum biomarkers for OMLDT. The OMLDT diagnostic model based on SVM algorithm has a good fitting effect and can provide valuable clues for the early diagnosis of OMLDT.