Combination of serum tumor markers dickkopf-1, DCP and AFP for the diagnosis of primary hepatocellular carcinoma

OBJECTIVE@#To evaluate the detection accuracy of the biomarkers dickkopf-1, DCP and AFP as a serum biomarker panel by comparing the sensitivity of the panel with those of the individual biomarkers.@*METHODS@#The study was composed of three groups, one with HCC patients, one with non-HCC liver diseases and one with healthy controls. Serum AFP was measured using a chemiluminescence assay and serum dickkopf-1 and DCP were measured with ELISA. The sensitivity and specificity of the biomarkers were analyzed as single parameters and as a serum panel.@*RESULTS@#The HCC group showed higher levels of dickkopf-1, DCP and AFP than the other two groups (P  0.05). The combination of the biomarkers as a serum panel produced much better sensitivity (93.02%) and specificity (78.00%) than each of the markers individually (P < 0.05).@*CONCLUSION@#The combination of AFP, DCP and dickkopf-1 as a biomarker panel can significantly improve the detection power with much higher sensitivity and specificity for HCC than any of the biomarkers alone. The tests are convenient and inexpensive, and may serve as a valuable addition to current options for the diagnosis of HCC.

Combination of serum tumor markers dickkopf-1, DCP and AFP for the diagnosis of primary hepatocellular carcinoma

Objective To evaluate the detection accuracy of the biomarkers dickkopf-1, DCP and AFP as a serum biomarker panel by comparing the sensitivity of the panel with those of the individual biomarkers. Methods The study was composed of three groups, one with HCC patients, one with non-HCC liver diseases and one with healthy controls. Serum AFP was measured using a chemiluminescence assay and serum dickkopf-1 and DCP were measured with ELISA. The sensitivity and specificity of the biomarkers were analyzed as single parameters and as a serum panel. Results The HCC group showed higher levels of dickkopf-1, DCP and AFP than the other two groups (P 0.05). The combination of the biomarkers as a serum panel produced much better sensitivity (93.02%) and specificity (78.00%) than each of the markers individually (P < 0.05). Conclusion The combination of AFP, DCP and dickkopf-1 as a biomarker panel can significantly improve the detection power with much higher sensitivity and specificity for HCC than any of the biomarkers alone. The tests are convenient and inexpensive, and may serve as a valuable addition to current options for the diagnosis of HCC.

Effect of NaFeEDTA-Fortified Soy Sauce on Anemia Prevalence in China: A Systematic Review and Meta-analysis of Randomized Controlled Trials / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To assess the effect of sodium iron ethylenediaminetetraacetate (NaFeEDTA)-fortified soy sauce on anemia prevalence in the Chinese population.</p><p><b>METHODS</b>A systematic review was performed to identify potential studies by searching the electronic databases of PubMed, Cochrane Library, WHO Library, HighWire, CNKI, and other sources. The selection criteria included randomized controlled trials that compared the efficacy of NaFeEDTA-fortified soy sauce with that of non-fortified soy sauce. Anemia rates and hemoglobin levels were the outcomes of interest. Inclusion decisions, quality assessment, and data extraction were performed by two reviewers independently. A total of 16 studies met the inclusion criteria for anemia rate analysis, of which 12 studies met the inclusion criteria for hemoglobin analysis. All included studies assessed the effect of NaFeEDTA-fortified soy sauce on anemia rates and hemoglobin concentrations.</p><p><b>RESULTS</b>After the intervention, the hemoglobin concentration increased and anemia rates decreased significantly as compared with the non-fortified soy sauce groups. For anemia rates, data from 16 studies could be pooled, and the pooled estimate odds ratio was 0.25 (95% CI 0.19-0.35). For hemoglobin concentrations, data from 12 studies could be pooled, and the pooled weighted mean difference was 8.81 g/L (95% CI 5.96-11.67).</p><p><b>CONCLUSION</b>NaFeEDTA-fortified soy sauce has a positive effect on anemia control and prevention in the at-risk population.</p>

An evaluation of the investment for child development in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study estimated the investment in child development from three aspects-public health, public education, and family investment to establish the level of investment, to provide reference information for government decision making and to provide international comparisons.</p><p><b>METHODS</b>Public investment in health was measured with macro data related to public health spending and child development in government expenditure. Public education investment was based on basic education data. Family investment evaluation was based on per capita family consumer spending data in different age groups to estimate the input for child development.</p><p><b>RESULTS</b>Both public health investment level and the proportion of GDP rose for all age groups over time, but the overall investment level was still insufficient. Public investment in children's education has increased year by year, but the trends in all age groups are unbalanced with much lower investment in early childhood education. Private investment in children has increased over the period, but has declined as a percentage of GDP. International comparisons show that Chinas investment in child development is much lower than OECD countries.</p><p><b>CONCLUSION</b>The private investment in child development was the main way in China, with public finance contributing only a small proportion. Given the poor international comparisons, the government needs to review the balance of public investment to redirect more towards the development of children under the age of six to their health and education.</p>

Effect of in-home fortification of complementary feeding on intellectual development of Chinese children / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore the effect of in-home fortification of complementary feeding on intellectual development of Chinese children aged below 24 months.</p><p><b>METHODS</b>One thousand and four hundred seventy eight children aged 4-12 months were recruited and divided into study groups (formula 1 group and formula 2 group) and control group. In two study groups, in addition to the usual complementary food, children were fed with a sachet of fortified food supplement each day. Protein and micronutrients were provided in formula 1 group. Formula 2 group had the same energy intake as the formula 1 group . In addition to measurement of physical growth and detection of hemoglobin level, Development Quotient (DQ) or Intelligence Quotient (IQ) was assessed.</p><p><b>RESULTS</b>The DQ of children aged below 24 months was 97.2, 95.5, and 93.8 in formula 1 group, formula 2 group and control group, respectively, and the differences were statistically significant (P < 0.05). The DQ of children in formula 1 group, formula 2 group, and control group was 92.7, 90.4, and 88.3 respectively in the first follow up showing statistically significant differences (P < 0.05). And, DQ of children in formula 1 group, formula 2 group and control group were 96.7, 94.5, and 93.7 respectively in the second follow up, showing statistically significant differences (P < 0.05). Full-IQ of children in the formula 1 group was 3.1 and 4.5 points higher than that in formula 2 group and in control group respectively. Verbal IQ of children in the formula 1 group was 2.1 and 5 points higher than that in formula 2 group and control group respectively. Performance IQ was 2.5 and 3.1 points higher than that in formula 2 group and control group respectively. All above mentioned comparisons were statistically significant.</p><p><b>CONCLUSION</b>Fortification of complementary feeding showed persistent effect on intelligence development of young children which could persist to 6 years of age. The critical time for correction of anemia could be under 18 months.</p>

The nutrition status of children aged 6-23 months after three months of Wenchuan Earthquake in Beichuan and Lixian, Sichuan Province / 中华预防医学杂志

<p><b>OBJECTIVE</b>This project aims to investigate the nutrition status of children aged from 6 to 23 months living in Beichuan and Lixian where were seriously affected by the earthquake in 2008.</p><p><b>METHODS</b>The height, body weight and hemoglobin concentration were measured for 478 children from Leigu township, Qushan township in Beichuan county and Zagunao township, Xuecheng township and Putou township in Lixian county; the number of group 6 - 11, 12 - 17, 18 - 23 months were 190, 144, 144 respectively. The height for age (HAZ), the body weight for age (WAZ) and the weight for height (WHZ) were calculated respectively. The low weight, stunting, wasting prevalence, anemic rate were analyzed.</p><p><b>RESULTS</b>The WAZ scores of 6 - 23 months males and females in Beichuan county and Lixian county ranged from -0.97 to -0.13 and from -0.67 to -0.23, HAZ scores ranged from -1.23 to -0.31 and from -1.25 to -0.38, respectively. The WAZ (-0.89 ± 1.16) and HAZ (-1.20 ± 1.60) of 18 - 23 months infants in Beichuan county were significantly different from the WAZ and HAZ of 6 - 11 months (WAZ: -0.32 ± 0.92; HAZ: -0.58 ± 0.98) and 12 - 17 months (WAZ: -0.47 ± 1.00; HAZ: -0.68 ± 1.34) infants (F values were 7.161 and 4.584, respectively; all P values < 0.05). The WAZ (-0.63 ± 1.03) and HAZ (-1.11 ± 1.15) of 18 - 23 months in Lixian county infants were significantly different from the WAZ and HAZ of 6 - 11 months (WAZ: -0.23 ± 0.93; HAZ: -0.51 ± 1.55) infants and 12 - 17 months (WAZ: -0.58 ± 0.52; HAZ: -0.80 ± 1.19) (F values were 3.156, 4.345, all P values < 0.05). The prevalence of low weight infants (18 - 23 months) these two counties were 15.6% (12/77) and 9.1% (6/66), respectively. The prevalence of stunting in Beichuan and Lixian have reached 26% (20/77) and 24.2% (16/66), respectively. The wasting rate of 18 - 23 months infants had reached 9.1% (7/77) in Beichuan. The total anemia prevalence among infants reached 49.6% (123/248) and 78.8% (178/226) in Beichuan and Lixian, respectively. The prevalence of moderate anemia have reached 7.7% (19/248) and 19.9% (45/226), respectively.</p><p><b>CONCLUSION</b>After the earthquake in Beichuan, Lixian, the growth of infants aged 6 to 23 months old was below average. The prevalence of anemia was high. The malnutrition status of infant and young children aged from 18 to 23 months in Beichuan and Lixian was more serious, should be targeted of nutrition interventions.</p>

Verification on the cut-offs of waist circumference for defining central obesity in Chinese elderly and tall adults / 中华流行病学杂志

Objective To describe the characteristics for distribution of waist circumference (WC) and validate the cut-offs of WC in defining the central obesity among Chinese elderly and tall adults. Methods Data from the 2002 National Nutrition and Health Survey was used to analyze the characteristics of WC distribution among subjects aged 45 and above and their height beyond the P85 percentile of Chinese adults. Kappa test was used to estimate the consistency of different cut-offs for WC with body mass index (BMI)≥24 in defining obesity. The odds ratios of diabetes and impaired fasting glucose in different cut-offs on WC were calculated by multiple logistic regression. ROC curves analysis was used to determine the cut-offs. Results The means of WC were: 80.8 cm in male elderly, 79.4 cm in female elderly, 84.1 cm in tall male and 77.9 em in tall female, respectively. The WC at 85 cm for male and 80 cm for female elderly had the best consistency with BMI at 24, and the distance of ROC curve was the shortest. The odds ratios for diabetes significantly increased from WC categories of 85- cm (OR=2.1,95% CI: 1.6-2.8), 90- cm (OR=3.0,95 % CI: 2.3-4.0), and 95- cm (OR=4.5,95%CI:3.4-5.8) in male elderly,and 80- cm (OR= 1.9,95%CI: 1.4-2.6) ,85- cm (OR=3.2, 95% CI: 2.4-4.3), and 90- cm (OR=4.8, 95% CI: 3.7-6.1 ) in female elderly (P<0.01). The odds ratios for impaired fasting glucose also significantly increased from WC categories of 85- cm (OR= 1.6, 95% CI: 1.2-2.2), 90- cm (OR=2.6,95% CI: 1.9-3.5), and 95- cm (OR=3.5,95% CI:2.6-4.6) in male elderly, and 80- cm (OR=2.5, 95% CI: 1.8-3.4), 85- cm (OR=3.2, 95% CI:2.4-4.4), and 90- cm (OR=4.2,95% CI: 3.2-5.6) in female elderly (P<0.01). The odds ratios for diabetes (OR=3.6, 95% CI: 2.1-6.4) and impaired fasting glucose (OR=5.5, 95% CI: 3.0-10.1)significantly increased from WC≥95 cm in tall males. The odds ratios for diabetes significantlyincreased from WC categories of 85- cm (OR=5.0,95%CI: 2.7-9.4) and 90- cm (OR=8.0,95%C1:4.6-14.1 ), and odds ratio for impaired fasting glucose of WC≥90 cm was 3.7 (95%CI: 2.0-6.9) intall females. Conclusion The recommended cut-off points of WC were 85 cm for elderly males and80 cm for elderly females. The eut-offs of WC were also effective predictors for impaired fasting glucose among tall adults. The cut-offs of WC in the Guidelines for Overweight and ObesityPrevention and Control for Chinese Adults were verified and should be applied as preventiveindicators.

Efficacy of different iron fortificants in wheat flour in controlling iron deficiency / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To observe the different impacts of electrolytic iron, FeSO4, and NaFeEDTA on body iron store of anemic school students.</p><p><b>METHODS</b>Four hundreds anemic students at the age of 11-18 years were divided into four groups. Of which, three consumed different iron fortificants from wheat flour as food vehicle for six months and one consumed non-fortified flour (control). The fortification level of electrolytic iron, FeSO4, and NaFeEDTA was 60 mg Fe/kg, 30 mg Fe/kg, and 20 mg Fe/kg, respectively. Blood samples were collected at 0, 2, 4, and 6 months and hemoglobin (Hb), serum ferritin (SF), and transferrin receptor (TfR) were measured.</p><p><b>RESULTS</b>The hemoglobin levels in three intervention groups increased, the increments of Hb in the NaFeEDTA group were significantly higher than that in the other groups. SF and TfR levels increased in the tested groups and body iron store in the NaFeEDTA group was higher than that in the other groups. These parameters did not show any significant changes in the control group.</p><p><b>CONCLUSION</b>NaFeEDTA and FeSO4 fortified wheat flour has positive impacts on iron status in anemic students and NaFeEDTA is more effective than FeSO4, while electrolytic iron is less effective in improving iron store in anemic students.</p>

Effects of nutrient fortified complementary food supplements on anemia of infants and young children in poor rural of Gansu / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To assess the effectiveness of complementary food supplements with protein and multi-micronutrients on hemoglobin and anemia in infants and young children.</p><p><b>METHODS</b>In 5 poor counties of Gansu, 984 children aged 6-12 months were enrolled and divided into two groups. In addition to the usual home-made complementary food, all the children were fed one sachet of either Formula I or Formula II supplements each day. Protein and micronutrients were provided in Formula I, while the same energy intake was secured in Formula II as in Formula I. A massive dose of vitamin A was supplemented to all the children every 6 months. Hemoglobin test was done at the same time.</p><p><b>RESULTS</b>Prevalence of anemia was about 35% in both Formula I and Formula II group at baseline, and there were no differences in hemoglobin concentration between the two groups. During the 6-month and 12-month supplementation, hemoglobin of children in Formula I group was higher than that in Formula II group (P < 0.05), and hemoglobin increase in Formula I group was significantly higher than that in Formula II group (P < 0.001). After 6- and 12-month supplementation, the prevalence of anemia in Formula I group dropped to 19.1% and 8.2% respectively, and it was 28.0% and 12.4% in Formula 2 group. The prevalence of anemia in Formula I group was significantly lower than that in Formula II group (P < 0.05). After adjusting age and hemoglobin level at baseline, the hemoglobin increase at age of 24 months in formula 1 group was higher (10.7 g/L vs 7.9 g/L, P < 0.0001).</p><p><b>CONCLUSION</b>Micronutrient fortified complementary food supplements, with large-dose vitamin A, is effective for children aged 6-12 months in terms of iron deficiency prevention.</p>

Temporally shifted hemodynamic response model helps to extract acupuncture-induced functional magnetic resonance imaging blood oxygenation-level dependent activities / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The onsets of needling sensation introduced by acupuncture stimulus can vary widely from subject to subject. This should be explicitly accounted for by the model blood oxygenation-level dependent (BOLD) time course used in general linear model (GLM) analysis to obtain more consistent across-subject group results. However, in standard GLM analysis, the model BOLD time course obtained by convolving a canonical hemodynamic response function with an experimental paradigm time course is assumed identical across subjects. Although some added-on properties to the model BOLD time course, such as temporal and dispersion derivatives, may be used to account for different BOLD response onsets, they can only account for the BOLD onset deviations to the extent of less than one repetition time (TR).</p><p><b>METHODS</b>In this study, we explicitly manipulated the onsets of model BOLD time course by shifting it with -2, -1, or 1 TR and used these temporally shifted BOLD model to analyze the functional magnetic resonance imaging (fMRI) data obtained from three acupuncture fMRI experiments with GLM analysis. One involved acupuncture stimulus on left ST42 acupoint and the other two on left GB40 and left BL64 acupoints.</p><p><b>RESULTS</b>The model BOLD time course with temporal shifts, in addition to temporal and dispersion derivatives, could result in better statistical power of the data analysis in terms of the average correlation coefficients between the used BOLD models and extracted BOLD responses from individual subject data and the T-values of the activation clusters in the grouped random effects.</p><p><b>CONCLUSIONS</b>The GLM analysis with ordinary BOLD model failed to catch the large variability of the onsets of the BOLD responses associated with the acupuncture needling sensation. Shifts in time with more than a TR on model BOLD time course might be required to better extract the acupuncture stimulus-induced BOLD activities from individual fMRI data.</p>

Complementary feeding and growth of infant and young child in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To understand the status and problems of complementary feeding and to explore the strategy of improving complementary feeding for infants and young children in China.</p><p><b>METHOD</b>Data of urban and rural children were selected from the China Food and Nutrition Surveillance System (CFNSS) dataset to describe the status of complementary feeding and growth of children. Logistic Regression was used to analyze the relationship between child growth and the complementary feeding pattern.</p><p><b>RESULTS</b>Applications of foods that come from animals, vegetable/fruit and dairy product in complementary feeding were negatively correlated to the prevalence of stunting and underweight. Attributable risk (AR) of no application of vegetable/fruit in complementary feeding to stunting was 30.2%, to underweight 35.4%; AR of no application of foods from animal products in complementary feeding to stunting was 28.2%, to underweight 11.7%; and the AR of no application of diary products in complementary feeding to stunting was 27.4%, to underweight was 15.9%.</p><p><b>CONCLUSION</b>Complementary feeding contributed to the improvement of infants and young children growth in China. There is an urgent need to develop health education in the public on infants and young children complementary feeding, in the mean time, it is pressing to pay attention and take actions to develop and promote affordable, acceptable, and accessible fortified complementary food in rural areas of China.</p>

Report on childhood obesity in China (6) evaluation of a classroom-based physical activity promotion program / 生物医学与环境科学（英文）

<p><b>OBJECTIVES</b>To evaluate the effect of Happy 10 program on the promotion of physical activity, physical growth and development of primary-school students, and on obesity control and prevention.</p><p><b>METHODS</b>Two similar primary schools from one district of Beijing, China were selected, one as an intervention school and the other as a control school. Happy 10 program was implemented at least once every school day in the intervention school for two semesters, whereas no intervention was adopted in the control school. The information on energy expenditure and duration of physical activity was collected by a validated 7-day physical activity questionnaire. Height and weight were measured by trained investigators following the standardized procedure. Energy expenditure and intensity of each Happy 10 session was measured by a physical activity monitor.</p><p><b>RESULTS</b>The average energy expenditure and duration of total physical activity per day among students in the intervention school increased significantly from 15.0 to 18.2 kcal/kg, and 2.8 to 3.3 h respectively, whereas the figures significantly decreased in the control school. There was a significant difference in change of weight and BMI between girls in the intervention and control school (2.4 kg vs 4.6 kg, -0.47 kg/m2 vs 0.66 kg/m2). The prevalence of overweight and obesity in the intervention school decreased by 0.4%-5.6%, as compared to the increase by 0.6%-4.5% in the control school. The average energy expenditure and intensity per 10-minute session ranged from 25.0-35.1 kcal, 4.8-6.2 kcal/kg/h respectively in grades 1-5.</p><p><b>CONCLUSION</b>Happy 10 program provides a useful strategy to promote physical activity among school children and also plays a positive role in building up physical growth and development of girls.</p>

Report on childhood obesity in China (2). Verification of BMI classification reference for overweight and obesity in Chinese children and adolescents / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To verify Working Group for Obesity in China (WGOC) recommended body mass index (BMI) classification reference for overweight and obesity in Chinese children and adolescents using the data of 2002 China Nationwide Nutrition and Health Survey.</p><p><b>METHODS</b>Pediatric metabolic syndrome (MetS) and abnormality of each risk factor for MetS were defined using the criteria for US adolescents. Definition of hyper-TC, LDL, and dyslipidemia in adults was applied as well. The average level and abnormality rate of the metabolic indicators were described by BMI percentiles and compared with general linear model analysis. Receiver operating characteristic analysis was used to summarize the potential of BMI to discriminate between the presence and absence of the abnormality of these indicators.</p><p><b>RESULTS</b>There was neither significantly increasing nor significantly decreasing trend of biochemical parameter levels in low BMI percentile range (<65th). Slight increasing trend from the 75th and a significant increase were found when BMI > or =85th percentile. In general, the prevalence of the examined risk factors varied slightly when BMI percentile<75th, and substantial increases were consistently seen when BMI percentile > or =75th. As an indicator of hyper-TG, hypertension and MetS, the sensitivity and specificity were equal at the point of BMI<75th percentile, and the Youden's index of risk factors also reached peak point before 75th percentile except for MetS. When the BMI percentile was used as the screening indicator of MetS, Youden's index reached peak point at 85th percentile, just the point in the ROC graph that was nearest to the upper left corner.</p><p><b>CONCLUSION</b>The BMI classification reference for overweight and obesity recommended by WGOC is rational to predict and prevent health risks in Chinese children and adolescents. Lower screening cut-off points, such as 83th percentile or 80th percentile, should not be excluded when they are considered as overweight criteria in future intervention or prevention studies.</p>

Effect of nutritional status during infancy and childhood on the risk of overweight and obesity in adulthood / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the association between fetal nutritional status and overweight and obesity in their adulthood and to provide evidence for formulation of the strategy on preventing low birth weight.</p><p><b>METHODS</b>Using data from 2002 Nationwide Nutrition and Health Survey to set up a case-control method in order to compare body mass index(BMI), prevalence of overweight and obesity as well as to calculate odds ratio of overweight and obesity of case group compared with control group. Three case groups were selected from those who were born in 1959, 1960,1961 respectively, and the controls were those who were born in 1964.</p><p><b>RESULTS</b>The health consequence of being famines on adulthood was evident in women. Means of BMI in women were significantly higher in three case groups than that in control group(P<0.01). After adjustment on geographic regions, the prevalence of overweight in women was significantly higher in three case groups than that in control group(P< 0.01). The prevalence rates of obesity were significantly higher in 1959, 1960 groups than 1964 group(P< 0.05). The odds ratios of overweight of women in three case groups were 28.9% (95% CI:1.063-1.565), 37.2% (95% CI:1. 136-1.658) and 35.2% (95% CI: 1. 103-1.657) respectively, all higher than that in the control group. The odds ratios of obesity of women born in 1959, 1960 groups were 46.5% (95% CI: 1.088-1.972) and 39.6% (95% CI: 1.039- 1.876) respectively, higher than that in the 1964 group. However, such differences were not found in men.</p><p><b>CONCLUSION</b>Higher risks of overweight and obesity in women were caused by malnutrition during their fetal lives. A strategy on preventing low birth weight should be formulated by the government to prevent the chronic disease in adulthood.</p>

Study on the effect of malnutrition and anemia identified among general population in 2002 to the future productivity in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To measure the social productivity loss and negative effect to economic development due to malnutrition in view of quantitative analysis.</p><p><b>METHODS</b>Using the data of childhood stunting and population anemia status, collected by 2002 National Nutrition and Health Survey to analyse the effect on present and future productivity. PROFILES model was used to estimate two kinds of productivity losses: "Future productivity loss" was figured out based on the data of stunting and anemia status in 0-5 year-old children while "Current productivity loss" was from anemia data of the adults.</p><p><b>RESULTS</b>If current prevalence levels of malnutrition remained unchange over the next ten years (from 2002 to 2012), the total net present value of future productivity lost would be 281.7 billion Yuan (RMB), equivalent to 2.70 % of the Gross Domestice Product( GDP) in 2002, with the productivity losses due to stunting, anemia in adults and children were 0.15 % , 0.46 % and 2.09% of the 2002 GDP, respectively. All the results of calculation mentioned above was restricted with the same assumption - the ignorance of the real cost.</p><p><b>CONCLUSION</b>The social economic development and the improvement of nutrition program would have a huge effect to population nutritional status. The social benefit and return on investment should be significant.</p>

The role of dietary factors in chronic disease control in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the association of dietary patterns with chronic diseases and their indicators.</p><p><b>METHODS</b>Using the data from 2002 National Nutrition and Health Survey, we divided the subjects into clusters according to their dietary patterns classified by different percentage of energy intake from cereal foods, carbohydrate and fat, respectively. The analysis of variance was used to identify the difference in chronic disease prevalence across clusters of subjects while controlling for age, gender and geographic regions. Logistic regression analysis was applied to calculate the odd ratios (OR) for association of chronic disease and each dietary pattern, after adjusted for age, gender, region, energy intake, leisure time.</p><p><b>RESULTS</b>The higher percentage of energy intake from cereals was significantly associated with lower body mass index (BMI), lower total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C). While it was significantly associated with lower risk for overweight/obesity, hypertension, high total cholesterol, high triglyceride (TG) and high LDL-C, but the prevalence of underweight was significantly higher in the cluster of subjects with cereal energy share more than 75%. The higher percentage of energy intake from fat was significantly associated with higher BMI, higher total cholesterol and higher LDL-C, which accordingly, was significantly associated with higher risk for overweight/obesity, hypertension, high total cholesterol, triglyceride and high LDL-C.</p><p><b>CONCLUSION</b>Our study confirmed the important role of dietary pattern in chronic disease control; in particular, appropriate percentage of energy intake from fat and cereals/carbohydrates are beneficial to control and prevention of chronic diseases.</p>

Economic burden of coronary heart disease and stroke attributable to hypertension in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>1) To estimate annual direct medical costs of coronary heart disease (CHD) and stroke attributable to hypertension among Chinese adults aged 35-74 years in China, 2) to analyze the correlation between the hypertension awareness and hypertension treatment rate.</p><p><b>METHODS</b>2003 National Health Services Survey (n = 93 018) was used to derive direct medical costs including costs for outpatient visits, physician services, inpatient stays, rehabilitation services, nurses fees, and medications. The medical costs of CHD and stroke attributable to hypertension were estimated by multiplying population attributable risk proportion by corresponding disease costs. Using 2002 National Nutrition and Health Survey (n = 148 804), the prevalence of hypertension awareness and hypertension treatment rate in 132 survey sites were calculated. Correlation was used to analyze the correlation between the two variables.</p><p><b>RESULTS</b>The direct medical costs of hypertension, CHD and stroke were 20.2, 15.7 and 24.3 billion Yuan, respectively. The medical costs attributable to hypertension were estimated at 19.1 billion Yuan (RMB), accounting for 47.7% of the total medical costs of the two chronic diseases. The prevalence of hypertension awareness is highly correlated with hypertension treatment rate (r = 0.9777, P < 0.0001).</p><p><b>CONCLUSION</b>The economic burden of CHD and stroke attributable to hypertension is very high, reaching about 50% of the total medical costs of the two diseases. The prevalence of hypertension awareness could be used as an important indicator to evaluate the effectiveness of hypertension prevention and control at community level.</p>

The influence of maternal nutrition on children physical development / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the effect of maternal nutrition status on child growth in China.</p><p><b>METHODS</b>The study was performed using data from 2002 China Nutrition Health Survey in which data were collected through stratified multi-stage cluster samples in 31 provinces, autonomous regions, and municipalities. Accroding to the height of women aged 18-44 y was 156.4 cm, the data on mother and children' weight and height/length (n = 1380) were analyzed.</p><p><b>RESULTS</b>The findings suggest child's length (age 2) were significantly correlated with maternal heights (P < 0.0001). The mean length in children born to mothers with a height below 156.4 cm was 2.4 cm less than those in children born to mothers with a height above 156.4 cm. The prevalence of stunting in children at age 2 born to mothers with a height below 156 cm was 2.07 times of that in children born to mothers with a height above 156 cm. Therefore, the risk for stunting in children at 2 is lower in children born to mothers with greater height.</p><p><b>CONCLUSION</b>The maternal nutrition status could have a significant influence on children physical development.</p>

The current prevalence status of body overweight and obesity in China: data from the China National Nutrition and Health Survey / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study on the prevalence of body overweight and obesity in China and its distribution in age, sex and economic development status.</p><p><b>METHODS</b>A total of 209,849 in all ages from the 2002 China National Nutrition and Health Survey (NNAHS) database were analyzed. The year 2000 population census data was used for age standardization. 1978 WHO criteria using Z scores was applied to age 0-7 years, criteria recommended by the Working Group on Obesity in China was applied to those aged 7-17 years and criteria in the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults was applied to those aged 18 years and above.</p><p><b>RESULTS</b>The overall prevalence was 17.6% for overweight and 5.6% for obesity. The combined prevalence of overweight and obesity was 23.2%. The prevalence of overweight was 25.0%, 21.6%, 17.4%, 15.1%, 19.2% and 12.8%, respectively for large city, middle-and-small city, class 1 rural, class 2 rural, class 3 rural and class 4 rural. For obesity, the rate was 10.6%, 7.2%, 6.4%, 4.3%, 6.0% and 2.7%, respectively for large city, middle-and-small city, class 1 rural, class 2 rural, class 3 rural and class 4 rural. By age groups, the prevalence of overweight was 3.4% in children age 0-6, 4.5% in adolescents age 7-17, 22.8% in adults age 18 and above; the prevalence of obesity was 2.0% in children age 0-6, 2.7% in adolescents age 7-17, 7.1% in adults age 18 and above. The sex difference in overweight and obesity differed between urban and rural, and among age groups.</p><p><b>CONCLUSION</b>Overweight and obesity should have affected nearly 1 quarter of the country's total population, and became a threatening hazard to resident's health. As the urbanization progress, obesity might doubly increase. Prevention and control of this hazard should be urgently needed.</p>

The study on relationship of body mass index and blood pressure in children and adolescents of Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To identify the relationship of body mass index (BMI) and blood pressure in 7 - 15 years children and adolescents of Beijing so as to provide scientific basis for early prevention of hypertension and to provide evidence for verification on the category criterion of overweight and obesity in children and adolescents of China, recommended by the Working Group on Obesity in China (WGOC) to sensitively distinguish the blood pressure in normal weight, overweight and obesity populations.</p><p><b>METHODS</b>A cross-sectional survey on epidemiological characteristics of obesity with stratified cluster sampling method carried out in Beijing in April and May, 2000. 5155 students aged 6 - 15 years were selecte das research subjects. The category criterion of overweight and obesity in children and adolescents of China was recommended by WGOC, the diagnostic criterion of hypertension in children was recommended by CDC in the USA. Statistics analysis system (SAS 8.1) including partial person correlation analysis, t-test, chi(2) test and logistic multi-factors regression analysis was used to analyses the data from 4982 subjects aged 7 - 15 years.</p><p><b>RESULTS</b>(1) after the age and gender were adjusted, the BMI positive correlation with systolic blood pressure (SBP) and diastolic blood pressure (DBP) was found independent in 7 - 15 years children and adolescents (P < 0.0001) and the partial relation coefficients(r) between BMI and SBP and DBP were 0.323 87 and 0.245 88 respectively. (2) the means of SBP and DBP in obesity group were significantly higher then overweight, while overweight was significantly higher then normal weight group (P < 0.0001). (3) the prevalence rates of hyper-SBP, hyper-DBP and hypertension were significantly different (P < 0.0001). When compared with the normal weight group, the relation risk (RR) for hypertension in overweight group and obesity group were 2.96 and 4.85 respectively. The prevalence rates of hypertension in overweight and obesity group were 19.70% and 24.22% respectively. (4) the results of logistic multi-factors regression analysis showed that both age and weight were effecting on hyper-SBP, hyper-DBP and hypertension (P < 0.0001). After age was adjusted, the RR for hypertension was 2.62, and their confidence interval (CI) was 2.36 - 2.91 in obesity or overweight, between overweight and normal weight.</p><p><b>CONCLUSION</b>(1) the BMI positive correlation with SBP and DBP was found independent in 7 - 15 years children and adolescents of Beijing, and the risk for hypertension maybe increased when these people with overweight and obesity, it is very important for hypertension prevention and control that overweight and obesity prevention and control in children and adolescents. (2) the sensitivity of the category criterion of overweight and obesity in children and adolescents of China, recommended by WGOC have been verified on distinguish the blood pressure in normal weight, overweight and obesity populations.</p>