Therapeutic Observation of Acupuncture plus Medication for Cough Variant Asthma / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture plus oral administration of self-made Chinese herbal decoction in treating cough variant asthma (CVA).Method Sixty-two CVA patients were randomized into a treatment group of 32 cases and a control group of 30 cases.The treatment group was intervened by acupuncture plus oral administration of self-made Chinese herbal decoction,and the control group was intervened by Montelukast sodium tablets.Before and after 3 courses of treatment,the score of cough,eosinophil (EOS) count,pulmonary function tests [peak expiratory flow (PEF),forced vital capacity (FVC),and forced expiratory volume in 1 second (FEV1)] were observed.The clinical efficacies were compared between the two groups.Result After the treatment,the score of cough,EOS count,and pulmonary function tests (PEF,FVC,and FEV1) were changed significantly in both groups (P＜0.05).The score of cough,EOS level and pulmonary function tests in the treatment group were significantly different from those in the control group after the treatment (P＜0.05,P＜0.01).The total effective rate was 93.8％ in the treatment group versus 80.0％ in the control group,and the difference was statistically significant (P＜0.05).Conclusion Acupuncture plus oral administration of self-made Chinese herbal decoction is an effective method in treating CVA.

Changes in knowledge and behavior related to tobacco consumption among urban population before and after the enforcement of the Smoke Control Ordinance in Public Places of Hangzhou in 2010 / 中华流行病学杂志

Objective To examine the changes in tobacco related knowledge,smoking habit and the amount if environmental tobacco smoke (ETS) among urban population before and after the enforcement of the Smoke Control Ordinance in Public Places of Hangzhou in March 2010.Methods Two independent cross-sectional surveys were conducted on random samples from adults aged 18-64 years in three districts of Hangzhou city between two petiods:October 2008 to August 2009 and June 2011 to February 2012.Results A total of 2016 adults at the initial stage and 2016adults during the follow-up program completed the survey.Nine out of the ten indices related to the knowledge on tobacco presented an improvement during the follow-up process.All the participants (22.4％ vs.17.7％,P＜0.001) and men (44.2％ vs.37.3％,P=0.004) showed statistically significant declines in the prevalence of smoking,when compared with women (1.7％ vs.1.2％,P=0.379).The proportions of individuals who had noticed anyone smoking in the previous 30 days demonstrated statistically significant declines in nine types of places:school (5.6％ vs.2.7％,P＜0.001),health centre (11.4％ vs.3.7％, P＜0.001),public transportation (19.2％ vs.12.2％,P＜0.001),government building (11.3％ vs.5.6％,P＜ 0.001),restaurant (67.0％ vs.61.3％,P=0.002),workplace (49.7％ vs.38.3％,P＜0.001),private office building (23.6％ vs.19.9％,P=0.023),home (41.0％ vs.35.5％,P=0.003),friend's home (33.9％ vs.29.5％,P=0.017).Conclusion Positive changes were noticed among urban population with respect to tobacco related knowledge,prevalence of smoking,and the environmental tobacco smoke (ETS) after the enforcement of the Smoke Control Ordinance in Public Places of Hangzhou.

Assessment on the short-term impact regarding the community-based interventions to improve physical activities in three urban areas of Hangzhou city / 中华流行病学杂志

Objective To evaluate the short-term impact of comprehensive communitybased intervention on physical activity (PA) of adults living in the three urban communities of Hangzhou city.Methods Within the framework of Community Interventions for Health (CIH) Program,a community trial was conducted in two urban areas (Xiacheng district and Gongshu district) and an urban area (Xihu district) as control,by a parallel comparison and random grouping based quasi-experimental design.Two independent questionnaire-based surveys of cross-sectional samples in the intervention and comparison areas were used to assess the short-term impact of the intervention program.Results A total of 2016 adults at baseline and 2016 adults at follow-up stages,completed the survey,including 1016 adults from the intervention areas and 1000 from the comparison area.Over the two-year intervention period,the cognitive level on benefits of physical activity in the intervention areas were trending downward.The changes observed in the comparison area did not show statistical significance.Intervention areas showed a statistically significant increase (1204 vs.1386,P=0.023) in the level of physical activity (metabolic equivalent,MET-minutes/week) compared with the comparison area (918 vs.924,P=0.201).And results remained the same after eliminating the possible effects of age factor.Conclusion After a two-year intervention,beneficial changes were noted in the intervention areas with respect to the level of physical activity.A community-based intervention program on physical activity seemed feasible and effective in the urban areas of Hangzhou.

The effects of occupational soluble chromate exposure on immunological function of T-cell / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the early changes of some immunological function of T-cell in chromate workers.</p><p><b>METHODS</b>A total of 115 workers exposed to different levels of soluble chromate were enrolled in exposed group; while 90 non-exposure workers who lived far away from the chromate plant were enrolled as control. The air concentration of soluble chromate was determined by atomic absorption spectrometry. CD3(+), CD3(+)CD4(+), CD3(+)CD8(+) and CD4(+)/CD8(+) of T-cell were determined by flow cytometry analysis.</p><p><b>RESULTS</b>The individual air chromate concentration in the exposed group was (27.51 +/- 33.25) microg/m(3), and the control group was (0.16 +/- 0.15) microg/m(3). The significant difference between the two groups was observed (z = 8.045, P < 0.01). The levels of the lymphocyte subsets (CD3(+), CD3(+)CD4(+), CD3(+)CD8(+) and CD4(+)/CD8(+)) in exposed group were (30.08 +/- 17.75)%, (1.04 +/- 1.73)%, (11.94 +/- 9.78)%, 0.10 +/- 0.14. While, those of control group were (63.00 +/- 13.57)%, (30.51 +/- 5.16)%, (14.82 +/- 4.59)%, 2.17 +/- 0.53, higher than that of the exposed group (z values were 4.484, 5.227, 1.976, -5.218, respectively, P < 0.05).</p><p><b>CONCLUSION</b>On the basis of individual air monitoring, the cellular immune function affected by soluble chromate is mainly based on T lymphocyte inhibition. The indicators CD3(+)CD4(+) mentioned above may be considered as efficient biomarkers in further research.</p>

Effects of diet and physical activity factors on blood pressure in nine provinces of China: a longitudinal analysis / 中华流行病学杂志

Objective To study the effects of diet and physical activity factors on blood pressure in nine provinces, using the multilevel model. Methods Data was collected in the China Health and Nutrition Survey (CHNS). A total of 6706 men and 7140 women aged above 18 who attended at least one of the surveys in the year of 1997,2000,2004 and 2006 were selected, and a two-level male and female random intercept-slope growth models were applied to estimate the relationship between the intake of daily salt, vegetable, fruit, fat, protein as well as the time spent on the moderate or heavy physical activity and blood pressure. Results After controlling for age,education, BMI, drinks and total energy intake, mean of the daily salt intake per person was positively associated with systolic blood pressure in women ( β= 0.0481, s-x= 0.0178, P＜0.01 ). Mean of the daily vegetable intake per person was negatively associated with systolic blood pressure in men and women, with the regression coefficients as -0.0063,-0.0068 respectively, indicating that if mean of the daily vegetable intake per person increased by 100 g, the systolic blood pressure would decrease by 0.6 mm Hg (1 mm Hg=0.133 kPa) or more. In addition, the daily vegetable intake was also negatively associated with diastolic blood pressure (P＜0.01). Daily fruit intake was negatively associated with systolic blood pressure both in men and women, with regression coefficients as -0.0029 and -0.0031 respectively. Time spent on the moderate or heavy physical activity was also negatively associated with systolic blood pressure in both men and women, and diastolic blood pressure in women (P＜0.05). No relationship was found between daily fat, protein intake and blood pressure. Conclusion Daily salt, vegetable, fruit intake, time spent on the moderate or heavy physical activity were associated with blood pressure in both men and women. Programs on integrated lifestyle modifications including dietary salt reduction, eating more vegetable and fruits, increasing physical activity level, plus weight control were critical for the control of high blood pressure.

Estimation of sampling error on data from cluster sample survey / 中华流行病学杂志

To clarify the necessity of applying appropriate statistical methods to calculate sampling error from data of cluster sample survey, we take a two-stage cluster sample survey developed from a population aged 15 and over as example. We use statistical methods based on the assumption of simple random samples and methods considering complex sample design to analyze our data, respectively. Through comparison, we hope to show the potential effects of using improper statistical methods to estimate sampling error on parameter estimation and hypothesis testing. Using standard error algorithms based on the assumption of simple random samples,the standard errors calculated often underestimate sampling error and the hypothesis testing even gets wrong conclusion. When the statistical methods and statistics package for complex survey data are already available, it is necessary for us to use appropriate methods to analyze and report the sampling errors of data from cluster sample survey.

Data analysis from surveys using complex sampling methods / 中华流行病学杂志

To present statistical methods on appropriate data analysis from complex surveys and errors arising from ignorance of weights or design of samples. We took Chinese National Nutrition and Health Survey in 2002 as an example to analyze the prevalence of hypertension among population aged 15 and over. We used four combinations of analyses, including with or without weighting or considering sample designs. If weights is omitted, it would result in biased prevalence estimates and also influence the estimates of standard errors. While omitting sample designs would result in underestimating the standard error estimates and then testing the false positive hypothesis. Through appropriate analysis, we found Chinese people in large-sized cities had the highest prevalence of hypertension (28.77%, 95%CI: 25.69% - 31.84%) while people in the poorest rural area having the lowest prevalence of hypertension (14.21%, 95%CI: 12.64% - 15.79%). The prevalence of hypertension among people in small and medium-sized cities and other rural areas ranged from 20.48% to 24.37% with statistically insignificant difference. It is necessary to use appropriate methods to analyze data from complex surveys.

The correlation between personal occupational exposure to soluble chromate and urinary chromium content / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore and provide the possible biological limit of urinary chromium for population occupationally exposure to soluble chromate, as to providing scientific evidences for health monitoring and risk assessment.</p><p><b>METHODS</b>A cross-sectional study was conducted. The studied population contained 83 workers from different processes of the chromate plant, in addition, 10 farmers without exposure to chromate matched with exposed subjects by age, gender and smoking status were identified as a control group. The air chromium concentration for personal exposure during 8-hours shift and the urinary chromium concentration post-shift were determined and their relationship was analyzed statistically. Meanwhile, the literatures of the biological limit of urinary chromium for occupational exposure to soluble chromate were studied.</p><p><b>RESULTS</b>For the control group, the air chromium concentration had a range from 0.00 microg/m(3) to 0.08 microg/m(3) and the urinary chromium concentration from 0.40 microg/g Cre to 1.02 microg/g Cre. For the exposure group, the air chromium concentration was from 0.10 microg/m(3) to 287.00 microg/m(3) and the urinary chromium concentration was from 1.14 microg/g Cre to 79.07 microg/g Cre. The positive relationship existed in between air chromium concentration and urinary concentration. The urinary chromium concentration was increased depending on the chromate exposed level. The regress equation was that Urinary chromium concentration (microg/g Cre) = 4.16 + 236.86 x air concentration for chromate (mg/m(3)), r = 0.976. The recommendation of ACGIH (USA, 2004) was 65.1 micromol/mol Cre (30 microg/g Cre) with the same TLV-TWA of 0.05 mg/m(3) as our National standard about the air chromate concentration.</p><p><b>CONCLUSION</b>Our findings suggested that the post-shift urinary chromium concentration might be used as an exposed biomarker for chromate. Considering the recommendation of ACGIH (USA, 2004) and the feasibility of the standard performed, we suggest that the biological threshold limit of urinary chromium for occupational exposure to soluble chromate in China should be 65.1 micromol/mol Cre (30 microg/g Cre) (post-shift urine for consecutive 5 work days.).</p>

Analysis on the trend of long-term change of blood pressure in hypertensive patients treated with benazepril / 中华流行病学杂志

<p><b>OBJECTIVE</b>To introduce the application of mixed linear model in the analysis of secular trend of blood pressure under antihypertensive treatment.</p><p><b>METHODS</b>A community-based postmarketing surveillance of benazepril was conducted in 1831 essential hypertensive patients (age range from 35 to 88 years) in Shanghai. Data of blood pressure was analyzed every 3 months with mixed linear model to describe the secular trend of blood pressure and changes of age-specific and gender-specific.</p><p><b>RESULTS</b>The changing trends of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were found to fit the curvilinear models. A piecewise model was fit for pulse pressure (PP), i.e., curvilinear model in the first 9 months and linear model after 9 months of taking medication. Both blood pressure and its velocity gradually slowed down. There were significant variation for the curve parameters of intercept, slope, and acceleration. Blood pressure in patients with higher initial levels was persistently declining in the 3-year-treatment. However blood pressures of patients with relatively low initial levels remained low when dropped down to some degree. Elderly patients showed high SBP but low DBP, so as with higher PP. The velocity and sizes of blood pressure reductions increased with the initial level of blood pressure.</p><p><b>CONCLUSION</b>Mixed linear model is flexible and robust when applied to the analysis of longitudinal data but with missing values and can also make the maximum use of available information.</p>