Prevalence of osteoporosis and related factors in postmenopausal women aged 40 and above in China / 中华流行病学杂志

Objective: To understand the prevalence of osteoporosis and related factors in postmenopausal women aged ≥40 years in China and provide scientific evidence for osteoporosis prevention and control. Methods: Data of this study were from the 2018 China Osteoporosis Epidemiological Survey, covering 44 counties (districts) in 11 provinces in China. Related variables were collected by questionnaire survey and physical measurement, and the BMD of lumbar spine and proximal femur was measured by dual-energy X-ray absorption method. The prevalence of osteoporosis and its 95%CI in postmenopausal women aged ≥40 years were estimated with complex sampling weights. Results: A total of 5 728 postmenopausal women aged ≥40 years were included in the analysis and the prevalence of osteoporosis was 32.5% (95%CI: 30.3%-34.7%). The prevalence of osteoporosis in postmenopausal women aged 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years were 16.0% (95%CI:4.5%-27.5%), 18.4% (95%CI:15.9%-20.8%), 37.5% (95%CI:34.5%-40.4%), 52.9% (95%CI: 47.5%-58.3%), and 68.0% (95%CI:55.9%-80.1%) respectively. The prevalence of osteoporosis was higher (P<0.001) in those with education level of primary school or below (47.2%, 95%CI: 43.0%-51.3%) and in those with individual annual income less than 10 000 Yuan, (40.3%, 95%CI: 36.9%-43.7%). The prevalence of osteoporosis was 35.1% in rural areas (95%CI: 32.0%-38.1%), which was higher than that in urban areas (P<0.001). The prevalence of osteoporosis in low weight, normal weight, overweight and obese groups were 69.9% (95%CI: 59.0%-80.8%), 42.2% (95%CI: 38.7%-45.7%), 24.2% (95%CI: 21.3%-27.1%) and 14.6% (95%CI: 11.1%-18.0%), respectively. The prevalence of osteoporosis in those with menstrual maintenance years ≤30 years and in those with menopause years ≥11 years were 46.1% (95%CI:40.8%-51.3%) and 48.2% (95%CI:45.0%-51.3%), respectively. Multivariate logistic analysis showed that age ≥60 years, education level of primary school or below, annual household income per capita less than 10 000 Yuan, low body weight, menstrual maintenance years ≤30 years, menopause years ≥11 years were risk factors of osteoporosis in postmenopausal women in China. Conclusions: The prevalence of osteoporosis was high in postmenopausal women aged ≥40 years in China, and there were differences in osteoporosis prevalence among different socioeconomic groups. Effective interventions should be taken for the prevention and control of osteoporosis in key groups in the future.

Prevalence of chronic respiratory symptoms and dyspnea and related factors in residents in China / 中华流行病学杂志

Objective: To understand the prevalence of chronic cough, chronic expectoration and dyspnea and related factors in residents aged ≥40 years in China, and provide basic data for the prevention and control of chronic respiratory diseases. Methods: Data were from 2014-2015 chronic obstructive pulmonary disease surveillance in China. The information about chronic respiratory symptoms were collected by face-to-face interview. The prevalence rates of chronic cough, chronic expectoration, dyspnea and chronic respiratory symptoms and their 95%CI were estimated with complex sampling weights. Results: A total of 75 082 subjects were included in the analysis. The prevalence rates of chronic cough, chronic expectoration, dyspnea and chronic respiratory symptoms in the Chinese aged ≥40 years were 3.75% (95%CI: 3.38%-4.11%), 5.83% (95%CI: 5.40%-6.26%), 2.45% (95%CI: 2.02%-2.87%) and 8.93% (95%CI: 8.25%-9.62%), respectively. The prevalence rates of chronic cough, chronic expectoration, dyspnea and chronic respiratory symptoms in patients with chronic respiratory diseases were relatively higher, which were 10.27%, 13.85%, 6.43%, 20.72% respectively. Multivariate logistic regression analysis showed that age, region, education level, occupation, BMI, family history of respiratory diseases, history of severe respiratory infections in childhood, exposure to dust or chemicals in workplace and smoking status affected the prevalence of chronic cough, chronic expectoration and dyspnea. The prevalence of the three types of chronic respiratory symptoms increased significantly with age, which were higher in western region, smokers and underweight/obese subjects. The three prevalence rates mentioned above were higher in those with a history of severe respiratory infection in childhood, those exposed to biomass fuel in household, and those exposed to dust or chemicals in workplace. Conclusions: The prevalence rate of chronic respiratory symptoms was high in residents aged ≥40 years in China. Many factors affected the prevalence of chronic respiratory symptoms. Comprehensive prevention and control measures targeting risk factors should be taken to reduce the burden of chronic respiratory diseases.

Adenovirus-mediated Expression of B-domain-Deleted Human Coagulation Factor Ⅷ in ADSC of SD Rats / 中国实验血液学杂志

OBJECTIVE@#To transinfect SD adipose tissue-derived stem cell (ADSC) in vitro with a recombinant adenoviral vector containing human B-domain-deleted FVIII (BDDhFⅧ), so as to lay the foundation for the treatment of hemophilia A by using ADSC combined with BDDhFⅧ gene.@*METHODS@#ADSCs were isolated from the inguinal adipose tissue of SD rats and passed to third passage for identification. Third passage ADSCs were transfected in vitro with recombinant adenovirus vector Ad-BDDhFⅧ-GFP. The experiments were divided into Ad-BDDhFⅧ-GFP-transfected ADSCs group (A), Ad-GFP-transfected ADSC group (B), and untransfected ADSC group (C). CCK-8 method was used to detect the proliferation of transfected cells in three groups, and the expression level of hFⅧ antigen in cell supernatant was detected by ELISA. RT-PCR and Western blot respectively were used to detect the mRNA and protein expression of BDDhFⅧ in the three groups after transfection.@*RESULTS@#The growth curve of third passage cells isolated and cultured showed an inverted "S" shap; the flow cytometry detection showed the positive expression of CD29, CD90, CD44, and the negative expression of CD45 in third passage cells. After the adipogenic and osteogenic induction, the cells could transformed to adipogenic and osteogenic directions. CCK-8 detection showed that the proliferation of cells in 3 groups not was influenced. ELISA showed that the expression of hFⅧAg in group A was significantly higher than that in group B and C (P＜0.05). RT-PCR showed that compared with group A, there was no target band in B and C groups, and BDDhFⅧ gene was not expressed. The results in group A were consistent with the length of amplified fragments, and BDDhFⅧ target gene was expressed. Western blot analysis showed that the expression of hFⅧ protein in group A was significantly higher than that in group B and C. (P＜0.05).@*CONCLUSION@#Recombinant adenovirus Ad-BDDhFⅧ-GFP can effectively transfect rat ADSC in vitro, which lays an experimental foundation for gene therapy of hemophilia A.

Clinical Observation of Relaxing Needling at Meridian-muscle Nodes plus PNF Method in Improving Upper-limb Motor Function and Quality of Life in Hemiplegic Shoulder Pain / 上海针灸杂志

Objective To observe the effect of relaxing needling at meridian-muscle nodes plus rehabilitation techniques on upper-limb motor function and quality of life (QOL) in hemiplegic shoulder pain after cerebral stroke. Method Ninety patients with hemiplegic shoulder pain after cerebral stroke were randomized into a rehabilitation group of 30 cases [intervened by proprioceptive neuromuscular facilitation (PNF) method], a relaxing needling group of 30 cases (intervened by relaxing needling at meridian-muscle nodes), and a comprehensive group of 30 cases (intervened by relaxing needling at meridian-muscle nodes plus PNF method), to receive 6-week treatment in total. Before and after the intervention, Assessment Face Scale (AFS), Fugl-Meyer Assessment Scale (FMA) and Stroke Specific Quality of Life Scale (SS-QOL) were evaluated, and the occurrence rate of shoulder-hand syndrome was assessed. Result After 1-week treatment, the AFS score of the comprehensive group was significantly different fromthat in the rehabilitation group and relaxing needling group (P<0.05). After 6-week treatment, the FMA and SS-QOL scores in the comprehensive group were significantly different from those in both rehabilitation group and relaxing needling group (P<0.05). Twelve weeks later, the occurrence rate of shoulder-hand syndrome in the comprehensive group was significantly different from that in the other two groups (P<0.05). Conclusion Relaxing needling at meridian-muscle nodes plus PNF method can effectively improve the efficacy in the treatment of hemiplegic shoulder pain, reduce the occurrence of shoulder-hand syndrome, and enhance the QOL, thus is an effective approach.

A Preliminary Exploration on the Pathogenesis of Osteopenia in Patients with Hemophilia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the influencing factors and pathogenesis of osteopenia in the patients with hemophilia.</p><p><b>METHODS</b>Twenty-three patients with hemophilia were admitted in the hospital affiliated to North China University of Science and technology from March to August 2015, including 13 severe cases, 10 mild and moderate cases. All the patients accepted the detection of serum I collagen cross-linking N terminal peptide (NTX I), osteoprotegerin (OPG), bone alkaline phosphatase (BALP), basic fibroblast growth factor (bFGF), insulin-like growth factor (IGF) and transforming growth factor-β1 (TGF-β1), the score scale of activity ability was recorded according to the criteria published by the U.S. Center for disease prevention and control in 2002, and 21 patients received the measurement of bone mineral density. According to the World Health Organization (WHO) definition, the clinical significance of bone mineral density (BMD) was assessed by measuring the Z level.</p><p><b>RESULTS</b>Z level>-2 was recorded in 10 cases, Z≤-2 was recorded in 11 cases; the levels of body mass index (BMI) and human bone alkaline phosphatase (BALP) reflecting bone formation in 11 cases (Z≤-2) were lower than there in 10 cases (Z>-2) (P<0.05); the levels of BALP (r=0.489, P<0.05), IGF (r=0.538, P<0.05) and BMI (r=0.572, P<0.01) positively correlated significantly with BMD (P<0.05); the levels of bFGF (r=0.570, P<0.01) and OPG (r=0.505, P<0.05) positively correlated with NTX I, indicating bone destruction (P<0.05); the score of activity ability of severe patients was significantly lower than that of mild and moderate cases (P<0.05), BMD levels of these 2 groups were not statistically different (P>0.05).</p><p><b>CONCLUSION</b>The BMD level does not correlate with the clinial grouping of hemophilia, the low body mass index may be a risk factor for bone lose; the mechanism of hemophilia patient's bone lose may be related with the decrease of osteogenic activity, the IGF can prevent bone lose in hemophilia, the bFGF and OPG can promote bone metabolism of the patients with hemophilia.</p>

Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Disease in Women in China: Surveillance Efforts / 生物医学与环境科学（英文）

In this study, we aimed to assess the relationship of socioeconomic status and acculturation with cardiovascular disease (CVD) risk profiles and CVD and examine the CVD risk factors associated with CVD. We used data from the 2010 China Chronic Disease and Risk Factor Surveillance surveys, which consisted of a nationally representative sample of women. The following prevalence was found: myocardial infarction (MI): 0.4%; stroke: 0.5%; abnormal cholesterolemia: 44.9%; overweight or obesity: 32.2%; hypertension: 31.7%; diabetes: 9.0%; and smoking: 2.5%. In total, 30.9% of Chinese women had no risk factors, but 13.3% had ⋝3 associated risk factors. In multivariate-adjusted models, hypertension, diabetes, overweight or obese, and smoking were all directly associated with MI; For stroke, associations were positive with hypertension, abnormal cholesterolemia, diabetes, and overweight or obesity. Therefore, it can be concluded that CVD risk factors are common among Chinese women aged ⋝18 years.

Dietary sodium intake and its impact factors in adults of Shandong province / 生物医学与环境科学（英文）

Dietary sodium intake and its impact factors in 2 140 adults aged 18-69 years were analyzed. The mean daily sodium intake was 5745.0 (5427.6-6062.5) mg per day, which was higher in males than in females (P<0.01). After having been adjusted for gender, age and urban/city areas, the mean daily sodium intake was significantly higher in participants with a lower education level, drinkers and smokers than in those with a higher education level, nondrinkers and nonsmokers (P<0.01). The dietary sodium intake in adults of Shandong Province is higher than the recommended standards.

Analysis of partner attitude toward HIV infected pregnant women and its influencing factors in western China during 2005-2011 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze partner attitude change and influencing factors on HIV infected pregnant women HIV disclosure.</p><p><b>METHOD</b>A multi-stage cross sectional method was used to collect information by questionnaires on 1164 HIV infected pregnant women in 6 counties including Ruili and Longchuan in Yunnan, Hezhou, Lingshan and Pingxiang in Guangxi and Yining in Xinjiang. Information on demographic characteristics and sexual behavior of the subjects and partner attitude toward HIV infected pregnant women were obtained. The influencing factors of partner's discrimination against HIV infected pregnant women were analyzed.</p><p><b>RESULT</b>A total of 991(85.1%) HIV infected pregnant women have disclosed HIV status to partners among 1164 respondents and 39 (3.9%) reported they were discriminated against partners. Multivariate analysis showed that the 6.5% (15/231) of HIV infected pregnant women in urban had discrimination from their husbands while the ratio among rural pregnant women was lower(3.2% (24/760), OR = 0.40, 95%CI:0.12-0.77) . Compared with the ratio of discrimination among the women of first marriage(2.9%, 21/731), the discrimination ratio among women with remarriage and other status was higher (6.5% (15/232),OR = 2.45, 95%CI:1.61-5.25 and 10.7% (3/28),OR = 3.77, 95%CI:1.46-9.88) respectively. The discrimination ratio among pregnant women with multiple sexual partners was 5.9% (23/389), higher than women with single partner (2.6%, 15/580) (OR = 2.21, 95%CI:1.80-6.23).</p><p><b>CONCLUSION</b>The discrimination toward HIV infected pregnant women from husbands was related to demographic characteristics and sexual behaviors.</p>

Self-rated health status among Chinese residents, China, 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the self-rated health status among Chinese residents in 2010.</p><p><b>METHODS</b>Data was from the Non-communicable Disease & Risk Factor Surveillance in China, 2010. A total of 98 638 adults aged ≥ 18 years were included in the study. Self-rated health was assessed by four questions: (1) Would you assess your health status as very good or good, general (not good/not poor), poor or very poor? (2) How many days was your health not good for physical illness during the past 30 days? (3) How many days was your health not good for injury during the past 30 days? (4) How many days was your health not good for mental illness, which include stress and problem with emotions depression during the past 30 days? After being weighed according to complex sampling scheme and post-stratification, the sample was used to estimate the prevalence of self-rated health. The Rao-scott χ(2) test with different samples was adopted for comparison among groups.</p><p><b>RESULTS</b>In total, 57.5% (95%CI:55.5%-59.5%) of the participants rated their health as being either very good or good, 36.2% (95%CI:34.5%-37.8%) as general, and only 6.3% (95%CI:5.7%-6.9%) as poor or very poor; In different age groups and gender, the differences were statistically significant (χ(2) values were 1179.88, 85.36, both P values were < 0.05) . The reported rate of poor or very poor health increased significantly with advancing age ranging from 2.0% (95%CI:1.5%-2.4%)in 18-24 year-old group to 14.9% (95%CI:12.6%-17.2%) in ≥ 75 year-old group; Females were more likely than males to rate their health as poor or very poor , respectively (7.2%; 95%CI 6.5%-7.9% and 5.4%; 95%CI:4.9%-5.9%). During the past 30 days 18.5% (95%CI:17.1%-19.8%) of the participants was not in good health for physical illness. The reported rate of physical illness increased significantly with advancing age (χ(2) = 211.99, P < 0.01), and it was the lowest in 25-34 year-old group (15.4%; 95%CI:13.7%-17.0%), and the highest in ≥ 75 year-old group (28.3%; 95%CI:24.9%-31.6%) . It was statistically higher among females (21.1%; 95%CI:19.5%-22.6%) compared to males (15.9%; 95%CI:14.6%-17.3%) (χ(2) = 231.81, P < 0.01); the reported rates of physical illness were 17.4% (95%CI:15.3%-19.5%) among residents in the east region, 17.2% (95%CI:14.7%-19.6%) in the middle region, and 21.5% (95%CI:18.7%-24.4%) in the western region(χ(2) = 6.75, P < 0.01). During the past 30 days 2.7% (95%CI:2.3%-3.2%) of the participants was not in good health for injure. The reported rate of injure decreased significantly with advancing age (χ(2) = 25.54, P < 0.01), and it was the highest in 18-24 year-old group (3.8%; 95%CI:2.6%-5.0%), and the lowest in 35-44 year-old group (2.3%; 95%CI:1.8%-2.7%) . It was statistically higher among males (3.0%; 95%CI:2.4%-3.5%) compared to females (2.5%; 95%CI:2.1%-2.9%) (χ(2) = 8.89 P < 0.01) ; the reported rates of injure were 2.3% (95%CI:1.9%-2.7%) among residents in the east region , 2.1% (1.7%-2.4%) in the middle region, and 4.1% (95%CI:2.6%-5.6%) in the west region (χ(2) = 16.26, P < 0.01). During the past 30 days 10.0% (95%CI:8.8%-11.3%) of the participants was not in good health for mental illness. The reported rate of mental illness decreased significantly with advancing age (χ(2) = 92.14 P < 0.01), and it was the highest in 18-24 year-old group (12.9%; 95%CI: 10.6%-15.2%), and the lowest in ≥ 75 year-old group (5.7%; 95%CI: 4.4%-7.0%) .It was statistically higher among females (10.8%; 95%CI:9.5%-12.1%) than males (9.2%; 95%CI:7.9%-10.5%) (χ(2) = 21.59, P < 0.01).</p><p><b>CONCLUSION</b>The self-rated health status among Chinese residents was good in 2010. Substantial variation exists in self-rated health status across age groups, between genders, and across regions. Considering these disparities will be important for developing health policy and allocating resources.</p>

A cross-sectional study of the association of movement disorders, constipation and sleep disturbances among elderly in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the current status and association between movement disorders, constipation and sleep disturbances in the elderly population of China.</p><p><b>METHODS</b>A total of 42 353 subjects aged over 60 years old from Chinese Chronic Non-communicable Disease & Risk Factor Surveillance (2010) was selected in our study. The information on movement disorders, constipation and sleep disturbances was collected by standardized questionnaire interview. The prevalence and association of self-reported movement disorders, constipation and sleep disturbances was measured according to different gender, age groups and regions.</p><p><b>RESULTS</b>The study was conducted among 42 353 old adults, including 21 893 males (51.7%) and 20 460 females (48.3%); 17 917 from urban areas (42.3%) and 24 436 from rural areas (57.7%); and the proportion of elderly from eastern, central and western regions were 37.9% (16 031 subjects), 29.1% (12 345 subjects) and 33.0% (13 977 subjects) respectively. After weighted complex analysis, the data showed that among the elderly population over 60 years old in China, the self-reported rates of movement disorders, constipation and sleep disturbances were all age-related, rising up with the age increasing. The rates of 60-64 age group were 2.8% (95%CI:1.9%-3.7%), 3.6% (95%CI:3.1%-4.1%) and 12.4% (95%CI:11.0%-13.8%);and in ≥ 80 age group, the rates were 13.2% (95%CI:10.2%-16.1%), 8.8% (95%CI:7.1%-10.6%) and 19.1% (95%CI:16.3%-21.9%). The self-reported rate of movement disorders was 5.7% (95%CI: 4.5%-7.0%); the prevalence of constipation was 5.1% (95%CI: 4.4%-5.7%), which was higher among women (5.8%, 95%CI: 5.0%-6.6%) than it among men (4.3%, 95%CI: 3.7%-4.8%) (χ(2) = 23.40, P < 0.05), and higher among subjects from urban areas (6.0%, 95%CI: 5.1%-7.0%) than from rural areas (4.6%, 95%CI: 3.8%-5.4%) (χ(2) = 5.62, P < 0.05); the prevalence of self-reported sleep disturbances was 14.2% (95%CI: 12.7%-15.8%), higher in women (17.4%, 95%CI: 15.4%-19.3%) than in men (11.0%, 95%CI: 9.7%-12.2%) (χ(2) = 172.05, P < 0.05); the prevalence of movement disorders in people with constipation (16.3%, 95%CI: 12.7%-19.9%) was much higher than it in people without constipation (5.2%, 95%CI: 4.0%-6.3%) (χ(2) = 242.73, P < 0.05); and the prevalence of movement disorders in people with sleep disturbances (13.0%, 95%CI: 10.6%-15.4%) was much higher than it in people without sleep disturbances (4.5%, 95%CI: 3.5%-5.5%) (χ(2) = 688.80, P < 0.05).Logistic regression analysis showed that constipation and sleep disturbances would increase the risk of movement disorders, with the OR (95%CI) at 2.93 (2.57-3.33) and 2.73 (2.48-3.02), respectively.</p><p><b>CONCLUSION</b>The present study showed that self-reported rates of movement disorders, constipation and sleep disturbances all rose up with age increasing in the elderly. The movement disorders was associated with constipation and sleep disturbances.</p>

The study of management of hypertensive people aged 35 and over in communities in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the community-based management status of hypertensive patients aged 35 or over in China and provide basic data for evaluation by investigating the hypertensive patients managed in communities.</p><p><b>METHODS</b>The subjects in this study were recruited from the individuals of the 2010 China Non-communicable and Chronic Diseases. In September 2011, flow-up survey and a cross-section analysis has been done during the same people interviewed in 2010. Clustering sampling method was used to select 11 977 samples aged 35 or over and diagnosed by doctors from community level or above hospitals to be interviewed. A face to face questionnaire survey was carried out to collect information on general demographic characteristics, the treatment and control of blood pressure and risk factors of the hypertensive patients of community management.Sample was weighted according to complex sampling scheme and post-stratification to represent the population of Chinese hypertensive patients aged 35 or over and the rates with 95% confidence intervals (CI) were calculated for the subgroups according to different characteristics. The Rao-scott χ(2) test was performed to test for the differences of the rates of the subgroups.</p><p><b>RESULTS</b>In the survey, there were 11 977 patients aged 35 or over diagnosed as hypertension by doctors, and among them, a total of 5120 hypertensive patients had been under management in communities. After being weighted the rate of management of hypertensive patients in communities was 43.99% (95%CI:38.17%-49.81%). There was a significant difference in the proportion of patients receiving management services when comparing different age groups (χ(2) = 21.98, P < 0.01) and sex (χ(2) = 4.18, P < 0.05), the rate of management among the patients aged 65 or over was 46.97% (95%CI:40.44%-53.50%), while among the patients aged 35 to 44 was only 37.72% (31.78%-43.65%). The rate of management was higher among females (45.37%, 95%CI:39.24%-51.50%) than males (42.50%, 95%CI:36.71%-48.30%). The overall rate of standardized management of hypertensive patients managed in communities was 35.30% (95%CI:31.78%-38.81%). The research also found differences in the proportions of patients receiving standardized management services when comparing different age groups (χ(2) = 28.66, P < 0.05), gender (χ(2) = 235.85, P < 0.01), and regions (χ(2) = 9.29, P < 0.05). The rate of receiving standardized management services among the patients aged 65 or over was 40.52% (95%CI:36.21%-44.82%), while among the patients aged 35 to 44 was only 26.18% (95%CI:20.07%-32.29%), the rate was lower among males (16.78%, 95%CI:14.13%-19.42%) than females(51.29%, 95%CI:46.41%-56.16%) , the rate of patients living in urban areas (38.53%, 95%CI:34.34%-42.72%) was higher than patients living in rural areas (33.36%, 95%CI:28.17%-38.55%) . The differences of the treatment rates of hypertensive patients managed in communities were found among different age groups (χ(2) = 26.39, P < 0.01), gender (χ(2) = 13.91, P < 0.01), and regions (χ(2) = 4.27, P < 0.05), the rate of treatment was 94.67% (93.41%-95.93%) among the patients aged 65 or over , while 86.47% (95%CI:81.05%-91.89%) among patients aged 35 to 44, the rate of treatment was higher among females (94.35%, 95%CI:93.15%-95.55%) than among males (90.84%, 95%CI:88.99%-92.70%), and it was also higher among patients living in urban regions (94.17%, 95%CI:92.62%-95.71%) than among patients living in rural regions (91.86%, 95%CI:90.20%-93.52%). The rate of control of hypertensive patients managed in communities was 33.13% (95%CI:29.50%-36.76%) and the rate was higher among the subjects living in the urban areas (45.09%, 95%CI:38.73%-51.45%) than in rural areas (25.96%, 95%CI:21.63%-30.30%) (χ(2) = 22.40, P < 0.01).</p><p><b>CONCLUSION</b>Results from our study showed that community management of hypertension had been popularized across the country. And it could significantly improve the program on the treatment and control of hypertension at the community level in China.</p>

Awareness rate, treatment rate and control rate of dyslipidemia in Chinese adults, 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the awareness, treatment and control rates of dyslipidemia among Chinese adults aged over 18 in 2010, and to analyze the prevalent features.</p><p><b>METHODS</b>97 409 subjects aged over 18 were recruited from 162 monitoring sites around 31 provinces in China mainland in 2010, applying multi-stage stratified cluster random sampling method. Information about subjects' history of dyslipidemia, treatment and control were collected by face-to-face interview; and each subject's fasting venous blood was drawn in the morning before having food, to test total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). In total, 51 818 cases of dyslipidemia ever or now, including 2235 subjects who once suffered from dyslipidemia but had their blood lipid controlled to normal, were screened out. And the awareness, treatment and control rates were calculated by complex weighting.</p><p><b>RESULTS</b>The awareness rate of dyslipidemia among Chinese adults was 10.93%, while the stratified rates were 6.00%, 16.75% and 18.74% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 1293.02, P < 0.01); 10.32% and 11.71% among males and females, respectively (χ² = 18.67, P < 0.01); 16.59% and 8.17% in groups from urban and rural areas, respectively (χ² = 618.38, P < 0.01); and 12.22%, 11.75% and 8.26% in groups from eastern, central and western China, respectively (χ² = 117.04, P < 0.01). The treatment rate of dyslipidemia was 6.84% among Chinese adults, while the stratified rates were 3.55%, 10.73% and 12.05% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 858.72, P < 0.01); 6.37% and 7.43% among males and females, respectively (χ² = 16.69, P < 0.01); 10.17% and 5.21% in groups from urban and rural areas, respectively (χ² = 327.51, P < 0.01); and 7.33%, 7.52% and 5.41% in groups from eastern, central and western China, respectively (χ² = 50.71, P < 0.01). The control rate of dyslipidemia was 3.53% among total subjects, while whose stratified rates were 1.64%, 5.49% and 6.94% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 554.12, P < 0.01); 2.57% and 4.75% among males and females, respectively (χ² = 131.04, P < 0.01); 5.23% and 2.70% in groups from urban and rural areas, respectively (χ² = 165.13, P < 0.01) ; and 4.21%, 3.89% and 2.17% in groups from eastern, central and western China, respectively (χ² = 91.45, P < 0.01).</p><p><b>CONCLUSION</b>The awareness, treatment and control rates of dyslipidemia have been comparatively low among Chinese adults, especially among the population who were young, or who were from rural area or western China.</p>

Current status of diabetes, hypertension and dyslipidemia among older Chinese adults in 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the distribution of hypertension, diabetes and dyslipidemia among elderly population in China in 2010.</p><p><b>METHODS</b>In 2010, The 3rd Chronic Non-communicable Disease & Risk Factor Surveillance in China was conducted in 31 provinces and Xinjiang Production & Construction Corps. A stratified multi-stage cluster sampling was used from 162 National Disease Surveillance Points (DSPs). A total of 19 981 residents aged ≥ 60 years received a set of standardized questionnaire interview, physical examinations and laboratory test for lipid & glucose levels in blood. After complex weighting of the sample, the prevalence of hypertension, diabetes and dyslipidemia were compared for different gender, age groups and regions.</p><p><b>RESULTS</b>After complex weighting, among elderly, the overall prevalence of hypertension was 66.9%, and the rates were greater in the eastern areas (67.9%) than in the western areas (62.5%) (P < 0.05), there was no significant difference between urban areas and rural areas (P > 0.05); the prevalence of diabetes was 19.6%, the rates were greater in the eastern areas (21.5%) than in the western areas (17.7%) (P < 0.05), and greater in the urban areas (25.0%) than in the rural areas (17.0%) (P < 0.05) ; the prevalence of high triglycerides, high blood cholesterol and high low-density lipoprotein were all higher in the urban areas (12.4%, 6.4% and 5.2%) than in the rural areas (10.1%, 4.2% and 2.8%) (all P values < 0.05), and also higher for women (12.9%, 6.9% and 4.7%) than for men (8.7%, 2.9% and 2.4%) (all P values < 0.05); the prevalence of hypertension in people with abnormal blood lipids (74.3%) was higher than those with normal blood lipids (65.7%) (P < 0.05); the prevalence of hypertension and dyslipidemia in people with diabetes (77.3%, 23.2%) were both greater than the prevalence in non-diabetic group (64.5%, 12.6%) (both P values < 0.05).</p><p><b>CONCLUSION</b>The present study showed high prevalence of hypertension, diabetes and dyslipidemia among elderly people in China. The rates were greater in the eastern than in the western and higher for women than for men. The rates of diabetes and dyslipidemia were significantly higher in the urban areas than in the rural areas. Comprehensive prevention and control of hypertension, diabetes and dyslipidemia among the elderly should be enhanced.</p>

Influence of aminoguanidine on retina morphology and expression of nitric oxide and inducible nitric oxide synthase after retina ischemia-reperfusion injury / 中华实验眼科杂志

Background Many eye diseases such as central retinal artery occlusion,glaucoma and ischemic optic neuropathy,etc.lead to retinal ischemia-reperfusion injury (RIRI) and furthmore visual functional damage.It is neeessary to study the treatment of RIRI.Objective This study was to observe and discuss the influence of aminoguanidine on the retina morphological changes and its mechanism after RIRI.Methods Eighty clean healthy male Japanese white rabbits were randomly divided into normal injury group,RIRI group and aminoguanidine (AG)treated group.The model of RIRI was established by infusing saline solution into the anterior chamber to elevate intraocular pressure (IOP) in both RIRI group and AG group.AG was intraperitoneally injected in the models of the AG group,and normal saline solution was used at the same method in tbe normal group and the RIRI group.The fundus photography and fundus fluorescein angiography(FFA) were pertormed on the rabbits at the moment of retina ischemia and 6,24 and 72 hours after reperfusion.The parts of rabbits were sacrificed 1,6,24 and 72 hours after reperfusion,followed by the enucleation of the eyeballs.Retinal section was prepared for TUNEL examination to evaluate the apoptosis of retinal cells.Nitric oxide (NO) concentration in retina was detected with nitrate reductase,and the activity of inducible nitric oxide synthase (iNOS) was measured by colorimetric detection.The use of the animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The fundus photography and FFA showed that the retinal edema was more mild,and the percentage of vascular occlusion was lower in the AG treatment group than that in RIRI group and the amount and area of fluorescein leakage were also smaller than the treatment group.The numbers of TUNEL positive cells in the AG treatment group were less than those in the RIRI model group at 1,6,24 and 72 hours after experiment (F分组 =2762.37,P =0.00 ; F时间 =894.24,P =0.00).Numbers of TUNEL positive cells between adjacent time points were significantly different in both RIRI model group and AG treatment group (RIRI group:q =24.475,36.591,-20.37,P＜0.05;AG group:q =20.94,16.79,-6.92,P＜0.05),with the peak value at 24 hours after experiment.NO contents were significantly higher in the RIRI model group compared to AG group at various time points(q =3.84,4.01,8.91,3.75,P＜0.05),and those between adjacent time points showed significant differences (RIRI group:q=4.77,13.403,-10.29,P＜0.05;AG group:q=4.55,9.05,-5.08,P＜0.05).iNOS activity was significantly elevated in the RIRI model group compared with AG group(q=-3.74,-4.94,-6.53,-3.98,P＜0.05),and obvious differences also were seen between the adjacent time points in both two groups(RIRI group:q =8.43,6.71,-6.39,P＜0.05 ;AG group:q =4.16,5.08,-3.93,P＜0.05).Conclusions Aminoguanidine can protect the retinal function and morpbology from oxidative stress damage after RIRI by reducing the NO level and inhibiting the iNOS activity in retina.

Analysis on the intervention services status of prevention of mother to child transmission of HIV/AIDS in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>The purpose of this study is to get to know the intervention services implementation status of prevention of mother to child transmission (PMTCT) of HIV/AIDS in China, and the trend of recent five years.</p><p><b>METHODS</b>We carried out relevant surveys and investigations among the areas where PMTCT work had been implemented during January 2005 to December 2009. Health providers in these fields provided routine maternal health care, HIV counseling and test for 10 360 655 pregnant women and comprehensive intervention measures to 10 123 HIV infected pregnant women which included antiretroviral (ARV) drugs usage, safety delivery, and exclusive breastfeeding, and collected relevant data and materials to analysis the ratio of main interventions and its change trend.</p><p><b>RESULTS</b>The HIV/AIDS counseling rate was increasing year by year (χ(2)(trend) = 3184.5, P < 0.001), during 2005 to 2009 the rate was 69.8% (406 151/581 975), 84.5% (1 346 745/1 594 579), 90.3% (1 582 757/1 753 191), 93.7% (1 926 224/2 055 232), 82.3% (3 599 228/4 375 678) respectively. HIV/AIDS test rate was increasing (χ(2)(trend) = 146 194.7, P < 0.001), the rate from 2005 to 2009 was 57.8% (336 459/581 975), 80.8% (1 287 812/1 594 579), 87.0% (1 524 595/1 753 191), 89.2% (1 833 246/2 055 232), 85.5% (3 741 337/4 375 678)respectively. The total number of HIV/AIDS infected maternities was 10 123 during 2005-2009, 6156 of them delivered, the general usage rate of ARVs was 71.0% (4373/6156), and increasing to 75.3% (1554/2065) by the end of 2009, the rates of 2005 to 2008 were 64.6% (362/560), 66.9% (623/931), 66.7% (857/1284), 74.2% (977/1316) respectively. The difference was significant (χ(2)(trend) = 47.6, P < 0.001). The proportion of using ARVs during pregnant period was 58.5% (2557/4373). The proportion of using ARVs among born infants of HIV infected maternities was 83.4% (4999/5994), and increasing yearly, 77.2% (409/530) of 2005, 80.1% (720/899) of 2006, 83.8% (1053/1257) of 2007, 89.4% (1116/1249) of 2008, 82.6% (1701/2059) of 2009, the difference was significant (χ(2)(trend) = 13.0, P < 0.001). The general rate of exclusive breastfeeding was 92.9% (5276/5681) and the rate of HIV test in 18 months was 74.6% (2482/3324).</p><p><b>CONCLUSION</b>The rate of HIV/AIDS counseling and test of general maternities is increasing and the proportion of mainly intervention measures have been increased year by year.</p>

Efficacy analysis of different antiretroviral drug regimens in mother to child HIV transmission prevention in some regions of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To determine the efficacy of different antiretroviral drug regimens in mother to child HIV transmission prevention (PMTCT) in China.</p><p><b>METHODS</b>From January 1st 2006 to Dec 30th 2008, a total of 1072 pairs of HIV positive pregnant women and their babies who were HIV antibody positive and older than 18 months were recruited in this study. These women who had received maternal health care in health care institutions were from 23 provinces. Subjects were investigated by questionnaire, including social demographic data, usage of ARVs, safe delivery and artificial feeding, and other PMTCT related informations. The trend of different antiretroviral drug regiments in different period were analyzed by Cochran-Mantel-Haenszel (CMH) χ(2) test. By stratified analysis and Fisher exact χ(2) test, the efficacy of different antiretroviral drug regimens in mother to child HIV transmission prevention were studied. Antiretroviral drug regimens applications mainly included sd-NVP drug regimen, prophylaxis regimen and highly active anti-retroviral therapy (HAART).</p><p><b>RESULTS</b>Among 1072 pairs of HIV positive maternities and babies, 31 babies older than 18 months were HIV infected, MTCT rate was 2.9% (31/1072). (1) The proportion of using ARVs was increasing from 76.4% (306/395) in 2006 to 83.8% (372/444) in 2008, the difference was significant (CMH χ(2) = 6.4, P < 0.05). (2) The ratio that HIV infected maternities adopted ARVs rose from 3.4% (6/178) in 2006 to 26.3% (104/395) in 2008, the ratio increased year by year (CMH χ(2) = 53.1, P < 0.01). On the contrary, usage of sd-NVP declined from 88.8% (158/178) in 2006 to 70.9% (264/372) in 2008 (CMH χ(2) = 48.5, P < 0.01). (3) Among maternities adopted vaginal delivery and artificial feeding, the MTCT rate of ARVs combination group was 1.0% (1/104), while the MTCT rate of sd-NVP group was 5.9% (16/272) (Fisher χ(2) = 5.5, P < 0.05). (4) In the case of artificial feeding, the MTCT rate of prophylaxis regimens and HAART among maternities adopted vaginal delivery was 3.1% (1/32) and 0 respectively. Among maternities adopted cesarean delivery, MTCT rate of prophylaxis regimens and HAART was 3.2% (2/63) and 3.1%(1/32) respectively, both showed no significant difference (Fisher χ(2) = 1.4, P > 0.05; Fisher χ(2) = 0.0001, P > 0.05).</p><p><b>CONCLUSION</b>Effect of combination of antiretroviral drugs to PMTCT is obvious, the rate of mother to child HIV transmission of prophylaxis regimens and HAART has not shown significant difference.</p>

Impact of being informed of HIV sero-status on the utilization of mother-to-child HIV transmission prevention services before or after pregnancy / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the impact of being informed of HIV infection before or after pregnancy on the prevention of mother-to-child transmission (PMTCT) HIV interventions uptake.</p><p><b>METHODS</b>From 2005 to 2009, a tatal of 5552 HIV-infected pregnant women and their 5894 pregnancies in Henan, Guangxi, Yunnan and Xinjiang province were investigated using the method of a cohort study. The social-demographic characters (the objects were divided three age groups 15-, 25-, 35-49), the period identified to be HIV positive, the outcome of pregnancy and the PMTCT interventions including uptake of antiretroviral drugs (ARVs) were investigated. Through single-factor and non-conditional logistic regression model, the factors influencing the utilization of PMTCT services were analyzed.</p><p><b>RESULTS</b>Of HIV-infected pregnant women, 84.5% (4979/5894) were under 35 year-old, and 56.0% (3108/5552) of them were Han group and the percentage of peasant or unemployment was 85.1% (4727/5552). 86.8% (4815/5552) of these women had junior high school education or less, and the proportion of women knowing HIV infection before the pregnancy was 31.2% (1836/5894). Of HIV positive pregnant women, 31.7% (1869/5894) chose to terminate the pregnancy artificially, and the percentage was 43.8% (805/1836) among those knowing HIV infection before pregnancy. The proportion of the ARVs uptake among HIV positive maternities who delivered was 80.0% (3046/3808), while the percentage among those knowing HIV positive before pregnancy was 92.3% (883/957), which was much higher than it (75.9% (2163/2851)) among the pregnant women knowing HIV infection just during the pregnancy (χ(2) = 120.39, P < 0.05). The results of multivariate analysis showed that the proportion of ARVs' uptake was high among those HIV positive pregnant women knowing to be HIV-infected before pregnancy (versus knowing to be HIV-infected after the pregnancy, OR = 3.91 (95%CI: 3.03 - 5.05)) and age of 15 to 24 year-old (versus age of 35 - 49 year-old, OR = 0.75 (95%CI: 0.57 - 0.98)).</p><p><b>CONCLUSION</b>It will promote the HIV-infected pregnant women to receive the PMTCT intervention services if they know their HIV sero-status before pregnancy.</p>

Analysis on maternal thyroid function of pregnant women with negative thyroid antibody in high water iodine area / 中国地方病学杂志

Objective To investigate the characteristics of maternal thyroid function of pregnant women with negative thyroid antibody in high water iodine area. Methods The investigation sites were selected,which were the Hospital for Women and Children of Jinghai county in the high water iodine area(drinking iodine > 200 μg/L) and the Hospital for Women and Children of Heping district in Tianjin in the adaptive iodine area (drinking iodine < 10μg/L,popularization rate of iodized salt > 90％,residents urinary iodine > 200μg/L). In the maternal and child hospitals,50 pregnant women of each stage from obstetric clinics in first,second,third term of pregnancy were selected,the blood samples were collected and the thyroid function were measured with chemiluminescence. Water,salt and diurnal optional urine samples were measured for iodine concentration. Iodine levels of urine,water,salt were determined respectively by As-Ce catalysis spoctrophotometry method,quantitative determining kit which use time-recorded determination by catalytic effect on the As-Ce reaction and sodium hyposulfite titration method. Results ①In pregnant women with negative thyroid antibody,serum TT_4,TT_3,FT_4 in first term of pregnaney and TT_4,TT_3 in second term of pregnancy were significantly lower in high water iodine area than low water iodine area(111.97 nmol/L vs 140.46 nmoL/L,Z = 3.56,P < 0.01 ; 1.86 nmol/L vs 2.26 nmol/L,Z = 2.35, P < 0.05; 14.13 pmol/L vs 16.32 pmol/L,Z = 5.14,P < 0.01,and 11.98 pmol/L vs 14.30 pmol/L,Z = 5.75,P < 0.01 ; 4.04 pmol/L vs 4.32 pmol/L,Z = 2.76,P < 0.01),while TT_3 and TSH in third term of pregnancy were significantly higher(2.88 nmoL/L vs 2.70 nmol/L,Z=-2.27,P< 0.05; 2.37 mU/L vs 1.75 mU/L,Z =-2.70, P < 0.01).②Concentration of water iodine and urine iodine were higher(205.57μg/L vs 8.26 μg/L,Z =-14.71,P < 0.01 ; 305.91 g/L vs 191.86 g/L,Z =-5.30,P < 0.01),while salt iodine was lower(26.5 mg/kg vs 31.7 mg/kg,Z =-5.86,P < 0.01) in high water iodine area. ③Among 290 selected healthy pregnant women without medical history of thyroid diseases,there was no significant difference in positive rate of thyroid antibody in each term of pregnancy between high water iodine area and low water iodine area(10.20％ vs 10.64％ ; 14％ vs 9.52％ ; 4％ vs 7.69％ ; all P > 0.05). Conclusions The thyroid function of pregnant women with negative thyroid antibody in high water iodine area is different from pregnant women in low water iodine area with universal salt iodization. Enhanced monitoring on thyroid function of pregnant women in high water iodine area should be performed,especially in first and second trimester.

The change trend of mother-to-child transmission rate of HIV-1 during 2005-2007 in some areas of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the change trend of mother-to-child-transmission (MTCT) of HIV-1 in some areas in China.</p><p><b>METHODS</b>The investigation was conducted in 15 counties or districts of 4 provinces in China with relatively high HIV prevalence from January 2005 to June 2009. The data on the death and HIV-status of the babies born to HIV-positive mothers from January 2005-December 2007 in research sites were collected through 18-month following up after they were born.</p><p><b>RESULTS</b>During the time that the research was conducted, there were 644 babies born to HIV-positive mothers who were followed up for 18 months. At the end of 18 months, full data were collected from 550 babies, 44 babies were lost to follow-up and 50 babies died. Among 550 babies who were followed up for 18 months, 53 babies were confirmed as HIV positive. The rate of MTCT of HIV-1 was 13.19% (24/182), 8.90% (17/191) and 6.78% (12/177) in 2005, 2006, 2007 respectively, which showed a descending trend yearly (chi(2) = 4.23, P < 0.05). Adjusted by the death data of the HIV-exposed children, it was found that during 2005-2007 the rate of MTCT of HIV-1 was 16.74%, 12.98%, 9.52% respectively, which was also descending year by year (chi(2) = 4.69, P < 0.05).</p><p><b>CONCLUSION</b>Long-term, effective prevention of mother-to-child-transmission of HIV (PMTCT) could reduce the level of MTCT of HIV-1 year-by-year. In addition, using death data of HIV-exposed children to adjust the level of MTCT of HIV-1 is valuable to grade the effect of PMTCT.</p>

Influencing factors on the death of infants born to HIV infected mothers / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the influencing factors on the death of infants born to HIV infected mothers in areas with high prevalence of HIV/AIDS in China.</p><p><b>METHODS</b>Based on the follow-up cohort study targeting at HIV/AIDS infected pregnant women and their babies initiated in 2004, a survey on the death status and influencing factors on the infants born to HIV/AIDS infected mothers enrolled in this cohort from Jan.2004 to Nov.2007 was carried out during Aug.to Nov.2008 in seven counties of four provinces in China. A total of 498 pairs of HIV-infected mothers and their infants were enrolled and their related information was collected. Single factor and multiple factors Cox model methods were adopted for data analysis.</p><p><b>RESULTS</b>The total observed person-years of 498 infants was 406.22, among which, 45 infants died, and the mortality density was 110.78 per 1000 child-year. A single factor Cox model showed, the pregnancy in pre-period of HIV/AIDS and HIV/AIDS period (RR = 1.971, 95%CI: 1.143 - 3.396), living status of the pregnancy (RR = 3.062, 95%CI: 1.097 - 8.550), multipara women (RR = 0.517, 95%CI: 0.278 - 0.961), natural childbirth (RR = 0.561, 95%CI: 0.345 - 0.910), premature labor (RR = 5.302, 95%CI: 2.944 - 9.547), low birth weight (RR = 4.920, 95%CI: 2.691 - 8.994), mother-child pairs taking antiretroviral drugs (RR = 0.227, 95%CI: 0.121 - 0.428) and infants infected HIV (RR = 5.870, 95%CI: 3.232 - 10.660) could affect the infants death. The death of HIV-exposed infants was influenced by various factors. The death risk of infants born to HIV infected mothers who were in the danger of pre-period of HIV/AIDS and HIV/AIDS period was greater than the infants delivered by HIV infected mothers who were in preclinical period of HIV/AIDS (RR = 6.99, 95%CI: 1.92 - 25.64). The death risks were greater in the group that the women whose CD4(+)TLC count number lower than 200 cells/microl (RR = 2.05, 95%CI: 1.01 - 4.15). The infants whose mothers had no ARV treatment had higher possibility to die than the others (RR = 6.17, 95%CI: 1.62 - 23.26). The death risk of premature delivered infants was 2.87 times of mature delivered infants (95%CI: 1.12 - 7.35). The death risk of HIV/AIDS infected infants was 9.87 times of the HIV/AIDS uninfected infants (95%CI: 3.81 - 25.62).</p><p><b>CONCLUSION</b>Some measurements including improving HIV-infected pregnant women's immunity, reducing mother to child transmission of HIV and premature birth, low birth weight are beneficial to reducing infant mortality.</p>