Epidemiological and spatiotemporal analyses of HIV/AIDS prevalence among older adults in Sichuan, China between 2008 and 2019: A population-based study.

OBJECTIVES: To describe epidemiological trends and spatial distributions of HIV/AIDS among older adults (aged ≥50) in Sichuan Province, China during 2008-19, and provide scientific reference for HIV/AIDS prevention, intervention and treatment. METHODS: Data on HIV/AIDS cases reported in 2008-19 was extracted from the Case Report System. The Cochran-Armitage trend test was used to determine epidemic trends. Spatial autocorrelation and space-time analysis were conducted with ArcGIS10.6 and ArcGIS Pro2.4, respectively. RESULTS: A total of 77854 HIV/AIDS cases among older adults were included in the study. Newly reported cases increased from 320 in 2008 to 22189 in 2019, and the reported incidence rate (number of new reported cases/older adult population) rose from 0.001% to 0.077%. Infections through heterosexual transmission increased from 65.3% to 98.2% of total cases in older adults in this period. Spatial analysis at the county-level showed significant clustering throughout Sichuan, with the main hot spots concentrated in the southeast. Spatiotemporal analysis indicated that most of the southeastern counties/districts were Consecutive Hot Spots. CONCLUSIONS: Older adults have become a key population in the HIV/AIDS epidemic in Sichuan; comprehensive prevention and intervention measures targeted to older adults are urgently needed to control the spread of HIV/AIDS.

[Epidemiology, Treatment, and Epidemic Prevention and Control of the Coronavirus Disease 2019: a Review].

This review summarizes the ongoing researches regarding etiology, epidemiology, transmission dynamics, treatment, and prevention and control strategies of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with comparison to severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and pandemic H1N1 virus. SARS-CoV-2 may be originated from bats, and the patients and asymptomatic carriers are the source of epidemic infection. The virus can be transmitted human-to-human through droplets and close contact, and people at all ages are susceptible to this virus. The main clinical symptoms of the patients are fever and cough, accompanied with leukocytopenia and lymphocytopenia. Effective drugs have been not yet available thus far. In terms of the prevention and control strategies, vaccine development as the primary prevention should be accelerated. Regarding the secondary prevention, ongoing efforts of the infected patients and close contacts quarantine, mask wearing promotion, regular disinfection in public places should be continued. Meanwhile, rapid detection kit for serological monitoring of the virus in general population is expected so as to achieve early detection, early diagnosis, early isolation and early treatment. In addition, public health education on this disease and prevention should be enhanced so as to mitigate panic and mobilize the public to jointly combat the epidemic.

[Currency Survey and Influencing Factors Analysis on the Knowledge and Behavior Related to Brucellosis among Occupational Workers in Jianyang City].

OBJECTIVE: To investigate the status and influencing factors of the knowledge and behavior related to brucellosis among occupational workers in Jianyang city, and to provide basic information for developing regional specific strategies for brucellosis prevention and control. METHODS: With multistage cluster random sampling, occupational workers aged ≥18 yr. who had been in contact with sheep and their products were interviewed through a questionnaire about demographic characteristic, knowledge, and behavior related to brucellosis. The knowledge and practice scores were described as frequency and percentage, and the awareness rate of knowledge about brucellosis was calculated. Unconditional logistic regression model was used to analyze the influencing factors of knowledge and behavior related to brucellosis. RESULTS: In total, 378 workers were recruited. The minority (25.1%) of the workers had heard of brucellosis, and the awareness rate of brucellosis was 22.0%. Occupational protective behaviors were poor, and the scoring rates of wearing protective clothes, mask and gloves were 58.7%, 76.5%, 71.7% respectively. The results of multivariate logistic regression analysis revealed that the awareness rate of knowledge about brucellosis decreased with age, while the low educational level was found to be associated with low awareness of knowledge about brucellosis, and occupation type had association with the awareness rate of knowledge. Besides, the awareness of knowledge about brucellosis was a protective factor and occupation type were associated with the behavior related to brucellosis. CONCLUSIONS: The knowledge and behavior related to brucellosis are poor among occupational workers in Jianyang. It is necessary to continuously implement targeted health education and health promotion programs in this region, and the people with low education level and livestock farmers should be paid special attention to.

Molecular characterization of enterovirus 71 sibling strains for thermal adaption in Vero cells with adaptive laboratory evolution.

Enterovirus 71 is the main pathogen that causes severe and fatal hand-foot-mouth-disease (HFMD) cases. As the enterovirus virus mutation has implications for pathogenesis, vaccine development, antiviral therapy, and epidemiological disease management of the virus. In this study, we investigated the variations of enterovirus 71 in thermal adaption, using the method of adaptive laboratory evolution. The sibling virus strains were isolated from a 2-year-old severe case of HFMD (#100) and her symptomless close contact (#101). Both strains were cultured in Vero cells by serial passage of 36 generations at the temperatures of 28.0 °C, 33.0 °C and 39.5 °C to construct adaptive lineages. According to the comparative analysis of phenotypes between adapted strains and parental strains, differences in growth rate were observed in the sibling lineages and a larger plaque was found mainly in the hot adapted strains for lineage #101. Two sets of adaptive strains from six time points (parental, 12th 17th, 31st, 35th passage and endpoint) were sequenced and analyzed by both Sanger sequencing and Next Generation Sequencing. Several variations in most coding genes and one reverse mutation in 5'UTR was observed, along with the identity of 99.8% for complete genome for both lineages. Notably, thermal specific non-synonymous mutations were found in the gene of VP1\VP3\3A\2C\3C. Moreover, the concurrent mutations A292G, A434G and A355C/T of sibling lineages in VP1 showed quantificational trace with distinguishing patterns for different temperatures, which were suspected to be the thermo-sensitive mutation hotspots. These results highlight the possible rules of thermal adaption in enterovirus 71, produce a novel picture of genome evolution of the virus, and shed light on viral variation and evolution.

Calpain-10 SNP43 and SNP19 polymorphisms and colorectal cancer: a matched case-control study.

OBJECTIVE: Insulin resistance (IR) is an established risk factor for colorectal cancer (CRC). Given that CRC and IR physiologically overlap and the calpain-10 gene (CAPN10) is a candidate for IR, we explored the association between CAPN10 and CRC risk. METHODS: Blood samples of 400 case-control pairs were genotyped, and the lifestyle and dietary habits of these pairs were recorded and collected. Unconditional logistic regression (LR) was used to assess the effects of CAPN10 SNP43 and SNP19, and environmental factors. Both generalized multifactor dimensionality reduction (GMDR) and the classification and regression tree (CART) were used to test gene-environment interactions for CRC risk. RESULTS: The GA+AA genotype of SNP43 and the Del/Ins+Ins/Ins genotype of SNP19 were marginally related to CRC risk (GA+AA: OR = 1.35, 95% CI = 0.92-1.99; Del/Ins+Ins/ Ins: OR = 1.31, 95% CI = 0.84-2.04). Notably, a high-order interaction was consistently identified by GMDR and CART analyses. In GMDR, the four-factor interaction model of SNP43, SNP19, red meat consumption, and smoked meat consumption was the best model, with a maximum cross-validation consistency of 10/10 and testing balance accuracy of 0.61 (P < 0.01). In LR, subjects with high red and smoked meat consumption and two risk genotypes had a 6.17-fold CRC risk (95% CI = 2.44-15.6) relative to that of subjects with low red and smoked meat consumption and null risk genotypes. In CART, individuals with high smoked and red meat consumption, SNP19 Del/Ins+Ins/Ins, and SNP43 GA+AA had higher CRC risk (OR = 4.56, 95%CI = 1.94-10.75) than those with low smoked and red meat consumption. CONCLUSIONS: Though the single loci of CAPN10 SNP43 and SNP19 are not enough to significantly increase the CRC susceptibility, the combination of SNP43, SNP19, red meat consumption, and smoked meat consumption is associated with elevated risk.

The changing trends of HIV/AIDS in an ethnic minority region of China: modeling the epidemic in Liangshan prefecture, Sichuan Province.

OBJECTIVE: This study was to investigate the HIV current situation in Liangshan prefecture, in order to predict prevalence and transmission trends. METHODS: Region-specific population, behavior, serosurveillence, and policy/program data (from 1995 to 2010) were gathered from various local and national organizations and applied to the Asian Epidemic Model (AEM) and used to derive estimates of future HIV prevalence, epidemic trends, and outcomes of intervention strategies. RESULTS: The AEM projections for 2020 included increased number of people living with HIV (PLHIV; to 136 617), increased HIV prevalence (2.51%), and 8037 deaths from acquired immunodeficiency syndrome (AIDS) in this region. However, the overall HIV incidence rate (per 10 000) was projected to decline from 27 in 2015 to 22 in 2020, largely due to a predicted decrease in HIV infection rate (per 10 000) from 658 in 2013 to 621 in 2020 among intravenous drug users. In contrast, the cases of HIV infection per 10 000 was projected to increase from 420 in 2010 to 503 in 2020 among men who have sex with men, and from 8 in 2010 to 15 in 2020 among the general population. The predominant risk factor for HIV transmission over the next decade in Liangshan was casual sex. Community-based outreach strategies to reduce injected drug use and casual sex, and to promote condom use, were predicted as effective interventions to decrease HIV transmission. CONCLUSION: Implementation of a comprehensive public health program, with targeting to the region-specific at-risk populations, will help to mitigate HIV/AIDS spread in Liangshan.

Epidemiological characteristics of Japanese encephalitis in Guizhou Province, China, 1971-2009.

OBJECTIVE: The aim of the study was to establish the contemporary epidemiological characteristics of Japanese encephalitis (JE) in Guizhou Province. METHODS: A retrospective study of National Notifiable Disease Reporting System (NNDRS) data from 1971 through 2009, was conducted to ascertain the geographical, seasonal, and age distributions of JE incidence in Guizhou Province, China. RESULTS: A total of 68 425 JE cases were reported in Guizhou from 1971-2009. The JE cases occurred sporadically in all 9 prefectures of Guizhou, mostly among residents of rural areas. Seasonal distribution of JE remained consistent over the period from 1971-2009 with the main transmission season starting from June to September and peaking in August. JE occurred mainly in children under the age of 15 years with peak incidence in the 0-6-year age group. Pearson's correlation analysis showed that JE vaccine distribution had a negative correlation with JE incidence rates during 1971-2009 (coefficient of correlation=-0.475, P<0.01). CONCLUSION: Over the period of 1971-2009, the JE incidence rate had declined dramatically in terms of geographical and age distributions due to JE vaccination to children at risk.

Spatial-temporal analysis of malaria and the effect of environmental factors on its incidence in Yongcheng, China, 2006-2010.

BACKGROUND: In 2003, Plasmodium vivax malaria has re-emerged in central eastern China including Yongcheng prefecture, Henan Province, where no case has been reported for eleven years. Our goals were to detect the space-time distribution pattern of malaria and to determine significant environmental variables contributing to malaria incidence in Yongcheng from 2006 to 2010, thus providing scientific basis for further optimizing current malaria surveillance and control programs. METHODS: This study examined the spatial and temporal heterogeneities in the risk of malaria and the influencing factors on malaria incidence using geographical information system (GIS) and time series analysis. Univariate analysis was conducted to estimate the crude correlations between malaria incidence and environmental variables, such as mosquito abundance and climatic factors. Multivariate analysis was implemented to construct predictive models to explore the principal environmental determinants on malaria epidemic using a Generalized Estimating Equation (GEE) approach. RESULTS: Annual malaria incidence at town-level decreased from the north to south, and monthly incidence at prefecture-level demonstrated a strong seasonal pattern with a peak from July to November. Yearly malaria incidence had a visual spatial association with yearly average temperature. Moreover, the best-fit temporal model (model 2) (QIC = 16.934, P<0.001, R2 = 0.818) indicated that significant factors contributing to malaria incidence were maximum temperature at one month lag, average humidity at one month lag, and malaria incidence of the previous month. CONCLUSIONS: Findings supported the effects of environment factors on malaria incidence and indicated that malaria control targets should vary with intensity of malaria incidence, with more public resource allocated to control the source of infections instead of large scale An. sinensis control when malaria incidence was at a low level, which would benefit for optimizing the malaria surveillance project in China and some other countries with unstable or low malaria transmission.

Casual sex and concurrent sexual partnerships among young people from an Yi community with a high prevalence of HIV in China.

Liangshan Prefecture in Sichuan province, China, has a high prevalence of HIV infection, which is reflective of a change in the mode of transmission from injection drug use (IDU) to heterosexual intercourse. However, few studies focus on HIV-related heterosexual risk behaviours among the majority Yi population. The objectives of this study were to explore the characteristics of an egocentric sexual network and estimate the prevalence of casual sexual behaviour. Yi villagers (n=108), aged 15-35 years, who reported having had sex within the previous year were interviewed as to their sexual behaviours and networks. In-depth interviews and focus group discussions provided supplementary information on sexual norms. Logistic regression analysis was used to calculate unadjusted odds ratios (ORs) and 95% confidence intervals (CIs). Most of the respondents reported having had casual sex at some time in their life, and 66.7% reported multiple sexual partnerships. Only 21.3% reported ever having used a condom. During the study year, a total of 137 partners were involved in 153 sexual partnerships. Among the reported sexual partnerships, 67.3% originated from a casual sexual relationship. For network members in components of size ≥ 3, 56.9% were involved in concurrent sexual partnerships. Having never been married (OR: 2.11; 95% CI: 1.03-4.33) and younger age (OR: 0.89; 95% CI: 0.83-0.95) were both associated with being in a component of size ≥ 3. Size (OR: 2.99; 95% CI: 1.17-7.66), pair (OR: 0.54; 95% CI: 0.39-0.74), the number of weak components of the egocentric sexual network (OR: 30.04; 95% CI: 6.47-139.46) and gender (OR: 0.19; 95% CI: 0.06-0.67) were all associated with being in concurrent sexual partnerships. HIV-related interventions for the Yi ethnic minority in Sichuan province must therefore address concurrent sexual partnerships and promote condom use.

[The correlation analysis between environmental factors, bone morphogenetic protein-4 and transforming growth factor beta-3 polymorphisms in nonsyndromic cleft lip with or without cleft palate].

OBJECTIVE: To investigate the effects of interactions among environmental factors, bone morphogenetic protein-4 (BMP4) and transforming growth factor beta-3 (TGF-ß(3)) polymorphisms on nonsyndromic cleft lip and cleft palate (NSCLP). METHODS: The data of environmental exposures were collected with questionnaires. Genotypes were determined with techniques of polymerase chain reaction-restriction fragment length polymorphism. Interactions between genes, environmental factors and NSCLP were analyzed using multifactor dimensionality reduction (MDR) method. The interactions were validated by logistic regression analysis. RESULTS: There was no correlation between three single nucleotide polymorphism (SNP) associated with NSCLP. The developmental accident of NSCLP had higher risk in the interaction between BMP4 T538C, maternal passive smoking and infection in first trimester pregnancy, as well as in the interaction of six factors between TGF-ß(3) G15572-, maternal passive smoking, infections, multivitamin supplement in the first trimester pregnancy, paternal smoking and high risk drinking before realizing pregnancy than in other interactions of environmental factors. The results could be validated by logistic regression analysis. CONCLUSIONS: The NSCLP is induced by the interactions between genes and environmental risk factors.

[AIDS/HIV prevention and control among long-distance drivers in China: a Meta analysis].

OBJECTIVE: To assess the efficacy of HIV/AIDS prevention and control among long-distance drivers in China. METHODS: Based on the principles and methods of Cochrane systematic reviews, we searched literature from CBM (from 1978 to 2009), VIP (1989 to 2009) CNKI (1980 to 2009), and MEDLINE (1950 to 2009) and also assessed the risk of bias of the included before-after studies according to Newcastle-Ottawa scale and their characteristics. Cochrane Collaboration's software RevMan 5.0 was used for Meta-analysis. RESULTS: 13 studies were included, with most of them were of low quality as having high risk of bias. (1) Knowledge index 1: We included 7 'pre-post' studies. Meta-analysis showed that AIDS/HIV prevention and control was effective in promoting the knowledge index 1 among long-distance drivers (RD = 0.15, 95%CI: 0.04 - 0.26). (2) Knowledge index 2: We included 10 pre-post studies, in which the results from Meta-analysis showed that AIDS/HIV prevention and control was effective in promoting the knowledge index 2 among long-distance drivers (RD = 0.24, 95%CI: 0.17 - 0.30). (3) Behavior index: We included 6 pre-post studies in which the results from Meta-analysis showed that AIDS/HIV prevention and control was effective in promoting the behavior index among long-distance drivers (RD = 0.15, 95%CI: 0.10 - 0.19). CONCLUSION: Current evidence demonstrated that HIV/AIDS prevention and control programs were effective.

[Development of evaluation tool for the risk level of abnormal glucose metabolism morbidity in middle-aged and elder populations].

OBJECTIVE: To develop the evaluation tool for the risk level of abnormal glucose metabolism morbidity in the middle-aged and elder populations. METHODS: By the stratified cluster sampling method, a survey was conducted in middle-aged and elder populations aged 40 - 70 years old in urban and rural areas of Chengdu during April-November 2008. The parameters included blood pressure, fasting blood glucose, blood glucose after oral administration of 75 g glucose, blood lipid, blood uric acid, height, body weight and waistline, etc. A total of 5205 valid copies of questionnaires were obtained. A discriminant analysis and a multifactorial logistic regression analysis were conducted. The quantitative scoring system was established and the ROC analysis conducted to screen the boundary point of the quantitative scoring system. The discriminant performance of simple scoring model was conducted in 336 subjects for physical examination. RESULTS: The accuracies of discriminant analysis in male and female models were 79.04% and 81.35% respectively. The simple male scoring mode included the following eight parameters: age, physical work intensity, parental history of diabetes mellitus, sibling's history of diabetes mellitus, BMI index, existing abdominal obesity and history of hypertension. The simple female scoring mode included the following eight parameters: age, physical work intensity, physical training, parental history of diabetes mellitus, sibling's history of diabetes mellitus, BMI index, existing abdominal obesity, history of hypertension, number of parturition and history of gestational diabetes mellitus. The ROC AUCs were 0.701 and 0.728 in male and female models respectively. During applications in other populations, the sensitivity and specificity of the male model were 86.86% and 65.12% while those of female model 88.89% and 72.97% respectively. CONCLUSIONS: The newly developed evaluation tool for the risk level of abnormal glucose metabolism morbidity in middle-aged and elder populations is both simple and practical. With an excellent practicability; it may be used to screen abnormal glucose metabolism in middle-aged and elder populations.

[Comparison between early outbreak detection models and simulated outbreaks of measles in Beijing].

OBJECTIVE: Using simulated outbreaks to choose the optimal model and its related parameters on measles so as to provide technical support for developing an Auto Warning System (AWS). METHODS: AEGIS-Cluster Creation Tool was applied to simulate a range of unique outbreak signals. Then these simulations were added to the actual daily counts of measles from the National Disease Surveillance System, between 2005 and 2007. Exponential weighted moving average (EWMA), C1-MILD (C1), C2-MEDIUM (C2), C3-ULTRA (C3) and space-time permutation scan statistic model were comprehensively applied to detect these simulations. Tools for evaluation as Youden' s index and detection time were calculated to optimize parameters before an optimal model was finally chosen. RESULTS: EWMA (lamda = 0.6, k = 1.0), CI (k = 0.1, H=3sigma), C2 (k = 0.1, H=3sigma), C3 (k = 1.0, H=4sigma) and space-time permutation scan statistic (maximum temporal cluster size=7 d, maximum spatial cluster size = 5 km) appeared to be the optimal parameters among these models. Youden's index of EWMA was 90.8% and detection time being 0.121 d. Youden's index of C1 was 88.7% and detection time being 0.142 d. Youden's index of C2 was 92.9% and detection time being 0.121 d. Youden's index of C3 was 87.9% and detection time being 0.058 d. Youden's index of space-time permutation scan statistic was 94.3% and detection time being 0.176 d. CONCLUSION: Among these five early warning detection models, space-time permutation scan statistic model had the highest efficacy.

[Bibliometric analysis of literatures on the oral poliomyelitis attenuated live vaccine mass immunization campaign in China].

OBJECTIVE: To explore the present situation on the strategy of oral polio vaccine (OPV) supplementary immunization for eliminating polio and to analyses new trends and directions of these studies in China. METHODS: Literatures on the strategy of OPV supplementary immunization for eliminating polio in china from 1993-2007 were analysed by quantitative study. RESULTS: 279 papers were identified through searching papers, which were gradually increasing between 1993-2007. There were a group of active and talented authors whose papers were mainly distributed in Beijing, Guangdong, Shandong, Zhejiang province, etc. Most of papers were published in Chinese journal of vaccines and immunization, Chinese journal of public health, Chinese journal of epidemiology, etc. The review on the OPV supplementary immunization, monitoring the GMT and maintaining the progress of free-polio, etc. were involved. CONCLUSION: There were also problems on the imbalance of the region distribution, the limitation of institution, the lower level of study methods and the insufficient study content about the strategy of OPV supplementary immunization. The coorporation between CDC and the medicine institution should be conducted. It is very important to evaluate the cost-effective and the methods of the strategy of OPV supplementary immunization.

Association of bone morphogenetic protein 4 gene polymorphisms with nonsyndromic cleft lip with or without cleft palate in Chinese children.

Nonsyndromic cleft lip with or without cleft palate (nsCL/P) is one of the most common congenital anomalies in humans. The pathogenesis of nsCL/P involves both genetic and environmental factors. On the basis of linkage data suggesting that 14q21-24 is one of the chromosomal regions that affects nsCL/P and data locating the BMP4 gene to 14q22-23, we performed a case-control study to evaluate whether BMP4 538T/C polymorphism, resulting in an amino acid change of Val/Ala (V152A) in the polypeptide, is associated with nsCL/P in a Chinese children population. Genotypes of 184 patients with nsCL/P and 205 controls were detected using a PCR-RFLP strategy. The results showed significant differences in the genotype and allele distribution of 538T/C polymorphisms of the BMP4 gene among the cases and controls. The 538C allele carriers were associated with a significantly increased risk of nsCL/P as compared with the noncarriers (odds ratio = 1.52; 95% confidence interval, 1.13-2.03; p = 0.005). Hence, our results support the hypothesis that this polymorphism contributes to risk of nsCL/P, which suggests that BMP4 538T/C polymorphisms could be used as genetic susceptibility markers of nsCL/P.

[The impact of complication on quality of life among diabetic patients in urban China].

OBJECTIVE: To explore the impact of chronic complications of type 2 diabetic mellitus (T2DM) on quality of life (QOL) among T2DM outpatients in urban China. METHODS: A cross-sectional study was carried out in 1524 T2DM outpatients recruited from 15 hospitals in 4 major cities of China. Questionnaire interviews were used to collect data on general characters and complications of T2DM. SF-36 questionnaire (version 1) was used and self-completed by patients under the help from interviewers for those having difficulties in reading. T test, one-way ANOVA and generalized linear model were used to explore the association between complications of T2DM and quality of life. RESULTS: Complication was a significant predictor leading to poorer SF-36 subscale scores (decreased by 4.68 - 16.06 scores) and two summary scores (PCS, MCS). The scores of role-physical subscale (decreased by 22.45%) and role-emotional subscale (decreased by 16.28%) decreased much more than the other subscales in patients with complication. Overall, QOL was reduced by 11.02% in patients with complication. The QOL had a gradual decrease with the increasing number of complications. The average scores descended from 2.82 to 10.33 in the eight subscales with the increase of one complication. CONCLUSION: Having complication or multiple complications seemed to be predictors of poor QOL among T2DM outpatients.

The prevalence of anxiety symptoms and depressive symptoms in patients with somatic disorders in urban China: a multi-center cross-sectional study.

OBJECTIVE: To assess the prevalence of anxiety and depressive symptoms among patients with somatic diseases in urban China. METHOD: A hospital-based cross-sectional study was carried out in four major cities of China from June to August in 2004. There were 2111 eligible subjects with Stroke, Parkinson's Disease, Epilepsy, Irritable Bowel Syndrome, Functional Dyspepsia, and Menopausal Syndrome, and 317 Post-natal women were recruited from general hospitals. Self-completed hospital anxiety and depression scale (HAD) questionnaire was used for screening anxiety and/or depressive symptoms. Subjects with a HAD score of > = 9 were further assessed with Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) by certified psychologists or psychiatrists. RESULTS: The prevalence of "screened" depressive and anxiety symptoms using HAD were 11-19% and 11-22% respectively in patients with above somatic diseases and post-natal women. Assessed by HAMA/HAMD scale, the prevalence of "definite" depressive symptoms was 30%-59% in subjects with "screened" depressive symptoms, and 44%-84% in subjects with "screened" anxiety symptoms. About half of the subjects had co-morbidity depressive and anxiety symptoms. Less than one-fourth of these subjects had ever been diagnosed as depressive/anxiety disorders and been treated prior to the investigation. CONCLUSION: There is a high prevalence and low diagnosis and treatment rate of depressive and anxiety symptoms in patients with these somatic diseases in China.

[One family investigation and risk factors analysis of developmental dysplasia of the hip].

OBJECTIVE: To investigate the clinical manifestations and risk factors of the patients from developmental dysplasia of the hip(DDH) family. METHODS: Detailed epidemiology investigation, physical examination, functional movement assessment, lab test and X-ray examination were applied to the whole members of a DDH family. RESULTS: In the family with 9 generations and 218 persons, the incidence of DDH was 31.03% in 145 survivors. Patients mainly manifested bilateral knee and hip joint pain, flexion contracture of hip, limitation in internal and external rotation of hip; a few had arthritic functional disorder, deformation, and limp. The radiography illustrated shallow acetabulum with increased inclination, which encompassed the femoral head badly. Deformation of the femoral head, narrow joint space and osteophyte were also found by X-ray examination. The main risk factors of DDH were genetic factors, gender, birth season etc. The son or daughter with one or two DDH parents had a higher risk for developing DDH than those with no DDH parents. Furthermore, first-degree relatives of the DDH patients also had a greater chance to develop DDH than second-degree relatives and third-degree relatives. The incidence among females was higher than males, and the family member who was given birth in winter had a highest risk for developing DDH. However, there was no difference between incidence of DDH in children and youths and in adults; the incidence of DDH in the immigrants with no blood relationship also did not differ from the incidence of DDH in the family member. CONCLUSION: The genetic factors play an important role in the development of DDH, so do the environmental factors.