Effect of Home Blood Pressure Telemonitoring Plus Additional Support on Blood Pressure Control: A Randomized Clinical Trial / 生物医学与环境科学（英文）

OBJECTIVE@#Current clinical evidence on the effects of home blood pressure telemonitoring (HBPT) on improving blood pressure control comes entirely from developed countries. Thus, we performed this randomized controlled trial to evaluate whether HBPT plus support (patient education and clinician remote hypertension management) improves blood pressure control more than usual care (UC) in the Chinese population.@*METHODS@#This single-center, randomized controlled study was conducted in Beijing, China. Patients aged 30-75 years were eligible for enrolment if they had blood pressure [systolic (SBP) ≥ 140 mmHg and/or diastolic (DBP) ≥ 90 mmHg; or SBP ≥ 130 mmHg and/or DBP ≥ 80 mmHg with diabetes]. We recruited 190 patients randomized to either the HBPT or the UC groups for 12 weeks. The primary endpoints were blood pressure reduction and the proportion of patients achieving the target blood pressure.@*RESULTS@#Totally, 172 patients completed the study, the HBPT plus support group ( n = 84), and the UC group ( n = 88). Patients in the plus support group showed a greater reduction in mean ambulatory blood pressure than those in the UC group. The plus support group had a significantly higher proportion of patients who achieved the target blood pressure and maintained a dipper blood pressure pattern at the 12th week of follow-up. Additionally, the patients in the plus support group showed lower blood pressure variability and higher drug adherence than those in the UC group.@*CONCLUSION@#HBPT plus additional support results in greater blood pressure reduction, better blood pressure control, a higher proportion of dipper blood pressure patterns, lower blood pressure variability, and higher drug adherence than UC. The development of telemedicine may be the cornerstone of hypertension management in primary care.

Early identification and influencing factors of post-traumatic stress disorder in high-stress rescue workers / 中华预防医学杂志

Objective: To explore the risk intensity and related influencing factors of post-traumatic stress disorder (PTSD) among high-stress rescue workers, and to provide effective tools for the risk assessment of PTSD in military rescue workers. Method: From June to August 2022, cluster sampling was used to select the high-stress rescue personnel of an Army department as the survey subjects. The acute Stress reaction (ASD) scale and PTSD checklist were used to evaluate the risk of PTSD in military rescue personnel. Multivariate logistic regression were used to analyze the influencing factors of PTSD. Results: The age of 4 460 subjects was (24.38±4.072) years old, including 4 396 males (98.6%). The positive rate of initial screening for ASD was 2.85% (127/4 460). The positive rate of PTSD was 0.67% (30/4 460). Multivariate logistic regression model analysis showed that female, older age, recent trauma exposure history, passive smoking and alcohol consumption were at higher risk of ASD, the values of OR (95%CI) were 4.183 (1.819-9.618), 6.278 (1.363-28.912), 3.094 (1.500-6.379), 2.059 (1.298-3.267) and 2.607 (1.614-4.211), respectively; Lower education level was associated with lower risk of ASD, OR (95%CI) was 0.593 (0.359-0.978); People who are older, thinner, have a history of mental illness, and drink alcohol were at higher risk for PTSD, the values of OR (95%CI) were 20.144 (2.459-165.043), 10.287 (2.218-47.700), 91.104 (8.592-965.980) and 2.866 (1.144-7.180), respectively. Conclusion: Gender, age, education level, passive smoking, alcohol consumption, past history of mental illness and body mass index may be related to the potential risk of PTSD in rescue workers,passive smoking, alcohol consumption, and weight controlling should be focused on to reduce potential risks of PTSD.

Combined Effect of Smoking and Obesity on Coronary Heart Disease Mortality in Male Veterans: A 30-year Cohort Study / 生物医学与环境科学（英文）

Objective@#Evidence is lacking regarding the combined effects of smoking and obesity on mortality from coronary heart disease in male veterans. This study aimed to explore the combined effect of smoking and obesity on coronary heart disease mortality in male veterans in China.@*Methods@#A cohort of 1,268 male veterans from 22 veteran centers in Xi'an (Shaanxi Province, China) were followed up once every 2 years from February 1, 1987 to October 30, 2016. The endpoint was death from any cause. The hazard ratio ( @*Results@#The total follow-up was 24394.21 person-years; each subject was followed up for a mean duration of 19.24 years. By the end of the study, of the 1,268 veterans, 889 had died, 363 were alive, and 16 were lost to follow-up. Cox regression analysis results revealed that current smoking ( @*Conclusion@#Our results suggest that obese veterans who smoke might be an important target population for coronary heart disease mortality control.

Analysis of Factors Influencing Insomnia and Construction of a Prediction Model: A Cross-sectional Survey on Rescuers / 生物医学与环境科学（英文）

Objective@#To determine the factors influencing insomnia and construct early insomnia warning tools for rescuers to informbest practices for early screening and intervention.@*Methods@#Cluster sampling was used to conduct a cross-sectional survey of 1,133 rescuers from one unit in Beijing, China. Logistic regression modeling and R software were used to analyze insomnia-related factors and construct a PRISM model, respectively.@*Results@#The positive rate of insomnia among rescuers was 2.74%. Accounting for participants' age, education, systolic pressure, smoking, per capita family monthly income, psychological resilience, and cognitive emotion regulation, logistic regression analysis revealed that, compared with families with an average monthly income less than 3,000 yuan, the odds ratio ( ) values and the [95% confidence interval ( )] for participants of the following categories were as follows: average monthly family income greater than 5,000 yuan: 2.998 (1.307-6.879), smoking: 4.124 (1.954-8.706), and psychological resilience: 0.960 (0.933-0.988). The ROC curve area of the PRISM model (AUC) = 0.7650, specificity = 0.7169, and sensitivity = 0.7419.@*Conclusion@#Insomnia was related to the participants' per capita family monthly income, smoking habits, and psychological resilience on rescue workers. The PRISM model's good diagnostic value advises its use to screen rescuer early sleep quality. Further, advisable interventions to optimize sleep quality and battle effectiveness include psychological resilience training and smoking cessation.

Optimal Timing of Surgical Revascularization for Myocardial Infarction and Left Ventricular Dysfunction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The optimal timing of surgical revascularization for patients presenting with ST-segment elevation myocardial infarction (STEMI) and impaired left ventricular function is not well established. This study aimed to examine the timing of surgical revascularization after STEMI in patients with ischemic heart disease and left ventricular dysfunction (LVD) by comparing early and late results.</p><p><b>METHODS</b>From January 2003 to December 2013, there were 2276 patients undergoing isolated coronary artery bypass grafting (CABG) in our institution. Two hundred and sixty-four (223 male, 41 females) patients with a history of STEMI and LVD were divided into early revascularization (ER, <3 weeks), mid-term revascularization (MR, 3 weeks to 3 months), and late revascularization (LR, >3 months) groups according to the time interval from STEMI to CABG. Mortality and complication rates were compared among the groups by Fisher's exact test. Cox regression analyses were performed to examine the effect of the time interval of surgery on long-term survival.</p><p><b>RESULTS</b>No significant differences in 30-day mortality, long-term survival, freedom from all-cause death, and rehospitalization for heart failure existed among the groups (P > 0.05). More patients in the ER group (12.90%) had low cardiac output syndrome than those in the MR (2.89%) and LR (3.05%) groups (P = 0.035). The mean follow-up times were 46.72 ± 30.65, 48.70 ± 32.74, and 43.75 ± 32.43 months, respectively (P = 0.716). Cox regression analyses showed a severe preoperative condition (odds ratio = 7.13, 95% confidence interval 2.05-24.74, P = 0.002) rather than the time interval of CABG (P > 0.05) after myocardial infarction was a risk factor of long-term survival.</p><p><b>CONCLUSIONS</b>Surgical revascularization for patients with STEMI and LVD can be performed at different times after STEMI with comparable operative mortality and long-term survival. However, ER (<3 weeks) has a higher incidence of postoperative low cardiac output syndrome. A severe preoperative condition rather than the time interval of CABG after STEMI is a risk factor of long-term survival.</p>

Application of intraoperative magnetic resonance imaging and multimodal navigation in surgical resection of glioblastoma / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of intraoperative magnetic resonance imaging (iMRI) and multimodal navigation in surgical resection of glioblastoma.</p><p><b>METHODS</b>Between February 2009 and July 2010, 76 glioblastoma patients underwent surgical resection guided by iMRI and multimodal navigation. The cohort consisted of 43 male and 33 female patients, with a mean age of 49 years (range: 14-79 years). Rates of gross total resection (GTR) and extent of resection (EoR) were calculated at first and final iMRI scans.Pearson χ(2) test was used to compare the rates of GTR.</p><p><b>RESULTS</b>iMRI and multimodal navigation were successfully implemented in all cases. Rates of GTR were misestimated by neurosurgeons in 24 cases (31.6%), which were confirmed by first iMRI. Total tumor resection were achieved in 20 cases (26.3%) as a result of iMRI scan, increasing the rates of gross total resection from 52.6% to 78.9% (χ(2) = 11.692, P = 0.001). Extent of resection in 28 patients who underwent further tumor resection were increased from 81.5% to 98.1%, leading to the overall extent of resection improved from 92.3% to 98.4%. At 3-month follow-up, 3 cases (3.9%) developed permanent neurologic deficits. The mean clinical follow-up was 15.6 months (range 3.0-45.0 months). The 2-year overall survival rate was 19.7%. The median progression-free survival of gross total resection group was 12 months (95% CI: 10.1-13.9 months), compared with 9 months (95%CI: 7.9-10.1 months) of the subtotal resection group (χ(2) = 4.756, P = 0.029). The overall survival of gross total resection group was 16 months (95% CI: 13.7-18.3 months), compared with 12 months (95% CI: 9.7-14.3 months) of the subtotal resection group (χ(2) = 7.885, P = 0.005).</p><p><b>CONCLUSION</b>Combined with multimodal navigation, iMRI helps maximize surgical resection of glioblastoma, preserving neurological function while increasing progression-free survival and overall survival.</p>

A cross sectional survey on the relationship between intolerance to eggs and body mass index in Beijing, China / 中华流行病学杂志

Objective To explore the prevalence of intolerance to eggs and its relationship with body mass index in Beijing,China.Methods A cross sectional survey which included 12 766 adults from health sciences center of general hospital of the Chinese People's Liberation Army from August,2008 to July,2009 was carried out.Data was entered computer and organized by EpiData 3.0 software for epidemiological analysis.Nonconditional logistic regression model was used for odd ratio (OR) and 95％CIcalculation,and statistics analysis was carried out by SPSS 13.0 software.Results Positive rate of intolerance to eggs in the cohort was 28.5％.Grades of intolerance to eggs were associated with sex(P＜0.05 ).Positive rate of intolerance to eggs in females(36.5％ ) was higher than those in males (24.9％).Data from multiple regression analysis showed that intolerance to eggs was associated with sex and body mass index.Compared with males,the OR(95％CI) of female was 1.732 (1.590-1.887).Compared with normal weights,the OR (95％ CI) of low weights was 1.443 ( 1.018-2.045 ).Conclusion Sex and body mass index might be associated with intolerance to eggs.

A cross sectional survey on the prevalence of food intolerance and its determinants in Beijing,China / 中华流行病学杂志

Objective To study the prevalence of food intolerance among attendants in a general hospital and to learn its related determinants in Beijing,China.Methods An cross sectional survey,from August 1st,2008 to June 30th,2009,was carried out,including 12 766 adults from Health Sciences Center,Chinese PLA General Hospital.Data for epidemiological analysis were entered (double entry) into computer and organized by EpiData 3.0.Non-conditional logistic regression model was used for odd ratio (OR) and 95%CI calculation,with statistic analysis through SPSS 13.0.Results The three leading intolerance food items were egg,crab and milk,and the prevalence rates were 28.5%,24.5% and 24.5% respectively.Prevalence of food intolerance increased along with aging.Levels and the kinds of food intolerance were associated with age,sex and appeared a linear correlation tendency (P＜0.05).Prevalence of food intolerance in females (67.3%) was higher than that in males (56.2%).Data from multiple regression analysis showed that,comparing with age group under 40 and 40 years,the OR(95%CI) of age group 41-50,51-60,and above 60 were 1.125(1.027-1.233),1.307(l.176-1.452)and 1.536(1.275-1.849)respectively.Compared to males,the OR (95% CI) of females was 1.602 (1.475-1.741).When compared with normal weights,the OR (95%CI) of people with low weight was 1.772 (1.207-2.602).Conclusion Food intolerance was associated with age,sex and body mass index.Health education should be carried out according to the related characteristics of age and sex.Suggesting that reducing the risk of food intolerance,keeping the suitable weight was necessary.

Study design and the preliminary results on the modes of smoking cessation in general hospitals / 中华流行病学杂志

To study the intervention programs on smoking cessation in a general hospital and to evaluate its effects of the programs. Four methods including: a) the intervention through specialists in the smoking cessation clinic, b) short-time intervention in the out-patient department,c) free medical intervention, d) group intervention, were adopted for different smokers, with health counseling, psychological intervention and drug treatment. Intervention effect was evaluated by standard methods. During the 20-month period of the project, we treated 690 cases and 402 completed 6-month follow-up. Preliminary results in 402 cases showed that the three methods of smoking cessation interventions could reduce the amount of cigarette smoking and increase the quitting rate. Motivation to quit smoking, intervention methods and intensity of intervention seemed cessation clinic (31.6%) and in the group intervention (30.9%) was higher than short-time intervention in free medical events (15.1%). The successful rate of smoking cessation depended on the motivation of quitters, and the attitude, methods and intervention skills of the physicians.Therefore, it is necessary to explore and develop smoking cessation service models suitable to national context and individual intervention methods in China.

An 18-year follow-up study on the risk factors of deaths regarding chronic obstructive pulmonary disease in Xi'an, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine risk factors of chronic obstructive pulmonary disease (COPD) deaths in Chinese military elderly men.</p><p><b>METHODS</b>A cohort analytic study was carried out in Xi'an, China. A total of 1268 retired military males aged 55 or older were examined in 1987 and followed for 18 years. Main outcome measures were all causes and COPD deaths.</p><p><b>RESULTS</b>The total person-years of follow-up from 1987 until June 2005 was 18 766.28. The mean follow-up time was 14.35 years; A total of 491 had died, with 748 alive and 29 lost of follow-up. COPD was the second cause of death in all deaths (16.90%). Results Univariate analysis of Cox model showed that age, number of smoking cigarettes per day, duration of smoking, negative affairs and existing COPD were risk factors of COPD deaths and the relative risks [95% confidence intervals (CI)] were 1.13 (1.09-1.17), 1.04 (1.02-1.06), 1.03 (1.01-1.04), 1.81 (2.85-6.77) and 4.39 (2.85-6.77) respectively. Data from Multivariate analysis of Cox model showed that age, number of smoking cigarettes per day and existing COPD were risk factors of COPD death with relative risks [95% confidence intervals (CI)] as 1.10 (1.06-1.15), 1.03 (1.01-1.06) and 3.07 (1.90-4.98) respectively. The risks for deaths increased significantly with increasing amount and duration of smoking resulting from all causes and COPD. Compared with current smokers, former smokers had lower risks of total mortality(excess risk reduction of 66.67%).</p><p><b>CONCLUSION</b>COPD was the second cause among all deaths in this cohort. Age, number of smoking cigarettes per day and existing COPD were the risk factors of COPD deaths which called for further survey to examine the relationship between quitting smoking and COPD deaths in this cohort.</p>

An 18-year Follow-up Study of Tobacco Smoking-related Mortality in 1 268 Aged Servicemen in Xi'an,China SAI / 中国慢性病预防与控制

Objective To examine the relationship between smoking and tobacco-related mortality in a cohort of the aged Chinese armymen.Methods A cohort study was carried out in Xi'an,China from 1987 to 2005.A total of 1 268 retired male military cadres aged 55 or older were examined in 1987 and followed up in the next 18 years.At baseline,388 men were non-smokers,461 were former smokers,and 419 were current smokers.The current smoking rate was 33.04%,Quitted rate was 52.39%.The terminal main observation items included all-cause and tobacco-associated mortality.Results Up to Jun 30,2005,a total of 491 subjects died.Compared with non-smokers,the relative risks(95% confidence intervals(CI)) of ever-smokers for all-cause deaths,chronic obstructive pulmonary disease(COPD),lung cancer,and coronary heart disease(CHD) were 1.24(1.01-1.53),1.91(1.06-3.46),2.91(1.36-6.23),and 1.15(0.68-1.93),respectively.Compared with current smokers,the risks of total mortality and death from lung cancer for former smokers were decreased by 66.7% and 14.98%,respectively.Conclusions Cigarette smoking was a major death risk factor in the cohort and quitting smoking could save lives.

The use of unsupervised classification of Landsat-5 TM images in analysing the types of vegetation in the areas of "breaking dikes or opening sluice for water store" / 中华流行病学杂志

<p><b>OBJECTIVE</b>To clarify the change of vegetation types and its relationship between the density of alive-snails in the areas of "breaking dikes or opening sluice for water store" in Jicheng.</p><p><b>METHODS</b>Synthesized false color images of Jicheng before and after 1998 (1994 and 2003) were classified without supervision and results were compared. Vegetation types were identified on the spot.</p><p><b>RESULTS</b>Normalized difference vegetation index (NDVI) of snail habitats before 1998 were between 126 and 183 in Jicheng, whose vegetation types were mainly paddy, cotton and cabbage. NDVI of snail habitats in Jicheng after 1998 were between 152 and 193 whose vegetation types were mainly poplar forest, bulrush and grass. Areas of snail habitats increased from 64.64% to 66.47%. Snail habitats were mostly composed of mixed vegetation types and mono-typed vegetation was hardly found. According to the density of alive-snails orders from high to low were poplar forest and bulrush, poplar forest and grass, bulrush.</p><p><b>CONCLUSION</b>Vegetation types would not be identified by unsupervised classification only. Poplar forest, bulrush and grass were closedly related to the density of alive-snails.</p>

Application of "time series analysis" in the prediction of schistosomiasis prevalence in areas of "breaking dikes or opening sluice for waterstore" in Dongting Lake areas, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To provide the fittest model for forecasting schistosomiasis prevalence in Haokou village of "breaking dikes or opening sluice for waterstore" in Dongting Lake areas by comparing the results of Moving Average, Exponential Smoothing, Autoregressive Model and Autoregressive integrated moving average model (ARIMA model) from 1990 to 2002.</p><p><b>METHODS</b>Error sum of square of four statistical methods was compared and the fittest model was chosen.</p><p><b>RESULTS</b>Error sum of square of predicted schistosomiasis prevalence rates in Haokou village from 1994 to 2002 were 39.40, 39.86, 26.63, 22.54 respectively.</p><p><b>CONCLUSION</b>ARIMA model seemed to be the fittest one in the prediction of schistosomiasis prevalence in Haokou village of "breaking dikes or opening sluice for waterstore" in Dongting Lake from 1990 to 2002.</p>