1.Survey of Hepatitis B infection and vaccination status among drug users in Xi'an.
Qian WU ; Jian ZU ; Xiaoli WEI ; Lijuan YOU ; Lingling KOU ; Hengxin LI ; Guihua ZHUANG
Chinese Journal of Preventive Medicine 2014;48(10):862-866
OBJECTIVETo explore seroepidemiological status and vaccine coverage of hepatitis B among drug users in Xi'an.
METHODS545 drug users in the Xi'an Compulsory Detoxification Center were asked to answer questionnaire and provide blood sample (3-5 ml) for test of HBsAg, anti-HBc and anti-HBs from March to June 2013. Totally, 545 subjects were surveyed and tested. All of them effectively completed the survey.
RESULTSThe positive rates of HBsAg, anti-HBc and anti-HBs were 29.4% (160/545), 60.0% (327/545) and 56.1% (306/545), respectively. Eighty five subjects (15.6%) were negative for all of the three markers. The prevalence of HBsAg and anti-HBc among injection drug users were 40.0% (94/235) and 65.6% (154/235), which was significantly higher than non- injection drug users' (21.6% (52/241), 58.5% (141/241)) and mixed non-injection and injection drug users ((20.3% (14/69), 46.4% (32/69)) (χ(2) = 23.518 and 9.017, respectively, P < 0.05) . The HBsAg positive rate (30.6% (153/500)) of subjects with more than once per day of drug using within one year was significantly higher than those who used drugs for 2-3 times per week (15.6% (7/45)) (χ(2) = 4.51, P < 0.05). Only 11.7% (64/545) of drug users had a clear history of hepatitis B vaccination. The vaccination rate of subjects (3.5% (5/141)) with primary education or below was significantly lower than those with high school (16.3% (45/276)) (χ(2) = 26.61, P < 0.05). The vaccination rate of subjects (7.8% (12/153)) over 45 years old was significantly lower than that of subjects below 30 years old (15.9% (21/132)) and 30-44 years old (11.9% (31/260)) (χ(2) = 30.36, P < 0.05). The vaccinees had a significantly higher positive rate of anti-HBs (73.4% (47/64)) than those who without vaccination (53.8% (259/481)) (χ(2) = 8.81, P = 0.003), but the positive rates of HBsAg (16.7% (11/64)) were lower than those who without vaccination (31.0% (149/481)) (χ(2) = 23.52 and 9.02, respectively;P > 0.05).
CONCLUSIONThe HBV infection status among drug users in Xi'an was in serious condition, while a low vaccination rate was also discovered among them.
Adult ; Age Factors ; China ; epidemiology ; Drug Users ; Hepatitis B ; epidemiology ; Hepatitis B Antibodies ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines ; Humans ; Middle Aged ; Prevalence ; Risk Factors ; Substance Abuse, Intravenous ; epidemiology ; Vaccination
2.A study on syphilis and HSV-2 infection and related behaviors among female sex workers who take new types of drugs in Jiaozhou city.
Zheng LI ; Dongmin LI ; Zhenxia JIANG ; Huixin LIU ; Ning WANG
Chinese Journal of Preventive Medicine 2014;48(10):857-861
OBJECTIVETo explore the prevalence of syphilis and HSV-2 among female sex workers (FSWs) who use new types of drugs in Jiaozhou city.
METHODSThrough convenient sampling, an anonymous questionnaire survey was conducted among female sex workers to collect demographic characteristics, new-type drugs abusing characteristics and related sexual behaviors from October to December, 2013. Blood specimens were drawn for serological tests of syphilis antibody and HSV-2 antibody. Urine specimens of the subjects surveyed were collected to test for methamphetamine. Differences in demographic characteristics, new-type drug abusing characteristics, and sexual behaviours between drug-abusing FSWs and non-drug-abusing FSWs were compared by t-test and χ(2)-test.
RESULTSA total of 460 FSWs were recruited in this study, and 105 FSWs admitted their drug abuse history. Among the 341 urine specimens confirmed to be methamphetamine positive, there were 3 FSWs claimed that they never abuse new-type drugs. The rate of new-type drug abuse was 23.5% (108/460). A total of 71.4% (75/105) of the new drug-abusing FSWs started using drugs under 25 years old. The main reasons for drug abuse were clients request (24, 22.9%), making more money (23, 21.9%) and companion temptations (22, 21.0%). Totally, 41.9% of them (44/105) took drugs with 4-5 persons, 32.4% (34/105) had sex with 2-3 men after taking drugs, and 60.2% of new-type drug-abusing FSWs (65/108) used condoms in the latest commercial intercourse, while only 7.4% FSWs (8/108) used condoms every time during their commercial sex activities in the recent month. Compared with FSWs having no drug abuse behavior, drug-abusing FSWs had higher single proportion (73.2% (79/108) vs 63.6% (224/352), χ(2) = 8.64, P < 0.05), lower condom use rate in the recent month (7.4% (8/108) vs 22.7% (80/352), χ(2) = 12.53, P < 0.01) and higher pregnancy rate in the recent 6 months (24.1% (26/108) vs 8.8% (31/352), χ(2) = 17.74, P < 0.01) and most of them come from the middle and high-level entertainmens (78.7% (85/108) vs 65.1% (229/352), χ(2) = 13.09, P < 0.01). Among the new-type drug-abusing FSWs, the prevalence rates of syphilis and HSV-2 were 12.0% (13/108) and 55.6% (60/108) , respectively. A total of 33 FSWs claimed that they were diagnosed with STDs in the recent year (30.6%) . The rates of syphilis(12.0% (13/108) vs 4.0% (14/352), χ(2) = 9.72, P < 0.01), HSV-2(55.6% (60/108) vs 39.2% (138/352), χ(2) = 9.01, P < 0.01) and diagnosed STDs (30.6% (33/108) vs 17.9% (63/352), χ(2) = 8.02, P < 0.01) among the drug-abusing FSWs were significantly higher than those of non-drug-abusing FSWs.
CONCLUSIONThere is a higher proportion of new-type drug abuse among the FSWs in Jiaozhou, with significantly higher prevalence rates of syphilis and HSV-2 infection, compared with non-new types of drug abusing FSWs. Prevalent risk sexual behaviors and ignorance of new-types drugs' harm were seen among them.
China ; epidemiology ; Condoms ; Designer Drugs ; Female ; Herpes Genitalis ; epidemiology ; Herpesvirus 2, Human ; Humans ; Methamphetamine ; Pregnancy ; Prevalence ; Risk Factors ; Risk-Taking ; Sex Work ; Sex Workers ; statistics & numerical data ; Sexual Behavior ; drug effects ; statistics & numerical data ; Sexual Partners ; Substance-Related Disorders ; Syphilis ; epidemiology
3.The efficacy of antiviral therapy and drug resistance analysis among HIV/AIDS patients with heroin addiction in Guangxi Zhuang Autonomous Region.
Bingyu LIANG ; Xiaoyi YANG ; Junjun JIANG ; Bo ZHOU ; Hui CHEN ; Rongfeng CHEN ; Fangning ZHAO ; Peijiang PAN ; Jiegang HUANG ; Li YE ; Hao LIANG
Chinese Journal of Preventive Medicine 2014;48(10):851-856
OBJECTIVETo investigate the impact of heroin for antiviral treatment, drug resistance, mutation types and frequency in HIV/AIDS patients in Guangxi Zhuang Autonomous Region.
METHODSHIV/AIDS patients were recruited in Methadone Maintenance Treatment Clinics, HIV/AIDS Clinic and HIV Voluntary Counseling and Testing Center Liuzhou and Baise city from April 2008 to October 2009. The patients were grouped by the situation of antiviral treatment and use of heroin. A total of 435 HIV/AIDS patients were recruited, among which 108 cases in antiviral treatment and heroin group, 93 cases in antiviral treatment and never using drug group, 105 cases in no antiviral treatment and using heroin group, 129 cases in no antiviral treatment and never using drug group. The effect of antiviral treatment was evaluated by questionnaire survey, viral load measurement and CD4(+) T lymphocyte count. HIV-1 RNA from plasma was extracted, and then the pol genes were amplified and sequenced. The sequences were analyzed for HIV-1 genotype drug-resistance.
RESULTSFor the patients who received antiviral treatment, the viral load in heroin group was higher than that in never using drug group (lg (2.61 ± 1.24) vs lg (2.08 ± 0.80), t = 3.54, P < 0.05) , and the percentage of viral load lower than 1 000 copies/ml in heroin group was significantly less than that in never using drug group (63.9% vs 86.0%,χ(2) = 12.76, P < 0.05). For the patients who received antiviral treatment, the difference has no significance in CD4(+) T lymphocyte count between heroin group and never using drug group ((337.92 ± 181.66) vs (326.14 ± 254.98), t = 0.38, P = 0.703). For the patients who didn't receive antiviral treatment, the difference also has no significance in CD4(+) T lymphocyte count between heroin group and never using drug group ((373.73 ± 155.97) vs (337.53 ± 209.26), t = 1.47, P = 0.143). For the patients who received antiviral treatment, there was no difference in the percentage of the CD4(+) T lymphocyte count more than 350/ml between heroin group and never using drug group (48.1% vs 43.0%, χ(2) = 0.53, P = 0.466). 319 HIV-1 pol gene sequences were obtained. Among the patients who received antiviral treatment, the mutation frequency of M184V/I, T215Y/F, L210W and T69N/S in heroin abuser group were significantly higher than that in never using drug group (14.9% (11/74) vs 4.4% (3/68), 12.2% (9/74) vs 1.5% (1/68), 12.2% (9/74) vs 1.5% (1/68) and 10.8% (8/74) vs 1.5% (1/68) respectively) (P < 0.05).
CONCLUSIONUsing heroin may promote HIV replication, reducing the virological response to antiviral treatment and increasing the frequencies of drug resistance loci among HIV/AIDS patients.Heroin rehabilitation may benefit from the antiviral treatment and obtain better antiviral effect.
Acquired Immunodeficiency Syndrome ; Anti-HIV Agents ; Antiviral Agents ; CD4 Lymphocyte Count ; China ; Drug Resistance ; Drug Resistance, Viral ; Genes, pol ; HIV Infections ; HIV-1 ; Heroin ; adverse effects ; Heroin Dependence ; Humans ; Mutation ; drug effects ; Mutation Rate ; Viral Load
4.The analyses of HIV-1 quasispecies in HIV-infected subjects by the application of single genome amplification assay.
Yanmin QIN ; Xiaohui WANG ; Dongfeng KONG ; Shunxiang ZHANG
Chinese Journal of Preventive Medicine 2014;48(9):819-822
OBJECTIVETo establish the single genome amplification (SGA) method and analyze the quasispecies in HIV-infected patients.
METHODSAll 6 sample RNA acquired in 2010 in Shenzhen and genetic sequenced as overlap peaks were extracted and diluted to a single copy, nest-PCR after one step RT-PCR was employed to amplify HIV-1 genome, and then PCR products was purified and sequenced. Mega 4.02 software was used to analyze the genetic distance among HIV-1 quasispecies, and phylogenetic tree was constructed.
RESULTSOur data showed that viral sequences derived from different patients were grouped into different clusters. Subcluster was also observed in several clusters, indicating these existed competition and preferential replication of certain viral strains. The genetic distance within one cluster of 6 samples were between 0.008 and 0.06, it was likely to associate with the duration since infection and viral load.
CONCLUSIONSGA is a useful approach to gain information on quasispecies, the genetic distance within one cluster may help to determine the infection time and immune escaping. The analysis of related affecting factors need more samples.
Base Sequence ; Genome, Viral ; HIV Infections ; HIV-1 ; Humans ; Phylogeny ; Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; Viral Load
5.Genotoxic effects of oral-exposed TiO2 nanoparticles on bone marrow cells in young rats.
Yun WANG ; Zhangjian CHEN ; Te BA ; Ji PU ; Yongen GU ; Jian GUO ; Guang JIA
Chinese Journal of Preventive Medicine 2014;48(9):815-818
OBJECTIVETo explore the genotoxic effects of oral-exposed TiO2 nanoparticles on bone marrow cells in young rats.
METHODSTwenty-eight SD male young rats (4 weeks old) were randomly divided into 4 groups, which were exposed to TiO2 nanoparticles ((75 ± 15) nm, anatase) through intragastric administration at 0, 10, 50 and 200 mg/kg body weight (bw) every day for 30 days. The bone marrow cells were collected for micronuclei and γ-H2AX immunofluorescence analysis.
RESULTSThe percentage of γ-H2AX foci-positive cells (37.4 ± 10.0)% in the 50 mg/kg bw dose group were significantly higher than that in the control group (19.8 ± 3.1)% (t value was -17.59, P < 0.01). No significantly difference was found in polychromatic erythrocyte/normochromatic erythrocyte (PCE/NCE) ratio and PCE micronucleus rate between three experimental groups and control group.
CONCLUSIONTiO2 nanoparticles can increase the frequency of DNA double-strand breaks in bone marrow cells, but has no effect on micronucleus of bone marrow cells in young rats.
Animals ; Bone Marrow Cells ; DNA Damage ; Histones ; Male ; Micronuclei, Chromosome-Defective ; Nanoparticles ; Rats ; Titanium
6.Comparative study on functional characters of MCF7 and HCC1937 cell lines in response to DNA damage.
Chao DONG ; Fengmei ZHANG ; Xipeng ZHAO ; Gongshe GUO ; Yue LUO ; Zhihui FENG
Chinese Journal of Preventive Medicine 2014;48(9):809-814
OBJECTIVEThe functional characters of MCF7 and HCC1937 cell lines were compared through the activity of BRCA1 and p53 following DNA damage in order to provide more research evidence for the related studies in both breast cancer cell lines.
METHODSThe protein level of BRCA1 and p53 in two breast cancer cell lines and the protein level of BRCA1 in MCF7, HCC1937 and HCC1937 wtBRCA1 breast cancer cell lines treated with 10Gy after 1 h, 4 h or 8 h were detected by western blotting analysis. The distribution and foci formation of BRCA1 in the cells were observed through immunostaining assay and the percentage of BRCA1 or Rad51 foci formation after ionizing radiation was calculated. Cell cycle profiling was analyzed using flow cytometry.
RESULTSMost of BRCA1 and p53 localized in nucleus, and both proteins responded to DNA damage in MCF7 cells. In MCF7 cells,BRCA1 and Rad51 foci formation respectively increased to (59.40 ± 3.66)% from (11.80 ± 3.51)% (t = 16.26, P < 0.05) and (73.90 ± 8.66) % from (16.70 ± 3.76) % (t = 10.49, P < 0.05) after 10 Gy 8 h ; p53 and p21 protein level was further separately induced and enhanced to (82.54 ± 1.04) from (23.75 ± 0.51) (t = 87.90, P < 0.05) and (90.95 ± 1.13) from (50.19 ± 0.89) ( t = 49.11, P < 0.05) after 10 Gy 8 h; and the cells were accumulated in G1 phase. In contrast to MCF7, in HCC1937 cell line, both of BRCA1 and p53 were defective in nucleus since both proteins were mutated; in response to DNA damage, BRCA1 foci formation was not found, p53 and p21 was not induced; there was no cell accumulation in both of G1-S and G2-M phases. However, after complementation of wild-type BRCA1 in HCC1937 cells, DNA damage-induced Rad51 foci formation increased to (61.70 ± 4.03) % from (6.22 ± 2.27) % (t = 20.78, P < 0.05) and accumulation of cells in G2-M phase was also restored after 10 Gy 8h , which was similar to that of in MCF7 cells.
CONCLUSIONSWe have identified that BRCA1 and p53 have dramatically different functions in MCF7 and HCC1937 cell lines in response to DNA damage.
Cell Cycle ; Cell Line, Tumor ; Cyclin-Dependent Kinase Inhibitor p21 ; DNA Damage ; Humans ; MCF-7 Cells ; Rad51 Recombinase ; Radiation, Ionizing ; Tumor Suppressor Protein p53 ; Ubiquitin-Protein Ligases
7.Application of European five-dimensional health questionnaire for the quality of life among the population over 60 years old in Dalian city.
Yu QIN ; Hairui ZHANG ; Lina ZHU ; Li MA ; Junfeng CHEN
Chinese Journal of Preventive Medicine 2014;48(9):805-808
OBJECTIVEUsing European five-dimensional health questionnaire (EQ-5D) to study the quality of life among the population over 60 years old in Dalian city and analyze the influence factors.
METHODIn 2013, multi-stage stratified cluster random sampling method and EQ-5D questionnaire were used to investigate the status of 4 081 participants over the age of 60 in Dalian. The questionnaire contained EQ-5D health describing system and the VAS. The EQ-5D index and EQ-VAS score of the study objects were calculated and the participants' quality of life and impact factors were analyzed.
RESULTWomen's percentage of "having difficulty" in 5 dimensionalities was 18.1% (373/2 059), 12.6% (264/2 059), 16.2% (334/2 059), 32.0% (659/2 059), 17.5% (371/2 059) respectively, men' percentage of "having difficulty" in 5 dimensionalities was 13.3% (269/2 022), 10.2% (218/2 022), 12.5% (253/2 022), 23.1% (467/2 022), 13.7% (77/2 022) respectively, and the difference was significant (P < 0.05). The EQ-5D index and VAS score of men was (0.82 ± 0.30), (72.75 ± 16.26), higher than those of women ( (0.79 ± 0.33), (70.79 ± 16.64 )) and the difference was significant (P < 0.05). The score of quality of life who were married was (0.82 ± 0.28) and (73.27 ± 16.60).With age increasing, the elders' quality of life score decreased, and with education level increasing, the elders' quality of life score increased (P < 0.05).
CONCLUSIONThe quality of life of the elders in Dalian city was kind of good, and it could be impacted by genders, marital status, education levels and the chronic diseases.
Age Factors ; China ; epidemiology ; Cities ; Education ; Female ; Health ; Humans ; Male ; Quality of Life ; Sex Factors ; Surveys and Questionnaires
8.11beta-hydroxysteroid dehydrogenase type 2 enzyme activity effect after exposures phthalate esters in maternal.
Xiaoya HU ; Yan ZHAO ; Beitao CHEN ; Yuan LIANG ; Luxi LI ; Changming XIE ; Yunhui ZHANG ; Zhenlang LIN ; Ailan XIE ; Shangqin CHEN
Chinese Journal of Preventive Medicine 2014;48(9):800-804
OBJECTIVETo study the association between phthalate esters (PAEs) metabolites in maternal urine and 11beta-hydroxysteroid dehydrogenase type 2 (11β-HSD2 ) enzyme activity, explore the possible mechanism of PAEs effect on fetal development.
METHODSAll of 33 cases of intrauterine growth retardation (IUGR) newborn were selected by random sampling in 2012. And 33 cases of normal control newborn were enrolled, use high performance liquid chromatography-tandem mass spectrometry method was used to detect 4 kinds of phthalate esters (PAEs) metabolites in maternal urine: mono-n-butyl phthalate ester (MBP), mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) and three kinds of cortisol corticosterone metabolites, tetrahydrocortisol (THF), allo-tetrahydrocortisol (allo-THF), tetrahydrocortisone (THE), and analyze the association between phthalate esters (PAEs) metabolites in maternal urine and 11β-HSD2 enzyme activity.
RESULTSMBP, MEHP, MEHHP, MEOHP metabolites can be detected in 98% (65 cases) , 89% (59 cases), 91% (60 cases), 91% (60 cases) of all 66 maternal urine samples, respectively. The median concentrations of test material in case group were 31.20 ng/ml for MBP, 24.61 ng/ml for MEHHP, 11.72 ng/ml for MEOHP and 48.67 ng/ml for SumDEHP which were significantly higher than those of the control group (were 17.32, 12.03, 5.68 and 28.64 ng/ml); 11β-HSD2 activity in case group ((THF+allo-THF)/THE = (0.79 ± 0.09) ng/ml) was significantly lower than that of the control group((THF+allo-THF)/THE = (0.58 ± 0.04) ng/ml); PAEs metabolites MBP (β' = 1.12), MEHHP(β' = 1.14), MEOHP(β' = 1.10), SumDEHP(β' = 1.08) in baby boy mother's urine was reversely correlated to 11β-HSD2 activity.
CONCLUSIONSPAEs could affect fetal development by inhibit 11β-HSD2 activity.
11-beta-Hydroxysteroid Dehydrogenase Type 2 ; Chromatography, Liquid ; Diethylhexyl Phthalate ; analogs & derivatives ; Fetal Development ; Humans ; Infant, Newborn ; Male ; Mass Spectrometry ; Phthalic Acids ; Tetrahydrocortisol ; analogs & derivatives ; Tetrahydrocortisone
9.Effects of daily mean temperature on respiratory hospital admissions in Shanghai: time-series analysis.
Yue ZHANG ; Haidong KAN ; Li PENG ; Yuan LIU ; Weibing WANG
Chinese Journal of Preventive Medicine 2014;48(9):795-799
OBJECTIVETo quantitatively evaluate the effects of daily mean temperature on respiratory diseases.
METHODSBased on the data of daily hospital admissions for respiratory diseases, meteorological parameters and air pollution in Shanghai between January 2006 and December 2011, we used a generalized additive model (GAM) to explore the effects of daily mean temperature on hospital admissions on respiratory diseases adjusted for the secular trend, seasonal trend, day of week and other confounders.
RESULTSA J-shaped relationship was found between daily mean temperature and respiratory disease and the optimum temperature (OT) corresponding to low risk of respiratory hospital admissions was about 25 °C. For cold effects over lag 0-30 days, the overall excess risk (ER) of hospital admission associated with 1 °C below the OT was 3.00% (95% CI: 2.54%-3.45%), 3.00% (95% CI: 2.55%-3.45%) and 3.02% (95% CI:2.51%-3.49%) for overall, males and females, respectively. For hot effects over lag 0-30 days, the overall excess risk (ER) was 2.15% (95% CI: 0.67%-3.66%), 1.86% (95% CI: 0.39%-3.34%) and 2.57% (95% CI: 0.82%-4.36%) for overall, males and females, respectively. The optimum temperature between daily mean temperature and respiratory disease were 14 °C, 20 °C, 25 °C and 28 °C in different age groups. The effect of low temperature increased with age for the people above 45 years old; however the effect of high temperature was significant for the people under 65 years old.
CONCLUSIONSBoth of higher temperature and lower temperature resulted in ER of respiratory hospital admissions increase with lag effects. The effects of lower temperature lagged longer and stronger than higher temperature. Different age group and gender shows different effects.
Age Factors ; Air Pollution ; China ; Cold Temperature ; Female ; Hospitalization ; Hot Temperature ; Humans ; Male ; Models, Theoretical ; Respiratory Tract Diseases ; Sex Factors ; Temperature
10.Analysis on absentees due to injury during 2012-2013 school year from 32 primary schools in Hubei province.
Li TAN ; Weirong YAN ; Ying WANG ; Yunzhou FAN ; Hongbo JIANG ; Wenwen YANG ; Shaofa NIE
Chinese Journal of Preventive Medicine 2014;48(9):791-794
OBJECTIVETo analyze absentees due to injury among primary school pupils in Hubei, 2012-2013; and to provide theoretical basis for the prevention and control of injuries.
METHODSA total of 32 primary schools in Qianjiang city and Shayang county were sampled to conduct injury absenteeism surveillance, and the total number of students was 21 493. The surveillance contents included absent dates, genders, grades, initial or return absent, and the detailed absent reasons. The classification of injury was based on the 10th Revision of the international classification of diseases developed by WHO. Data from 2012-2013 school-year were extracted from the surveillance system for analysis. The total surveillance period was 182 days, of which the fall semester was 98 days and the spring semester was 84 days. The absenteeism rate and injury rate in different characteristics of primary school students were compared by χ² test, and the possible risk factors of injury were preliminary explored by calculating the RR (95% CI) value.
RESULTSThe total daily injury absenteeism rate was 8.26/100 100 during 2012-2013 school-year in 32 primary schools in Hubei province, which was higher in fall semester (9.16/100 000), Qianjiang area (9.63/100 000), rural primary schools (13.44/100 000), boys (9.57/100 000), 1-2 grades (10.41/100 000), and the differences were significant (P < 0.05). The total injury rate was 0.46%. Rural primary schools (RR = 2.32, 95% CI: 1.46-3.70), boys (RR = 1.88, 95% CI: 1.23-2.87), and 3-4 grades (RR = 1.85, 95% CI: 1.10-3.09) were identified as high-risk factors, while using city primary schools, girls, and 5-6 grades as references, respectively.
CONCLUSIONThe injury absenteeism rate and injury rate were more higher in rural primary schools, boys and low or middle grades in Hubei province during 2012 to 2013 school year, so monitoring and preventive measures should be focused on those students.
Absenteeism ; Adolescent ; Child ; Female ; Humans ; Male ; Risk Factors ; Rural Population ; Schools ; Sex Factors ; Students ; Wounds and Injuries