Prevalence and influencing factors of diabetes mellitus among a community population aged from 20 to 74 in Songjiang District， Shanghai / 上海预防医学

ObjectiveTo investigate the prevalence and influencing factors of diabetes mellitus among community population in Songjiang District of Shanghai， and to provide scientific basis for prevention and treatment of diabetes mellitus. MethodsBased on the baseline data of the Shanghai Suburban Adult Cohort （2016‒2017） and local medication database， the prevalence of diabetes in the cohort was described， and the influencing factors for the prevalence of diabetes in different genders were analyzed. ResultsAmong 35 928 participants， males accounted for 40.57%， and the median age was 58 years old. There were 5 342 diabetic patients with a crude prevalence rate of 14.87% and the standardized prevalence rate of diabetes mellitus was 7.57%. The prevalence rate of diabetes in males （15.81%） was significantly higher than that in females （14.23%， P<0.001）. Multivariate logistic regression analysis showed that the following factors were associated with high risk of diabetes mellitus in males： 40‒59 age group （OR=7.111，95%CI：4.900‒10.320）， 60‒74 age group （OR=8.994，95%CI：6.154‒13.144）， family history of diabetes （OR=3.369，95%CI：2.963‒3.83）， overweight （OR=1.272，95%CI：1.123‒1.439）， obesity （OR=1.912，95%CI：1.623‒2.252）， hypertension （OR=1.685，95%CI：1.512‒1.877）， and dyslipidemia （OR=1.396，95%CI：1.263‒1.542）. In females， the high risk of diabetes was associated with： 40‒59 age group （OR=2.718，95%CI：1.838‒4.02）， 60‒74 age group （OR=3.517，95%CI：2.34‒5.286）， family history of diabetes （OR=3.071，95%CI：2.761‒3.416）， overweight （OR=1.254，95%CI：1.125‒1.398）， obesity （OR=2.018，95%CI：1.764‒2.308）， central obesity （OR=1.515，95%CI：1.357‒1.692）， hypertension （OR=2.128，95%CI：1.929‒2.347）， dyslipidemia （OR=1.506，95%CI：1.379‒1.644）， exercise （OR=1.241，95%CI：1.137‒1.355）， and menopause （OR=1.967，95%CI：1.693‒2.286）. ConclusionThe prevalence rate of diabetes is high in Shanghai， and the related factors are different in different gender groups.

New progress in research and prevention of respiratory syncytial virus infection in children / 上海预防医学

Respiratory syncytial virus （RSV） is the most important viral pathogen causing acute lower respiratory tract infections in children under 5 years of age and poses a serious threat to infant health. After more than 60 years， the development of RSV vaccines and monoclonal antibodies has been moving forward amid bumps. Recently， several RSV vaccines and monoclonal antibodies have entered phase Ш clinical trials， which brings light to the prevention of RSV. We reviewed the new progress in research and prevention of RSV， so as to provide help for the prevention and control of RSV.

Epidemiological characteristics and risk factors of hypertension in residents in Songjiang District， Shanghai： a cohort based cross-sectional study / 上海预防医学

ObjectiveTo determine the epidemiological characteristics and risk factors of hypertension in residents in Songjiang District of Shanghai， and provide evidence for prevention and control of hypertension. MethodsLocal residents aged between 20 and 74 years were recruited from four towns in Songjiang District from 2016 to 2017 by using a multistage sampling strategy. Questionnaire surveys were conducted， and then physical examination， blood pressure measurement， glucose test and lipid test were performed. The data was analyzed by SPSS 16.0 software. Chi-square test was used to compare the differences in the prevalence of hypertension in residents， stratified by demographics and health conditions. Risk factors were determined by multivariate logistic regression. ResultsAmong 35 759 residents with a median age of 58 years and the proportion of male being 40.67%， crude prevalence of hypertension was 54.24% （19 395/35 759） and standardized prevalence was 31.69%. In the hypertensive patients， proportion of hypertension awareness was 61.09%， with 63.67% in male and 59.10% in female. Proportion of receiving treatment was 49.00%， with 50.91% in male and 47.51% in female. Furthermore， in the hypertensive patients with treatment， proportion of effectively controlling hypertension was 40.50%， with 44.46% in male and 37.21% in female. Multivariate logistic regression showed that male （OR=1.272）， senior age （40‒59 years old： OR=4.353， 60‒74 years old： OR=9.802）， overweight （OR=1.823）， obesity （OR=3.070）， central obesity （OR=1.380）， diabetes （OR=1.923）， dyslipidemia （OR=1.452）， and drinking （OR=1.338） were risk factors associated with hypertension. ConclusionPrevalence of hypertension is high， while the proportions of receiving treatment and effective control remain low in residents in Songjiang District. It warrants strengthening prevention and control of hypertension in targeted and young residents.

Epidemiological characteristics and antibiotics susceptibility of Streptococcus pneumoniae isolated from children in Suzhou area during 2010 to 2017 / 中华传染病杂志

Objective:To explore the epidemiological characteristics and the antibiotic resistance of Streptococcus pneumoniae isolates, and to provide the evidence for the rational use of antimicrobial agents to treat Streptococcus pneumoniae infection. Methods:The positive microbiological laboratory identification and antimicrobial susceptibility testing of Streptococcus pneumoniae from sputum of children with respiratory infections during January 2010 to December 2017 in Children′s Hospital of Soochow University were retrospectively analyzed. The positive rates of Streptococcus pneumoniae of different genders, ages, years and seasons were compared. The annual detection rates and trends of drug resistance of Streptococcus pneumoniae to penicillin, amoxicillin and cefotaxime were analyzed by Mann-Kendall trend test. The seasonal decomposition of time series was conducted to assess the association between Streptococcus pneumoniae detection rate and season. Enumeration data was compared using χ2 test. Results:Of the 88 480 sputum specimens, the total positive rate of Streptococcus pneumoniae was 10.3%(9 081/88 480). The detection rates of Streptococcus pneumoniae in children aged 0 to <0.5 years old, 0.5 to <2 years old, 2 to <3 years old, 3 to <5 years old, and 5 to <15 years old were 4.2%(1 407/33 224), 13.1%(3 191/24 390), 14.9%(2 417/16 252), 17.9%(1 474/8 246) and 9.3%(592/6 368), respectively. The difference was statistically significant ( χ2=2 421.6, P<0.01). The detection rates were 8.1%(1 321/16 306) from January to March, 10.9%(2 194/20 207) from April to June, 8.5%(2 141/25 058) from July to September, and 12.7%(3 425/26 909) from October to December. The discrepancy of positive rates in different seasons showed statistical significance ( χ2=311.5, P<0.01). During 2010 to 2017, significant decreases in antibiotic resistant rates of Streptococcus pneumoniae to penicillin, amoxicillin and cefotaxime were detected (tau=-0.93, -0.93 and -0.71, respectively, all P<0.05). Conclusions:The detection rate of Streptococcus pneumoniae in sputum of children with respiratory infections may present seasonal pattern and vary between different ages of children. The resistance to β-lactam antibiotics has declined.

The prevalence of gout and related factors in community population / 中华内分泌代谢杂志

Objective:To explore the prevalence of gout and related factors in community population, thereby provide evidence for comprehensive prevention and control of gout in community.Methods:A stratified multi-stage cluster sampling was used to survey the permanent residents of 20 to 75 years old in the 3 selected streets (towns), univariate analysis was performed using logistic regression by SPSS statistical software.Results:The prevalences of hyperuricemia and gout were 9.82% and 5.75% respectively(male 18.88% and 7.94%, female 3.79% and 4.29%)in Jiading Shanghai. The positive rate of family history was 17.13%, and the relationship between family history and gout was significant( OR=3.140, 95% CI 2.365-4.169, P<0.01). Age( OR=1.034, 95% CI 1.021-1.047), body mass index ( OR=1.102, 95% CI 1.074-1.131), waist-hip ratio ( OR=4.876, 95% CI 1.153-20.622), sleep quality ( OR=1.310, 95% CI 1.159-1.480), other animal meat ( OR=1.117, 95% CI 1.007-1.240), fresh water fish ( OR=1.138, 95% CI 1.005-1.288), and processed meat ( OR=1.145, 95% CI 1.033-1.270) were closely related to gout ( P<0.05 or P<0.01). Sex, alcohol drinking, marine fish, and soybean milk/soymilk were related to gout ( P<0.05 or P<0.01), but showed a protective effect ( OR<1.000). Conclusion:Reducing uric acid production through less consumption of purine-rich food such as animal meat as well as processed meat and weight control would be helpful in preventing gout.

Epidemiological features of adult chronic kidney diseases in a community-based population in Songjiang district, Shanghai / 中华流行病学杂志

Objective To investigate the prevalence and associated factors of chronic kidney diseases (CKD) in adult residents living in a community of Songjiang district,Shanghai.Methods A total of 9 257 residents aged 20-75 years old in Xinqiao township of Songjiang district were selected by random cluster sampling.All the participants were interviewed to complete a set of personal questionnaire and undergo physical examinations.Urine and blood tests including markers of kidney damage and related associated factors with CKD,were carried out.Results Eligible data from 8 207 subjects were enrolled in the study.After adjustment for age and gender,the prevalence of CKD was 8.4％ (95％CI:7.8％-9.0％),with majority of the patients (76.5％) appeared in the early stage (Ⅰ and Ⅱ) of the disease.The prevalence of CKD increased with age and higher prevalence was seen in females than in males (P＜0.001).Results from logistic regression analysis showed that factors as:being elderly or female,having hypertension,hyperuricemia,and hyperlipidemia were all independently associated with CKD.Conclusions The prevalence of CKD appeared relatively high in adult residents of Xinqiao township,Songjiang district where CKD had become a public health problem.Factors as:being female or elderly,hypertension,hyperuricemia,and hyperlipidemia were found to be associated with CKD.Our findings suggested that early prevention and control on CKD to reduce the incidence of end-stage renal diseases and related complications had called for more urgent attention.

Clinical characteristics and economic burden of influenza among children under 5 years old, in Suzhou, 2011-2017 / 中华流行病学杂志

Objective To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou,China,2011-2017.Methods From March 2011 to February 2017,we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital.Through standard questionnaires and follow-up survey via telephone,we collected information regarding the demographic characteristics,medical history,clinical symptoms and both direct and indirect costs associated with influenza,of the patients.We then compared clinical characteristics and economic burden of influenza A/H1N1,A/H3N2,and B infections among children with ILI.Results We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs.791 (12.9％) of the swabs showed positive for influenza virus,including 88 (11.1％) subtype influenza A/H1N1,288 (36.4％) subtype influenza A/H3N2,and 415 (52.5％) type influenza B.The proportions of cough,rhinorrhea,wheezing,vomiting and convulsion in influenza-positive children were higher than those influenza-negative children.Except for the prevalence rates of cough (x2=9.227,P=0.010),wheezing (x2=7.273,P=0.026) and vomiting (x2=8.163,P=0.017),other clinical symptoms appeared similar between the three viral subtypes.Among all the ILI children,the average total cost per episode of influenza was 688.4 Yuan (95％ CI:630.1-746.7) for influenza-negative children;768.0 Yuan (95％CI:686.8-849.3) for influenza-positive children and 738.3 Yuan (95％CI:655.5-821.1) for influenza B.Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (x2=7.237,P=0.028).Conclusion Children infected influenza showed higher prevalence rates of cough,rhinorrhea,wheezing,vomiting and convulsion than those without influenza.Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes.

Epidemiological features of adult chronic kidney diseases in a community-based population in Songjiang district, Shanghai / 中华流行病学杂志

Objective To investigate the prevalence and associated factors of chronic kidney diseases (CKD) in adult residents living in a community of Songjiang district,Shanghai.Methods A total of 9 257 residents aged 20-75 years old in Xinqiao township of Songjiang district were selected by random cluster sampling.All the participants were interviewed to complete a set of personal questionnaire and undergo physical examinations.Urine and blood tests including markers of kidney damage and related associated factors with CKD,were carried out.Results Eligible data from 8 207 subjects were enrolled in the study.After adjustment for age and gender,the prevalence of CKD was 8.4％ (95％CI:7.8％-9.0％),with majority of the patients (76.5％) appeared in the early stage (Ⅰ and Ⅱ) of the disease.The prevalence of CKD increased with age and higher prevalence was seen in females than in males (P＜0.001).Results from logistic regression analysis showed that factors as:being elderly or female,having hypertension,hyperuricemia,and hyperlipidemia were all independently associated with CKD.Conclusions The prevalence of CKD appeared relatively high in adult residents of Xinqiao township,Songjiang district where CKD had become a public health problem.Factors as:being female or elderly,hypertension,hyperuricemia,and hyperlipidemia were found to be associated with CKD.Our findings suggested that early prevention and control on CKD to reduce the incidence of end-stage renal diseases and related complications had called for more urgent attention.

Clinical characteristics and economic burden of influenza among children under 5 years old, in Suzhou, 2011-2017 / 中华流行病学杂志

Objective To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou,China,2011-2017.Methods From March 2011 to February 2017,we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital.Through standard questionnaires and follow-up survey via telephone,we collected information regarding the demographic characteristics,medical history,clinical symptoms and both direct and indirect costs associated with influenza,of the patients.We then compared clinical characteristics and economic burden of influenza A/H1N1,A/H3N2,and B infections among children with ILI.Results We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs.791 (12.9％) of the swabs showed positive for influenza virus,including 88 (11.1％) subtype influenza A/H1N1,288 (36.4％) subtype influenza A/H3N2,and 415 (52.5％) type influenza B.The proportions of cough,rhinorrhea,wheezing,vomiting and convulsion in influenza-positive children were higher than those influenza-negative children.Except for the prevalence rates of cough (x2=9.227,P=0.010),wheezing (x2=7.273,P=0.026) and vomiting (x2=8.163,P=0.017),other clinical symptoms appeared similar between the three viral subtypes.Among all the ILI children,the average total cost per episode of influenza was 688.4 Yuan (95％ CI:630.1-746.7) for influenza-negative children;768.0 Yuan (95％CI:686.8-849.3) for influenza-positive children and 738.3 Yuan (95％CI:655.5-821.1) for influenza B.Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (x2=7.237,P=0.028).Conclusion Children infected influenza showed higher prevalence rates of cough,rhinorrhea,wheezing,vomiting and convulsion than those without influenza.Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes.

Cost-effectiveness of multiple screening modalities on breast cancer in Chinese women from Shanghai / 中华流行病学杂志

Objective To determine the most cost-effective modality for breast cancer screening in women living in Shanghai.Methods A Markov model for breast cancer was redeveloped based on true effect which was derived from a project for detection of women at high risk of breast cancer and an organized breast cancer screening program conducted simultaneously in Minhang district,Shanghai,during 2008 to 2012.Parameters of the model were derived from literatures.General principles related to cost-effectiveness analysis were used to compare the costs and effects of 12 different screening modalities in a simulated cohort involving 100 000 women aged 45 years.Incremental cost-effectiveness ratio (ICER) was used to determine the most cost-effective modality.Sensitivity analysis was conducted to evaluate how these factors affected the estimated cost-effectiveness.Results The modality of biennial CBE followed by ultrasonic and mammography among those with positive CBE was observed as the most cost-effective one.The costs appeared as 182 526 Yuan RMB per life year gained and 144 386 Yuan RMB per quality adjusted life-year (QALY) saved,which were within the threshold of 2-3 times of local per capita Gross Domestic Product.Results from sensitivity analysis showed that,due to higher incidence rate of breast cancer in Shanghai,the cost per QALY would be 64 836 Yuan RMB lower in Shanghai than the average level in China.Conclusion Our research findings showed that the biennial CBE program followed by ultrasonic and mammography for those with positive CBE results might serve as the optimal breast cancer screening modality for Chinese women living in Shanghai,and thus be widely promoted in this population elsewhere.

A 22-year-follow-up cohort study on primary liver cancer in Haimen city of Jiangsu province / 中华流行病学杂志

Objective A prospective cohort study was carried out to assess the mortality and potential risk factors for primary liver cancer (PLC) in Haimen city of Jiangsu province.Methods The cohort involved 89 789 adult residents aged 25-69 years.Upon the entry of this project,each subject was asked to complete a questionnaire and to provide a blood sample of 10 ml.Surface antigen of hepatitis B virus (HBsAg) was tested by radioimmunoassay.All the subjects were followed-up every year for vital statistics and death certificate information until 2014.Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95％ confidence interval (95％ CI) for PLC mortality associated with HBsAg status and other risk factors.Results During the 1 299 611 person-years of follow-up,a total of 2 583 PLC cases were identified,including 2 149 men and 434 women.Mortality of the PLC for men and women were 247.80/100 000 person-years and 100.38/100000 person-years,respectively.Among those who died of PLC,73.87％ had been tested HBsAg positive.HBV infection seemed the predominant risk factor for PLC and the HRs were 15.97 for men (95％CI:14.29-17.85) and 21.63 for women (95％CI:16.16-28.96) respectively.Ageing,cigarette smoking,previous history of hepatitis,and family history of HCC were factors associated with the increased risk for PLC.Conclusion People living in Haimen city had a high risk on PLC.HBV infection appeared the most important risk factor for HCC mortality in this area.

Cost-effectiveness of multiple screening modalities on breast cancer in Chinese women from Shanghai / 中华流行病学杂志

Objective To determine the most cost-effective modality for breast cancer screening in women living in Shanghai.Methods A Markov model for breast cancer was redeveloped based on true effect which was derived from a project for detection of women at high risk of breast cancer and an organized breast cancer screening program conducted simultaneously in Minhang district,Shanghai,during 2008 to 2012.Parameters of the model were derived from literatures.General principles related to cost-effectiveness analysis were used to compare the costs and effects of 12 different screening modalities in a simulated cohort involving 100 000 women aged 45 years.Incremental cost-effectiveness ratio (ICER) was used to determine the most cost-effective modality.Sensitivity analysis was conducted to evaluate how these factors affected the estimated cost-effectiveness.Results The modality of biennial CBE followed by ultrasonic and mammography among those with positive CBE was observed as the most cost-effective one.The costs appeared as 182 526 Yuan RMB per life year gained and 144 386 Yuan RMB per quality adjusted life-year (QALY) saved,which were within the threshold of 2-3 times of local per capita Gross Domestic Product.Results from sensitivity analysis showed that,due to higher incidence rate of breast cancer in Shanghai,the cost per QALY would be 64 836 Yuan RMB lower in Shanghai than the average level in China.Conclusion Our research findings showed that the biennial CBE program followed by ultrasonic and mammography for those with positive CBE results might serve as the optimal breast cancer screening modality for Chinese women living in Shanghai,and thus be widely promoted in this population elsewhere.

A 22-year-follow-up cohort study on primary liver cancer in Haimen city of Jiangsu province / 中华流行病学杂志

Objective A prospective cohort study was carried out to assess the mortality and potential risk factors for primary liver cancer (PLC) in Haimen city of Jiangsu province.Methods The cohort involved 89 789 adult residents aged 25-69 years.Upon the entry of this project,each subject was asked to complete a questionnaire and to provide a blood sample of 10 ml.Surface antigen of hepatitis B virus (HBsAg) was tested by radioimmunoassay.All the subjects were followed-up every year for vital statistics and death certificate information until 2014.Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95％ confidence interval (95％ CI) for PLC mortality associated with HBsAg status and other risk factors.Results During the 1 299 611 person-years of follow-up,a total of 2 583 PLC cases were identified,including 2 149 men and 434 women.Mortality of the PLC for men and women were 247.80/100 000 person-years and 100.38/100000 person-years,respectively.Among those who died of PLC,73.87％ had been tested HBsAg positive.HBV infection seemed the predominant risk factor for PLC and the HRs were 15.97 for men (95％CI:14.29-17.85) and 21.63 for women (95％CI:16.16-28.96) respectively.Ageing,cigarette smoking,previous history of hepatitis,and family history of HCC were factors associated with the increased risk for PLC.Conclusion People living in Haimen city had a high risk on PLC.HBV infection appeared the most important risk factor for HCC mortality in this area.

Management and control of hypertension and diabetes in rural areas of China: Based on the practice of China Rural Health Project / 中国卫生政策研究

With the support of World Bank ( WB ) and UK Department for International Development ( DFID) , China Rural Health Project ( hereinafter referred asHealth XI Project) has successfully covered 40 coun-ties in 8 provinces. With the establishment of community diagnosis and health records as the entry point, hyperten-sion, diabetes and other major chronic diseases as the starting point, and focus on the needs of healthy people, high-risk groups and patients, the project mainly adopts health education and promotion, health management, disease management and other measures to explore the establishment of a new model of rural chronic disease management. By analyzing the monitoring data of chronic diseases in the project zones, this study found that the number of registered and managed patients with hypertension and diabetes increased significantly, from 397,113 and 136,326 in 2009 to 1,500,252 and 388,846 in 2013, respectively. The management rate also increased from 60. 8% and 32. 2% in 2009 to 92. 2% and 88. 8% in 2013, respectively. The results of the 5th National Health Service Survey show that, the control rates for self-reported hypertension and diabetes ((53. 8% and 50. 2%, respectively) in the project zones were significantly higher than the national average in rural areas ( 54 . 9% and 38 . 3%, respectively ) . This paper suggests that, with focus on training, health education, health promotion, health management and disease manage-ment as the core mainline, the chronic disease management model has effectively improved the chronic disease service capabilities in rural areas,. The comprehensive and integrated chronic disease interventions implemented by the pro-ject in the rural areas is practical, and it has value of popularization and application.

Applications of the performance evaluation index system for rural public health service system in China's rural health reform / 中国卫生政策研究

Objective: To evaluate the project performance of public health service system in rural areas during the implementation of China Rural Health Project ( hereinafter referred to asHealth XI Project) . Methods: In this paper, all 40 counties covered by the Health XI Project are selected as case study. This paper uses the performance evaluation index system for rural public health system developed for the project and continuously collect input and out-put indexes between 2008 and 2013 in order to conduct a comprehensive analysis and evaluation. Results: During the implementation of the Health XI Project, the inputs and outputs of the rural public health service system had gradual-ly increased in all the countries covered by the project. The score for inputs and outputs increased from 22. 73 and 39. 05 in 2008 to 32. 62 and 57. 60 in 2013, with a growth rate of 43. 15% and 47. 50%, respectively. The input scores significantly grew faster than output scores in some provinces. The input-output ratio increased from 1. 72 to 1. 77, with slight fluctuations between different years. Conclusion: The application of the performance evaluation index system for public health service system in monitoring project implementation process can help to timely discover the weak links associated with the implementation of rural public health service system, and thus take effective measures to promote the improvement of the system. . When increasing investment in public health, how to efficiently use re-sources and improve the service effectiveness is still an urgent problem.

Distribution of univalvia molluscs in area with natural decline of Oncomela-nia hupensis snails in Eastern Dongting Lake area / 中国血吸虫病防治杂志

Objective To understand the distribution of univalvia molluscs in Eastern Dongting lake area where the Oncome-lania hupensis is extinct,so as to explore the causes of extinction and to provide the evidence for formulating schistosomiasis con-trol strategy. Methods The univalvia molluscs of the Qianliang Lake district,Jianxin District and Junshan Park were investigat-ed in August of 2013. All the collected snails were classified and identified. The data were analyzed by using the method of Shapiro-Wilk normality test and non-parametric test. The ecological biodiversity differences from each district were compared by the biodi-versity indexes. Results The univalvia molluscs collected were from 6 species in 3 families in Gastropoda class,namely Oncome-lania hupensis Gredler in Pomatiopsidae family,Parafossarulus striatulus,Alocinma longicornis,Parafossarulus sinensis,Bithynia fuchsisana in Bithyniidae family,and one genus provisionally named Radix in Lymaneidae family. In Junshan Park ,a total of 4 553 snails were collected,among which 1 264 were Oncomelania snails. In Jianxin District,336 univalvia molluscs were collect-ed,and no Oncomelania snails were found. In Qianliang Lake district,there were only 7 Alocinma longicornis snails,2 Parafossa-rulus sinensis snails and 1 Parafossarulus striatulus snail collected. There were significant differences among the distributions of the samples from the three districts(χ2=166.225,P<0.01).The Simpson’s diversity indexes in Qianliang Lake area,Jianxin Dis- trict and Junshan Park were 0.402 8,0.718 6 and 0.678 8,respectively,and the Shannon-Wiener indexes of the 3 areas were 0.721 5,1.431 3 and 1.199 9,respectively. Conclusions With the extinction of Oncomelania snails,the species and quanti-ties of other snails become rare in Qianliang Lake area. Whether their causes are relevant is worth further studying.

An enlightenment from a chronic disease prevention——the China Da Qing Diabetes Prevention Study / 中华内分泌代谢杂志

To reduce morbidity and mortality and improve quality of life for patients with diabetes,the China Da Qing Diabetes Prevention Study was initiated as health education and behavior intervention in the 1980s in Daqing City.576 subjects with impaired glucose tolerance (IGT) were recruited and randonized into a clinical trial,either to a control group or to one of three active treatment groups:diet only,exercise only,or diet plus exercise.Follow-up evaluation examinations were conducted 2-year intervals over a 6-year period and after 20-year period to identify subjects who developed diabetes mellitus.Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a 6-year and 20-year period among those with IGT.The implementation of this study indicates that diabetes can be prevented through health education and behavioral intervention,and the prevention of diabetes and other chronic diseases should also focused on strengthening the muhi-sectoral cooperation,developing professional skills of health care providers,re-orientating health care services toward prevention of illness and promotion of health.

Epidemiology investigation of chronic kidney disease in adults of Shanghai Pudong New Area / 中华肾脏病杂志

Objective To investigate the prevalence and risk factors of chronic kidney disease (CKD) in adult residents of Shanghai Pudong New Area. Methods A total of 5584 residents aged 20-80 years old were randomly selected from Shanghai Pudong New Area through multistage sampling and interview between April and July 2008. Fasting blood samples and morning urine samples were collected to detect Scr and urinary albumin and creatinine. Urine albumin to creatinine ratio (ACR) and glomerular filtration rate (GFR) was calculated to estimate the renal function. Logistic regression model was used to examine the associations of demographic and lifestyle factors with indicators of kidney damage. Results The age-standardized prevalence of albuminuria, reduced renal function and CKD was 9.9% (male 8.0%, female 12.4%), 1.1% (male 1.3%, female 0.9%) and 11.0%(male 8.8%, female 12.7%), respectively. The prevalence of CKD was higher in female and increased with age. No significant difference in the prevalence was observed between urban and rural areas. Elder, female, high blood pressure, high fasting glucose, dyslipidemia and obesity were associated with CKD independently. Conclusions The prevalence of CKD in Shanghai Pudong New Area is comparable to that previously reported in China or other developed countries, and even higher. CKD is going to be a public health problem and warrants the community-integrated control strategy to prevent the incidence of end-stage renal disease (ESRD) and related complications.

A retrospective study on the clinical features of the hospitalized children with influenza in Suzhou from 2005 to 2009 / 中华传染病杂志

Objective To analyze the clinical features of the hospitalized children with laboratory-confirmed influenza in Suzhou. Methods The demographic information, laboratory test results, clinical features, treatments and outcomes of the hospitalized children with laboratoryconfirmed influenza were collected retrospectively. The data were analyzed using chi square test,Cochran-Armitage trend test. Results Four hundred and eighty hospitalized children were diagnosed with laboratory-confirmed influenza during the period of 2005 to 2009. Among these cases, 414 were subtype A and 66 were subtype B. The positive rate was 2.66%. Four hundred and nineteen cases (87.29 %) were ≤ 5 years old. Most of the cases developed during winter (from December to April the next year) and summer (from July to August). The age and sex distribution didn't vary from year to year (x2=9. 7768,x2 = 8. 7573; both P＞0.05). The mean disease course was (16.22± 9.41)days, and the mean hospitalization duration was (7.89 ±2.97) days. The percentages of patients with symptoms of fever, dyspnea and diarrhea or requiring oxygen treatment decreased with age (Z =4. 9430, Z=2. 1021, Z=3. 2073 and Z=2. 3277, respectively; all P＜0.05). The percentages of cases with concomitant pneumonia and upper respiratory infection also decreased with age (Z =-3. 8762 and Z=-3. 5095, respectively; both P＜0.01). Fifteen point five percent (60/387 cases)of the cases were co-infected with pneumococcus and 15. 0% (72/480 cases) were co-infected with respiratory syncytial virus (RSV). The level of C-reactive protein was significantly higher in cases with bacterial co-infection than those with viral co-infection (Z= -3.1290, P ＜ 0. 01 ).Conclusions Hospitalized children with influenza are more common in winter and summer in Shuzhou.Many patients are co-infected with pneumococcus or RSV. The symptoms are more severe in younger children.

Carriage and Antibiotic Resistance of Streptococcus pneumoniae from Respiratory Infected Children / 中华医院感染学杂志

OBJECTIVE To study the carriage,the risk factors and the antibiotic resistant pattern of Streptococcus pneumoniae isolated from hospitalized children with respiratory infection below 3 years old.METHODS A total of 453 children with respiratory infection hospitalized at Children′s Hospital of Soochow University in Suzhou Jiangsu Province from Mar 2006 to Mar 2007 were enrolled and given deep orotracheal aspiration(OTA) technique to get the sputum.S.pneumoniae strains were tested and analyzed.RESULTS The carriage rate of S.pneumoniae was 9.3% which was related with age and season.The percentage of resistance to penicillin,erythromycin,tetracycline,clindamycin,chloramphenicol and trimethoprim/sulfamethoxazole was 16.7%,100%,95.2%,95.2%,14.3% and 73.8%,respectively.No resistant strains to ceftriaxone,ofloxacin and vancomycin were detected.All S.pneumoniae strains were resistant to multiple drugs.CONCLUSIONS The carriage of S.pneumoniae in respiratory infected children below 3 years old in Suzhou area is relatively low.Age and incidence season are the risk factors.The antibiotic resistance is serious.