Current status of public health system in Guangdong-Hong Kong-Macao Greater Bay Area and improvement suggestion / 中华流行病学杂志

Guangdong-Hong Kong-Macao Greater Bay Area (GBA) has three public health systems under different systems, which plays an important role in the construction of the public health system in China. Further strengthening the construction of the public health system in the GBA will play an important reference role in the optimization and upgrade of China's public health system in the future. Based on the key consulting project of "research on the strategy of the modern public health system and capacity building in China" by Chinese Academy of Engineering, this paper deeply analyzes the current status and existing problems of public health system construction in GBA and suggests to improve and innovate the mechanisms of collaborative prevention and control of public health risks, resource coordination and joint research and result sharing, information sharing and exchange, personnel training and team building in order to comprehensively improve the capacity of public health system in GBA, and promote the construction of Healthy China.

Epidemiological characteristics of local COVID-19 epidemics and control experience in routine prevention and control phase in China / 中华流行病学杂志

The COVID-19 pandemic is still ongoing in the world, the risk of COVID-19 spread from other countries or in the country will exist for a long term in China. In the routine prevention and control phase, a number of local COVID-19 epidemics have occurred in China, most COVID-19 cases were sporadic ones, but a few case clusters or outbreaks were reported. Winter and spring were the seasons with high incidences of the epidemics; border and port cities had higher risk for outbreaks. Active surveillance in key populations was an effective way for the early detection of the epidemics. Through a series of comprehensive prevention and control measures, including mass nucleic acid screening, close contact tracing and isolation, classified management of areas and groups at risk, wider social distancing and strict travel management, the local COVID-19 epidemics have been quickly and effectively controlled. The experiences obtained in the control of the local epidemics would benefit the routine prevention and control of COVID-19 in China. The occurrence of a series of COVID-19 case clusters or outbreaks has revealed the weakness or deficiencies in the COVID-19 prevention and control in China, so this paper suggests some measures for the improvement of the future prevention and control of COVID-19.

Course of disease and related epidemiological parameters of COVID-19: a prospective study based on contact tracing cohort / 中华预防医学杂志

Objective: To analyze the course of disease and epidemiological parameters of COVID-19 and provide evidence for making prevention and control strategies. Methods: To display the distribution of course of disease of the infectors who had close contacts with COVID-19 cases from January 1 to March 15, 2020 in Guangdong Provincial, the models of Lognormal, Weibull and gamma distribution were applied. A descriptive analysis was conducted on the basic characteristics and epidemiological parameters of course of disease. Results: In total, 515 of 11 580 close contacts were infected, with an attack rate about 4.4%, including 449 confirmed cases and 66 asymptomatic cases. Lognormal distribution was fitting best for latent period, incubation period, pre-symptomatic infection period of confirmed cases and infection period of asymptomatic cases; Gamma distribution was fitting best for infectious period and clinical symptom period of confirmed cases; Weibull distribution was fitting best for latent period of asymptomatic cases. The latent period, incubation period, pre-symptomatic infection period, infectious period and clinical symptoms period of confirmed cases were 4.50 (95%CI:3.86-5.13) days, 5.12 (95%CI:4.63-5.62) days, 0.87 (95%CI:0.67-1.07) days, 11.89 (95%CI:9.81-13.98) days and 22.00 (95%CI:21.24-22.77) days, respectively. The latent period and infectious period of asymptomatic cases were 8.88 (95%CI:6.89-10.86) days and 6.18 (95%CI:1.89-10.47) days, respectively. Conclusion: The estimated course of COVID-19 and related epidemiological parameters are similar to the existing data.

Effects of 275 nm and 310 nm ultraviolet irradiation on bone metabolism in ovariectomized osteoporotic rats / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effect of 275 nm and 310 nm ultraviolet irradiation on ovariectomized rats' bone metabolism.@*METHODS@#Twenty four 3-month-old female Sprague-Dawley (SD) rat were randomly divided into control group, sham operated group, 275 nm ultraviolet (UV) irradiation group and 310 nm UV irradiation group. Each group contained 6 rats. The rats in the two irradiation groups were treated with bilateral ovariectomy. The rats in sham operated group received sham operation (They were given the same back incision and a bit of par-ovarian fat were removed). Control group received no disposition. About 24 weeks after operation, all the rats received detailed bone mineral density (BMD) detection again. Detection regions include cervical vertebra, lumbar vertebra, proximal femur, mid femur and distal femur. Next, osteopenia rats in 275 nm irradiation group were UV irradiated 275 nm with fixed illumination intensity (15 μW/cm2) everyday for 16 weeks. The osteopenia rats in 310 nm irradiation group were UV irradiated 310 nm with fixed illumination intensity (15 μW/cm2) everyday for 16 weeks. The backs of the rats were shaved regularly as irradiation area (6 cm×8 cm). After 16-week irradiation, all the rats' BMD of cervical vertebra, lumbar vertebra, proximal femur, mid femur and distal femur were measured. At the end of the trial, all the rats' blood specimens were obtained and serum 25(OH)D, procollagen type Ⅰ N-peptide (PINP) and osteocalcin (OC) were measured.@*RESULTS@#Compared with control group [(238.78±26.74) mg/cm3], the BMD of the whole body were significantly lower in 275 nm [(193.34±13.28) mg/cm3] and 310 nm [(191.19±18.48) mg/cm3] irradiation groups (P=0.002, P=0.001). There were no significant difference between sham operated group [(227.20±14.32) mg/cm3] and control group. After 16-week ultraviolet irradiation, the BMD of the whole body were significantly increased in 275 nm [(193.34±13.28) mg/cm3 vs. (221.68±25.52) mg/cm3, P=0.005] and 310 nm groups [(191.19±18.48) mg/cm3 vs. (267.48±20.54) mg/cm3, P < 0.001] after corresponding irradiation. The BMD of the four body regions (lumbar vertebra, proximal femur, mid femur and distal femur) had significantly increased after irradiation in 275 nm irradiation group. For 310 nm irradiation group, the BMD in cervical vertebra, lumbar vertebra, proximal femur, mid femur and distal femur also had increased significantly after 310 nm ultraviolet irradiation. The concentration of serum 25(OH)D and OC was higher in 275 nm irradiation group than in control group [(46.78±5.59) μg/L vs. (21.32±6.65) μg/L, P=0.002;(2.05±0.53) U/L vs. (1.32±0.07) U/L, P=0.022]. Compared with the control, the concentration of serum 25(OH)D [(58.05±12.74) μg/L], OC [(2.04±0.53) U/L] and PINP [(176.16±24.18) U/L] was significantly higher (P < 0.001, P=0.015, P=0.005) in 310 nm irradiation group. However, there were no significantly difference between sham operated group and the control.@*CONCLUSION@#Both 275 nm and 310 nm ultraviolet could improve rats' vitamin D synthesis. Both 275 nm and 310 nm ultraviolet could improve osteopenia rats' bone condition. The irradiation of 310 nm might be more effective on bone condition improvement.

Risk assessment of exported risk of novel coronavirus pneumonia from Hubei Province / 中华预防医学杂志

To evaluate the exported risk of novel coronavirus pneumonia (NCP) from Hubei Province and the imported risk in various provinces across China. Data of reported NCP cases and Baidu Migration Indexin all provinces of the country as of February 14, 2020 were collected. The correlation analysis between cumulative number of reported cases and the migration index from Hubei was performed, and the imported risks from Hubei to different provinces across China were further evaluated. A total of 49 970 confirmed cases were reported nationwide, of which 37 884 were in Hubei Province. The average daily migration index from Hubei to other provinces was 312.09, Wuhan and other cities in Hubei were 117.95 and 194.16, respectively. The cumulative NCP cases of provinces was positively correlated with the migration index derived from Hubei province, also in Wuhan and other cities in Hubei, with correlation coefficients of 0.84, 0.84, and 0.81. In linear model, population migration from Hubei Province, Wuhan and other cities in Hubei account for 71.2%, 70.1%, and 66.3% of the variation, respectively. The period of high exported risk from Hubei occurred before January 27, of which the risks before January 23 mainly came from Wuhan, and then mainly from other cities in Hubei. Hunan Province, Henan Province and Guangdong Province ranked the top three in terms of cumulative imported risk (the cumulative risk indices were 58.61, 54.75 and 49.62 respectively). The epidemic in each province was mainly caused by the importation of Hubei Province. Taking measures such as restricting the migration of population in Hubei Province and strengthening quarantine measures for immigrants from Hubei Province may greatly reduce the risk of continued spread of the epidemic.

Effects of Polybrominated Diphenyl Ethers on the Human Body Exposure in E-Waste Dismantling Region / 法医学杂志

Objective To discuss the effects of polybrominated diphenyl ethers （PBDEs） exposure in e-waste dismantling region on the human body and provide data support for the identification of environmental health damage to residents in the e-waste dismantling region. Methods Adults in an e-waste dismantling region （exposed group, 54 participants） and a control region （control group, 58 participants） were selected, questionnaires were carried out and blood and urine samples were collected. Blood PBDEs, blood lipids, blood routine, blood lead, urine cadmium, urine chromium and urine nickel were detected. T-test was utilized to compare the differences of PBDEs between the two groups. Multivariate analysis were utilized to compare the differences between the two groups in blood routine indexes. Linear regression was used to analyze the relationship between PBDEs and blood routine. Results Exposure levels of PBDEs were significantly higher in the exposed group （240.00 ng/g, adjusted mass fraction of blood lipids, thereafter） than in the control group （93.00 ng/g, P<0.05）. There was no statistical significance in the differences in most blood routine indexes of the two groups （ P>0.05）, and their reference values were all within normal ranges. Mean platelet volume, plateletcrit, basophils percentage, absolute value of basophils, and mean corpuscular hemoglobin concentration were higher in the exposed group than in the control group （P<0.05）. Platelet distribution widths were lower in the exposed group than in the control group and below the normal reference range （P<0.05）. Conclusion PBDEs exposure in e-waste dismantling region tend to change platelet morphology, the number of basophils, and mean corpuscular hemoglobin concentration, and may pose potential health hazards to local residents.

Clinical Observation of Acupuncture plus Medication in Treating Chronic Pelvic Inflammatory Disease / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture plus medication in treating chronic pelvic inflammatory disease. Method By using the random number table, sixty-eight patients with chronic pelvic inflammatory disease were randomized into an acupuncture-medication group of 34 cases and a medication group of 34 cases. The clinical efficacies were compared after 2 courses of treatment, and the symptoms and body signs scores and syndrome score of traditional Chinese medicine (TCM) were also compared. Result There was a significant difference in comparing the therapeutic efficacy between the acupuncture-medication group and the medication group (P<0.05). After the treatment, the symptoms and body signs scores and TCM syndrome score dropped significantly in both groups (P<0.05), indicating that the two groups both had improvement in the symptoms, body signs and TCM syndrome; there were significant between-group differences in comparing the score differences in the symptoms and body signs scores and TCM syndrome score after the treatment (P<0.05), and the acupuncture-medication group was higher than the medication group. Conclusion Acupuncture plus medication can better ameliorate the symptoms and body signs and TCM syndrome in chronic pelvic inflammatory disease.

Relationship between temperature and the risks of mortality in China: a Meta-analysis / 中华流行病学杂志

Objective To understand the effect of temperature on the risk of mortality and the modification effect of latitude,in China.Methods Relevant papers were searched and Meta-analysis was used to determine the exposure-response relationship for each health outcome which was associated with the exposure to temperature.Meta-regression analysis was used to evaluate the effect modification by latitude.Results Ten studies in 15 cities were included in the study.When temperature increased by one centigrade,the risks of mortality showed the following changes:deaths from non-accidental increased by 2％ (95％CI:1％,3％),from cardiovascular disease increased by 4％ (95％CI:2％,6％)and from the respiratory disease increased by 2％ (95％CI:1％,4％).As temperature decreased by one centigrade,the mortality risks of the following diseases showed the changes as:non-accidental death increased by 4％ (95％CI:2％,7％),cardiovascular disease increased by 4％ (95％CI:1％,7％) and the respiratory diseases increased by 2％ (95％CI:0％,4％).When latitude ranged from 0 to 25,26 to 30,31 to 39 degree or over 40 degrees,respectively and the temperature decreased by one centigrade,the mortality risks of the general population increased by 6.5％ (95％CI:-2.7％,15.6％),5.8％(95％ CI:2.4％,9.3％),0.8％(95％CI:0.4％,1.2％),0.5％(95％CI:-0.5％,1.5％).As temperature increased by one centigrade,mortality risk of the general population increased by 0.6％ (95％ CI:-0.3％,1.4％),1.9％ (95％ CI:0.7％,3.1％),2.0％ (95％ CI:1.0％,3.0％) and 5.8％ (95％CI:-3.2％,14.8％).As latitude increased by five degrees with high temperature,the mortality risk of general people increased by 0.3％ (95％CI:0.1％,0.8％) while decreased by 0.8％ (95％ CI:0.5％,0.9％) under low temperature.Conclusion In China,the mortality risk increased along with the changes of temperature.The adaptability to cold ness among people living in high latitude areas seemed to be stronger than those living in other areas of latitudes.Who were more vulnerable to high temperature.

Investigation on the perception of risk level of heat wave and its related factors in Guangdong province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the risk perception of heat wave, and further explore its related factors in Guangdong province.</p><p><b>METHODS</b>A total of 2183 adults were selected by a multi-stage sampling method in Guangdong province. Each subject was interviewed in their home with a structured questionnaire by a well trained investigator from September to November, 2010. The questionnaire contained socio-demographic characteristics, heat wave related knowledge, risk perception of heat wave, etc. Chi-square test and multivariate logistic regression were employed in this study.</p><p><b>RESULTS</b>The average age of total 2183 participants was (39.31 ± 14.16) years, among which 53.37% (1165/2183) were males, and 48.74% (1064/2183) were selected from urban. About 38.11% (832/2183) of participants heard about heat wave, and 38.52% (841/2183) of subjects thought the heat wave had higher impact on their health (risk perception score of heat wave ≥ 5 points). About 81.91% (1788/2183) of all participants thought the weather in most recent years was hotter than several years ago. Among these people, 30.48% (545/1788) thought the main reason of weather becoming hotter was due to emission of carbon dioxide, and 26.51% (474/1788) thought it was due to air pollution. Results from the multivariate logistic regression showed that the risk perception score of heat wave were higher in subjects with higher education (OR = 2.16, 95%CI: 1.41 - 3.30), from urban(OR = 1.37, 95%CI: 1.10 - 1.72), with higher score of trust(OR = 1.08, 95%CI: 1.01 - 1.14) and participants with higher score of heat wave related knowledge (OR = 1.39, 95%CI: 1.27 - 1.52). Furthermore, compared to hierarchist, egalitarian (OR = 1.73, 95%CI: 1.30 - 2.29), individualist (OR = 1.93, 95%CI: 1.41 - 2.65) and fatalist (OR = 1.80, 95%CI: 1.41 - 2.29) also had higher risk perception score of heat wave.</p><p><b>CONCLUSION</b>There is a lack of knowledge and risk perception to heat wave among the residents in Guangdong province. Risk perception of heat wave was higher in people who were from urban, had higher level of trust on government, experts and media, had higher health-related knowledge score, and non-hierarchists.</p>

Time-series analysis on the malaria morbidity affected by meteorological factors in Guangdong province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the associations between malaria risk and meteorological factors.</p><p><b>METHODS</b>A negative binomial distribution regression analysis was built between the temperature, relative humidity, rainfall capacity and the monthly incidence of malaria, based on the temperature information provided by Guangdong Meteorological Department and the malaria incidence information provided by Guangdong Center of Disease Prevention and Control during year 1980 to 2004, adopting the time-series analysis method and by distributed lag non-linear model, in order to analyze the immediate factors.</p><p><b>RESULTS</b>The number of monthly malaria cases in Guangdong province reached 4010 between year 1984 and 2004, while the monthly maximal temperature, minimal temperature, average temperature, relative humidity and average rainfall capacity was separately 26.3°C, 18.8°C, 21.9°C, 88.0% and 5.6 mm. The immediate effect of monthly maximal temperature on malaria incidence showed non-linear relationships. When the temperature reached 32.3°C, the risk was highest, the relative risk (RR) was 2.51 (95%CI: 1.99 - 3.16); when the relative humidity was 60.0%, the relative risk of malaria was highest as 1.19 (95%CI: 0.66 - 2.11) and then decreased gradually; and when the relative humidity was 86.6%, the risk of malaria was lowest at 0.51 (95%CI: 0.34 - 0.76). The risk of malaria increased while the rainfall capacity was 14.5 mm, the risk of malaria was the highest at 1.29 (95%CI: 0.87 - 1.93). Strongest delayed effects on malaria incidence was observed when the monthly maximal temperature reached 31.5°C at lagged 2 months, with the value of RR at 1.81 (95%CI: 1.02 - 3.22). When the monthly rainfall capacity was over 15.2 mm, the delayed effects was strong but short. When the monthly maximal temperature of 33.7°C, the excess risk of malaria was comparatively high, the excess risk was 92.2% (95%CI: 30.5% - 183.2%) when lagging one month. When the relative humidity was low, the delayed effect of malaria lasted for a long time, and the cumulative effect was huge. When the relative humidity reached 87.0%, the excess risk lagging 3 months was only -66.6% (95%CI: -86.4% - -17.7%). When the rainfall capacity was 15.5 mm, the cumulative effect on malaria reached the peak after 3 months, while the excess risk was 40.7% (95%CI: -30.0% - -182.6%); afterwards the cumulative effect gradually weakened. Positive and negative interaction effects were significant between malaria risk and maximal temperature and monthly rainfall capacity, and monthly rainfall capacity and relative humidity at lagged 2 months, respectively.</p><p><b>CONCLUSION</b>High temperature and large rainfall capacity might be the risk factors of malaria in Guangdong province, and there was an obvious interaction between the two factors.</p>

What temperature index is the best predictor for the impact of temperature on mortality / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the suitable temperature index to establish temperature-mortality model.</p><p><b>METHODS</b>The mortality and meteorological information of Guangzhou between year 2006 and 2010 were collected to explore the association between sendible temperature, heat index and deaths by adopting distributed lag non-linear model to fit the daily maximum, mean and minimum temperature with and without humidity. Q-Q plots based on the standardized residuals of each model were used to qualitatively access the goodness of fitting. The minimum Akaike information criterion (AIC) and residual sum of squares (RSS) value were used to explore the most suitable temperature index for model establishment, and to further analyze the fittest temperature index for different diseases, ages and cold and hot effect.</p><p><b>RESULTS</b>Guangzhou features a subtropical monsoon climate, with an annual average temperature at 22.9°C and daily average relative humidity of 71%. The standardized residuals of all models followed normal distribution. For all death, death from circulation system diseases, the 65-84 years old aging groups and cold effect models, the daily average temperature fit better, whose AIC (RSS) values were the smallest as 11 537 (1897), 9527 (1928), 10 595 (2018) and 11 523 (1899), respectively. However, for death from respiratory system disease, groups aging under 65 years old or over 85 years old and hot effect models, the daily average sendible temperature fit better, whose AIC (RSS) values were the smallest as 8265(1854), 675 (1739), 8550 (1871) and 11 687 (1938), respectively. In comparison with the model controlling both temperature and relative humidity, different diseases, aging groups and cold and hot effect models fitted by sendible temperature index showed smaller AIC (RSS) values. The relative risk (RR) value of the cold effect lagging 0 - 3 days fitting by daily maximal temperature was < 1, and the RR value of it fitting by daily minimum temperature was > 1.04. The RR value of the hot effect lagging 0 - 1 days fitting by daily maximal temperature was < 1.16, and the RR values of it fitting by daily minimum temperature and daily average temperature were > 1.16.</p><p><b>CONCLUSION</b>There were no best temperature indicators for different diseases, ages and cold and hot effect. The model using sendible temperature index better fit the model including relative humidity as a covariable.</p>

The assessment of vulnerability to floods in Guangdong province at district level / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the vulnerability to floods in Guangdong province at district level.</p><p><b>METHODS</b>Data were collected from the sixth census, the 2010 Statistical Yearbook of Guangdong, the 2010 Health Statistics Yearbook of Guangdong and China Disease Prevention and Control information systems, etc. The weight of each indicator was determined based on subjective method and objective method respectively; and finally the results of the two methods were compared.</p><p><b>RESULTS</b>13 indicators were selected for the assessment of vulnerability to floods, including 6 sensitivity indicators, 5 adaptability indicators and 2 exposure indicators. Indicators with large weight (subjective weight/objective weight) were the proportion of population older than 65 years old (0.31/0.30), the proportion of population older than 65 years old (0.16/0.23), infant mortality rate (0.18/0.20), the total Gross Domestic Product (GDP) per capita (0.33/0.21), the proportion of illiterate in the population older than 15 years old (0.19/0.28), history frequency of floods (0.75/0.75). The mean vulnerability index (VI) calculated by subjective method was 0.35 with the standard deviation of 0.10; the mean vulnerability index calculated by objective method was 0.31 with the standard deviation of 0.08. The two weighting methods showed consistent results of vulnerability index (ICC = 0.975, P < 0.01). VI of most districts dropped in the interval of 0.30 - 0.39. Districts with subjective VI > 0.50 or objective VI > 0.40 should pay more attention to floods, including parts of the coastal areas, Beijiang River Basin, the eastern tributary area of Dongjiang River and the northern part of Pearl River Delta. Dapu district of Meizhou (0.55/0.45), Dianbai district and Maogang district of Maoming (0.54/0.48) were most vulnerable. Districts of Heyuan, Dongguan, Zhaoqing and Huizhou were less vulnerable, Yuancheng district of Heyuan showed least vulnerable to floods (0.15/0.12) followed by Dongguan (0.18/0.16), Duanzhou district (0.18/0.16) and Guangning (0.17/0.15) district of Zhaoqing. The score of indicators differed among different level of vulnerability (P < 0.05).</p><p><b>CONCLUSION</b>Different regions of Guangdong province showed different vulnerability to floods, vulnerable areas should be priority in the prevention and control of floods.</p>

The impact of temperature on cardiovascular disease deaths in 4 cities, China: a time-series study / 中华流行病学杂志

Objective To estimate the effects of temperature on cardiovascular disease (CVD) deaths in 4 cities-Kunming,Changsha,Guangzhou and Zhuhai,from southern part of China.Methods Daily CVD deaths,meteorological and air pollution data were used to explore the association between temperature and mortality.Distributed lag non-linear model was fitted for each city to access the delayed and cumulative effects of low,median and high temperature on CVD deaths.Cold and hot effects of temperature on CVD deaths were then accessed,based on the linear threshold model.Results The city-specific exposure-response functions appeared to be non-linear.Temperatures that associated with the lowest mortality for Changsha,Kunming,Guangzhou and Zhuhai were 22.0 ℃,20.0 ℃,26.0 ℃,and 25.5 ℃.The greatest cumulative RRs (95％CI) for CVD deaths of low temperature during the delayed period of the study in the 4 cities were 1.858 (1.089-3.170),1.537 (1.306-1.809),2.121 (1.771-2.540) and 1.934 (1.469-2.548),while 1.100 (0.816-1.483),1.061 (0.956-1.177),1.134 (1.047-1.230) and 1.259 (1.104-1.436) for high temperatures in Changsha,Kunming,Guangzhou and Zhuhai respectively.The hot effect was greater than the cold effect on the current days.The hot effect was restricted to the first week,whereas the cold effect increased over the lag days,and then last for 3-4 weeks.Conclusion The city-specific exposure-response functions appeared to be non-linear.Both high and cold temperatures were associated with increased CVD deaths,but the impact of low temperature was more notable.Cold effect was delayed by several days but last for a longer period than the hot effect did.

Prevalence regarding weight misperception and related influencing factors among residents in Guangdong province / 中华流行病学杂志

Objective To explore the prevalence of weight misperception and related influencing factors among adult residents in Guangdong province so as to provide information for prevention and control on weight misperception.Methods A multi-stage stratified random sampling method was used to select the sample.Forty-two streets/villages were selected from 21 counties/districts through randomly sampling.Four communities were then chosen from every selected town or district,followed by 40 families chosen from every village or community.Questionnaire was used to collect data on weight perception and its related risk factors.SPSS 16.0 was used for data analysis.Results There were 6625 respondents participating in the study.Out of them,50.2％ participants misperceived their weight status,among which 35.9％ of them underestimated while 14.3％overestimated their weights.Females aged 15-24 were more likely to overestimate weights than males in the same age group (38.6％ vs.18.5％),while males were more likely to underestimate weights than females (25.8％ vs.8.5％ ).The prevalence of underestimation on weights increased with the increase of age in both males and females but the prevalence of overestimation on weights decreased.Data from multivariate results from logistic analysis showed that rural residents,males,being elderly,residents with low education level,manual occupations (agriculture,forestry,animal husbandry and fishery),low family income and with anxiety were the major risk factors on underestimation of weight.However,factors as being urban residents,females,adolescents,minority and never having received weight measurement etc.were the major risk factors of overestimated on weight.Conclusion Misperceptions of weight status in Guangdong province exhibited a high prevalence with complicated influencing factors,calling for more psychological research to be carried out to prevent and reduce the misperceptions on weight status.

Application of different nutrition therapies in pregnancy with abnormal glucose metabolism / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the effect of different nutrition therapies on abnormal glucose metabolism during pregnancy and pregnancy outcomes.</p><p><b>METHODS</b>The 83 cases of pregnant women with abnormal glucose metabolism who came to nutrition clinic were randomly divided into two groups before 30 weeks pregnancy: 42 cases in traditional food exchange serving group (FES) and 41 cases in food exchange serving based on glycemic load group (FES + GL). Traditional food exchange serving and food exchange serving based on glycemic load were used as the different nutrition therapies for two groups respectively until the time of delivery. The influence of two nutrition therapies on the blood glucose and pregnancy outcomes were observed.</p><p><b>RESULTS</b>The daily food glucose load (GL) after nutrition therapy in the FES + GL group (145.9 ± 26.3) were significantly decreased than that of the FES group (179.9 ± 28.9, t = 5.602, P < 0.01). Fasting plasma glucose (FPG) and 2 h postprandial glucose (2 h PG) ((4.63 ± 0.97) and (6.15 ± 1.07) mmol/L, respectively) after nutrition therapy in the FES + GL group were significantly lower than that in pre-nutrition therapy ((4.96 ± 0.81) and (9.13 ± 1.61) mmol/L, t = 2.237, 11.202, respectively, all P values < 0.05). The 2 h PG in the FES + GL group ((6.15 ± 1.07) mmol/L) after nutrition therapy was significantly lower than that of the FES group ((6.86 ± 1.26) mmol/L, t = 2.760, P < 0.05). 19.51% (8/41) of the total incidence of complications in the FES + GL group was lower than that (11/42, 26.19%) in the FES group, but the difference was not significant (χ² = 0.524, P > 0.05).</p><p><b>CONCLUSION</b>FES based on GL was much easier to reduce blood glucose compared with FES. Two nutrition therapies can improve maternal and neonatal outcomes in pregnant women with abnormal glucose metabolism.</p>

Association between distorted weight perception and suicide ideation among normal weight adolescents / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the relationship between distorted weight perception and suicide ideation among normal weight adolescents in Guangdong province.</p><p><b>METHODS</b>This study used the data of Guangdong Provincial Youth Health Risk Behavior Survey in 2004 and 2007. To identify the association between distorted weight perception and suicide ideation, a logistic regression analysis was performed. The effects of age, economic status, mother's education, mental health, and depression were also adjusted.</p><p><b>RESULTS</b>A total of 12 729 people participated in this study, 6096 males and 6633 females. The prevalence of suicide ideation among normal weight adolescents was 13.58% (1729/12 729) in the past 12 months, with higher prevalence in girls (16.15%, 1071/6633) than that in boys (10.79%, 658/6096) (χ(2) = 77.71, P = 0.00). It was common that the adolescents misperceived their weight. Only 44.93% (5719/12 729) of normal weight students correctly perceived their body weight while 43.52% (5540/12 729) of them overestimated their weight and 11.43% (1455/12 729) underestimated their weight. The distorted weight perception in girls (65.58%, 4350/6633) was higher than that in boys (43.39%, 2645/6096) (χ(2) = 993.91, P = 0.00). Distorted weight perception was significantly associated with suicide ideation after controlling for factors age, economic status, mother's education, mental health, and depression. The students who overestimate their body weight were more likely to have suicide ideation than that who correctly perceived their weight (OR = 1.43, 95%CI: 1.27 - 1.61).</p><p><b>CONCLUSION</b>The prevalence of distorted weight perception was high and it significantly associated with suicide ideation.</p>

Association between temperature and daily mortality in Guangzhou, 2006-2009: a time-series study / 中华流行病学杂志

Objective To study the association between temperature and daily mortality from June 1, 2006 to December 31, 2009 in Guangzhou. Methods Time series approach was used to estimate the impact of temperature on the rates of total and cause-specific daily mortality. We fitted generalized additive Poisson regression using non-parametric smooth functions to control for the long-term time trend, day of week, air pollution and other weather variables. Results A slight sloping U-like relationship between the total mortality and temperature was found, with an optimum average temperature (temperature with lowest mortality risk) value of 19.7 ℃ in Guangzhou. For temperature above the optimum value, the relative risk of total mortality increased by 3.0% (RR=1.030,95%CI: 1.011-1.050) for each increase of degree in Celsius. For average temperature below the optimum value, the relative risk of total mortality and diseases of circulatory system had a 3.3%(RR=0.967,95%CI: 0.936-0.997 ) decrease and a 3.6% ( RR= 0.964,95%CI:0.935-0.994 ) increase,for each degree of Celsius increase, respectively. Conclusion Our findings showed that the temperature had an impact on the daily mortality in Guangzhou. Countermeasures needed to be taken to reduce the temperature related mortality.

N-terminal pro-B-type natriuretic peptide and diastolic function measurements by adenosine stress echocardiography in prediction of coronary stenosis in patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Stress echocardiography is mainly used in detection of coronary artery disease (CAD) and to assess risk. This study aimed to use adenosine stress echocardiography (ASE) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) to noninvasively assess coronary stenosis in patients with chest pain syndromes or anginal equivalent.</p><p><b>METHODS</b>NT-proBNP was measured after overnight fast in fifty patients, 42 males and 8 females, who were (57 ± 11) years old. They then underwent echocardiography before and during adenosine administration. Left ventricular (LV) diastolic function analyzed included mitral annular early (E') and late velocity (A') both at the mitral septal and lateral level and the mitral inflow to annulus ratio (E/E'). Coronary angiography was performed the following day after which patients were assigned to three groups: normal results (16 patients), stenosis 50% - 69% (17 patients) and stenosis ≥ 70% (17 patients).</p><p><b>RESULTS</b>NT-proBNP levels in the groups of stenosis 50% - 69% and ≥ 70% were significantly higher than that in the group with normal results (P = 0.014 and P = 0.040). During adenosine stress, the E/E' in the group of stenosis ≥ 70% was higher than in the group of normal results (P = 0.024). E'(lateral)/A'(lateral) in the group of stenosis 50% - 69% and E'(septal)/A'(septal) and E'(lateral)/A'(lateral) in the group of stenosis ≥ 70% were also decreased during stress compared with baseline (P = 0.003, P = 0.001, P = 0.022). The variation of E'(septal)/A'(septal) before and during adenosine stress (ΔE'(septal)/A'(septal)) between the groups of normal results and stenosis ≥ 70% were significantly different (P = 0.001). By receiver operating characteristic (ROC), the specificity of ΔE'(septal)/A'(septal) ≥ 0.037 predicting coronary stenosis < 70% was 94%. The sensitivity and specificity of NT-proBNP ≥ 544.6 fmol/ml in predicting coronary stenosis ≥ 70% were 93% and 75%, respectively. NT-proBNP inversely correlated with E'(lateral)/A'(lateral) (r = - 0.390, P = 0.014) and positively correlated with E/E'(lateral) (r = 0.550, P = 0.001).</p><p><b>CONCLUSIONS</b>Adenosine might induce diastolic dysfunction in patients with coronary stenosis more than 70% and NT-proBNP could reflect LV diastolic function to a certain extent. We support the prediction that most patients having chest pain syndromes or anginal equivalent with NT-proBNP < 544.6 fmol/ml and in ASE ΔE'(septal)/A'(septal) ≥ 0.037 might be spared coronary angiography.</p>

Features on suicide attempts and its influencing factors among residents in Guangdong province / 中华流行病学杂志

Objective To understand the prevalence of suicide attempts and its related risk factors in Guangdong province to provide scientific basis information for suicide intervention.Methods Multi-stage stratified random sampling method was used to select the sample.42 sweets or towns were selected from 21 counties or districts through randomly sampling.4 communities were then chosen from every selected town or district,followed by 40 families chosen from every village or community.Questionnaire was used to collect data on suicide attempts and its related risk factors.SPSS 16.0 was used for data analysis.Results 6625 peoples were participated in the study.The 12-month incidence of suicidal attempts was 0.8%.It was higher for females ( 1.1% ) than that for males(0.5%) ,and the 25-35 years(1.6%) age group was among the highest.There was no significant difference between the prevalence rates in urban or rural residents.Results from multivariate analysis showed that factors as:being female (OR=2.1),experienced negative events of life (OR= 15.5),in poor sleeping condition ( OR = 1.6),feeling lonely (OR=1.5 ) and anxiety (OR = 1.8 ) were high risk for suicide attempts.Conclusion Suicide attempts in Guangdong province exhibited a high prevalence with complicated influencing factors.Comprehensive countermeasures are needed to prevent and reduce suicidal behaviors.

Evaluation on the health education program regarding prevention of non-fatal drowning amongschool-aged children in Lianping county, Guangdong province / 中华流行病学杂志

Objective To evaluate the outcome of health education program on drowning prevention among primary and secondary school children in rural areas. Methods A township was selected and all the students from grade 3 to 5, grade 7 to 8, and grade 10 to 11 were selected to take part in the program. Twelve intervention measures on natural water safety and drowning prevention were carried out for one year. Information was collected using the same questionnaire before and after the intervention program. Results One year after the intervention was carried out, children's knowledge on drowning prevention improved significantly (13.21, 95% CI: 12.51-13.90) , and a positive effect was also noticed among boys (12.77, 95%CI: 11.77-13.77), girls (13.80, 95%CI: 12.82-14.78),and among primary school children (15.51,95%CI: 14.30-16.72), senior high school children (10.78,95%CI: 9.50-12.05) and junior high school children (12.77,95%CI: 11.84-13.71). Overall rates on risk behaviors dropped from 41.4% to 32.2% (by 22.2%) including 15.6% for boys, 35.2% for girls and 13.8%, 29.3%, 26.3% for primary school children, senior high school children, junior high school children, respectively. The incidence rates for non-fatal drowning decreased by 58.9% (from 5.6% to 2.3%). The person-times for treatment on sight, in emergency settings, in outpatient clinic or in the hospitals had a reduction from 399, 78, 36 to 175, 32, 14, respectively. Conclusion Health education program could improve children's perception on water safety, and reduce their risk behaviors as well as on the incidence of non-fatal drowning in the rural areas.