Analysis of the contradiction between the supply and demand of Chinese graduate students′ emergency professional ability in public health and preventive medicine in China / 中华预防医学杂志

In order to underst and the status of health emergency personnel training development and raising coping measures, electronic questionnaire surveys were conducted among 22 colleges and universities in different region of China. The result showed that colleges universities in China invested less in the training of emergency personnel. It is different and emphasized particularly for the cultivation of emergency professional ability among different types of public health students. Universities and employer hold relative evaluation of students′ emergency professional ability with distinct regional differences.

Study on the current status of postgraduates training in public health and preventive medicine in China in 2016 / 中华预防医学杂志

To investigate the current status of postgraduates training in public health and preventive medicine in China. In this study, a questionnaire survey was conducted among directors of enrollment and teaching in 22 universities with postgraduate admission qualifications in corresponding disciplines nationwide. In 2016, full-time postgraduates were mainly academic masters. In addition to the graduate entrance examination, the common enrollment mode in colleges was to enroll a high qualified student with recommendations from relevant experts or institutions and an exemption from entrance examination (20/22). The emphasis on training contents between academic and public health master was different. Currently, the scale of public health postgraduate enrollment in public health and preventive medicine in China is stable, and the training program is reasonable, but there is an issue of monotonous model and uneven distribution of enrollment.

Investigation on the current status of the cultivation of the master of public health (MPH) in colleges in China / 中华预防医学杂志

In order to understand the status of the cultivation of the masters of public health (MPH) in colleges in China and improve the cultivation model, an electronic questionnaire survey were conducted among 22 schools of public health in colleges. The result showed that the size and the enrolment scale of Chinese MPH students were relatively small, and the training objectives were still unclear. There was no obvious difference between the curriculum setting for MPH and academic master degree. The practical skill-oriented courses and emergency response ability of public health practice were insufficient. The cultivation model of MPH should be improved in future.

A Meta-analysis on the relations between short-term exposure to PM2.5 and both mortality and related emergency visits in China / 中华流行病学杂志

Objective To carry out a quantitative estimate that related to the effects of shortterm exposure to PM2.5 on all-cause mortality and emergency visits in China by using the systematic review and Meta-analysis.Methods We selected all the studies published before March 2018 from China National Knowledge Infrastructure,Wanfang database,PubMed and EMBASE and data on relative risk (RR),excess risk (ER) and their 95％CIs:appeared in these papers were extracted.According to the differences in the size or direction (heterogeneity) of the results,we computed summary estimates of the effect values using a random-effect or fixed effect model.We also conducted the subgroup analysis and Meta-analysis to have assessed the selected studies for the evidence of study bias.Results A total of 33 original studies,indexed in databases,were identified.Among those studies,39 sets of data on mortality and 4 sets of data on emergency were valid to show that within the daily concentration range from 47.7 to 176.7 pg/m3,for 10 μg/m3 increases in PM2.5 concentrations,it would increase the daily numbers of deaths by 0.49％ (95％CI:0.39％-0.59％) and 0.30％ (95％CI:0.10％-0.51％) for all-cause deaths and all-cause emergency-room visits,respectively.For subgroup analysis,the combined effect of PM2.5 in causing short-term all-cause deaths in the northern areas (ER=0.42％,95％CI:0.30％-0.54％) seemed lower than that in the southern areas (ER=0.63％,95％CI:0.44％-0.82％).The combined effect of PM2.5 concentration below 75 μg/m3 (ER=0.50％,95％CI:0.37％-0.62％) was higher than that of PM25 concentration ≥75 μ g/m3 (ER=0.39％,95％ CI:0.26％-0.52％).Conclusion Within the concentration range from 47.7 to 176.7 μg/m3,short-term exposure to current level of PM2.5 might increase both the all-cause daily mortality and daily emergency visits in China.

Prevalence of diabetes in Chinese adults: a Meta-analysis / 中华流行病学杂志

Objective To evaluate the prevalence and trend of diabetes mellitus among Chinese adults during the past thirty years.Methods Papers,published before October 1,2017 and related to the prevalence of diabetes mellitus among Chinese adults,were searched through PubMed,China Knowledge Resource Integrated Database,Wanfang Digital Database and VIP Citation Databases.Stata 13.0 software was used to estimate the prevalence of diabetes mellitus,with pooled prevalence calculated based on random effects.Subgroup analysis was conducted based on time,sex,areas and body mass index groups of investigation.Continuous fractional polynomial regression model on the midpoint of each survey period,weighted by the number of participants in each study,was used to estimate and illustrate the trends of prevalence of diabetes over the years.Results In total,15 studies were included and two of them were excluded in the primary analysis with the age limitation of participants as ≥40 years old,for recruitment.The average prevalence of diabetes among Chinese adults was 6.3％ (95％CI:4.6％-8.0％),during the past thirty years.The pooled prevalence appeared higher in urban than in rural areas and higher in men than in women.Between 1980 and 2013,the increase of Chinese diabetes prevalence did not follow the linear trend.Before 2000,the average prevalence showed as 3.5％ (95％CI:2.0％-4.9％),with an annual increase rate as 0.17％.Since 2000,the average annual prevalence of diabetes mellitus had appeared around 8.0％ (95％CI:6.0％-10.1％),with an annual growth rate of 0.72％ (95％CI:0.34％-1.10％).Conclusion The prevalence of diabetes in Chinese adults had been rapidly increasing since the year 2000,indicating that efforts should be strengthened for diabetes prevention,in China.

Progress in research of family-based cohort study on common chronic non-communicable diseases in rural population in northern China / 中华流行病学杂志

Family-based cohort study is a special type of study design,in which biological samples and environmental exposure information of the member in a family are collected and related follow up is conducted.Family-based cohort study can be applied to explore the effect of genetic factors,environmental factors,gene-gene interaction,and gene-environment interaction in the etiology of complex diseases.This paper summarizes the objectives,methods and results,as well as the opportunities and challenges of the family-based cohort study on common chronic non-communicable diseases in rural population in northern China.

A Meta-analysis on the relations between short-term exposure to PM2.5 and both mortality and related emergency visits in China / 中华流行病学杂志

Objective To carry out a quantitative estimate that related to the effects of shortterm exposure to PM2.5 on all-cause mortality and emergency visits in China by using the systematic review and Meta-analysis.Methods We selected all the studies published before March 2018 from China National Knowledge Infrastructure,Wanfang database,PubMed and EMBASE and data on relative risk (RR),excess risk (ER) and their 95％CIs:appeared in these papers were extracted.According to the differences in the size or direction (heterogeneity) of the results,we computed summary estimates of the effect values using a random-effect or fixed effect model.We also conducted the subgroup analysis and Meta-analysis to have assessed the selected studies for the evidence of study bias.Results A total of 33 original studies,indexed in databases,were identified.Among those studies,39 sets of data on mortality and 4 sets of data on emergency were valid to show that within the daily concentration range from 47.7 to 176.7 pg/m3,for 10 μg/m3 increases in PM2.5 concentrations,it would increase the daily numbers of deaths by 0.49％ (95％CI:0.39％-0.59％) and 0.30％ (95％CI:0.10％-0.51％) for all-cause deaths and all-cause emergency-room visits,respectively.For subgroup analysis,the combined effect of PM2.5 in causing short-term all-cause deaths in the northern areas (ER=0.42％,95％CI:0.30％-0.54％) seemed lower than that in the southern areas (ER=0.63％,95％CI:0.44％-0.82％).The combined effect of PM2.5 concentration below 75 μg/m3 (ER=0.50％,95％CI:0.37％-0.62％) was higher than that of PM25 concentration ≥75 μ g/m3 (ER=0.39％,95％ CI:0.26％-0.52％).Conclusion Within the concentration range from 47.7 to 176.7 μg/m3,short-term exposure to current level of PM2.5 might increase both the all-cause daily mortality and daily emergency visits in China.

Prevalence of diabetes in Chinese adults: a Meta-analysis / 中华流行病学杂志

Objective To evaluate the prevalence and trend of diabetes mellitus among Chinese adults during the past thirty years.Methods Papers,published before October 1,2017 and related to the prevalence of diabetes mellitus among Chinese adults,were searched through PubMed,China Knowledge Resource Integrated Database,Wanfang Digital Database and VIP Citation Databases.Stata 13.0 software was used to estimate the prevalence of diabetes mellitus,with pooled prevalence calculated based on random effects.Subgroup analysis was conducted based on time,sex,areas and body mass index groups of investigation.Continuous fractional polynomial regression model on the midpoint of each survey period,weighted by the number of participants in each study,was used to estimate and illustrate the trends of prevalence of diabetes over the years.Results In total,15 studies were included and two of them were excluded in the primary analysis with the age limitation of participants as ≥40 years old,for recruitment.The average prevalence of diabetes among Chinese adults was 6.3％ (95％CI:4.6％-8.0％),during the past thirty years.The pooled prevalence appeared higher in urban than in rural areas and higher in men than in women.Between 1980 and 2013,the increase of Chinese diabetes prevalence did not follow the linear trend.Before 2000,the average prevalence showed as 3.5％ (95％CI:2.0％-4.9％),with an annual increase rate as 0.17％.Since 2000,the average annual prevalence of diabetes mellitus had appeared around 8.0％ (95％CI:6.0％-10.1％),with an annual growth rate of 0.72％ (95％CI:0.34％-1.10％).Conclusion The prevalence of diabetes in Chinese adults had been rapidly increasing since the year 2000,indicating that efforts should be strengthened for diabetes prevention,in China.

Progress in research of family-based cohort study on common chronic non-communicable diseases in rural population in northern China / 中华流行病学杂志

Family-based cohort study is a special type of study design,in which biological samples and environmental exposure information of the member in a family are collected and related follow up is conducted.Family-based cohort study can be applied to explore the effect of genetic factors,environmental factors,gene-gene interaction,and gene-environment interaction in the etiology of complex diseases.This paper summarizes the objectives,methods and results,as well as the opportunities and challenges of the family-based cohort study on common chronic non-communicable diseases in rural population in northern China.

Application of the China-PAR risk prediction model for atherosclerotic cardiovascular disease in a rural northern Chinese population / 北京大学学报(医学版)

Objective:To validate five-year risk prediction models for atherosclerotic cardiovascular di-sease (ASCVD) in a contemporary rural Northern Chinese population.Methods: Totally 6 489 rural adults aged 40 to 79 years without clinical ASCVD were enrolled at baseline between June and August 2010, and followed up through January 2017.Expected prediction risk using the China-PAR (prediction for ASCVD risk in China) model was compared with the pooled cohort equations (PCE) reported in the American College of Cardiology / American Heart Association guideline.Kaplan-Meier analysis was used to obtain the observed ASCVD event (including nonfatal myocardial infarction, coronary heart disease death, nonfatal or fatal stroke) rate at 5 years, and the expected-observed ratios were calculated to eva-luate overestimation or underestimation in the cohort.The participants in the cohort were divided into 4 categories (<5.0%, 5.0%-7.4%, 7.5%-9.9%, and ≥10.0%) for comparisons based on ASCVD prediction risk.The models were assessed by discrimination C statistic, calibration χ2, and calibration charts and plots for illustration as well.Results: Over an average 5.82 years of follow-up in this validation cohort with 6 489 rural Chinese participants, 955 subjects developed a first ASCVD event.Recalibrated China-PAR model overestimated ASCVD events by 22.2% in men and 33.1% in women, while the overestimations were much higher for recalibrated PCE as 67.3% in men and 53.1% in women.Gender-specific China-PAR model had C statistics of 0.696 (95%CI, 0.669-0.723) for men and 0.709 (95%CI, 0.690-0.728) for women, which were similar to those of 0.702 (95%CI, 0.675-0.730) for men and 0.714 (95%CI, 0.695-0.733) for women in the PCE.Calibration χ2 values in China-PAR were 17.2 and 54.2 for men and women, respectively;however, the PCE showed poorer ca-libration (χ2=192.0 for men and χ2=181.2 for women).In addition, the calibration charts and plots illustrated good agreement between the observations and the predictions only in the China-PAR model, especially for men.Conclusion: In this validation cohort of rural Northern Chinese adults, the China-PAR model had better performance of five-year ASCVD risk prediction than the PCE, indicating that recalibrated China-PAR model might be an appropriate tool for risk assessment and primary prevention of ASCVD in China.

Relationship between glycemic control and visceral adiposity index among the patients with type 2 diabetes mellitus / 北京大学学报(医学版)

Objective: To explore the relationship between glycemic control and visceral adiposity index (VAI) among type 2 diabetes mellitus (T2DM) patients.Methods: A community-based epidemiological field study for patients with T2DM aged ≥ 40 years was conducted in China.Every participant underwent physical examinations, biochemical tests of fasting glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and so on, and a questionnaire, including anthropometric characteristics, lifestyle, disease history, family history, and medication use.Those participants with HbA1c ≥7.0% were classified as the poorly controlled in our analysis of relationship between glycemic control and VAI.Anthropometric characteristics, lifestyle, and biochemical indexes of the participants were compared among the groups of different VAI levels.Logistic models were applied in multiple analysis adjusting for possible confounders.Results: A total of 1 607 patients with T2DM were recruited in our analysis with a mean age of (59.4±8.1) years and an average T2DM duration of (7.0±6.4) years.Among them, 78.3% were on hypoglycemic therapy.The cutoff points of quartiles of VAI were calculated for the males and females, respectively.According to the ascending order of the quartiles of VAI, the participants were divided into four groups, i.e.Q1, Q2, Q3, and Q4.The poor glycemic control rate for these groups were 60.6%, 65.7%, 70.1%, and 71.0%, respectively (Trend χ2=12.20, P<0.001).After adjustment for age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), LDL-C, smoking, cardio-cerebral vascular disease (CVD) history, hypoglycemic therapy, T2DM duration, and family history of diabetes, the Logistic regression models showed that the glycemic control rate was significantly associated with VAI levels among the patients with T2DM.Compared with the participants in group Q1, the ORs of poor glycemic control for those in groups Q2, Q3, and Q4 were 1.239 (95%CI 0.918 to 1.672), 1.513 (95%CI 1.117 to 2.050), and 1.535 (95%CI 1.128to 2.088), respectively (trend P=0.003).With each quartile increase in VAI, the OR of poor glycemic control was 1.162 (95%CI 1.054 to 1.282).Conclusion: The glycemic control among the patients with T2DM is significantly associated with VAI.High level of VAI is an indicator of poor glycemic control.

The impact of broadened diagnostic criteria on the prevalence of hypertension, hyperlipidemia and diabetes mellitus in China / 中华预防医学杂志

Objective@#The burden of chronic disease has been continuously increasing in China since the early 1980s. Besides the worsening of risk factors, the change in diagnostic criteria is very likely an important explanation for the increase in the prevalence of hypertension, hyperlipidemia and diabetes mellitus, three commonest, major chronic conditions that can lead to major vascular events and deaths. This study aims to estimate the contribution of changes in diagnostic criteria to the increase in the prevalence of the three conditions in China.@*Methods@#The data from two representative nation-wide surveys in China in 2002 and 2009, with 145 254 and 8 813 adults included respectively, were used to estimate the prevalence rate of the three conditions and the proportion attributable to the change in diagnostic criteria around year 2000. The new and old cutoff values for hypertension, hyperlipidemia, and hyperglycemia were 140/90 and 160/95 mmHg (1 mmHg=0.133 kPa), 5.7 and 6.2 mmol/L, and 7.0 and 7.8 mmol/L, respectively. The prevalence was standardized according to the distribution of age, sex and rural-urban residence of the 2000 national census of the country so as to compare between the old and new diagnostic criteria and project the situation for the entire country.@*Results@#The standardized prevalence of hypertension, hyperlipidemia, and diabetes mellitus for the entire Chinese adult population in 2002 was 8.21%, 1.71% and 1.43% according to the immediate previous diagnostic criteria, and 19.18%, 3.53% and 2.66% according to the new criteria. In 2009, the prevalence was 11.89%, 9.34% and 4.29% according to the old criteria, and 24.78%, 18.36% and 6.55% according to the new criteria. The total cumulative prevalence of the three conditions was increased by 124% in 2002 and 95% in 2009 as a result of change in diagnostic criteria. Put it differently, the change in diagnostic criteria increased the number of the three conditions from 2002 to 2009 by approximately 359 million and could increase the annual drug costs by some 271 billion RMB if all the conditions are treated. The drug costs alone of treating all the three conditions could consume 56% of the total health budget of the Government in 2010.@*Conclusion@#About half of the number of the three conditions is a result of the change in diagnostic criteria. These criteria were adopted from western populations, which are designed to meet the population need and suit healthcare resources available in these countries. It is important for China to consider the resources available and needs and values of the population in addition to the benefits, harms and costs of treatment in determining the cutoff values for defining these conditions for drug interventions.

Relationship between type 2 diabetes mellitus and serum stromal cell derived factor 1 levels / 实用医学杂志

Objective To explore the relationship between type 2 diabetes mellitus(T2DM)and serum stromal cell derived factor-1(SDF-1)levels. Methods A community-based epidemiological field study for T2DM patients and non-T2DM subjects was conducted in Beijing,China. Every subject underwent physical examinations, biochemical tests of stromal cell derived factor 1 and so on,and completed a standardized questionnaire. A total of 756 subjects were recruited in our analysis ,including 267 T2DM patients and 489 non-T2DM subjects ,T2DM patients were further divided into 81 simple T2DM patients and 186 macrovascular complication patients on the basis of the status of macrovascular complication. The correlation between serum SDF-1 levels and T2DM was analyzed. Results Compared with non-T2DM group,the level of SDF-1 in T2DM group was higher(P=0.019). The level of SDF-1 in simple T2DM group was also higher than macrovascular complication group(P=0.044). In the multi-ple linear regression analysis,after adjustment for age,gender,smoking,drinking,dyslipidemia,hypertension and BMI,SDF-1 level in simple T2DM group was higher than macrovascular complication group(P = 0.049), still. Conclusions Simple T2DM patients had a higher serum SDF-1 level than T2DM patients with macrovascular complications as well as those who did not suffer T2DM,suggesting that the stromal cell derived factor-1 may play a certain role in the development of T2DM and macrovascular complications.

Relationship between type 2 diabetes mellitus and serum stromal cell derived factor 1 levels / 实用医学杂志

Objective To explore the relationship between type 2 diabetes mellitus(T2DM)and serum stromal cell derived factor-1(SDF-1)levels. Methods A community-based epidemiological field study for T2DM patients and non-T2DM subjects was conducted in Beijing,China. Every subject underwent physical examinations, biochemical tests of stromal cell derived factor 1 and so on,and completed a standardized questionnaire. A total of 756 subjects were recruited in our analysis ,including 267 T2DM patients and 489 non-T2DM subjects ,T2DM patients were further divided into 81 simple T2DM patients and 186 macrovascular complication patients on the basis of the status of macrovascular complication. The correlation between serum SDF-1 levels and T2DM was analyzed. Results Compared with non-T2DM group,the level of SDF-1 in T2DM group was higher(P=0.019). The level of SDF-1 in simple T2DM group was also higher than macrovascular complication group(P=0.044). In the multi-ple linear regression analysis,after adjustment for age,gender,smoking,drinking,dyslipidemia,hypertension and BMI,SDF-1 level in simple T2DM group was higher than macrovascular complication group(P = 0.049), still. Conclusions Simple T2DM patients had a higher serum SDF-1 level than T2DM patients with macrovascular complications as well as those who did not suffer T2DM,suggesting that the stromal cell derived factor-1 may play a certain role in the development of T2DM and macrovascular complications.

Medical big data and precision medicine: prospects of epidemiology / 中华流行病学杂志

Since the development of high-throughput technology,electronic medical record system and big data technology,the value of medical data has caused more attention.On the other hand,the proposal of Precision Medicine Initiative opens up the prospect for medical big data.As a Tool-related Discipline,Epidemiology is,focusing on exploitation the resources of existing big data and promoting the integration of translational research and knowledge to completely unlocking the "black box" of exposure-disease continuum.It also tries to accelerating the realization of the ultimate goal on precision medicine.The overall purpose,however is to translate the evidence from scientific research to improve the health of the people.

Retrospective cohort study for the impact on readmission of patients with ischemic stroke after treatment of aspirin plus clopidogrel or aspirin mono-therapy / 北京大学学报(医学版)

Objective:To see the influence of different antiplatelet therapies on stroke patients’ readmission by performing a deep data-mining into Beijing Healthcare Insuring Database,based on a large sample size.Methods:Aretrospective cohort study,was adopted to extract patients primarily diag-nosed as ischemic stroke from healthcare database.The first hospital records were considered as the pa-tient’s baseline in this study,who were divided into MAPT (aspirin)and DAPT (aspirin and clopi-dogrel)according to the patient’s baseline medications.A follow-up was conducted to see whether the patients would have rehospitalization record because of major result events after medication.The major re-sult events,included:(1 )recurrence of ischemic stroke;(2)hemorrhagic transformation of ischemic stroke;(3)myocardial infarction;(4)the digestive hemorrhage.The Kaplan-Meier figure was used to compare the survival situations between these two groups,the log-rank test was used to test the difference of the survival curve,and 1 ∶1 propensity score matching was calculated from the patients’baseline da-ta.Cox proportional hazards model was used to calculate the hazard ratio (HR).Results:A total of 27 695 patients From January 201 0 to September 201 3 were included,4 047 with DAPT,and 23 648 with MAPT.Because the baseline characteristics of the patients was disequilibrium,so we used 1 ∶1 pro-pensity score matching,after which,the number of the two groups was 4 046 each.Adjusted for the gen-eral demographic characteristics such as age,sex,nationality,complication and drug combination,no statistical significance was observed between the survival curves of the two groups (P =0.06).HR value of major result events between the groups was 0.91 (0.82 -1 .01 ,P =0.07),which was not statistically significant.The covariate gender HR =1 .36 (1 .20 -1 .55,P 1 .05)did not increase the risk of readmission.Conclusion:There was no difference in prevention of readmission between patients with DAPT and MAPT.Patients with complications should actively treat the complications at the same time as they prevent recurrence after first attack.

Relationship of menopause with cardiovascular disease and related metabolic disorders / 北京大学学报(医学版)

Objective:To explore the associations of menopause with cardiovascular disease (CVD) and related metabolic disorders (including hypertension,diabetes or higher blood sugar,obesity,dyslipi-demia)in Chinese females aged 45 -59 years .Methods:Data were acquired from a national cross-sectional survey conducted in 201 3,China,which was also the second follow-up survey of China Health and Retirement Longitudinal Study (CHARLS).In the study,4 702 Chinese perimenopausal women aged 45 -59 years were enrolled,including 1 769 premenopausal women and 2 933 postmenopausal women.Information was collected from questionnaires of health status and functioning and physical exa-mination.General liner models were employed to calculate age-adjusted or age-and-body-mass-index-adjusted or multiple-factor-adjusted means and their 95% confidence intervals (95% CIs)of cardiovas-cular risk factors (CRFs).The comparisons of CVD and its risk factors according to menopausal status, and calculation of adjusted odds ratios (ORs)and their 95%CIs for the associations of menopause with CVD and its risk factors were performed by multivariate Logistic regression models separately.Results:After adjustment for age and other confounders (including body mass index,marriage,education,current smoking,drink alcohol more than once per month),statistically significant associations of menopause with cardiovascular disease,which referred to having a history of heart disease or stroke in this study, were observed in the participants (OR =1 .34,95% CI:1 .04 -1 .74);prevalence of hypertension (OR =1 .42,95%CI:1 .1 0 -1 .84),prevalence of CRFs clustering number≥2 (OR =1 .31 ,95%CI:1 .02 -1 .68)and average waist circumference level (87.1 1 cm,95%CI:86.81 -87.42 cm in post-menopausal group vs.86.41 cm,95%CI:85.99 -86.84 cm in premenopausal group)were presented higher in postmenopausal group,compared with the premenopausal one.However,diabetes or higher blood sugar (OR =0.96,95%CI:0.60 -1 .52),dyslipidemia (OR =0.84,95%CI:0.59 -1 .20) and obesity (OR =1 .06,95%CI:0.86 -1 .32)were not shown significantly statistically related to me-nopause,after excluding effect of age and other confounders.Conclusion:Postmenopausal women in China had worse CRFs profile than the premenopausal ones,which implied menopause might aggravate the CRFs epidemic and increase the risk of cardiovascular disease beyond effects of aging,which would increase the CVD burden during and after their middle ages.

Medical big data and precision medicine: prospects of epidemiology / 中华流行病学杂志

Since the development of high-throughput technology,electronic medical record system and big data technology,the value of medical data has caused more attention.On the other hand,the proposal of Precision Medicine Initiative opens up the prospect for medical big data.As a Tool-related Discipline,Epidemiology is,focusing on exploitation the resources of existing big data and promoting the integration of translational research and knowledge to completely unlocking the "black box" of exposure-disease continuum.It also tries to accelerating the realization of the ultimate goal on precision medicine.The overall purpose,however is to translate the evidence from scientific research to improve the health of the people.

Precision medicine: new opportunities and challenges for molecular epidemiology / 中华流行病学杂志

Since the completion of the Human Genome Project in 2003 and the announcement of the Precision Medicine Initiative by U.S.President Barack Obama in January 2015,human beings have initially completed the "three steps" of "genomics to biology,genomics to health as well as genomics to society".As a new inter-discipline,the emergence and development of precision medicine have relied on the support and promotion from biological science,basic medicine,clinical medicine,epidemiology,statistics,sociology and information science,etc.Meanwhile,molecular epidemiology is considered to be the core power to promote precision medical as a cross discipline of epidemiology and molecular biology.This article is based on the characteristics and research progress of medicine and molecular epidemiology respectively,focusing on the contribution and significance of molecular epidemiology to precision medicine,and exploring the possible opportunities and challenges in the future.

Relationship between brachial-ankle pulse wave velocity and glycemic control of type 2 diabetes mellitus patients in Beijing community population / 北京大学学报(医学版)

Objective:To explore the correlation between glycemic control of type 2 diabetes mellitus (T2DM) patients and brachial-ankle pulse velocity (baPWV). Methods:A community-based cross-sec-tional study was conducted in Beijing, China. Every subject underwent physical examinations, glycated hemoglobin ( HbA1 c ) , blood lipid and baPWV measurements and completed a standardized question-naire. T2DM patients were divided into well controlled and poorly controlled groups according to HbA1c levels. The correlation between glycemic control of T2DM patients and baPWV was analyzed. Results:In this study, 1 341 subjects were recruited, including 733 T2DM patients and 608 non-diabetes sub-jects. Compared with non-diabetes subjects, abnormal baPWV ( baPWV≥1 700 cm/s) rate for T2DM patients was higher (40. 8% vs. 26. 8%, P<0. 001). With HbA1c<6. 5% or <7. 0% as the aim of glycemic control in T2DM patients, the abnormal baPWV rates for non-diabetes subjects, well controlled and poorly controlled T2DM patients were significantly different (non-diabetes vs. HbA1c<6. 5% T2DM vs. HbA1c≥6. 5% T2DM: 26. 8% vs. 32. 8% vs. 42. 6%, P <0. 001; non-diabetes vs. HbA1c <7. 0% T2DM vs. HbA1c≥7. 0% T2DM:26. 8% vs. 36. 1% vs. 43. 4%, P<0. 001). After being ad-justed for gender, age, smoking status, diabetes mellitus family history, T2DM duration, cardiovascular diseases ( CVD ) , waist hip ratio ( WHR ) , systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP) , total triglycerides ( TG) , high density lipoprotein cholesterol ( HDL-C) , and low density lipo-protein cholesterol ( LDL-C ) , the Logistic regression models suggested that glycemic control status of T2DM patients was associated with abnormal baPWV. Compared with non-diabetes subjects, the ORs for abnormal baPWV in HbA1 c <6 . 5% T2 DM patients and HbA1 c≥6 . 5% T2 DM patients were 0 . 927 (95%CI 0. 560-1. 537) and 1. 826 (95%CI 1. 287-2. 591). Compared with non-diabetes subjects, the ORs for abnormal baPWV in HbA1c<7. 0% T2DM patients and HbA1c≥7. 0% T2DM patients were 1. 210 (95%CI 0. 808-1. 811) and 1. 898 (95%CI 1. 313-2. 745). Conclusion:The glycemic con-trol status of T2DM patients from communities is significantly associated with baPWV. Poor glycemic con-trol is a risk factor for abnormal baPWV. Keeping HbA1c under control might lower the risk of cardiovas-cular diseases in T2DM patients.