Deepening the Action on Salt Reduction in China-suggestions on strategy and implementation plan / 中华预防医学杂志

Excessive sodium/salt intake is the leading dietary risk factor for the loss of healthy life in the Chinese population. The "Healthy China 2030" Action Plan set the goal of reducing salt intake by 20% by 2030. However, salt intake in China is still at a very high level in the world, with adults reaching 11 g/d, more than twice the recommended limit of 5 g/d. The current policies and action plans of China have targeted catering workers, children, adolescents, and home chefs in salt, oil, and sugar reduction actions. However, there are still obvious deficiencies in the coordinated promotion and implementation. This study, therefore, proposed a set of comprehensive strategies (named CHRPS that is composed of communication and education, salt reduction in home cooking, salt reduction in restaurants, reducing salt content in pre-packaged food, and surveillance and evaluation) and key implementation points for further deepening the salt reduction action in China. These strategies were developed based on the main sources of dietary sodium for Chinese residents, the status of "knowledge, attitude and practice" in salt reduction, evidence of effective intervention measures, existing policies and requirements, and the salt reduction strategies of the World Health Organization and experience from some other countries. As a scientific reference, the CHRPS strategies will help the government and relevant organizations quickly implement salt reduction work and facilitate the earlier realization of China's salt reduction goal.

Burden of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption in China / 中华流行病学杂志

Objective: To describe the prevalence of alcohol consumption and the burden of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption in adults aged ≥20 years in 31 provinces in China from 2005 to 2018. Methods: Data from several national representative surveys was used to estimate provincial alcohol exposure level of adults aged ≥20 years from 2005 to 2018 by using kriging interpolation and locally weighted regression methods. Global disease burden research method and data, and China's death cause surveillance data were used to calculate the population attributable fraction (PAF) of hemorrhagic stroke and hypertensive heart disease and the deaths due to alcohol consumption in men and women aged ≥20 years in 31 provinces in China. China census data of 2010 were used to calculate the attributable standardized mortality rate. Results: In 2005 and 2018, the prevalence of alcohol consumption was 58.7% (95%CI: 57.8%-59.5%) and 58.4% (95%CI: 57.6%-59.3%), respectively, in men and 17.0% (95%CI: 16.6%-17.4%) and 18.7% (95%CI:18.1%-19.3%), respectively, in women. The daily alcohol intake was 24.6 (95%CI: 23.8-25.3) g and 27.7 (95%CI: 26.8-28.7) g, respectively, in men and 6.3 (95%CI: 6.0-6.5) g and 5.3 (95%CI: 5.0-5.6) g, respectively, in women. Alcohol exposure level was higher in the provinces in central and eastern China than in western provinces. The lowest exposure level was found in northwestern provinces. From 2005 to 2018, the PAF of hemorrhagic stroke death due to alcohol consumption increased from 5.5% to 6.8%, the attributable deaths increased from 50 200 to 59 100, while the PAF of hypertensive heart disease death due to alcohol consumption increased from 7.0% to 7.7%, the attributable deaths increased from 15 200 to 29 300. The PAF of hypertensive heart disease and hemorrhagic stroke was higher in men than in women, and in central and eastern provinces than in western provinces. In 2018, the standardized mortality rates of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption were 4.58/100 000 and 2.11/100 000, respectively. Conclusions: The prevalence of alcohol consumption in men and daily alcohol intake of drinkers were relatively high in China, especially in eastern provinces. Alcohol exposure level was lower in women than in men. Regional measures should be taken to reduce the alcohol intakes in men and current drinkers in order to reduce the health problems caused by alcohol consumption.

Malnutrition in Relation with Dietary, Geographical, and Socioeconomic Factors among Older Chinese / 生物医学与环境科学（英文）

Objective@#Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary, geographical, and socioeconomic factors.@*Methods@#A total of 13,987 ≥ 60-year-old persons from the 2010-2013 Chinese National Nutrition and Health Survey were included to evaluate various aspects of malnutrition, including underweight, overweight or obesity, and micronutrient inadequacy.@*Results@#Overall, the prevalence of obesity, overweight, and underweight was 12.4%, 34.8%, and 5.7%, respectively, with disparities both geographically and socioeconomically. The prevalence of underweight was higher among the older old (≥ 75 years), rural residents and those with low income, with low education status, and residing in undeveloped West areas. More than 75% of the elderly do not meet the Dietary Reference Intakes for vitamins A, B @*Conclusions@#Obesity epidemic, inadequacy of micronutrient intake, and high prevalence of underweight and anemia in susceptible older people are the major nutrition challenges for the rapidly aging population in China.

Association between Chinese Famine Exposure and the Risk of Overweight/Obesity and Abdominal Obesity in Laterlife: A Cross-sectional Study / 生物医学与环境科学（英文）

This study aimed to examine the association between famine exposure in different stages of life and the risk of overweight/obesity and abdominal obesity in laterlife. A total of 12,458 participants were categorized into non-exposure and four direct exposures, including fetal, childhood, adolescence, and adult exposure. Only risk of being overweight or obesity in adolescence exposure [odds ratio ( ), 1.45; 95% confidence interval ( ), 1.08-1.94] was significantly higher than in non-exposure. Childhood ( , 1.27; 95% , 1.05-1.54) and adolescence ( , 1.53; 95% , 1.15-2.05) exposures had significantly an increased risk of abdominal obesity compared with non-exposure. Additionally, different famine severity exposures had different influences on the development of overweight/obesity and abdominal obesity. Famine exposure in adolescence, which was a behavior formative period, can increase the risk of overweight/obesity and abdominal obesity in adulthood, specifically in famine severely affect area.

Association of Red Meat Usual Intake with Serum Ferritin and the Risk of Metabolic Syndrome in Chinese Adults: A Longitudinal Study from the China Health and Nutrition Survey / 生物医学与环境科学（英文）

Objective@#The present study aimed to investigate the association of red meat usual intake with metabolic syndrome (MetS), and explore the contribution of red meat usual intake to serum ferritin.@*Methods@#Based on the data from the longitudinal China Health and Nutrition Survey (CHNS), 2,797 healthy adults aged 18-75 years without hypertension, diabetes, and MetS were selected in 2009 as subjects and follow-up studies were carried out till 2015. We used the National Cancer Institute (NCI) method to estimate the usual intake of foods. Multivariable logistic regressions were performed to evaluate the association between red meat usual intake and the risk of MetS. Quantile regression analysis was used to study the relationship between red meat consumption and serum ferritin levels.@*Results@#After adjusting for potential confounders, red meat, and fresh red meat were positively associated with the risk of MetS ( = 1.41, 95% : 1.05-1.90 and = 1.37, 95% : 1.02-1.85, respectively). These relationships showed increasing trend ( < 0.05). The level of serum ferritin increased significantly with the number of MetS components ( < 0.05). The quantile regression analysis showed that red meat and fresh red meat usual intake had a significant positive association with serum ferritin levels across the entire conditional serum ferritin distribution ( < 0.05). Processed red meat did not exhibit a similar association.@*Conclusion@#Higher red meat usual intake was associated with an increased risk of MetS and elevated serum ferritin levels.

Comparison of Undernutrition Prevalence of Children under 5 Years in China between 2002 and 2013 / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To describe the undernutrition status of children under 5-year in China, and study the trend between 2002 and 2013).</p><p><b>METHODS</b>The study was based on two national surveys. Undernutrition was determined against WHO's 2006 growth standards. The prevalence in 2013 and 2002 was weighted by China sixth National Population Census (2010). The relationship between undernutrition and gender/age groups/different areas use weighted logistic regression.</p><p><b>RESULTS</b>The results indicated the overall prevalence of stunting, underweight, and wasting of Chinese children under 5-year was 8.1%, 2.4%, and 1.9% in 2013, respectively. The prevalence of stunting was higher for children aged 12-47 month, while underweight was higher for children aged 48-59 month. The prevalence of undernutrition was higher in rural areas than in urban areas, especially in poor rural areas. There was a decline of stunting, underweight, and wasting between 2002 and 2013 among the children, with greater reduction in rural areas than in urban areas.</p><p><b>CONCLUSION</b>The prevalence of undernutrition of children under 5-year remains high in rural areas especially in poor rural areas in China. It is urgent to take action to control undernutrition in the vulnerable areas and subgroups.</p>

A survey on the nutritional status of vitamin A among urban residents / 预防医学

Objective To evaluate the nutritional status of vitamin A among urban residents. Methods Using stratified random sampling method,a total of 400 residents from two cities in Zhejiang were selected. They were interviewed by questionnaire,also, the dietary survey, physical measurement and blood sample testing were used. According to Recommended Nutrient Intake( RNI)of vitamin A,to evaluate the intake of Vitamin A and analysis the nutritional status and influenc factors. Results The median of vitamin A concentration was 0. 463( inter-quartile range is 0. 213)μg/mL, and the percentage of severe vitamin A deficiency( VAD ),VAD,insufficiency and adequate serum vitamin A were 0. 25%,0. 50%,6. 75% and 92. 50% respectively. Among 299 individuals who participated in the dietary survey,the median of daily vitamin A intake was 350. 5( inter-quartile range was 351. 5)μgRE. Only 25. 42% of participants' dietary intake of vitamin A met the level of 80% RNI,while 61. 87% of peoples' daily intake of vitamin A under 60%RNI. Male, from the bigger city,older age,high level of triglyceride and more intake of cholesterol may contribute to a higher level of serum vitamin A. Conclusion The majority of urban residents had adequate vitamin A . But the intake of dietary vitamin A still should be paid more attention. Serum vitamin A was associated with age,gender and district.

Dietary Patterns Associated Metabolic Syndrome in Chinese Adults / 生物医学与环境科学（英文）

Dietary pattern has been revealed to be associated with metabolic syndrome. However, the association was not well documented in Chinese due to the complexity of Chinese foods. We mainly assessed the dietary patterns and examined their effects on metabolic syndrome among Chinese adults. Four dietary patterns including 'Refined Grains & Vegetables' Pattern, 'Dairy & Eggs' Pattern, 'Organ Meat & Poultry' Pattern, and 'Coarse Grains & Beans' Pattern were extracted. 'Dairy & Eggs' Pattern was associated with a decreased odds of metabolic syndrome in women, and 'Coarse Grains & Beans' Pattern was associated with a decreased odds of hypertension in men. These results provided a scientific basis for future research and dietary guideline perfection.

Negative Association of Domestic Activity and Active Commuting with Metabolic Syndrome in a Chinese Population Aged 35-64 Years / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To understand the associations of physical activity domains with metabolic syndrome among a middle-aged Chinese population.</p><p><b>METHODS</b>In all, 3326 professional adults aged 35-64 years from Beijing and Zhejiang province were recruited with a cluster random sampling method. The Global Physical Activity Questionnaire was modified, and the recommended Asia-Pacific cut-offs of waist circumstance were introduced into the criteria for metabolic syndrome from the Adult Treatment Panel III. A binary logistic regression model was applied to examine the association of all physical activity domains with the risk of the syndrome.</p><p><b>RESULTS</b>Participants who engaged in domestic activity for ⋜1176 MET-min/week had a 41.6% less chance of having metabolic syndrome [odds ratio (OR), 0.584; 95% confidence interval (CI), 0.480-0.710] than those without this activity. In adjusted models, adults who actively commuted for ⋜33 MET-min/week but <528 MET-min/week had a 25% less chance of having the syndrome (OR, 0.750; 95% CI, 0.582-0.966) than those who did not. No interaction was detected between the two domains of activity and the syndrome.</p><p><b>CONCLUSION</b>This study highlighted the independently negative association of traffic and house activity with the prevalence of the syndrome in this sample with a generally low level of moderate activity.</p>

An investigation on vitamin D status of residents in Zhejiang province / 预防医学

Objective To evaluate the vitamin D status of residents in two cities of Zhejiang province.Methods 442 participants from Hangzhou and Ningbo were selected using multi-stage cluster random sampling method,then the blood samples were collected and the serum level of 25 -hydroxyl vitamin D [25 (OH)D]was detected by the method of radioimmunoassay to analyze the Vitamin D status.Results Median (25 th-75 th percentile)level of serum 25 (OH)D in subjects aged 6 -11,12 -17,18 -44,45 -59 and over 60 years were 53.19 (41.85 -64.89),48.76 (32.56 -60.52),59.91 (48.05 -72.79),68.67 (55.50 -78.07)and 70.97 (56.91 -84.65)nmol/L,respectively.The number of vitamin D deficiency [25(OH)D<25 nmol/L],insufficiency[25≤25(OH)D <50 nmol/L],normal [50≤25 (OH)D <75 nmol/L ],sufficiency [25 (OH )D ≥75 nmol/L ] were 2.95%,30.84%,44.22% and 22.00%, respectively.Conclusion The deficient and insufficient status of vitamin D is common among residents in two cities of Zhejiang province.Vitamin D nutrition situation should be improved.

An evaluation on dietary pattern and quality among residents in Zhejiang province / 预防医学

Objective To assess the dietary pattern and quality of residents in Zhejiang province.Methods 21 52 residents aged 1 8 -79 years old were selected using multi-stage stratified cluster random sampling method and the data from Chinese nutrition status monitoring project during 201 0 -201 2 was used.The results were evaluated using Chinese diet balance index.Results 41.08% of the residents in Zhejiang province was mild diet imbalance and 50.79% was middle diet imbalance while insufficient and excessive intakes were coexist.Mild and middle insufficient intakes were accounted for 66.1 7%and 27.88%respectively,while mild excessive intake was accounted for 35.55%.The diet balance indexes including DBI-LBS,DBI-HBS and DBI-DQD were 46.00,26.00 and 57.00 respectively.The dietary quality of males,rural areas was lower while residents aged 40 -49 years had the lowest dietary quality.There was positive correlation between dietary quality and degree of education (P<0.05 ).The main dietary pattern of residents in Zhejiang was pattern B (62.41%)following by pattern A (26.44%).Conclusion Insufficient and excessive intakes coexist among residents in Zhejiang province.Male,living in rural areas,people aged 40 -49 years or with lower degree of education should be taken as target intervention subjects.

Single-chain human anti-EGFR antibody/truncated protamine fusion protein carrying Hsp47 siRNA can induce apoptosis of human hepatic stellate cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To construct a single-chain human anti-EGFR antibody (scFv) and truncated protamine (tP) fusion protein, ScFv/tP, carrying small interfering (si)RNA directed against the heat shock protein Hsp47, a collagen-binding glycoprotein, in order to evaluate the role Hsp47 in apoptosis of hepatic stellate cells.</p><p><b>METHODS</b>A single chain of the human variable fragment was obtained by phage display and fused with the tP gene and with or without (negative control) the Hsp47 siRNA sequences. Following expression and purification of the scFv/tP fusion protein and the scFv/tPHsp47 siRNA fusion protein, internalization capabilities were tested in isolated human hepatic stellate cells and the QSG-7701 human hepatocyte cells with visualization by immunofluorescent staining. The DNA binding ability of the fusion proteins were verified by gel shift assay.Following ScFv/tP-Hsp47 siRNA fusion protein transfection into the human hepatic stellate cells, the levels of Hsp47 mRNA and protein expression were tested by RT-PCR and Western blotting; in addition, effects of siRNA-mediated silencing of Hsp47 on cell proliferation and apoptosis were analyzed by the cell counting kit (CCK)-8, flow cytometry and Western blot detection of the apoptosis marker poly (ADP-ribose) polymerase (PARP).</p><p><b>RESULTS</b>Indirect immunofluorescence revealed that the ScFv/tP fusion proteins were internalized into human hepatic stellate cells but not into the QSG-7701 cells.The ScFv/tP-Hsp47 siRNA fusion protein caused reduced expression of Hsp47 mRNA and protein expression in the human hepatic stellate cells, as well as increased the cells' apoptosis remarkably.</p><p><b>CONCLUSION</b>The ScFv/tP fusion protein can be used as a transfection reagent to deliver Hsp47 siRNA into hepatic stellate cells and to mediate apoptosis via blockade of Hsp47 expression.</p>

Analysis of the prevalence and its influencing factors of diffuse goiter in Zhejiang / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the status of diffuse goiter of population in Zhejiang Province and to analyze the relevant influencing factors.</p><p><b>METHODS</b>A total of 18 188 subjects were recruited in the cross sectional survey, by multistage stratified cluster random sampling method. B ultrasound measurement were carried among the subjects to detect the thyroid volume, and the basic information and life styles were interviewed by questionnaires. Then, we analyzed the distribution and its influencing factors of diffuse goiter.</p><p><b>RESULTS</b>The ratio of diffuse goiter among the surveyed population was 2.2% (403/18 188), the difference showed statistical significance (χ(2) = 267.11, P < 0.05). The ratio among the group aged 6-7 years old and 8-10 years old was comparatively high, separately 10.3% (27/262) and 9.8% (51/519). The ratio among women (2.9%, 305/10 470) was higher than it among men (1.3%, 97/7672) (χ(2) = 55.55, P < 0.05). The residents from inland areas had the highest prevalence (3.2%, 138/4374), followed by residents from sub-coastal areas (2.0%, 131/6411), coastal areas minimum (1.8%, 138/4374) (χ(2) = 24.31, P < 0.05). The content of water iodine and salt iodine among people with symptoms of goiter had statistical difference with it among ordinary population (water iodine:χ(2) = 4.95, P = 0.026; salt iodine: χ(2) = 11.03, P < 0.01). The median(quartile) of water iodine in ordinary population was 2.41 (1.96-6.15) µg/L and among people with symptoms of goiter was 1.88 (1.49-5.15) µg/L. The median(quartile) of salt iodine in ordinary population was 30.18 (24.69-32.65) mg/kg and among people with symptoms of goiter was 29.1 (24.70-31.95) mg/kg. The influential factors of goiter were as follows: the family income, the education degree, the job and profession status, the diet character, the habitual sea food consumption, the alcohol intake status (χ(2) were separately 8.08, 37.85, 98.78, 68.69, 10.91, 12.21, 26.94, P < 0.05). Multi-factor analysis showed the results as follows: female (OR = 0.27 95%CI:0.18-0.39), school students (OR = 8.05, 95%CI:3.87-16.73), vegetarian (OR = 1.60, 95%CI:1.15-2.22) took a higher risk of getting pathogenic goiter; while the group of those who had university degree or above (OR = 0.84, 95%CI: 0.73-0.97), ate sea food frequently (OR = 0.62, 95%CI:0.44-0.88) took a lower risk.</p><p><b>CONCLUSIONS</b>The ratio of diffuse goiter in the group aged among 6-7 years old and 8-10 years old was comparatively high. The ratio was influenced by many factors.</p>

Prevalence and risk factors of pre-hypertension among adults of Zhejiang province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To access the prevalence rates of pre-hypertensive patients at different stages and its associated risk factors among adults of Zhejiang province.</p><p><b>METHODS</b>Study subjects were selected among local residents aged ≥ 18 years from 15 counties by multi stage stratified cluster random sampling method, from July to November, 2010. Each participant was required to complete questionnaire, physical examination and testing for overnight fasting blood specimen.</p><p><b>RESULTS</b>17 437 residents were surveyed including 8169 males and 9268 females. The overall prevalence of prehypertension was 34.39%. The prevalence of pre-hypertension appeared to be higher in males (38.57%) than in females (30.70%) (χ(2) = 119.36, P < 0.0001). The prevalence of pre-hypertension decreased with the increase of age in males who were above 25 year olds (χ(2) = 76.94, P < 0.0001) and in females who were above 45 year olds (χ(2) = 114.66, P < 0.0001). The prevalence of pre-hypertension appeared to be higher in the rural (35.60%) than in the urban (32.39%) areas (χ(2) = 18.69, P < 0.0001). Data from multivariable logistic regression showed that factors as being male, aged older than 35 years of age, with waist circumference as ≥ 85 cm for men and ≥ 80 cm for women, body mass index ≥ 25.0 kg/m(2) and triglyceride ≥ 1.7 mmol/L were risk factors of pre-hypertension while having had higher education was a protective factor.</p><p><b>CONCLUSION</b>Pre-hypertension was prevalent among adults residents in Zhejiang province. Factors as overweight, obesity, dyslipidemia appeared to be major risk factors for pre-hypertension.</p>

A cross-sectional study on iodine nutrition in general population from Zhejiang province,China / 中华流行病学杂志

Objective To understand the current status of iodine nutrition among the community residents to compare the level of iodine nutrition in different areas and groups of populations in Zhejiang province.Methods Stratified cluster sampling method was adopted and residents from twenty-two communities in Zhejiang province were selected.A cross-sectional survey was conducted,using questionnaires,laboratory tests,on urinary iodine,water iodine and the concentration of the iodine in salt,which had played positive roles in the calculation of the level of iodine nutrition.Results Results of the iodine nutrition in this cross-sectional survey were as follows:the median water iodine and salt iodine of Zhejiang were 2.42 μg/L and 28.8 mg/kg,respectively.The coverage of iodized salts was 79.54％,with the ingesting rate of qualified iodized-salt as 76.65％ and the median content of urinary iodine in the population of Zhejiang was 161 μg/L.The average iodine content among pregnant women was 138 μg/L,with the percentage of samples less than 100 μg/L as 25.92％,more than 300 μg/L as 15.30％.The proportions of iodine intake through water,salt and other foods were 1.70％,76.41％ and 21.89％,respectively.Conclusion The status of iodine nutrition in Zhejiang province in general seemed to be appropriate,but the level of iodine nutrition in pregnant women was less than the requirement,which should call for attention.

Association between dyslipidemia and different subtypes of hypertension among Zhejiang population in 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the association between dyslipidemia and different subtypes of hypertension among Zhejiang population.</p><p><b>METHODS</b>From June to October in 2010, 19 113 local residents aged ≥ 18 years old were selected among 7571 families from fifteen counties in Zhejiang by four stage stratified-random sampling method. A self-designed questionnaire was adopted to collect information on demographic characteristics, physical activity and life style. At the same time, physical examinations including height, weight, blood pressure and blood lipids were carried out.</p><p><b>RESULTS</b>A total of 19 113 participants completed the interviews, physical examinations and collected the blood samples.Excluding those who did not meet the criteria, 14 731 were finally enrolled in the study. The prevalence rates of isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), systolic and diastolic hypertension (SDH) were 7.16% (1055/14 731, standardized rate:5.46%), 4.60% (677/14 731, standardized rate:4.41%), 7.09% (1045/14 731, standardized rate:5.75%), respectively. Among normal blood pressure group, subjects with normal TC, high TC and abnormal TC were separately 10 571 (88.43%), 1173 (9.81%) and 210 (1.76%); subjects with normal HDL-C and low HDL-C were separately 6885 (57.60%) and 5069 (42.40%); subjects with normal TG, high TG, abnormal TG were separately 9952 (79.91%), 1213 (10.15%) and 1189(9.95%).In ISH group, subjects with normal TC, high TC and abnormal TC were separately 826 (78.29%), 188 (17.82%) and 41 (3.89%); subjects with normal HDL-C and low HDL-C were separately 666(63.13%) and 389 (36.87%); subjects with normal TG, high TG and abnormal TG were separately 737 (69.86%), 150 (14.22%) and 168 (15.92%). Multi factor analysis showed that high TG and abnormal TG were associated with ISH (OR (95%CI):1.43 (1.16-1.76), 1.65 (1.34-2.03) respectively). Among IDH group, subjects with normal TC, high TC, abnormal TC were separately 556(82.13%), 99(14.62%) and 22 (3.25%); subjects with normal HDL-C, low HDL-C were separately 335 (49.48%) and 342 (50.52%); subjects with normal TG, high TG, and abnormal TG separately were 402 (59.38%), 107 (15.81%) and 168 (24.82%). The multi factor analysis showed that high TG and abnormal TG could increase the risk of IDH (OR(95%CI):1.57 (1.24-1.98), 2.18 (1.76-2.70) respectively). Among SDH group, subjects with normal TC, high TC and abnormal TC were 817 (78.18%), 193 (18.47%) and 35 (3.35%); subjects with normal HDL-C and abnormal HDL-C were separately 599 (57.32%) and 446 (42.68%); subjects with normal TG, high TG, abnormal TG were separately 675 (64.59%), 164 (15.69%) and 206 (19.71%). The multi factor analysis showed that high TC, high TG and abnormal TG were also associated with the increased risk of SDH (OR (95%CI):1.38 (1.14-1.67), 1.43(1.18-1.75), 1.73 (1.43-2.10) respectively).</p><p><b>CONCLUSION</b>Dyslipidemia is an important factor of different subtypes of hypertension among Zhejiang population, especially triglycerides. Dyslipidemia screening should be strengthened to reduce the risk of cardiovascular diseases.</p>

Study on level of dietary iodine intake and its contribution rate of residents in Zhejiang / 中华预防医学杂志

<p><b>OBJECTIVE</b>To assess the level of dietary iodine intake and its contribution in Zhejiang.</p><p><b>METHODS</b>A total of 9798 subjects were recruited in this survey with multi-stage stratified cluster random sampling method in April, 2010, the 24-hours dietary recall method and the "food composition table" were used to obtain the dietary iodine intake, and edible salt and drinking water samples were collected to detect the content of iodine.</p><p><b>RESULTS</b>A total of 9798 subjects were included in this survey. The mean intake of dietary iodine in Zhejiang residents per standard man-days was (395.13 ± 78.16) µg/d, which in between of Recommended Nutrient Intake (RNI) 150 µg/d and Tolerable Upper Intake Level (UL) 1000 µg/d; the iodine intake of 18.40% (1803/9798) subjects was lower than estimated average requirement of iodine (EAR), 4.68% (459/9798) subjects was higher than the UL. The means of dietary iodine intake in various areas were (498.85 ± 96.77) µg/d, (384.50 ± 88.76) µg/d and (326.33 ± 78.32)µg/d in inland areas, sub-coastal areas and coastal areas, successively (F = 27.17, P < 0.05); the proportions of dietary iodine intake lower than EAR were 34.89% (1239/3551), 10.48% (370/3530) and 7.14% (197/2717) in coastal areas, sub-coastal area and inland areas, successively (χ(2) = 62.87, P < 0.01) , while those higher than UL were 5.10% (180/3530), 4.86% (132/2717) and 4.14% (147/3551) in sub-coastal area, inland areas and coastal areas.In the condition of ignoring cooking loss, the mean contribution of dietary iodine intake in edible salt, all kinds of food and drinking water were 74.92% (296.03/395.13), 23.85% (94.24/395.13) and 1.23% (4.86/395.13), successively; the contributions of edible salt in inland areas, sub-coastal areas and coastal areas were 83.72% (417.64/498.85), 73.05% (280.88/384.50) and 66.83% (280.09/326.33), successively; the contributions of drinking water in sub-coastal areas, coastal areas and inland areas were 1.61% (6.19/384.50) , 1.44% (4.70/326.33) and 0.65% (3.24/498.85) , successively (χ(2) = 7.24, P = 0.032) ; the contribution of laver in coastal areas, sub-coastal areas and inland areas were 22.57% (73.65/326.33), 17.11% (65.79/384.50) and 8.09% (40.36/498.85), successively (χ(2) = 82.17, P < 0.01) ; the contribution of sea fish in coastal areas, sub-coastal areas and inland areas were 2.38% (7.77/326.33), 0.72% (2.77/384.50) and 0.68% (3.39/498.85) (χ(2) = 19.47, P = 0.012).</p><p><b>CONCLUSIONS</b>The dietary iodine intake of Zhejiang residents was at recommended intake levels; the iodized salt turns out to be the main source, the iodine nutrition level was relatively low in coastal areas of Zhejiang, which the coverage of iodized salt should be improved.</p>

Analysis of urine iodine level and its influencing factors in Zhejiang from 2009 to 2011 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the iodine nutrition level of population in Zhejiang province and to analyze the relevant influencing factors from 2009 to 2011.</p><p><b>METHODS</b>From October 2009 to October 2011, a total of 19 517 subjects were recruited in this cross sectional survey, by multistage stratified cluster random sampling method. The subjects were all living over three years in Zhejiang province. The basic information and life styles were interviewed by questionnaires; and the samples of drinking water, edible salt and urines were separately collected from the subjects to test the content of iodine. In total, 16 228 subjects answered the questionnaire, and 265 samples of drinking water, 7811 samples of edible salt and 19 517 samples of urine were collected. Then, we analyzed the distribution of iodine in water, edible salt and urine samples, as well as the relevance.</p><p><b>RESULTS</b>The median (25% - 75% percentile) of water iodine was 2.42 (1.17 - 6.28) µg/L in drinking water among Zhejiang residents; while separately 2.79 (1.60 - 6.87) µg/L in city and 2.04 (1.03 - 5.29) µg/L in country side (Z = 2.07, P < 0.05). The figures turned out to be 2.17 (1.22 - 5.73) µg/L, 2.77 (1.88 - 6.87) µg/L, and 1.40 (0.77 - 5.65) µg/L, respectively, in coastal areas, coastal periphery areas and inland areas (χ(2) = 11.16, P < 0.05). The median (25% - 75% percentile) of salt iodine was 28.80 (22.93 - 32.40) mg/kg; while separately 29.00 (24.50 - 32.60) mg/kg and 28.50 (13.90 - 32.29) mg/kg in city and country side (Z = 6.32, P < 0.05). The figures turned out to be 25.19 (0.00 - 30.20) mg/kg, 29.00 (26.60 - 31.70) mg/kg and 32.40 (28.94 - 36.30) mg/kg, respectively, in coastal areas, coastal periphery areas and inland areas (χ(2) = 1581.62, P < 0.05). The coverage rate of iodized salt was 79.54% (6213/7811) in all province. The urinary iodine median was 160.74(97.20 - 247.00) µg/L, while the urinary iodine median in pregnant women was 137.99 (82.40 - 215.30) µg/L, lower than the recommended optimal levels, which was 150 - 249 µg/L. The figures turned out to be 153.45(92.00 - 237.50) µg/L in city and 168.00 (102.18 - 257.00) µg/L in country side (Z = -9.25, P < 0.05); while in coastal, coastal periphery place and inland areas, the median were separately 156.00 (94.29 - 242.80) µg/L, 150.14 (94.70 - 227.00) µg/L and 187.70 (109.00 - 276.80) µg/L (χ(2) = 194.12, P < 0.05). The analysis of relevance between urine iodine, water iodine and iodized salt showed that the urine iodine would increase as long as the iodized salt increased; and the difference had statistical significance (χ(2) = 440.88, P < 0.01). And there were no relevance between urine iodine level and the water iodine level (χ(2)cmh = 0.57, P = 0.45). The analysis of the influencing factors showed that education background (χ(2) = 14.17, P < 0.05), different styles of career (χ(2) = 16.15, P < 0.01) and diet habits (χ(2) = 108.63, P < 0.01) could influence the level of urine iodine.</p><p><b>CONCLUSION</b>Iodine was deficient in Zhejiang province. The nutrition level of iodine was fine in Zhejiang in 2009, however, the coverage rate of iodine was commonly low in coastal areas, especially the pregnant women suffered from iodine deficiency. In our study, the factors influencing the urine iodine level included iodized salt, age, education background and diet habits.</p>

Efficacy of standard antiviral therapy retreatment following interferon treatment failure in chronic hepatitis C patients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic efficacy of standard antiviral therapy applied after interferon (IFN) treatment failure in patients with chronic hepatitis C (CHC).</p><p><b>METHODS</b>CHC patients who completed a 48-week course of IFN therapy (pegylated (Peg)-IFNa-2a at 180 mug, qw, ih with or without ribavirin (RBV) at 15 mg/kg/w) in our hospital between January 2009 and June 2012 but who showed no response (at week 48) or who relapsed (at week 72) were enrolled in the study. Prior to initiating the 48-week course of retreatment therapy (Peg-IFNa-2a plus RBV as above), the hepatitis C virus (HCV) genotype was detected and the viral load measured (baseline) by PCR of HCV RNA. Each patient's response to therapy was classified as follows: baseline vs. week 4 (rapid virological response, RVR), vs. weeks 12 and 24 (early virological response, EVR), vs. week 48 (end of treatment virological response, ETVR) and vs. week 72 (sustained virological response, SVR).</p><p><b>RESULTS</b>Of the total 235 cases administered retreatment therapy, 60.0% (n = 140) achieved RVR, 77.4% (n = 182) achieved EVR, 83.8% (n = 197) achieved ETVR, 68.0% (n = 68%) achieved SVR, and 15.7% (n = 37) relapsed. Stratification analysis of recurrence (n = 158) and non-responsive (n = 77) sub-groups showed that the recurrence group experienced significantly higher rates of RVR, EVR, ETVR and SVR, but a significantly lower rate of relapse. Stratification analysis of genotype 1b carrier (n = 206) and non-1b carrier (n = 29) sub-groups showed that the 1b carriers had significantly lower rates of RVR, EVR, ETVR and SVR, but a significantly higher rate of relapse. Finally, the patients who achieved RVR (vs. non RVR, n = 95) and EVR (vs. non-EVR, n = 53) showed higher rates of SVR and ETVR.</p><p><b>CONCLUSION</b>CHC patients who fail to respond to the initial course of standard IFN-based therapy may achieve SVR upon retreatment, especially those infected with the HCV genotype 1b.</p>

Exposure assessment on dietary lead and cadmium of residents in three areas of Zhejiang province from 2009 to 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To assess the safety of dietary lead and cadmium intake in 3 areas of Zhejiang province.</p><p><b>METHODS</b>Using the total dietary study method, the study was conducted in 3 regions which represented coastal, city and rural areas in Zhejiang province from 2009 to 2010. The dietary survey was conducted on the residents (512 subjects) and the categories and volume of food consumption were obtained. The analytical food samples were obtained by food consumption survey, food aggregation, food sampling and preparation. The food samples were detected by inductively coupled plasma mass spectrometry (ICP-MS). The safety of dietary lead and cadmium intake was evaluated.</p><p><b>RESULTS</b>The median dietary lead intake (P₅₀) in Zhejiang province was 37.8 µg/d. The 97.5% dietary lead intake (P₉₇.₅) was 72.3 µg/d. The P₅₀ dietary lead intakes of different age and gender groups ranged from 23.2 to 44.2 µg/d. The P₉₇.₅ dietary lead intakes of different age and gender groups ranged from 34.2 to 88.1 µg/d. The P₅₀ dietary cadmium intake in Zhejiang province was 9.6 µg/d. The P₉₇.₅ dietary cadmium intake was 15.7 µg/d. The P₅₀ dietary cadmium intakes of different age and gender groups ranged from 6.4 to 11.4 µg/d, accounting 15.6% - 42.6% of PTMI (provisional tolerable monthly intake, 25 µg/kg). The P₉₇.₅ dietary cadmium intakes of different age and gender groups ranged from 10.5 to 21.4 µg/d, accounting 27.5% - 77.6% of PTMI. Vegetable (11.3 µg), cereal (11.0 µg) and meat (9.8 µg) were the first three food sources which accounted for 84.9% of dietary lead (P₅₀: 37.8 µg/d). Cereal (3.6 µg), vegetable (2.1 µg) and legume (0.9 µg) were the first three food sources which accounted for 68.8% of dietary cadmium (P₅₀: 9.6 µg/d).</p><p><b>CONCLUSION</b>Dietary lead and cadmium intakes of most residents in 3 areas of Zhejiang province as well as the average level are safe.</p>