Objective: To analyze the characteristics and trends of drowning mortality among Chinese residents from 2010 to 2021, so as to provide a basis for developing targeted prevention strategies and reducing the burden of drowning deaths. Methods: Data on drowning mortality among Chinese residents from 2010 to 2021 were collected from the China Cause of Death Surveillance Dataset (2010-2021). The crude mortality was calculated and then standardized using the data from the Sixth National Population Census in 2010. The characteristics of drowning mortality were analyzed by genders, regions, and ages. The average annual percent change (AAPC) was employed to assess the trend in drowning mortality. Results: From 2010 to 2021, the overall crude drowning mortality among Chinese residents was 3.53/100 000, with a standardized mortality of 3.34/100 000, both showed decreasing trends (AAPC=-2.438% and -3.739%, both P<0.05). The crude and standardized mortality were higher in males than in females (4.55/100 000 vs. 2.47/100 000, 4.43/100 000 vs. 2.16/100 000, both P<0.05). Both the crude drowning mortality (AAPC=-2.974% and -1.337%) and standardized drowning mortality (AAPC=-3.806% and -3.599%) among males and females showed decreasing trends, respectively (all P<0.05). The crude and standardized drowning mortality were higher in rural residents than in urban residents (4.13/100 000 vs. 2.35/100 000, 3.86/100 000 vs. 2.27/100 000, both P<0.05). Both the crude and standardized drowning mortality in rural residents showed decreasing trends (AAPC=-3.343% and -4.515%, both P<0.05), whereas no statistically significant trends were observed in urban residents (both P>0.05). Both the crude and standardized drowning mortality were higher in western residents than in eastern residents and central residents (4.30/100 000 vs. 2.89/100 000 and 3.66/100 000, 4.14/100 000 vs. 2.64/100 000 and 3.49/100 000, all P<0.05). The standardized mortality showed decreasing trends in eastern, central and western residents (AAPC=-3.237%, -2.344%, and -5.467%, all P<0.05). The groups aged ≥65 years and 1-<5 years experienced relatively high crude drowning mortality of 8.81/105 and 7.38/105, respectively. Decreasing trends were observed in groups aged <1 year, 1-<5 years, and 5-<15 years (AAPC=-14.126%, -11.452%, and -7.443%, all P<0.05). In contrast, no statistically significant trends were observed in the other age groups (all P>0.05). Conclusions The overall drowning mortality rate among Chinese residents showed a declining trend from 2010 to 2021. However, the risks of drowning mortality remained relatively high among males, rural residents, residents in the western region, children, and the elderly.

Objective: To analyze the correlation and gender differences between adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) and depression and anxiety symptoms among middle school students, so as to provide a reference for promoting the mental health of middle school students. Methods: With a stratified random cluster sampling method, a total of 6 656 middle school students in 4 cities, including Nanchang, Shenyang, Taiyuan, and Zhengzhou, were selected as research subjects from October 2021 to October 2022. The Adverse Childhood Experiences International Questionnaire (ACEs-IQ), Benevolent Childhood Experiences Scale (BCEs), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7) scale were used to conduct questionnaire surveys.The Chi square test was used to compare the reporting rates of depression and anxiety symptoms among middle school students in different groups, and a Logistic regression model was established to analyze the effects of ACEs and PCEs on depression and anxiety symptoms among middle school students and their gender differences. Results: The reporting rate of depressive symptoms among middle school students was 20.1%, and the reporting rate of anxiety symptoms was 13.9% . ACEs were positively correlated with depression and anxiety symptoms among middle school students (depression symptoms: OR =1.20, 95% CI =1.18-1.22, anxiety symptoms: OR =1.18, 95% CI =1.16-1.20), while PCEs were negatively correlated with depression and anxiety symptoms among middle school students(depression symptoms: OR =0.84, 95% CI = 0.83 -0.86, anxiety symptoms: OR =0.85, 95% CI =0.83-0.87) ( P <0.05). In the general population (depression symptoms ： OR =0.99, 95% CI = 0.98- 0.99, anxiety symptoms: OR =0.99, 95% CI =0.99-1.00) and among girls (depression symptoms: OR = 0.98 , 95% CI = 0.97- 0.99 , anxiety symptoms ： OR =0.99, 95% CI =0.98-1.00), the interaction term between ACEs and PCEs were negatively correlated with depression and anxiety symptoms ( P <0.05). Conclusions ACEs significantly affect the depression and anxiety symptoms of middle school students, while PCEs can help reduce the impact of ACEs on the depression and anxiety symptoms of middle school students, girls are more susceptible to the impact of early experiences than boys. It should focus on gender differences, formulate comprehensive mental health protection strategies, to promote the mental health development of middle school students.

Objective To explore the relationship between health literacy of chronic diseases and the effect of blood glucose control in newly diagnosed and prediabetes patients. Methods A total of 180 newly diagnosed and prediabetes patients treated in the Western Theater Command General Hospital from January 2021 to January 2023 were selected, including 94 newly diagnosed and 86 prediabetes patients. The health literacy of chronic diseases in these patients was evaluated by using the health literacy management scale (HeLMS) developed by Jordan et al. The differences of clinical general information and blood glucose control between patients with adequate and insufficient health literacy were analyzed. Results Among the 180 patients, the total score of information acquisition ability, communication and interaction ability, willingness to improve health, willingness for financial support, total score of health literacy, and adequate proportion of health literacy assessed by HeLMS were (35.54 ± 7.21), (33.02 ± 8.15), (15.54 ± 3.92), (7.10 ± 0.98), (91.87 ± 7.28), and 51.67%, respectively. The age of patients with adequate health literacy in the newly diagnosed diabetes group was (52.23 ± 7.15) years old, which was significantly lower than that of patients with insufficient health literacy (P<0.05). The proportions of patients with high school education and above, monthly income ≥ 3000 yuan, and relatives engaged in medical work were 68.09%, 68.09%, and 34.04%, respectively, which were significantly higher than those of patients with insufficient health literacy (P<0.05). The age of patients with adequate health literacy in prediabetes group was (82.23 ± 4.15) years old, which was significantly lower than that of patients with insufficient health literacy (P<0.05). The proportions of patients with high school education and above, monthly income ≥ 3000 yuan, number of children ≥ 2, and relatives engaged in medical work were 65.22%, 67.39%, 34.78%, and 41.30%, respectively, which were significantly higher than those of patients with insufficient health literacy (P<0.05). The fasting blood glucose, glycosylated hemoglobin and 2h postprandial blood glucose of patients with adequate health literacy in the newly diagnosed diabetes group after treatment were (6.43 ± 0.93) mmol/L, (6.02 ± 0.91)% and (7.71 ± 1.01) mmol/L, respectively, which were significantly lower than those of patients with insufficient health literacy (P<0.05). The fasting blood glucose, glycosylated hemoglobin and 2h postprandial blood glucose in patients with adequate health literacy in prediabetes group after treatment were (5.21 ± 0.37) mmol/L, (5.20 ± 0.40)% and (6.20 ± 0.92) mmol/L, respectively, which were significantly lower than those in patients with insufficient health literacy (P<0.05). Conclusion The chronic disease health literacy of prediabetes and new-onset patients is related to the age, education and monthly income level, number of children, relatives engaged in medical work of patients, and the level of health literacy is helpful to the control of blood glucose.

Objective: To explore the interaction of multi-target stool DNA (MT-sDNA), intestinal flora and environmental factors in the development of colorectal cancer, so as to provide insights into pathogenesis study of colorectal cancer. Methods: A total of 54 cases of colorectal cancer from the First Affiliated Hospital of Ningbo University were included in the case group and 51 healthy subjects were included in the control group. Demographic information, diet and family history of colorectal cancer were collected by a questionnaire survey. MT-sDNA, intestinal flora, cancer antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA) and other tumor markers were detected. Interactions of MT-sDNA, intestinal flora and environmental factors with the development of colorectal cancer was analyzed by multifactor dimensionality reduction (MDR), crossover analysis and additive model. Results: The case group included 20 males (37.04%) and 34 females (62.96%), and had a mean age of (64.89±9.72) years. The control group included 24 males (47.06%) and 27 females (52.94%), and had a mean age of (53.94±10.33) years. MDR analysis showed that subjects with both high absolute intestinal flora indexes and positive MT-sDNA had an increased risk of colorectal cancer (OR=3.782, 95%CI: 1.190-5.034). Crossover analysis showed that subjects with positive MT-sDNA and >5 μg/L of CEA had an increased risk of colorectal cancer (OR=2.121, 95%CI: 1.162-4.033). Additive model analysis showed that MT-sDNA had positive additive interaction with CEA (SI=3.687, 95%CI: 1.229-7.238), and MT-sDNA had negative additive interaction with fruit intake (SI=0.145, 95%CI: 0.020-0.753). Conclusion Positive MT-sDNA can synergistically increase the risk of colorectal cancer with high intestinal flora index and CEA, and fruit intake can reduce the risk of colorectal cancer in MT-sDNA-positive population.

Humans ; Lymph Nodes/pathology* ; Lymph Node Excision ; Neoplasms/pathology* ; Dissection

Humans ; Sarcoma ; Transcription Factors ; Biomarkers, Tumor ; Oncogene Proteins, Fusion

Humans ; Female ; Receptors, Estrogen/metabolism* ; Breast Neoplasms/metabolism* ; Receptors, Progesterone/metabolism* ; Immunohistochemistry ; Estrogen Receptor alpha

Objective: To examine the effects of air pollution on overall mortality, mortality of respiratory diseases, and mortality of circulatory diseases among residents in Hangzhou City. Methods: Residents' mortality data in Hangzhou City from 2014 to 2016 were captured from Zhejiang Provincial Chronic Disease Surveillance Information Management System, and the ambient air quality in Hangzhou City from 2014 to 2016 were collected from Hangzhou Environmental Monitoring Center, while the meteorological monitoring data during the study period were collected from Hangzhou Meteorological Bureau. The effects of PM2.5, PM10, NO2 and SO2 on overall mortality, morality of respiratory diseases and mortality of circulatory diseases were evaluated a generalized additive model (GAM) based on Poisson distribution, and the risk of mortality was described with excess risk (ER) and its 95%CI. Results: The daily M (QR) overall deaths, deaths from respiratory diseases and deaths from circulatory diseases were 111 (30), 16 (9) and 37 (14) persons in Hangzhou City from 2014 to 2016, respectively. A 10 μg/m3 increase in PM2.5, PM10, NO2 and SO2 resulted in 0.47% (95%CI: 0.23%-0.70%), 0.37% (95%CI: 0.21%-0.53%), 1.06% (95%CI: 0.50%-1.61%) and 3.08% (95%CI: 2.18%-3.99%) rises in the risk of overall mortality, 0.60% (95%CI: 0.04%-1.16%), 0.45% (95%CI: 0.06%-0.83%), 2.01% (95%CI: 0.84%-3.20%) and 6.06% (95%CI: 3.80%-8.37%) rises in the risk of mortality of respiratory diseases, and 0.45% (95%CI: 0.08%-0.83%), 0.44% (95%CI: 0.17%-0.71%), 1.43% (95%CI: 0.49%-2.37%) and 3.66% (95%CI: 2.13%-5.22%) rises in the risk of mortality of circulatory diseases, and the greatest effect was observed at a 2-day lag. Multi-pollutant model analysis showed that, after adjustment for PM2.5, NO2 and PM2.5+NO2+SO2, a 10 μg/m3 increase in SO2 resulted in an elevated risk of mortality of respiratory diseases than a single-pollutant model. Conclusions The air pollutants PM10, PM2.5, NO2, and SO2 correlated positively with the risk of overall mortality, mortality of respiratory diseases and mortality of circulatory diseases in Hangzhou City from 2014 to 2016, and the co-existence of multiple pollutants enhanced the effect of SO2 on mortality of respiratory diseases.

Objective: To investigate the risk factors for yersiniosis, so as to provide insights into prevention of yersiniosis. Methods: The patients with yersiniosis admitted to the clinics in the surveillance site of Chengbei Township of Jin'an District and Chengnan Township of Yu'an District in Lu'an City from 2013 to 2021 were included as the case group, and the healthy family members matched to cases were selected as the family control group, while normal residents with a 1︰2 match in the same village, gender, and age difference within 5 years were included in the community control group. Participants' demographics, hand-washing and eating habits, living environment hygiene, poultry and livestock feeding were collected using questionnaire surveys, and factors affecting yersiniosis were identified using a multivariable conditional logistic regression model. Results: There were 43 cases in the case group, with a median (interquartile range) age of 45 (34) years, 91 cases in the family control group, with a median (interquartile range) age of 36 (36) years and 86 cases in the community control group, with a median (interquartile range) age of 46 (34) years. Multivariable conditional logistic regression analysis showed that compared with the family control group, the habit of drinking unboiled water (OR=6.721, 95%CI: 1.765-25.588), and direct consumption of food stored in the refrigerator (OR=7.089, 95%CI: 1.873-26.829) were risk factors for yersiniosis in the case group; and compared with the community control group, not washing hands after contacting with poultry and livestock (OR=50.592, 95%CI: 2.758-927.997), habit of eating raw vegetables and fruits (OR=5.340, 95%CI: 1.022-27.887), direct consumption of food stored in the refrigerator (OR=19.973, 95%CI: 2.118-188.336), and unclean refrigerator (OR=12.692, 95%CI: 1.992-80.869) were risk factors for yersiniosis in the case group. Compared with the family and community control groups, not washing hands after contacting with poultry and livestock (OR=4.075, 95%CI: 1.427-11.637), habit of drinking unboiled water (OR=4.153, 95%CI: 1.331-12.957), habit of eating raw vegetables and fruits (OR=4.744, 95%CI: 1.609-13.993), and direct consumption of food stored in the refrigerator (OR=5.051, 95%CI: 1.773-14.395) were risk factors for yersiniosis in the control group. Conclusion Unhealthy habits such as eating raw vegetables and fruits, drinking unboiled water, direct consumption of food stored in the refrigerator, unclean refrigerator, and not washing hands after contacting poultry and livestock may increase the risk of yersiniosis.

Abstract: Objective To investigate the willingness to receiving multitarget stool DNA (MT-sDNA) testing and factors affecting the payment among individuals receiving colonoscopy screening, so as to provide the evidence for the formulation and health economic evaluation of colorectal cancer screening strategies. Methods: Individuals at ages of 40 to 75 years that received colonoscopy screening in The Affiliated Hospital of Ningbo University Medical School from August 2021 to March 2022 were sampled. Participants' demographics, living behaviors, family history, willingness to receive MT-sDNA testing and willingness to pay for MT-sDNA testing were collected using questionnaire surveys, and factors affecting the willingness to receive and pay for MT-sDNA testing were analyzed using a multivariable logistic regression model. Results : A total of 546 respondents were enrolled, with a mean age of (56.25±8.66) years and including 282 men (51.65%). There were 504 respondents that were willing to receiving MT-sDNA testing (92.31%) and 480 that were willing to pay for the MT-sDNA testing (88.24%). Multivariable logistic regression analysis showed that a family history of colorectal cancer in first-degree relatives (OR=0.246, 95%CI: 0.068-0.888), history of hemorrhoids (OR=0.300, 95%CI: 0.109-0.826) resulted in low willingness to receive MT-sDNA testing, and recognizing the reliability of MT-sDNA testing (OR=5.749, 95%CI: 1.480-22.323), considering no difficulty in sampling for MT-sDNA testing (OR=32.042, 95%CI: 6.666-154.021) and considering a difficulty in sampling for MT-sDNA testing (OR=20.278, 95%CI: 4.405-93.354) resulted in high willingness to receive MT-sDNA testing, while recognizing the reliability of MT-sDNA testing (OR=5.003, 95%CI: 1.761-14.216), concern about the reliability of MT-sDNA testing (OR=4.166, 95%CI: 1.285-13.501), considering no difficulty in sampling for MT-sDNA testing (OR=6.558, 95%CI: 2.105-20.428) and considering a difficulty in sampling for MT-sDNA testing (OR=5.820, 95%CI: 1.810-18.720) resulted in high willingness to pay for the MT-sDNA testing among individuals receiving colonoscopy screening. Conclusion A family history of colorectal cancer in first-degree relatives, history of hemorrhoids and awareness of MT-sDNA testing are factors affecting the willingness to receive and pay for the MT-sDNA testing among individuals receiving colonoscopy screening.