Health risk factors and presenteeism: a look into employees at two enterprises in China / 中华健康管理学杂志

Objective To analyze the effects of health risk factors on presenteeism in enterprise employees.Methods A hospital in Jinan of Shandong province and a publishing enterprise in Beijing were selected as target settings of this cross-sectional study. Questionnaire survey was carried out to collect information on demographic data,health condition and presenteeism,and multiple logistic regression was used to analyze the influence of health risk factors on labor-related presenteeism.Results Insufficient physical activity was found in 42％ percent of the participants,and those with heavy-loaded pressure,overweight or obesity,high blood pressure and unhealthy diet habit accounted for 46％,41％,40％ and 34％,respectively. Proportions of employees with presenteeism varied with age ( x2 =10.1665,P =0.0377),occupation ( x2 =35.3579,P ＜ 0.05 ) and education level ( x2 =50.5377,P ＜ 0.05 ).Female employees ( P =0.0323,OR =1.728,95％ CI 1.047 to 2.850),graduates ( P ＜ 0.05,OR =6.159,95％ CI 2.510 to 15.109),overweight or obesity individuals ( P =0.0076,OR =1.673,95％ CI 1.147 to 2.44) and adults with poor self-perception of health ( P =0.0049,OR =2.284,95％ CI 1.285 to 4.060)seemed to be more likely to be presenteeism.Conclusions Overweight or obesity and poor self-perception of health may be associated with labor-related presenteeism.

Body mass index and hypertension hemodynamic subtypes in Yi farmers and migrants / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To examine the relationship between overweight or obesity and the risk of the various hypertension hemodynamic subtypes in Yi farmers and migrants.</p><p><b>METHODS</b>A cross-sectional study of 2 358 Yi farmers and 1 392 Yi migrants was carried out in the Liangshan Yi autonomous prefecture, Sichuan, China in 2007.</p><p><b>RESULTS</b>The standardized prevalence of overweight in female Yi farmers (6.22%) was higher than in males (3.15%), whereas in Yi migrants 31.56% of males and 18.78% of females were overweight. The standardized prevalence of obesity was 0 and 0.61% in male and female Yi farmers, compared to 3.91% and 5.57% in male and female Yi migrants, respectively. For both genders the standardized prevalence of ISH, IDH, and SDH was higher in Yi migrants than Yi farmers. Overweight and obese Yi men and women had a higher risk for IDH and SDH (P<0.001) than non-overweight/obese individuals. However, an association of overweight or obesity with ISH was observed only in men.</p><p><b>CONCLUSION</b>Yi migrants have substantially higher proportion of overweight and obese individuals, as well as individuals affected by ISH, IDH, and SDH, than do Yi farmers. Overweight and obesity are significant risk factors for the development of hypertension in Yi people.</p>

Silicosis in automobile foundry workers: a 29-year cohort study / 生物医学与环境科学（英文）

<p><b>OBJECTIVES</b>The purposes were to determine the relationship between silicosis among foundry workers and their cumulative exposure to silica dust, and to establish a regression model to predict the risk for developing silicosis by a given length of employment and air concentrations of silica at worksites.</p><p><b>METHODS</b>A 29-year cohort study was conducted, including all those employed for more than one year during January 1, 1980 to December 31, 1996 and all members of the cohort were followed-up to December 31, 2008. In total, 2009 workers of an automobile foundry in Shiyan, Hubei province were recruited in the study, 1300 at eight worksites including sand preparation, cast shakeout, and finishing, melting, moulding, core-making, overhead crane operation and pouring as exposed group, and the other 709 auxiliary workers at the same factory, such as electricians, inspectors, fitters, and so on, as control group. Person-years of observation were calculated by persons observed and years followed-up for each of them. Person-year incidence of silicosis and its relative risk (RR) or odds ratio (OR) and 95% confidence intervals (CI) among the workers were estimated, adjusted for relevant factors with logistic regression model using SPSS version 15.0 software.</p><p><b>RESULTS</b>Totally, 2009 workers were followed-up for 37 151 person-years and 48 cases of silicosis were found, with an overall incidence of 1.34 per thousand, 2.02 per thousand in exposed group, and 0.15 per thousand in control one. Risk of silicosis was significantly higher in the exposed group than that in the control one (RR = 13.13, 95% CI 3.18-54.13), higher in men than that in women (RR = 13.92, 95% CI 1.92-100.93). Risks of silicosis varied by job, highest in those exposed to cast shakeout and finishing (RR = 28.14, 95% CI 6.43-123.11), followed by those exposed to pouring (RR = 22.23, 95% CI 5.01-98.55) in the foundry. Average length of employment at onset of silicosis was 25.94 years, and silicosis incidence increased with length of employment. Average age at onset of silicosis was 47.83 years old. The risk of silicosis in workers with pulmonary tuberculosis was 2.57 folds as those without it (P < 0.01). Ten deaths were recorded in those with silicosis, with a case-fatality rate of 20.83 percent three of them died of lung cancer, three of liver cancer, two of ischemic heart disease, and two of other diseases as their immediate causes of death. Incidence of silicosis in foundry workers positively correlated with their cumulative silica exposure (OR = 3.00, 95% CI 2.34-3.83). Risks of silicosis increased by 4.38 folds with an increase of 1 mg/m3-year of cumulative silica exposure, and by 3.79 folds with smoking, respectively, adjusted for alcohol drinking and age. Based on a logistic regression model fitted, incidence of silicosis is expected to be 44.6 per thousand for those with daily exposure to silica of 4.18 mg/m3 in average for 30 years, and if incidence of silicosis is expected to be less than 1 per thousand, daily exposure to silica should be controlled below 0.2 mg/m3 for those with 20 years of employment, or below 0.1 mg/m3 for those with 30 or 40 years of silica exposure.</p><p><b>CONCLUSIONS</b>At present, foundry workers in China still face high risk of developing silicosis. For lowering occurrence of silicosis in exposed workers, it seems necessary that current occupational exposure limits for silica at worksites in China should be reexamined and silica dust control measures be strengthened.</p>

Study on severity, status of awareness and therapy regarding urinary incontinence in elderly people from rural areas in Jixian county,Tianjin / 中华流行病学杂志

Objective To understand the prevalence of urinary incontinence(UI)and its severity in rural elderly people,as well as to investigate the awareness on UI in the elderly and health-care service seeking behavior.Methods A cross-sectional study was carried out in two townships of Jixian county,Tianjin.A total of 743 people aged 60 years and over were selected under cluster sampling method.All the information was collected with a standardized structured questionnaire by face-to-face interview.Prevalence,severity,the awareness on UI in the elderly and their utilization of health-care service for its diagnosis and treatment were analyzed.Results Prevalence of UI was 33.38% among people aged 60 years and over in two townships of Jixian,higher in females than in males(43.15% vs.22.75%,χ~2=34.70,P＜0.0001).The prevalence rates of UI in 60-age group,65-age group,70-age group,75-age group,80-age group,85-95 age group were 28.64%,32.12%,34.08%,35.45%,47.76%,30.00%,respectively,and increased with age (for trend χ~2=219,P=0.029).Stress urinary incontinence(SUI)and urge urinary incontinence(UUI)were mild,while mixed urinary incontinence(MUI)were mainly moderate.The differences of severity of SUI,UUI,MUI between men and women did not show statistical significance(all P＞0.05).In 743 elderly people,more than half of the respondents had never heard of UI(50.20%,373/743)and only 170(22.88%)elderly people considered UI as a disease.630(84.79%)and 665(89.50%)elderly people in our research group did not know that such condition was curable and preventable.In 248 elderly people with UI,only 12(4.84%)of them ever seeking community health-care services in the health-care centers or hospitals.For the ones who did visit the centers,the purpose was only to seek for drug treatment.Conclusion Prevalence of UI appeared to be high among the elderly people in rural areas of Jixian county.Most of the elderly people were lack of knowledge about UI that hindered them from seeking for diagnosis and treatment in the clinics,plus the treatment program for UI was not standardized.Knowledge on UI and health care seeking behavior should be popularized and strengthened among elderly people living in the rural areas.

Prevalence and related factors of falls among the elderly in an urban community of Beijing / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To understand the prevalence, consequences and risk factors of falls among urban community-dwelling elderly in Beijing.</p><p><b>METHODS</b>A cross-sectional study was conducted in Longtan Community, Beijing. A total of 1512 individuals aged 60 years or over were selected by stratified cluster sampling. Data regarding the frequency of falls in the previous year, as well as circumstances, consequence and related factors of falls were collected from the elderly through face-to-face interviews with questionnaires in their home.</p><p><b>RESULTS</b>The prevalence of falls was 18.0% on the average among 1512 participants, higher in women (20.1%) than in men (14.9%) (P = 0.006), and increased with age (chi2(for trend) = 10.37, P = 0.001). The total rate of falls-induced injuries among the fallers was 37.7%. Falls usually resulted in soft-tissues bruises (58.7%), fear of repeated episodes of falls (58.8%), loss of independence and confidence in movement (35.7%) and even in hip fracture. In addition to the burden of medical care, falls also generated a big economic burden. Occurrence of falls was significantly associated with both intrinsic and extrinsic factors. The related factors of falls in the elderly included age > or = 60-70 years, femininity, less physical activities, fear of future falls, living alone, severely impaired vision, health problem-impacted activities of daily living, chronic diseases (diabetes, hypertension, postural hypotension, stroke sequela, cataract, arthritis, dementia and depression), medications (psychoactive, anti-diabetic), gait imbalance, high bed and faintly-lighted stairway.</p><p><b>CONCLUSION</b>The prevalence of falls among urban community-dwelling elderly in Beijing is closely associated with significant associated with intrinsic and extrinsic factors. Efforts to prevent falls in the elderly should be made at community level.</p>

Factors influencing the rate oil retention to methadone maintenance treatment program among heroin addicts in Guizhou,China / 中华流行病学杂志

Objective To understand the situation of client-retention to methadone maintenance treatment(MMT)program and related factors.Methods A Cohon study was adopted.In toml,1003 heroin addicts who were treated at 8 local MMT clinics with less than one month period.were recruited under nominal informed consent from Guizhou province.southwest part of China.during June to October 2006.Face-to-face interview and questionnaire administered to collect relevant information from the clients who were also followed nntil June 2007 to understand the situation on retention.Data were analyzed with Kaplan-Meier method to estimate the retention rate at different time spans while factors related to retention were analyzed with Cox proportional hazard regression model.Results All the clients were followed-up for 14 months,with an average retention of ten months.The retention rates of the clients were 68.8%and 57.4%at 6th-month and 12th-month of the treatment program.estimated by Kaplan-Meier method.Results of Cox regression analysis showed that factors influencing retention rate on MMT among the clients,including their awareness on MMT,dailv dose of methadone intake,and difierent MMT clinics which they were attached to.Risk influencing the withdrawal from MMT had a 20%decrease along with the increase when the daily dose of methadone intake reached 25 mg,with a hazard ratio of 0.80(P＜0.01).If the clients were aware that methadone was a life-time treatment when they began the MMT program.the risk for withdrawal would be lower than those who were not and the hazard ratio became 0.66(P＜0.05).Conclusion Our data showed that about half of the clients who were at the MMT program would still stick to it after 12-months.suggesting that the retention rate was not satisfactory and need to be improved.Factors as the MMT clinics themselves that the clients visited,(Laily methadone dosage they took,and the awareness on MMT etc.were important predictors to the rate of retention on MMT program.

Acceptability of vaginal microbicides among female sex workers in urban Beijing,China / 中华流行病学杂志

Objective To explore the aaitudes and willingness towards vaginal microbicides use among female sex workers(FSWs)for HIV/AIDS and sexually transmitted infection(STI)prevention jn an urban district of Beiiing,China,as well as its related factors.Methods A cross-sectional study using convenience sampling Was conducted.A total of 54 FSWs were recruited from Shijingshan District in urban Beijing.Main outcome vailables were measured by microbicide acceptability score with questionnaire,including high-risk sexual behaviors,self-reported condom use,self-reported HIV/STI history and perception on the risk of HIV/STI.Results Mean score of microbicide acceptability in FSWs was 2.73(ranging 1 to 4).Acceptability score varied by the type of their sex panner(P=0.049),experience of HIV testing(P=0.037)and concems about contracting STI(P=0.042).Willingness to use and covert use of microbicides in FSWS varied significantly with their sex partners(P=0.001).Conclusion FSWs in Shijingshan district might have a positive response to vaginal microbicides use across all hypothetical characteristics in general.Further study iS needed for comprehensive understanding of contextual factors related to it.

Study on the relationship between chronic diseases and falls in the elderly / 中华流行病学杂志

Objective To explore the risk factors on chronic diseases related to falls in the urban-community elderly and to provide evidence for developing a three-tier program for prevention. Methods A cross-sectional study was conducted in one community of Beijing. People aged 60 years and over were selected, using a stratified cluster sampling method, and data on falls within the past 12 months and falls-related chronic diseases were collected through face-to-face interview. Results The incidence of falls was 18.0% within one year among the 1512 interviewees. Seven factors showed statistical significances through univariate analysis including diabetes mellitus (OR =1.62), postural hypotension (OR=1.84), hypertension (OR=1.48), cerebral infarction (OR=1.98), cataract (OR=1.56), osteoarthritis (OR=1.50), dementia (OR=5.34) and depression (OR=4.61). Data from multivariate logistic regression analysis showed that the risk factors for falls would include dementia (OR=4.82), depression (OR=4.27), postural hypotension (OR=1.92) and suffering from several kinds of chronic diseases etc. Conclusion The incidence of falls in an urban elderly community of Beijing was considered to be high. The risk of falls was higher among persons suffering from dementia and depression and having more than two kinds of chronic disease. The chances of falls would parallel the increase of several kinds of chronic diseases among the elderly, suggesting that measures should be actively taken to prevent from falls.

Study on the prevalence of urinary incontinence and its related factors among elderly in rural areas,Jixian county,Tianjin / 中华流行病学杂志

Objective To understand the prevalence of urinary incontinence(UI) and its related factors so as to develop a three-tier program for prevention of the disease.Methods A cross-sectional study was carried out in two townships of Jixian county,Tianjin,during July to November 2007.A total of 743 people aged 60 years and over were selected under cluster sampling,and all information were collected with a standardized structured questionnaire by face-to-face interview.All the data were analyzed with multivariate logistic regression method to explore the related factors for UI in the elderly.Results The overall prevalence of UI was 33.38 percent among people aged 60 years and over in two townships.Risk factors flor UI in men would include older age (OR=1.39).occupation(OR=5.00),awareness of UI(OR=1.91),having in chronic respiratory diseases(OR=2.23),prostate(OR=11.47),neurological(OR=11.76),or motor systems (OR=2.48).while protective factors would include high educational level(taking primary school or below as control group),OR for the junior middle school group appeared to be 0.35,for senior middle school group it was 0.77.and ofundergraduate group it was 0.53.Risk factors for UI in women would include older age(OR=1.31),constipation(OR=1.46),awareness of UI(OR=1.94),increased bodv nlass index(when normal weight group served as control group,OR in the overweight group was 1.03 and in the obesity group OR was 1.54),suffering from chronic respiratory diseases(OR=4.84).diabetes mellitus(OR=2.36),or motor system diseases(OR=1.37),more gravidity(OR=1.03),more parity(OR=1.02),suffering from perinea laceration(OR=1.72) and wound infection during delivery(OR=1.65),while protective factors would include physical exercises(OR=0.64).Conclusion Prevalence of UI was higher among the elderly people in rural areas of Jixian county,Tianjin.UI in the elderly might have been influenced by various factors which suggesting the intervention strategy should be targeted at those related factors as well as focusing on primary prevention.

Reliability and validity of addiction severity index in drug users with methadone maintenance treatment in Guizhou province, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To evaluate the reliability and validity of the Chinese version of addiction severity index (ASI)-5th version (ASI-C-5), in illegal drug users receiving methadone maintenance treatment (MMT) in China.</p><p><b>METHODS</b>One hundred and eighty-six heroin addicts (144 men and 42 women) receiving MMT at three clinics in Guizhou province, southwest China, were recruited. They were all interviewed with a questionnaire of ASI-C-5 and 35 were re-interviewed at an interval of seven days to assess its test-retest reliability.</p><p><b>RESULTS</b>Cronbach's alpha for internal consistency of CSs varied from 0.60 to 0.81 in all domains. Test-retest reliability of composite scores (CSs) of ASI-C-5 were satisfactory (r=0.38-0.97). Based on item analysis and expert's suggestions, five items were deleted and one item was modified in ASI-C-5. Criterion validity of ASI-C-5 was found acceptable, as compared to addicts' self-rating anxiety scale (SAS) and self-rating depression scale (SDS) (r=0.59 and 0.45) except for social support rating scale (SSRS).</p><p><b>CONCLUSIONS</b>ASI-C-5 can be used for heroin addicts receiving MMT with acceptable reliability and validity.</p>

Epidemiologic study on STD/HIV infections among tin mining workers in Gejiu, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To estimate human immunodeficiency virus (HIV)/sexually transmitted diseases (STDs) related knowledge, the prevalence and risk factors for HIV/STDs among tin miners in Gejiu, Yunnan Province.</p><p><b>METHODS</b>A cross-sectional study was conducted in tin miners working at 5 mining regions from March to June 2006 in Gejiu City, Yunnan Province. A total of 1796 miners were enrolled in the study, and a standardized questionnaire was administered probing socio-demographic factors, knowledge of HIV/STDs and sexual behavior. 7 ml-volume venous blood and 15 ml urine specimens were collected for HIV/STDs testing.</p><p><b>RESULTS</b>Twelve participants [0.7%] (12/1760) were identified HIV positive. While, the positive proportions for syphilis, herpes simplex virus type-2 (HSV-2), Neisseria gonorrhea and Chlamydia trachoma were 1.8% (31/1760), 9.6% (169/1760), 0.8% (14/1773), 4.8% (85/1773), respectively. The total prevalence of STDs was 14.9% (264/1776). Factors associated with HIV infection were illegal drug use (adjusted OR = 17.8; 95% CI: 4.0 - 78.8), frequencies of visiting female sex workers in the past twelve months (adjusted OR = 8.7; 95% CI: 1.9 - 39.0), tattoos (adjusted OR = 6.6; 95% CI: 1.8 - 24.0), surgical operation experiences (adjusted OR = 6.0; 95% CI: 1.6 - 22.5) and toothbrush sharing (adjusted OR = 5.6; 95% CI: 1.0 - 31.3). Factors associated with STDs infection were race (adjusted OR = 2.0; 95% CI: 1.5 - 2.7), age (adjusted OR = 1.7; 95% CI: 1.0 - 2.9), illegal drug use (adjusted OR = 2.3; 95% CI: 1.0 - 5.2), living with spouses (adjusted OR = 1.4; 95% CI: 1.1 - 1.9) and visiting female sex workers (adjusted OR = 1.9; 95% CI: 1.4 - 2.6). Only 4.1% (49/1201) of respondents aware the correct transmission routes of HIV. 21.6% (339/1569) of the miners who had previous sexual experience self-reported visiting female sex workers.</p><p><b>CONCLUSION</b>HIV and other STDs are highly prevalent amongst miners in this region. In addition, the awareness of HIV/STDs is low and multiple routes of HIV transmission, such as heterosexual intercourse and IDU, were also observed in these study subject. HIV/STDs interventions should therefore be reinforced among the miners in this region.</p>

Study on the association between vaginal douching and sexually transmitted diseases among female sex workers in a county of Yunnan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the epidemic characteristics of vaginal douching, human immunodeficiency virus (HIV) and other sexually transmitted diseases(STD) among female sex workers (FSWs) in Yunnan province.</p><p><b>METHODS</b>FSWs were recruited to be investigated on their demographic data, drug abuse and sexual behavior, HIV/AIDS knowledge and procreation health status. Venous blood were collected to test for HIV, herpes simplex virus 2 (HSV-2) and syphilis while urine specimen was for morphine, cervical secretion for Gonorrhoea and Chlamydia trachomatis, and vaginal secretion for Trichomonas.</p><p><b>RESULTS</b>A total number of 833 blood specimen were collected, in which 84 specimen were confirmed to be HIV positive with a prevalence rate of 10.1%. The prevalence rates of syphilis and HSV-2 were 8.2% and 68.4% respectively. 832 vaginal and cervical secretion specimen were collected with the prevalence rates of Gonorrhoea, Chlamydia trachomatis and Trichomonas were 11.5%, 28.2% and 11.9% respectively. In multivariate logistic analysis, the factors associated with vaginal douching were: being Han nationality, locations of sex work at middle/high level, ever heard of HIV/AIDS, emerged hypogastric pain last year, the number of sex work location > or =4.</p><p><b>CONCLUSION</b>Vaginal douching was shown a risk factor for HIV and some STD.</p>

Multiple risk factor clustering and risk of hypertension in the Mongolian ethnic population of China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To evaluate whether the clustering of risk factors, both environmental and genetic, increases the risk of essential hypertension (EH) and the accumulation of risk factors influences the blood pressure level in normotensives.</p><p><b>METHODS</b>On the basis of a prevalence survey, 501 subjects of Mongolian ethnicity (243 hypertensives and 258 normotensives) who were not related to each other were selected to conduct a case-control study. All subjects were interviewed with questionnaires and their blood specimens were collected. Renin gene insertion/deletion (I/D) polymorphism, a new genetic marker, was genotyped with PCR and polyacrylamide gel electrophoresis.</p><p><b>RESULTS</b>Overweight, alcohol consumption, and renin gene I/D polymorphism were significant risk factors of EH (P<0.05). The odds ratios (OR) for the number of risk factors were 2.39 (95%CI: 0.98-6.74) for one risk factor, 5.03 (95%CI: 2.06-14.18) for two, and 6.09 (95%CI: 1.85-22.38) for three respectively after adjusting for age and sex. In normotensives, age- and sex-adjusted mean blood pressures increased with more accumulation of risk factors. However, there were no significant differences among the different blood pressure levels according to the number of risk factors (P>0.05).</p><p><b>CONCLUSION</b>Overweight, alcohol consumption, and renin gene I/D polymorphism are risk factors of EH in the Mongolian ethnic population of China. The accumulation of the risk factors causes a sharp increase of the risk of EH.</p>

Severe acute respiratory syndrome--retrospect and lessons of 2004 outbreak in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To summarize lessons learned from an outbreak of severe acute respiratory syndrome (SARS) in China during the spring of 2004.</p><p><b>METHODS</b>Data of SARS cases were officially reported by Beijing Municipal Center for Disease Control and Prevention (BCDC) and Anhui Provincial Center for Disease Control and Prevention (APCDC) and results of epidemiological investigations were collected and analyzed.</p><p><b>RESULTS</b>Three generations of 11 cases of SARS were identified during the outbreak. Initial two cases were most likely to be infected in Diarrhea Virus Laboratory of National Institute of Virology, China Centers for Disease Control and Prevention and main mode of transmission was direct contact with SARS patients. Delay in detecting initial case resulted in spread of the illness at hospitals and communities with two generations of secondary cases.</p><p><b>CONCLUSIONS</b>SARS outbreak in 2004 has yielded following lessons for public health globally. (1) Lab bio-safety programs should be made and should be strictly abided by. Studies in highly pathogenic viruses such as SARS coronavirus should be utmost cautious. (2) Management systems of occupational exposure to virus and disease surveillance need to be strengthened to take all risk factors into account so as to detect potential patients with infectious disease as early as possible.</p>

Sampling survey of disability in 0-6 year-old children in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the current status of disabled children and prevalence of disabilities in children aged 0-6 years and their risk factors, and to provide scientific evidence for making relevant policies for disabled children.</p><p><b>METHODS</b>In a community-based cross-sectional study, multi-phase, stratified, unequal proportional and cluster sampling was adopted to survey 60 124 children aged 0-6 years. All the investigated children were screened for disabilities, and those with positive screening tests were further diagnosed by various specialties.</p><p><b>RESULTS</b>A total of 819 children were diagnosed as disabled with an overall prevalence of 1.362%, 0.155% for hearing disability, 0.160% for visual disability, 0.931% for intelligent disability, 0.424% for limb disability, and 0.101% for mental disability. Prevalence of disability in children was higher in rural areas, and in families with two or more children, low educational level or in divorced families.</p><p><b>CONCLUSION</b>The prevalence of disability can be reduced by economic development, improvement of health care and quality of population, as well as harmonious familial relationship, early prevention of disability, and preschool education for disabled children.</p>

To assess the demands of community-based health care service among 717 elderly / 中华流行病学杂志

<p><b>UNLABELLED</b>OBJECTIVE To understand the demands and influencing factors on the community-based health care service (CHS) among the elderly and to provide evidence of implementing health service for them</p><p><b>METHODS</b>Cluster sampling method was used on 717 persons aged 60 and above in Yanjiao Developing Area. A survey was carried out, using questionnaire and focus group discussion approaches.</p><p><b>RESULTS</b>Data showed that a two-week prevalence of diseases was 56.3% while the overall prevalence of chronic diseases was 92.1% with 70.0% of them suffering from more than two kinds of chronic diseases. The rates of ADL and IADL loss were 1.8% and 7.0% respectively with 37.0% of them sought medical consultation in the past two weeks. Major reason affecting the use of health service was low income. 57.7% of the elderly expressed their willingness of accepting CHS with the strongest demands as regular physical check-up, health education and consultation, specialized care services, home care service while major reasons hindering the acceptance of CHS could be referred to self-perception on good stamina and lack of awareness to CHS.</p><p><b>CONCLUSION</b>The demands of CHS in the elderly were greater than those in general population that called for CHS programs to be acceptable and relevant to meet the different needs.</p>

Interaction and relationship between angiotensin converting enzyme gene and environmental factors predisposing to essential hypertension in Mongolian population of China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the association of specific functional gene ACE (I/D) variants of the renin-angiotensin system with essential hypertension (EH) and interaction between ACE (I/D) gene and risk factors for EH in a genetically homogenous Mongolia rural population of China.</p><p><b>METHODS</b>Individuals (n=1099) were recruited from general population of Kezuohouqi Banner in Inner Mongolian Autonomous Region.</p><p><b>RESULTS</b>The association was found between ACE genotype DD plus ID and EH, with an interaction between ACE genotype DD plus ID and cigarette smoking in an additive model. Cigarette smoking index and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 7.10 to 1.16. Interaction between ACE genotype DD plus ID and alcohol drinking on EH appeared an additive model. Alcohol drinking index and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 1.66 to 1.09. BMI and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 6.15 to 2.49. Interactions between ACE genotype and WHR on EH showed a multiplicative model. In a short,there was an interaction between ACE gene and cigarette smoking, alcohol drinking and BMI on EH, especially in a low dose-exposure effect</p><p><b>CONCLUSION</b>It is important for individuals who carry ACE D allele gene to prevent EH, and furthermore, to prevent and control coronary heart disease, in a view of population-based prevention.</p>

A case-control study on the risk factors for road injury / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the risk factors of road injury.</p><p><b>METHODS</b>Case-control study was used. From November 2001 to August 2002, 406 drivers who had 438 drivers who had not experienced a motor vehicle crash in Huanggu district, Shenyang city were recruited by randomly selection on time of day, day of week and site in the same period at same district. Face to face interviews with drivers were conducted according to a highly structured questionnaire covering the circumstances of the current trip, usual behavior and background characteristics of the drivers and the condition of motor vehicles. Stanford sleepiness scale and Epworth sleepiness scale were used to quantify acute and chronic sleepiness respectively.</p><p><b>RESULTS</b>Increased risk was associated with drivers who identified themselves as having chronic doziness (OR = 1.98, 95% CI: 1.26 - 3.12). Increase in risk was associated with measures of acute tiredness, but without statistical significance (OR = 2.38, 95% CI: 0.89 - 6.31). Comparing to permanent daytime work pattern, rotating shifts or permanent night-work pattern increased the risk of crash (OR = 2.09, 95% CI: 1.48 - 2.94). The risk of motor vehicle crash among the drivers who drank alcohol in the previous 6 hours was 3.59 times (95% CI: 1.13 - 11.39) of those drivers who did not drink. Driving violations also contributed to the increased risk of crash (OR = 1.73, 95% CI: 1.22 - 2.46).</p><p><b>CONCLUSION</b>Factors as chronic doziness, rotating shifts or permanent night-work pattern, driving under alcohol impairment, violation of motor vehicle regulation all significantly increased the risk of road injury. Acute sleepiness might serve as a potential risk factor for road injury.</p>

Evaluation on the effectiveness for self-management of hypertensive patients in a community / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the acceptability of self-management project for patients with hypertension and the short term result, and provide the evidence of preventing and controlling hypertension using chronic disease self-management.</p><p><b>METHODS</b>Voluntary patients with hypertension were grouped into the control and experimental groups after matching age, sex, education levels and the number of chronic diseases between the two groups. Data collected through questionnaire after intervention were compared with the baseline data through analysis of covariance and chi(2) test.</p><p><b>RESULTS</b>Rate of awareness for the diagnostic criteria of hypertension, risk factors and associated diseases increased by 56.4%, 50.4% and 37.6% respectively, and the rate of high salt diet intake, body mass index and the times of visiting doctors decreased by 27.1%, 0.8 kg/m(2) and 2.7 times on average in experimental group, as compared with control group. The health status (energy, fatigue, shortness of breathe, pain) improved (P < 0.05). In the similar comparison, the rate in which the hypertensive patients took antihypertensive medicine increased by 20%, and the scores of cognitive symptoms management and of patient communication with physician increased by 3.9 and 1.1 points respectively. The rate of compliance to medication increased by 21.5% compared with themselves.</p><p><b>CONCLUSION</b>The awareness rate of hypertensive patients on knowledge and on unhealthy life style improved after implementing the self-management program. Their emotion, healthy behavior, health status and symptoms related to hypertension improved. Data showed that it was effective for hypertensive patients to use chronic diseases self-management.</p>

An outbreak of SARS in Dongcheng District, Beijing during March to June 2003 / 中国医学科学院学报

<p><b>OBJECTIVE</b>To describe epidemiological characteristics of an outbreak of severe acute respiratory syndrome (SRAS) in Dongcheng District, Beijing during March to June 2003.</p><p><b>METHODS</b>Data of SARS cases notified from Dongcheng District Center for Disease Control and Prevention (CDC) and supplemented by other channels were collected. All data were input into dataset files by Microsoft Excel-2000 software and analyzed with SPSS version 10.0 software.</p><p><b>RESULTS</b>Totally, 572 cases notified were collected during this period in Dongcheng District, Beijing, and 99 of them were excluded from SARS, because of diagnosis of common cold, pneumonia, measles, or rubella, etc. Actually, 473 SARS cases were analyzed. Attack rate of SARS in permanent residents of Dongcheng was 28.3 per 100,000. Forty-one of them died, with a case-fatality ratio of 8.7%. Outbreak of SARS in Dongcheng District started on March 14, with a peak during mid- and late April, and dropped from May 5, 2003. Persons were all susceptible to SARS, with the highest proportion at ages of 20-50 years, which accounted for 68.7% of the total cases. Average age of the patients at their onset was 40.7 years. No gender difference in SARS cases was found. Number of SARS cases in health care workers (HCWs) accounted for 18.0% and that in the retired persons accounted for 15.4% of the total cases. Cases occurred in all 10 sub-districts of Dongcheng. Totally, 230 of the 572 notified cases (40.2%) hospitalized at local hospitals under the jurisdiction of Dongcheng District. Eighteen of 85 cases of SARS occurred in health care workers of local hospitals, accounting for 4.5% of the total number of health care workers working at the wards caring for SARS patients or at fever clinics. There were 34.7% of SARS cases without any contact histories before their onset. Familial aggregation phenomena were observed in 41.8% of the cases and 18.1% of households. And, 7.4% (attack rate) in those exposed to SARS cases suffered the illness during the periods of quarantine.</p><p><b>CONCLUSIONS</b>SARS appeared outbreak in Dongcheng District, Beijing during March to June 2003. People were all susceptible to SARS, which mainly threatened the young adults and the middle-aged, as well as health care workers and the retired workers. Main mode of transmission was exposure to SARS patients in a near distance at hospitals or families. Prevention and control of SARS should be focused on early isolation of patients and quarantine for the contacts. Current available measures to prevent and control SARS proved effective.</p>