Effect of Age and Sex on Stroke Mortality of Young and Middle-aged Adults in China, 2002-2019, and Predictions to 2030 / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.@*METHODS@#Data were obtained from the China national vital registration system. Significant changes in mortality were assessed by Joinpoint regression. Age-period-cohort analysis was used to explain the reasons for the changes. Future mortality and counts were predicted by the Bayesian age-period-cohort model.@*RESULTS@#Between 2002 and 2019, a total of 6,253,951 stroke mortality in young and middle-aged adults were recorded. The age-adjusted mortality rates (AAMRs) of women showed a downward trend. The annual percent changes (APC) were -3.5% (-5.2%, -1.7%) for urban women and -2.8% (-3.7%, -1.9%) for rural women. By contrast, the AAMRs per 100,000 for rural men aged 25-44 years continued to rise from 9.40 to 15.46. The AAMRS for urban men aged 25-44 years and urban and rural men aged 45-64 years did not change significantly. Between 2020 and 2030, the projected stroke deaths are 1,423,584 in men and 401,712 in women.@*CONCLUSION@#Significant sex and age disparities in the trends of stroke mortality among young and middle-aged adults were identified in China. Targeted health policy measures are needed to address the burden of stroke in the young generation, especially for rural men, with a focus on the prevention and management of high risk factors.

Recent Trends in Physical Activity among Chinese Children Based on Their Demographic and Social Characteristics / 生物医学与环境科学（英文）

Aimed to explore the trends in physical activity among Chinese children, data of 4,341 children aged 6-17 years who participated in at least one round of "China Health and Nutrition Survey" from 2004 to 2015 were analyzed. Repeated measures mixed models were applied to test the trends in physical activity, which were further analyzed after applying stratification on gender, age, urbanization level, residential area and region. The volume of total physical activity in Chinese children aged 6-17 years showed a downward trend from 2004 to 2015, especially among children residing in medium and high urbanization communities, the south and urban areas of China, so that more efforts need to be put to promote their physical activity.

Association between Baseline SBP/DBP and All-Cause Mortality in Residents of Shanxi, China: A Population-based Cohort Study from 2002 to 2015 / 生物医学与环境科学（英文）

Objective@#To investigate the association between blood pressure and all-cause mortality in Shanxi, China.@*Methods@#The '2002 China Nutrition and Health Survey' baseline data in Shanxi province was used. A retrospective investigation was performed in 2015. The effects of SBP and DBP on the all-cause mortality were analyzed using the Cox regression model. The hazard ratio ( @*Results@#The follow-up rate was 76.52% over 13 years, while the cumulative mortality rate for all participants was 917.12/100,000 person-years. The mortality rose with an increasing SBP ( @*Conclusion@#Adults with SBP > 160 mmHg and DBP > 100 mmHg had a higher mortality risk. Sex and age difference was noted in both DBP and mortality risk.

National Nutrition and Health Systematic Survey for Children 0-17 Years of Age in China / 生物医学与环境科学（英文）

The main purpose of the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC) was to collect basic data on the nutrition, development, and health status for children in different regions across China using evidence-based, reliable, and cost-effective approaches. Children and their parents or guardians from seven regions (south, southwest, north, northwest, eastern, central, and northeast China) in China were recruited. A multi-stage stratified randomized sampling method was used. Two provinces were randomly sampled from each of the seven regions, from which one urban district and one rural country were also randomly sampled, resulting in a total of 28 survey counties/districts. Dietary surveys, health examinations, laboratory testing, and questionnaires were used to collect dietary intake, nutritional status, child development, and health status information. Nutrition, health, and lifestyle assessment of children and their parents was determined using the Knowledge Attitude Practice (KAP) survey. Greater than 100,000 children (38,000 children < 6 years of age and 66,000 children 6-17 years of age) completed the survey. The survey provided comprehensive data on child nutrition and health status for future studies and will serve as the basis for an integrated nutrition and health improvement strategies proposal for children in China.

The correlation of diffusional kurtosis imaging parameters with cognitive function and cytokine secretion in patients with Alzheimer's disease / 中国医师杂志

Objective To detect the diffusional kurtosis imaging (DKI) parameters of patients with Alzheimer's disease (AD),and evaluate the inner link of DKI parameters with cognitive function and serum nerve injury index.Methods 78 patients who were first diagnosed with AD in our hospital between December 2015 and January 2018 were enrolled in AD group,and 50 healthy volunteers who had physical examination in our hospital during the same period were enrolled in normal control group.The corpus callosum DKI parameters [mean kurtosis (MK),axial kurtosis (AK) and radial kurtosis (RK)] values,Mini-Mental State Examination (MMSE) score as well as serum nerve damage indexes [β amyloid 1-42 (Aβ1-422),S100B protein (S100B) and brain-derived neurotrophic factor (BDNF)] were compared between the two groups of subjects.Pearson test was used to evaluate the correlation of DKI parameters with MMSE score as well as serum nerve injury index in patients with AD.Results MK,AK and RK levels in AD group were lower than those in normal control group;MMSE score was lower than that of normal control group;serum Aβ1-42 and S100B contents were higher than those of normal control group while BDNF content was lower than that of normal control group (P ＜ 0.05).Correlation analysis revealed that the MK,AK and RK values in AD patients were directly correlated with the MMSE score as well as Aβ1-42,S100B and BDNF levels (P ＜ 0.05).Conclusions The corpus callosum DKI parameter levels decrease in AD patients,and the specific levels are closely related to the severity of cognitive function and nerve injury,which may be one of the effective methods for early assessment of AD condition.

Abdominal Obesity and Its Attribution to All-cause Mortality in the General Population with 14 Years Follow-up: Findings from Shanxi Cohort in China / 生物医学与环境科学（英文）

Objective@#This study aimed to assess the association of waist circumference (WC) with all-cause mortality among Chinese adults.@*Methods@#The baseline data were from Shanxi Province of 2002 China Nutrition and Health Survey. The death investigation and follow-up visit were conducted from December 2015 to March 2016. The visits covered up to 5,360 of 7,007 participants, representing a response rate of 76.5%. The Cox regression model and floating absolute risk were used to estimate hazard ratio and 95% floating of death by gender and age groups (≥ 60 and < 60 years old). Sensitivity analysis was performed by excluding current smokers; participants with stroke, hypertension, and diabetes; participants who accidentally died; and participants who died during the first 2 years of follow-up.@*Results@#This study followed 67,129 person-years for 12.5 years on average, including 615 deaths. The mortality density was 916 per 100,000 person-years. Low WC was associated with all-cause mortality among men. Multifactor-adjusted hazard ratios ( ) were 1.60 (1.35-1.90) for WC < 75.0 cm and 1.40 (1.11-1.76) for WC ranging from 75.0 cm to 79.9 cm. Low WC (< 70.0 cm and 70.0-74.9 cm) and high WC (≥ 95.0 cm) groups had a high risk of mortality among women. The adjusted s of death were 1.43 (1.11-1.83), 1.39 (1.05-1.84), and 1.91 (1.13-3.22).@*Conclusion@#WC was an important predictor of death independent of body mass index (BMI). WC should be used as a simple rapid screening and predictive indicator of the risk of death.

The correlation of diffusional kurtosis imaging parameters with cognitive function and cytokine secretion in patients with Alzheimer's disease / 中国医师杂志

Objective@#To detect the diffusional kurtosis imaging (DKI) parameters of patients with Alzheimer's disease (AD), and evaluate the inner link of DKI parameters with cognitive function and serum nerve injury index.@*Methods@#78 patients who were first diagnosed with AD in our hospital between December 2015 and January 2018 were enrolled in AD group, and 50 healthy volunteers who had physical examination in our hospital during the same period were enrolled in normal control group. The corpus callosum DKI parameters [mean kurtosis (MK), axial kurtosis (AK) and radial kurtosis (RK)] values, Mini-Mental State Examination (MMSE) score as well as serum nerve damage indexes [β amyloid 1-42 (Aβ1-422), S100B protein (S100B) and brain-derived neurotrophic factor (BDNF)] were compared between the two groups of subjects. Pearson test was used to evaluate the correlation of DKI parameters with MMSE score as well as serum nerve injury index in patients with AD.@*Results@#MK, AK and RK levels in AD group were lower than those in normal control group; MMSE score was lower than that of normal control group; serum Aβ1-42 and S100B contents were higher than those of normal control group while BDNF content was lower than that of normal control group (P<0.05). Correlation analysis revealed that the MK, AK and RK values in AD patients were directly correlated with the MMSE score as well as Aβ1-42, S100B and BDNF levels (P<0.05).@*Conclusions@#The corpus callosum DKI parameter levels decrease in AD patients, and the specific levels are closely related to the severity of cognitive function and nerve injury, which may be one of the effective methods for early assessment of AD condition.

The changing trend of capacity on policy implementation related to the prevention and control of chronic non-communicable disease at the provincial level, from 2011 to 2017 / 中华流行病学杂志

Objective@#To assess the follow-up situstion and changes of policies related to the prevention and control on chronic non-communicable diseases (NCDs), in various provinces from 2011 to 2017.@*Methods@#Three national assessment programs on the prevention and control capacity of NCDs were carried out from September 2012 to March 2013, September 2014 to March 2015, and July to November 2018 respectively. Data related to the capacity on policy implementation among the 31 provinces, autonomous regions, municipality directly under the central government and Xinjiang Production and Construction Corps, were collected through online surveys.@*Results@#The rate of data collection in all the provinces reached 100%, for all three surveys. In 2011, 2013, and 2017, the capacity for policy development special funding was distributed for prevention and control NCDs under the provincial fiscal revenue by 27 provinces (84.4%), 26 provinces (81.3%) and 25 provinces (78.1%), and the numbers of provincial governments leaders attended the local activities related to prevention and control NCDs was 15 (46.9%), 13 (40.6%) and 19(59.4%), respectively. From 2009 to 2011, 14 (43.8%) proposals related to the topics on prevention and control of NCDs, were raised at the provincial People’s Congress and Political Consultative Conference, while from 2011 to 2013 and2014 to 2017, 13 (40.6%) and 12 (37.5%) were respectively raised. In terms of capacity for policy development, numbers of provincial comprehensive plan which targeting prevention and control of NCDs reached 6 (18.8%), 20 (62.5%) and 27 (84.4%) in 2011, 2013, and 2017 respectively. In 2011, 2013 and 2017, numbers of provincial special plans that targeting on NCDs or the risk factors of NCDs prevention and control were 0, 1, and 3, respectively.@*Conclusions@#Under the continuous introduction of international and national policies related to prevention and control on NCDs, capacity for policy formulation in various provinces has been greatly improved. However, a slight progress has been made in the capacity for policy making. The increase of capacity building on policy making regarding prevention and control of NCDs, at the provincial government level, has become a key issue.

Blood pressure changes in 18-59 years old adults in rural area of Shanxi province, China / 中华流行病学杂志

Objective@#To analyze the blood pressure changes of adults aged 18-59 years in rural area of Shanxi province based on a cohort study, and provide reference for the study of the blood pressure level of rural residents and hypertension prevention and control in rural areas in China.@*Methods@#Data were obtained from Shanxi Nutrition and Chronic Disease Family Cohort from 2002 to 2015. Subjects aged <18 years or ≥60 years and individuals with hypertension at baseline survey in 2002, and those who had taken antihypertensive drugs for nearly two weeks during the follow-up survey in 2015 were excluded from the study. A total of 1 629 subjects aged 18-59 years were included in the analyses of the blood pressure level and its change from the baseline survey in 2002 to follow-up survey in 2015.@*Results@#The systolic blood pressure (SBP) of the subjects increased from (122.7±10.4) mmHg in 2002 to (132.8±17.6) mmHg in 2015 and the diastolic pressure (DBP) increased from (72.7±6.9) mmHg in 2002 to (78.8±10.3) mmHg in 2015. The SBP in men and women increased with growth rates of 6.7% and 9.5%. While DBP in men and women increased with growth rates of 9.3% and 7.8%. The SBP levels of those aged 18-, 30-, 40- and 50-59 years increased with growth rates of 5.0%, 6.7%, 9.4% and 11.8%. While the DBP of these age groups increased with growth rates of 12.2%, 8.2%, 8.2% and 6.5%.@*Conclusions@#The blood pressure of adults aged 18-59 years old in rural area of Shanxi showed a substantially increasing trend. The mean increase level of SBP in women was higher than that in men, and increased with age. While the mean increase level of DBP in men is higher than that in women, and decreased with age.

Follow-up analysis on change of serum total cholesterol concentration in rural residents in Shanxi province / 中华流行病学杂志

Objective@#To analyze the longitudinal change of serum total cholesterol concentration in 733 rural residents in Shanxi province.@*Methods@#Based on the residents of five rural areas in Shanxi province who participated in China nutrition and health survey in 2002, a follow-up survey was conducted in 2015. Fasting venous blood of the participants was collected and serum TC concentration was tested by cholesterol oxidase method.@*Results@#Of 733 participants, 332 were male and 401 were female. In 2002 baseline survey, the age of the participants was (42.6±9.5) years old, 76.2% of male and 83.8% of female had junior middle school education or below. Proportion of smoking were 65.7% and 1.2%, drinking were 26.8% and 4.0%, obesity were 6.3% and 12.0%, and central obesity were 27.1% and 31.9%, respectively in male and female. The follow-up age of participants in 2015 was (55.8±9.5) years old, proportion of smoking changed to 48.2% and 1.5%, drinking were 49.7% and 3.0%, obesity increased to 11.8% and 18.2% and central obesity increased to 41.6% and 53.6%, respectively in male and female. The overall serum TC level increased from (3.82±0.89) mmol/L to (4.72±0.97) mmol/L with an average increase of 27.2%, which increased from (3.84±0.94) mmol/L to (4.54±0.93) mmol/L in male with an average increase of 22.7%, and increased from (3.81±0.84) mmol/L to (4.86±0.98) mmol/L in female with an average increase of 30.9%. The serum TC levels in 18-, 30-, 40-, and 50-59 years old group increased from (3.42±0.83), (3.72±0.77), (3.90±0.83) and (4.00±1.03) mmol/L to (4.38±1.01), (4.79±0.92), (4.73±0.99) and (4.76±0.96) mmol/L, with average increase range of 31.4%, 32.1%, 25.2% and 22.6%, respectively. The mean serum TC levels between two years all had statistically significant difference among groups of gender, age, education, marital status, family history of cardiovascular disease, smoking, drinking, BMI and waist circumference after paired t-test and ANOVA analysis (P<0.01).@*Conclusion@#The longitudinal serum TC level of rural residents in Shanxi province increased rapidly.

Body mass index and related attribution to all-cause mortality in adults of Family Cohort of Nutrition and Chronic Diseases in Shanxi province / 中华流行病学杂志

Objective@#To assess the relationship between body mass index (BMI) and mortality in adults of Shanxi, China.@*Methods@#Baseline data were from the '2002 China Nutrition and Health Survey’ in Shanxi province. All the death-related investigation and follow-up visits were carried out from December 2015 to March 2016. The follow-up program covered 5 360 people from all the 7 007 participants aged 18 years and over that having complete core information, with a rate as 76.5%. Participants of this study were divided into eight groups, according to the appearance of BMI. Taking the group with the lowest mortality density as the reference group, Cox regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of deaths by the whole population, gender and age groups (≥60 years, <60 years). Results were then adjusted by age, gender, smoking, alcohol use and education level from the baseline survey. Sensitivity analysis was also conducted.@*Results@#Results from the study showed that among the total number of 67 129 person- years from the average period of 12.5 years, there were 615 deaths occurred, with the mortality density as 916 per 100 000 person-years. Taking the BMI range of 26.0-27.9 kg/m2 as the reference, the aHRs of death increased to 1.90 (95%CI: 1.26-2.86), 1.68 (95%CI: 1.15-2.45), 1.49 (95%CI: 1.08-2.06) and 1.72 (95%CI: 1.07-2.76) after the multivariate adjustment, in these four groups (BMI<18.5, 18.5-19.9, 22.0-23.9 and ≥30.0 kg/m2), respectively. Low body weight (BMI<18.5 kg/m2) was associated with higher risks of death in the elderly of ≥60 years, with the aHR of death as 1.94 (95%CI: 1.20-3.15).@*Conclusions@#When BMI appeared as ≤19.9 kg/m2, 22.0-23.9 kg/m2 and ≥30.0 kg/m2, the risks of death would increase. In addition to programs that focusing on obesity, special attention should be paid to the high risk of mortality which was caused by low-weight and malnutrition in the elderly.

A cohort study on the association between dietary patterns which benefit for normal kidney function and the cognitive performance in the Chinese elderly / 中华流行病学杂志

Objective@#To explore the association between dietary pattern which benefit for normal kidney function and the risk of cognitive decline or impairment in the elderly.@*Methods@#In 2015, subjects aged 60 and over from four counties in the Nutrition and Chronic Disease Family Cohort project, were followed up in 2017. Cognitive function was repeatedly assessed, using the Mini Mental State Evaluation (MMSE) scale. Dietary pattern that benefit for normal kidney function was extracted, using the reduced rank regression method and followed by logistic regression models to explore the associations between scores that showing the kidney function on dietary patterns and the risk of cognitive deterioration and impairment in two years among those who were with normal cognition in 2015.@*Results@#Dietary pattern that benefit for normal kidney function, was characterized by high consumption of cereal, vegetables, legume and fruits but with less meat and soy products. Comparing with the group with lowest score quartile on this dietary pattern, the risk of cognitive deterioration in the highest quartile group was significantly low (P<0.01) in two years, with an odds ratio as 0.57 (95%CI: 0.37-0.85). Linear trend was also obviously visible (P=0.007) in this group. The ones at the highest quartile group among the normal cognition ones in 2015, the risk of cognitive impairment also significantly reduced (P<0.05) in two years time, with an odds ratio as 0.52 (95%CI: 0.29-0.93). Also, linear trend could obviously be seen (P=0.01).@*Conclusion@#Dietary pattern that benefit for normal kidney function was both inversely associated with cognitive deterioration and impairment, in two years.

A systematic review of evaluation studies on physical activity questionnaires for children and adolescents / 中华预防医学杂志

Objective@#To systematically review the structure and content of physical activity questionnaires for children and adolescents and assess the overall validity and reliability of the existing international questionnaires in the last 10 years.@*Methods@#Search terms, including"Physical Activity" AND "Questionnaire" OR "Self-report" OR "Recall" AND "Child*" OR "Adolescen*" OR "Youth" AND 'Valid*’ OR "Reliab*" OR "Reproducib*" OR "Sensitiv*" OR "Responsiv*", were searched for evaluation studies on physical activity questionnaires for children and adolescents in PubMed/Medline and EMBASE database from January 2008 to December 2018. The quality of eligible literature was assessed by using the consensus-based standards for the selection of health status measurement instruments (COSMIN).@*Results@#A total of 37 articles containing 36 physical activity questionnaires in 7 989 participants were included. There were 68 studies on the assessment of the validity and reliability of assorted physical activity questionnaires, 45 studies for validity and 23 for reliability. The median Spearman correlation coefficients in validity studies were 0.28 for moderate-to-vigorous intensity physical activity, 0.15 for moderate-intensity physical activity, 0.27 for vigorous-intensity physical activity and 0.31 for physical activity energy expenditure. The median reliability correlation coefficients were 0.32 for sedentary behaviors, 0.53 for light-intensity physical activity, 0.80 for moderate-to-vigorous intensity physical activity, 0.54 for moderate-intensity physical activity and 0.69 for vigorous-intensity physical activity.@*Conclusion@#The reliability of physical activity questionnaires measured moderate-to-vigorous intensity physical activity for children and adolescents is acceptable, but the validity is low.

Childhood BMI and Adult Obesity in a Chinese Sample: A 13-Year Follow-up Study / 生物医学与环境科学（英文）

OBJECTIVE@#Obesity is recognized as a significant risk factor for diabetes and hypertension. The present study aimed to examine the associations between adults'obesity risk and childhood and parental obesity.@*METHODS@#A total of 204 children aged 6-17 years were recruited in 2002 with an average follow-up period of 13.2 years. Height and body weight were measured by trained staffs. Overweight and obesity were defined based on the Chinese standard for children and adults. T-test, analysis of variance, and Chi-square analysis were used for single factor analysis. Multiple linear and logistic regression analyses were used to perform multifactor analysis.@*RESULTS@#The percentage of non-obese children who grew up to be non-obese adults was 62.6%, and that of obese children who grew up to be obese adults was 80.0%. There was a significant association between childhood body mass index (BMI) and adulthood BMI with a β regression coefficient of 3.76 [95% confidence interval (CI): 1.36-6.16], and between childhood obesity and adulthood obesity with an odds ratio of 5.76 (95% CI: 1.37-24.34). There was no statistical difference between parental obesity at baseline and children's adulthood obesity, after adjustment of confounders. Male participants and those aged 10.0-13.0 years had a higher risk of adulthood obesity with odds ratios of 2.50 (95% CI: 1.12-5.26) and 3.62 (95% CI: 1.17-11.24), respectively.@*CONCLUSION@#Childhood obesity is an important predictor of adulthood obesity.

Validity and Reliability of Chinese Physical Activity Questionnaire for Children Aged 10-17 Years / 生物医学与环境科学（英文）

OBJECTIVE@#This study is aimed to report the development, the reliability and validity of the Chinese Children Physical Activity Questionnaire (CCPAQ) which was designed for the assessment of physical activity pattern in young population in China.@*METHODS@#The CCPAQ was administered for two times in 119 children (mean age 13.1 ± 2.4 years; boys 47%) to examine reliability by using intraclass correlation coefficients. Validity was determined in 106 participants by agreement with the CCPAQ measures and the objective method, the ActiGraph accelerometer. Data on physical activity pattern including time spent on different intensities and total physical activity, sedentary behavior as well as physical activity energy expenditure were used to assess the validity with Spearman's correlation coefficient and the Bland-Altman plots.@*RESULTS@#The reliability coefficient of the CCPAQ ranged from 0.63-0.93 (Intra-class correlation coefficient). Spearman's correlation coefficient for validity of time spent on total physical activity and sedentary behavior were all 0.32 (P < 0.001), and for physical activity energy expenditure was 0.58 (P < 0.001). Time spent on moderate-to-vigorous physical activity and light physical activity showed a relatively low correlation with the accelerometer (rho = 0.20, P = 0.040; rho = 0.19, P = 0.054).@*CONCLUSION@#The CCPAQ appears to be a promising and feasible method to assess physical activity pattern in Chinese children.

Assessment on the capacity for prevention and control programs for chronic non-communicable diseases in China, in 2014 / 中华流行病学杂志

Objective To assess the capacity of prevention and control on chronic non-communicable diseases (NCDs) in China.Methods On-line questionnaire survey was adopted by 3 395 CDCs at provincial,municipal and county (district) levels and 3 000 primary health care units,and assess on capacity of policy,infrastructure,capacity of training and guidance,cooperation,surveillance,intervention and management,assessment and scientific research from September 2014 to March 2015.Results (1) Capacity of policy:23 (71.9％) provincial,139 (40.6％) municipal and 919 (31.2％) county (district) governments or health administrative departments had existing plans for prevention and control of NCDs.(2) Capacity of infrastructure:25 (78.1％) provincial,136 (39.8％)municipal and 529 (18.0％) county (district) CDCs had set up departments dedicated to the prevention and control of NCDs,with 9 787 staff members,accounting for 5.0％ of the total CDC personnel,working on NCDs prevention and control programs.68.1％ of the CDCs had special funding set for NCDs prevention and control.(3) Capacity of training and guidance:2 485 CDCs (74.9％) held all kinds of training on prevention and control ofNCDs.2 571 (87.3％) CDCs at the county (district) level provided technical guidance for primary health care units.(4) Capacity of cooperation:42.0％ of the CDCs had experiences collaborating with the mass media.(5) Capacity of surveillance:73.8％ of the CDCs had set up programs for death registration while less than 50.0％ of the CDCs had implemented surveillance programs on major NCDs and related risk factors.In terms of primary health care units,32.4％ of them had set up reporting system for newly developed stroke case and 29.9％ of them having programs on myocardial infarction case reporting.(6) Capacity of intervention and management:69.1％ and 68.2％ of the CDCs conducted individualized intervention programs on hypertension and diabetes,while less than 40.0％ CDCs conducting intervention programs on other NCDs and risk factors.More than 90.0％ of the primary health care units carried out follow-up surveys on hypertension and diabetes.However,only 17.4％ and 13.7％ of the CDCs working on hypertension and diabetes patient management programs while 83.7％ and 80.4％,of them following the standardized guidelines for management,with successful rates of control as 59.2％ and 55.2％,respectively.(7) Capacity of assessment:32.4％ of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs.(8) Capacity of scientific research:the capacity on scientific research among provincial CDCs was apparently higher than that at the municipal or county (district) CDCs.Conclusions Compared with the results of previous two surveys,the capacity on policies set for the prevention and control programs improved continuously,at all level NCDs,but remained relatively weak,especially at both county (district) and primary health care units.

Assessment on the capacity for prevention and control programs for chronic non-communicable diseases in China, in 2014 / 中华流行病学杂志

Objective To assess the capacity of prevention and control on chronic non-communicable diseases (NCDs) in China.Methods On-line questionnaire survey was adopted by 3 395 CDCs at provincial,municipal and county (district) levels and 3 000 primary health care units,and assess on capacity of policy,infrastructure,capacity of training and guidance,cooperation,surveillance,intervention and management,assessment and scientific research from September 2014 to March 2015.Results (1) Capacity of policy:23 (71.9％) provincial,139 (40.6％) municipal and 919 (31.2％) county (district) governments or health administrative departments had existing plans for prevention and control of NCDs.(2) Capacity of infrastructure:25 (78.1％) provincial,136 (39.8％)municipal and 529 (18.0％) county (district) CDCs had set up departments dedicated to the prevention and control of NCDs,with 9 787 staff members,accounting for 5.0％ of the total CDC personnel,working on NCDs prevention and control programs.68.1％ of the CDCs had special funding set for NCDs prevention and control.(3) Capacity of training and guidance:2 485 CDCs (74.9％) held all kinds of training on prevention and control ofNCDs.2 571 (87.3％) CDCs at the county (district) level provided technical guidance for primary health care units.(4) Capacity of cooperation:42.0％ of the CDCs had experiences collaborating with the mass media.(5) Capacity of surveillance:73.8％ of the CDCs had set up programs for death registration while less than 50.0％ of the CDCs had implemented surveillance programs on major NCDs and related risk factors.In terms of primary health care units,32.4％ of them had set up reporting system for newly developed stroke case and 29.9％ of them having programs on myocardial infarction case reporting.(6) Capacity of intervention and management:69.1％ and 68.2％ of the CDCs conducted individualized intervention programs on hypertension and diabetes,while less than 40.0％ CDCs conducting intervention programs on other NCDs and risk factors.More than 90.0％ of the primary health care units carried out follow-up surveys on hypertension and diabetes.However,only 17.4％ and 13.7％ of the CDCs working on hypertension and diabetes patient management programs while 83.7％ and 80.4％,of them following the standardized guidelines for management,with successful rates of control as 59.2％ and 55.2％,respectively.(7) Capacity of assessment:32.4％ of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs.(8) Capacity of scientific research:the capacity on scientific research among provincial CDCs was apparently higher than that at the municipal or county (district) CDCs.Conclusions Compared with the results of previous two surveys,the capacity on policies set for the prevention and control programs improved continuously,at all level NCDs,but remained relatively weak,especially at both county (district) and primary health care units.

The correlation of whole brain apparent diffusion coefficient with neurological impairment, Hcy metabolism and oxygen free radical generation in patients with Alzheimer's Disease / 中国医师杂志

Objective To study the correlation of whole brain apparent diffusion coefficient (ADC) with neurological impairment,homocysteine (Hcy) metabolism and oxygen free radical generation in patients with Alzheimer's disease (AD).Methods The patients diagnosed as AD in Xuanwu Hospital of Capital Medical University from March 2014 to December 2017 were selected as AD group and healthy persons as control group.The ADC of whole brain was calculated after magnetic resonance scanning.The degree of neurological impairment was evaluated by Montreal Cognitive Function Assessment Scale (MoCA).The levels of Hcy metabolic index and oxygen free radical production were measured after collecting serum.Results ADC values of AD group in parietal lobe,frontal lobe,temporal lobe and occipital lobe were not significantly different from those of control group (P ＞ 0.05).The ADC value of hippocampus as well as serum Hcy,malondialdehyde (MDA) and nitric oxide (NO) contents were significantly higher than those of control group,while MoCA score as well as folic acid (FA),vitamin B12 (VitB12),superoxide dismutase (SOD) and glutathione peroxidase (GSH) contents in serum were significantly lower than those of control group (P ＜ 0.05);ADC value of hippocampus in AD patients was negatively correlated with MoCA score as well as serum FA,VitB12,SOD and GSH contents,and positively correlated with serum Hcy,MDA and NO contents.Conclusions The increased ADC value of hippocampus in AD patients was related to the cognitive function injury,Hcy metabolism disorder and excessive generation of oxygen free radicals.

Practice and exploration of a standardized training program for general practitioner assistant (3 +2mode) in Shanghai Jiading District / 中华全科医师杂志

A"3+2"standardized training program of assistant general practitioner was launched in Shanghai Jiading District in 2012 in order to train new medical talent in suburb area.The program was developed through the jointed efforts among the government,medical school and train bases.The model was designed as training assistant general practitioners with distinctive sequential education process in different levels and stages.After five years of practice,the"3+2"standardized training program of assistant general practitioner has accomplished its goal,which provides a reference for training assistant general practitioners in Shanghai Municipality.

Effect of influenza and 23-valent pneumococcal polysaccharide vaccinations on elderly with chronic obstructive pulmonary diseases: a community-based intervention study / 中华流行病学杂志

Objective To explore the effect of influenza and 23 valent pneumococcal polysaccharide pneumococcal vaccinations on symptom-improvement among elderly with chronic obstructive pulmonary diseases (COPD).Methods Data was gathered from 4 communities in 3 National Demonstration Areas set for comprehensive prevention and control of chronic non-communicable diseases in Chongqing city and Ningbo city respectively,from November 2013 to October 2014.The communities were selected by cluster sampling and divided into 4 groups:(1) injected influenza vaccines;(2) injected with pneumococcal vaccines;(3) received both of the two vaccines;(4) the control group that without any intervention measures.All the subjects aged from 60 to 75 were selected to fill in demographic information questionnaire and receive (COPD assessment test,CAT) scores twice,before intervention and 1 year after the vaccination.SAS 9.4 software was used to analyze the change of symptoms and CAT scores before and after the intervention program and comparing the improvement on symptoms among the elderly people under study.Results A total of 1 244 subjects with nearly same baseline conditions after the propensity score matching,were involved in this study.CAT scores appeared as Median=21 (IQR:17-26) at baseline.The CAT scores appeared as Median=18 (IQR:14-24),decreasing in all the 3 vaccinated groups,one year after the intervention program (influenza vaccines,matching t test,t=-6.531,P=0.403;pneumococcal vaccines,Wilcoxon test,H=-9 623,P＜0.001;combined vaccine vaccines,matching t test,t=-10.803,P＜0.001).However,in the control group,no obvious change was observed (Wilcoxon H=1 167,P=0.403).Proportions of impacts at high or very high levels all decreased in the 3 intervention groups,while little change was observed in the control group.Outcomes from the Factorial analysis suggested that influenza vaccination could improve the general conditions and symptoms including cough,chest tightness,dyspnea,physical activities,and stamina.Pneumococcal vaccination appeared more effective on all of symptoms and indicators.Conclusion Pneumococcal and influenza vaccination seemed helpful for elderly people suffering COPD to improve the general health condition.