Incidence and risk factors of metabolic syndrome in rural community population on islands in Zhejiang province / 中华流行病学杂志

Objective: To estimate the incidence of metabolic syndrome and explore possible risk factors for metabolic syndrome in adults of rural communities in Yuhuan county, Zhejiang province, China. Methods: During June-December, 2018, a follow-up survey was conducted in participants without metabolic syndrome at baseline survey in 2012 to obtain the information collected in questionnaire survey, anthropometric data and laboratory data. The incidence of metabolic syndrome in the participants was estimated, and Logistic regression model was used to explore the risk factors, adjusted risk ratio (aRR) and 95%CI. Results: Among 3 162 participants, 522 new metabolic syndrome cases were identified. The 6-year cumulative incidence rate of metabolic syndrome was 16.5%, and the cumulative incidence rate was higher in women (20.6%) than that in men (12.3%, P<0.001). Those incidence rates were higher in those in jobless, smoking or drinking groups. Being women (aRR=1.96, 95%CI: 1.50-2.58) and family history of hypertension (aRR=1.31, 95%CI: 1.04-1.63) were independent risk factors for metabolic syndrome. Conclusion: The follow up indicated that the incidence of metabolic syndrome was relatively high in rural adults on islands in Zhejiang, and women or those with family history of hypertension were more likely to have metabolic syndrome.

Management of vaccine cold chain delivery by international organizations / 上海预防医学

Most of serious vaccine-related adverse events in China are believed to be due to the poor management of vaccine cold chain delivery.It is an urgent need to strengthen the vaccine management system.To obtain a more comprehensive understanding of the management of vaccine cold chain delivery, including practical experience in specific regions and its supervision, we reviewed the documents/guidelines/literature, published by the WHO, GAVI and UNICEF in recent ten years, on vaccine cold chain delivery.The current study serves a good reference for the regulation, policy formulation and optimization of vaccine management.

Experience of international vaccine surveillance systems management / 上海预防医学

We summarized the experiences of construction and management of vaccine safety surveillance systems in different countries and regions by using literature review, and then made the recommendations of strengthening vaccine surveillance system in China. In the study, we found that multiple existing national and regional vaccine surveillance systems, such as VAERS and EudraVigilance, can ensure vaccine safety through multi-sectoral surveillance, identification of adverse signals, and promotion of awareness of active reporting. However, the monitoring systems have some limitations, such as reporting bias and system decentralization. Therefore, China's vaccine monitoring system should establish an effective vaccine surveillance system, which achieves multi-sectoral, active, open to the public surveillance.

Association between sleep quality and risk of acute exacerbation of mild and moderate chronic obstructive pulmonary disease： a community-based prospective study / 上海预防医学

Objective:To investigate the association between sleep quality and the risk of acute exacerbation in mild and moderate chronic obstructive pulmonary disease （COPD） patients in Pudong New Area of Shanghai. Methods:This was a prospective study involving eligible mild and moderate COPD patients from 10 communities randomly selected in Pudong New District of Shanghai. A structured questionnaire was used to collect demographic characteristics， clinical information and information on acute exacerbation. Sleep quality was assessed using the Pittsburgh Sleep Quality Index （PSQI） in Chinese. Multiple negative binomial regression was used to estimate the association between sleep quality and risk of exacerbation. Results:Altogether 212 mild/moderate COPD patients participated and completed the entire survey， of whom the majority （95.8%） were mild COPD patients， 110 persons female and over half （54.2%） over 65 years old. 32.9% of the patients had poorer sleep quality at baseline. 18.9% of the patients reported exacerbation over the past year during follow-ups. Multiple negative binomial regression suggested that increased PSQI was related to higher risk of exacerbation （RRad=1.12， 95%CI：1.02-1.24）， and patients with poorer sleep efficiency had a higher risk of exacerbation （RRad=1.66， 95%CI：1.17-5.43）. Conclusion:Poorer sleep quality is associated with a higher risk of exacerbation in community mild/moderate COPD patients， especially in those with problem of sleep efficiency. More attention to sleep disorders is warranted in community management or self-management of patients with COPD.

Association of alcohol drinking with the incident risk of type 2 diabetes among rural adult males in Deqing County， Zhejiang Province： a prospective cohort study / 上海预防医学

Objective:To investigate the association of alcohol drinking and the incident risk of type 2 diabetes in men and to provide evidences for early prevention of diabetes. Methods:Rural adult males without diabetes in Deqing County， Zhejiang Province were enrolled. A dynamic prospective cohort study was conducted. Data were collected through questionnaires， physical examination， experimental measurements and a electronic follow-up database. Cox multivariate regression was performed to assess the association of alcohol drinking and the incident risk of type 2 diabetes in men. Results:During the follow-up period （7.15±2.90 years）， 354 men developed diabetes， and the incidence rate was 4.15/1 000 person-years. After adjusting for confounding factors， the incident risk of type 2 diabetes among the men with high alcohol drinking frequency （≥7 times/week） and low single alcohol intake （0.1-19.9 g/occasion） was lower than that among non-alcohol drinkers， and the value of HR （95%CI） was 0.72 （0.56-0.94） and 0.54 （0.30-0.99）， respectively. Consumption of ≥40.0 g alcohol per occasion 3-6 times a week increased the incidence of type 2 diabetes， and consumption of <40.0 g alcohol per occasion over 7 times a week decreased the incidence of type 2 diabetes， with the value of HR （95%CI） of 1.53 （1.02-2.30） and 0.52 （0.28-0.99） respectively. Conclusion:Different alcohol drinking patterns affect the incident risk of type 2 diabetes among rural adult males in Deqing County. Further study on alcohol drinking and diabetes may have ethical and practical significance for the prevention and control of diabetes in rural China.

Comparative analysis on the management of vaccine distribution in China and some other Asian countries / 上海预防医学

Objective To compare the framework of immunization programme and management of vaccine distributionin in China and some Asian countries, and further improve the immunization policy in China. Methods Using literature review, we compared the current status of immunization programme and vaccine distribution in China, Japan, Thailand, and Vietnam. Results Vaccine distribution has its own characteristics among Asian countries. Japan started early with a complete supervision system and compensation system. Thailand and Vietnam have also formed an efficient and complete cold chain transportation mode after implementing Expanded Programme on Immunization. Conclusion China can refer to the typical framework of immunization and experience of vaccine distributionfromsome Asian countries, which may improve vaccine accessand production links, standardize vaccine circulation market, and establish an efficient vaccine supervision and traceability system.

Impact of public health emergencies on public knowledge， behavior and psychological status and the intervention strategies / 上海预防医学

The epidemic of coronavirus disease 2019 （COVID-19） since December 2019 is a severe public health emergency， which seriously affected the daily life of the public at home and abroad. This review summarized the public knowledge， behavior and psychological status in public health emergencies， analyzed the possible influence factors and mechanisms， and suggested some possible intervention strategies.

Prevention and control of malaria in Deqing County from 1951 to 2015 / 上海预防医学

Objective:To make a retrospective analysis on malaria epidemic history and control efforts in Deqing County from 1951 to 2015， and so as to provide a scientific basis for further consolidating the achievements after malaria elimination. Methods:Data on the epidemic， monitoring， prevention and control of malaria in Deqing from 1951 to 2015 were collected and analyzed by the method of descriptive research. Results:Totally 123 000 cases of malaria were reported in Deqing County from 1951 to 2015， and the annual average incidence was 529.61/100 000. There were 49 deaths with the mortality rate of 39.84/100 000. The epidemic peaked in 1960-1964 and reached its highest in 1963 with 21 942 cases and an incidence of 7825.25/100 000. After decades of the comprehensive prevention and control， eliminating malaria was accomplished in Deqing County in 2015. Conclusion:The prevention and control strategies/measures of malaria in different stages in Deqing County are effective. However， monitoring， health education and management for the migrant population， especial the returning workers from high-risk areas of malaria， should be further strengthened.

Hyperglycemia analysis in some community population in Xuhui District of Shanghai in 2010 and 2015 / 上海预防医学

Objective To investigate the hyperglycemia rate and its correlative factors for the undiagnosed diabetes population in Xuhui District of Shanghai, and to provide the basis for early intervention of diabetes mellitus. Methods Multi-stage cluster sampling was adopted by probability proportionate to size method, and physical examination information and questionnaires were made and collected from 10 130 and 9085 people in 2010 and 2015 respectively from 5 000 households, blood-glucose being examined at the same time.Univariate analysis was made by t test and χ2 test and logistic regression was used for analysis of related factors. Results In 2010 and 2015, the diabetes incidence rate was 2.21% and 1.93% respectively, and the hyperglycemia incidence rate in 2015 was higher than that in 2010 (15.28% vs. 12.63%), both increased with age and BMI value.The rate was higher in those with lower education, abnormal blood pressure, self-reported hypertension, self-reported coronary heart disease and smokers.The logistic regression analysis results showed the incidence of diabetes was positively correlated with age, BMI, abnormal blood pressure and smoking, while the incidence of hyperglycemia was positively correlated with the survey year, sex, age, BMI and abnormal blood pressure; both were negatively correlated with educational level. Conclusion The hyperglycemia incidence rate is high among the community undiagnosed diabetic population.We should focus on high-risk screening for diabetes mellitus, and key intervention of the population with low educational level, overweight and obesity, hypertension and unhealthy lifestyle.

The prevalence and risk factors of diabetes and hypertension in Deqing rural community / 中华疾病控制杂志

Objective This study aimed to describe the prevalence of both type 2 diabetes (T2D) and hypertension, and to explore possible risk factors. Methods A Cross-sectional study was conducted in eight towns cluster-sampled randomly from Deqing County, Zhejiang Province. Totally. 29 306 subjects aged≥18 years old were recruited into this survey. Information on general information, life styles, health status and family history of chronic diseases was collected. Physical examinations including height, weight, blood pressure, etc. were done. Fasting plasma glucose was also tested. Results The prevalence of only T2DM, only hypertension and both of them was 3.34%, 28.72%, and 2.01%, respectively. Such prevalence of both reached a peak at the age of 70-79 years old.Family history of diabetes mellitus(OR=4.94, 95% CI:3.24-7.54, P<0.001) and having a spouse(OR=2.17, 95% CI: 1.18-4.00, P=0.013) were possible risk factors of diabetes mellitus, body mass index(BMI)<24 kg/m2(OR=0.48, 95% CI: 0.39-0.59, P<0.001) was the possible protective factor of diabetes mellitus, BMI<24 kg/m2(OR=0.60, 95% CI: 0.56-0.64, P<0.001), completing compulsory education(OR=0.54, 95% CI:0.49-0.59, P<0.001) and exercise(OR=0.77, 95% CI: 0.69-0.86, P<0.001) were protective factors of hypertension, drinking(OR=1.18 , 95% CI: 1.08-1.29, P<0.001) was the possible risk factor of hypertension. BMI<24 kg/m2(OR= 0.26, 95% CI: 0.21-0.31, P<0.001), completing compulsory education(OR=0.50, 95% CI: 0.35-0.72, P<0.001) and drinking tea(OR=0.80, 95% CI:0.64-0.99, P=0.045) were protective factors of these two diseases. Farmers(OR=1.35, 95% CI: 1.04-1.76, P=0.024), family history of diabetes(OR=4.21, 95% CI: 2.71-6.57, P<0.001) and family history of hypertension(OR=1.86, 95% CI: 1.31-2.64, P=0.001) were risk factors for the co occurrence of two diseases. Conclusions The prevalence of diabetes among adults in Deqing County was relatively lower than other places. The prevalence of hypertension was close to the level of other regions. Age, overweight, alcohol consumption, family history of diabetes and hypertension were the risk factors of diabetes and hypertension. Diabetes mellitus was a high-risk group of hypertension. Further means should be taken to strengthen the self-management and treatment of this group. Further intervention action should be taken to promote health and quality of life.

The association of overweight and obesity with hypertension among residents aged 35 years or older in Yuhuan county / 中华疾病控制杂志

Objective To assess the prevalence of overweight and obesity among residents aged 35 years or older in Yuhuan county of Zhejiang Province and explore the associations of overweight and obesity with hypertension. Methods A cross-sectional study was conducted among 124 693 permanent residents aged 35 years or older, who were randomly selected using cluster sampling method from Yuhuan county. Results The prevalence of overweight and obesity was 34.53% and 10.18% among subjects, respectively. The overweight prevalence for male (35.56%) was higher than that for female (33.66%), whereas the obesity prevalence for female (11.26%) was higher than that for male (8.90%) (all P<0.05). The multivariate analysis showed that age, education, occupation, regular physical exercise, smoking, drinking and high-salt diet were possible factors for overweight and obesity (all P<0.05). After adjustment for covariates, compared to participants with normal weight, the multivariate logistic regression indicated that the adjusted odds ratio (OR) and their 95% confidential interval of overweight and obesity were 2.02 (95% CI:1.93-2.11) and 3.83 (95% CI:3.57-4.10) for hypertension in men, and were 1.94(95% CI:1.86-2.02)and 3.56(95% CI:3.35-3.77) in women, respectively. Conclusions The prevalence of overweight and obesity was high among residents aged 35 years or older in Yuhuan county, and they may relate to the increasing risk of hypertension.

Study on the relationship of the haplotypes of programmed cell death 1 gene and ultraviolet history with systemic lupus erythematosus / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship of gene polymorphisms of programmed cell death 1 gene (PDCD1) and ultraviolet history with systemic lupus erythematosus (SLE) among the Han population in the southern region of yangtze river in China.</p><p><b>METHODS</b>With a case control design, a total of 159 SLE cases and 159 controls were enrolled in this study, and single nucleotide polymorphisms (SNPs) of the PDCD1 gene were determined by PCR-restriction fragment length polymorphism (RFLP). With the aid of the logistic regression model, the effect of gene polymorphism, environmental factor and the interaction between gene and environment were fitted under the recessive, dominant, additive and codominant mode, respectively.</p><p><b>RESULTS</b>Three models were screened as the optimal models under the additive mode and one model under the dominant mode, according to the lowest value of Akaike's Information Criteria (AIC). After the control of age and gender, it was found that the frequency of ultraviolet exposure was higher in cases than in controls with significant difference under all models (P<0.05). For the haplotypes composed of the alleles of PD1.2, PD1.5 and PD1.6, there was significantly higher frequency of G-T-A haplotype (0.1196 vs 0.0363) and lower frequency of A-C-A haplotype (0.4746 vs 0.5399) in cases than that in controls (P<0.05) under the additive mode, and the G-T-A haplotype was associated with an increased risk for SLE (OR=4.319), while A-C-A haplotype was shown as a protective factor for SLE (OR=0.571). Moreover, interaction between A-C-G haplotype and ultraviolet exposure, which was related to an increased risk for SLE (beta5=1.182, Z=2.2898, P<0.05, OR=3.261), was also found under this mode. Additionally, the frequency of G-C-G haplotype was higher in cases than that in controls (0.1287 vs 0.0361) under the dominant mode with statistically significant difference (P<0.05, OR=4.332).</p><p><b>CONCLUSION</b>Authors' results indicate that ultraviolet exposure, G-T-A or G-C-G haplotype and interaction between A-C-G and ultraviolet exposure may be associated with genetic susceptibility to SLE in Han population in the southern region of yangtze river in China under certain genetic modes.</p>

Using satisfaction questionnaire status version (DTSQs) to study on the reliability, construct validity and responsiveness of diabetes treatment among Chinese diabetic outpatients / 中华流行病学杂志

<p><b>OBJECTIVE</b>Using 'diabetes treatment satisfaction questionnaire status version (DTSQs)' to evaluate the reliability, validity and responsiveness, among Chinese type 2 diabetes mellitus (T2DM) outpatients.</p><p><b>METHODS</b>A cross-sectional study was carried out in 749 T2DM outpatients from seven hospitals in Guangzhou and Shanghai, China. The DTSQs was self-administered by patients, under the help from interviewers for those having difficulties in reading. Split-half reliability correlation coefficient, Cronbach alpha and Spearman' were used to test the reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed separately to examine the construct validity of the scale. The responsiveness of the scale was appraised by the multiple analysis of covariance (MANCOVA).</p><p><b>RESULTS</b>The split-half correlation coefficient was 0.807 and the Cronbach alpha was 0.717 of the six items on satisfaction of treatment. The three factors extracted by EFA explained 67.656% of the overall variance. The relative chi2 was 4.95 and DK was 0.18 in the goodness of test by CFA. The vector of treatment satisfaction, perceived hyperglycemia and hypoglycemia were different in males versus females and in poor versus good blood glucose controlled groups. The DTSQs showed good reliability and validity among T2DM outpatients.</p><p><b>CONCLUSION</b>DTSQs was applicable to Chinese T2DM patients.</p>

The impact of complication on quality of life among diabetic patients in urban China / 中华流行病学杂志

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-emotionsl subscale(decreased by 16.28％)decreased much more than the other subscales in patients with complication.Overall,QOI 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 predietors of poor QOL among T2DM outpatients.

A cross-sectional study on the prevalence of depressive and/or anxiety symptoms in neurological patients from four cities in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the prevalence of depressive and/or anxiety symptoms in patients with some neurological diseases in the general hospitals of major cities in China.</p><p><b>METHODS</b>A hospital-based cross-sectional study was conducted in four big cities in China in 2004. 1197 eligible subjects with Stroke, Parkinson's disease and Epilepsy were recruited from the outpatient or inpatient departments within three months. Face-to-face interview was used in data collection together with the self-completed Hospital Anxiety and Depression (HAD) scale for depressive and/or anxiety symptom, were screened. Subjects getting a HAD score of 9 and above were further assessed for depressive and/or anxiety disorders with Hamilton anxiety scales and Hamilton depression scales by the licensed psychologists or psychiatrists.</p><p><b>RESULTS</b>The prevalence rates of "self-scaled" depressive and/or anxiety symptoms were 19.5%, 24.1% and 21.9% respectively in patients with stroke, Parkinson's disease and epilepsy. Among cases with "self-scaled" depressive and/or anxiety symptoms, the prevalence rates of depressive and/or anxiety symptoms were 50.8%, 73.1% and 38.6% respectively; less than 17% of subjects had obtained a diagnosis of depressive disorders and had been treated but only 4% of the subjects having obtained a diagnosis of anxiety disorders and been treated prior to the study. The sex specific prevalence varied over the somatic diseases. In patients with Parkinson's disease, the prevalence of "self-scaled" anxiety symptom was significantly higher in females than in males (21.1% vs. 12.2%; chi2 = 5. 679, P = 0.017),and the total prevalence of "self-scaled" depressive and/or anxiety symptoms was also higher in female (30.3% vs. 20.5%; chi2 = 4.978, P = 0.026); in patients with stroke while the prevalence of depressive and anxiety symptoms in female was higher than that in male (52.2% vs. 20.0%; chi2 = 6.009, P = 0.014), and a higher prevalence of depressive symptoms in female patients with epilepsy was also reported (32.4% vs. 13.6%; chi2 = 4.108, P = 0.043).</p><p><b>CONCLUSION</b>It was of great importance to remind the healthcare providers and health policy makers that high prevalence of depressive and/or anxiety symptoms was found in patients with somatic diseases but with low percentages of previous diagnosis or treatment in the departments of neurology at the general hospitals in urban China.</p>

Relationship between ambient air pollution and daily mortality of SARS in Beijing / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the relationship between ambient air pollution and daily mortality of SARS in Beijing.</p><p><b>METHODS</b>The approach of time-series Poisson regression was used to assess the relationship between daily SARS mortality, ambient air pollution, and other factors from April 25 to May 31, 2003 in Beijing.</p><p><b>RESULTS</b>An increase of each 10 microg/m3 over a 5-day moving average of PM10, SO2 and NO2 corresponded to 1.06 (1.00-1.12), 0.74 (0.48-1.13) and 1.22 (1.01-1.48) relative risks (RRs) of daily SARS mortality, respectively. The relative risks (RRs) values depended largely on the selection of lag days.</p><p><b>CONCLUSION</b>The daily mortality of SARS might be associated with certain air pollutants in Beijing.</p>

Study on the identification of HIV/AIDS and its surveillance system in rural areas of central China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the effective strategies for human immunodeficiency virus (HIV) surveillance and identification in rural areas of central China.</p><p><b>METHODS</b>In a selected rural prefecture area of central China, an epidemiological investigation was conducted for all reported HIV/AIDS cases. A historical and analytic review was performed, with particular interests in examining the HIV epidemic reporting and identification system.</p><p><b>RESULTS</b>Among all 626 reported HIV-infected individuals in the selected prefecture, 86.1% (539/626) of them were infected through commercial plasma donation or clinically operated blood transfusion. With respect to disease surveillance and identification in the area, 52.2% (327/626) of all the cases were reported by hospitals or clinics. The number and proportion of HIV/AIDS cases identified or reported at county, prefecture, and provincial levels were 207 (33.1%), 303 (48.4%) and 116 (18.5%), respectively. The number and proportion of HIV/AIDS identified through specific epidemiological investigations and/or voluntary testing had been increased in recent years. In addition, among HIV/AIDS cases that were clinically identified, the proportion of those who were identified as outpatients had steadily increased,with the highest proportion (59.3%) observed in 2004.</p><p><b>CONCLUSIONS</b>In rural areas of central China where the major mode of HIV transmission was through commercial plasma donation or clinically operated blood transfusion, hospitals and clinics seemed to have played and would continue to play important roles regarding HIV identification and surveillance. The role of institutions or settings at the prefecture level regarding HIV identification and surveillance should not be ignored.</p>