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BACKGROUND@#Measuring the health of the population is of great significance to the development of a region. We aimed to estimate the population, probability of death, and quality of life in western China.@*METHODS@#We calculated the age-specific mortality rate and prevalence rate of diseases and injuries using the Full Population Database and the Home Page of Inpatient Medical Record. We used multiple interpolation methods to insert missing information from the death data and the model of Kannisto to adjust the mortality rate for elderly individuals. The age-specific prevalence rate of diseases and injuries was adjusted according to the standard ratio of age and methods of equal proportional allocation. Life expectancy was calculated by a life table, and the quality of life was estimated using the Sullivan method.@*RESULTS@#The total population continued to increase in 2015 to 2019 in the Shaanxi Province, China. The mortality rate of children under five has improved, and the mortality rate of people over 65 is decreasing year by year. Life expectancy increased from 74.66 years in 2015 to 77.19 years in 2019. Even with the total risk of disease and injury, the health-adjusted life expectancy increased by 1.90 years within 5 years, and the number of unhealthy years significantly improved. Health-adjusted life expectancy increased by 1.75 years when only considered the ten major disease systems (tumors; endocrinology, nutrition and metabolism; mental and behavioral disorders; nervous system; sensory diseases; circulatory system; respiratory system; digestive system; genitourinary system; musculoskeletal system and connective tissue), and the number of unhealthy years increased slightly.@*CONCLUSIONS@#In the past five years, Shaanxi Province has made progress in improving life expectancy and controlling the development of chronic diseases. It is necessary to take specific preventive measures and improve the quality of basic public health services.
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Enfant , Humains , Sujet âgé , Études transversales , Qualité de vie , Espérance de vie , Chine/épidémiologie , PrévalenceRésumé
Objective To investigate the prevalence of thyroid nodules in women participating in physical examination in Beijing and analyze the influencing factors. Methods The data of physical examination (height, weight, blood pressure, blood glucose, etc.) and questionnaire survey (activity intensity, eating habits, etc.) of women in Beijing in 2016 were collected, and the influencing factors of thyroid nodules were analyzed by multivariate logistic regression. Results A total of 4 732 women were included in this study. The prevalence of thyroid nodules was 49.6%. Multivariate logistic regression analysis showed that compared with women aged 18-29 years, OR value was 1.769 (95% CI =1.489 ~ 2.102) for women aged 30 ~ 59 years, and OR value was 4.716 (95% CI = 3.577- 6.216) for women aged 60 years and over. Compared with the balanced diet, the OR value was1.237(95%CI=1.056-1.450)for vegetarian diet. Compared with the normal weight, the OR value was 1.331(95%CI=1.153-1.537)for the overweight. Compared with the healthy women, the OR value was 1.405 (95%CI=1.146-1.723)for hypertension, the OR value was 1.184(95%CI=1.040-1.347)for hyperlipidemia, and the OR value was 1.779(95%CI=1.178-2.687)for diabetes, while the OR value was 1.183(95%CI=1.018-1.376)for women with mammary gland nodules, and the OR value was 1.376(95%CI=1.201-1.575)for women with uterine leiomyoma. Compared with the education degree of high school, technical secondary school, technical school and below, the OR value was 0.648(95%CI=0.522-0.806)for college or undergraduate, and the OR value was 0.564(95%CI=0.440-0.723)for graduate students and above. Conclusion The prevalence of thyroid nodules in women in Beijing is at a high level. Age, vegetarian diet, overweight, hypertension, hyperlipidemia, diabetes, mammary gland nodules and uterine leiomyoma are risk factors for thyroid nodules. Education level is a protective factor for the prevalence of thyroid nodules.
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To compare the performance of generalized additive model (GAM) and long short-term memory recurrent neural network (LSTM-RNN) on the prediction of daily admissions of respiratory diseases with comorbid diabetes. Daily data on air pollutants, meteorological factors and hospital admissions for respiratory diseases from Jan 1st, 2014 to Dec 31st, 2019 in Beijing were collected. LSTM-RNN was used to predict the daily admissions of respiratory diseases with comorbid diabetes, and the results were compared with those of GAM. The evaluation indexes were calculated by five-fold cross validation. Compared with the GAM, the prediction errors of LSTM-RNN were significantly lower [root mean squared error (RMSE): 21.21±3.30 vs. 46.13±7.60, <0.01; mean absolute error (MAE): 14.64±1.99 vs. 36.08±6.20, <0.01], and the value was significantly higher (0.79±0.06 vs. 0.57±0.12, <0.01). In gender stratification, RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting female admission (all <0.05), but there were no significant difference in predicting male admission between two models (all >0.05). In seasonal stratification, RMSE and MAE of LSTM-RNN were lower than those of GAM in predicting warm season admission (all <0.05), but there was no significant difference in value (>0.05). There were no significant difference in RMSE, MAE and between the two models in predicting cold season admission (all >0.05). In the stratification of functional areas, the RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting core area admission (all <0.05). has lower prediction errors and better fitting than the GAM, which can provide scientific basis for precise allocation of medical resources in polluted weather in advance.
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Femelle , Humains , Mâle , Pékin/épidémiologie , Diabète/épidémiologie , Hospitalisation , Mémoire à court terme ,Résumé
This paper analyzed the feasibility of SPOC-mixed teaching in view of bottlenecks faced by the current health statistics curriculum, and deeply analyzed the limitations of traditional classroom teaching and network teaching only, as well as the advantages of SPOC-mixed teaching mode. At the same time, the construction of SPOC-mixed teaching mode of health statistics curriculum was explored from three aspects: teaching preparation, teaching implementation and teaching evaluation. It is hoped that the traditional teaching mode of "mainly teaching' "existed in health statistics will be transformed into a student-led and learning-based mode. According to each student's learning levels, professional background and cognitive style, individualized teaching was conducted to teach students in accordance with their ability, and promote the reform on traditional education concepts and teaching modes of health statistics.
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Objective@#To learn the temporal and spatial distribution of abnormalalanine aminotransferase(ALT)and its influencing factorsamong candidates for the high school entrance examination in Beijing,and to provide evidence for prevention of abnormal ALT in adolescents.@*Methods@#The physical examination data of the candidates in Beijing from 2009 to 2018 were collected from Beijing Physical Examination Center. The time,space and population distribution of abnormal ALT was analyzed;the time-space interaction trend of abnormal ALT was described by bubble map;and the Bayesian spatio-temporal model was built to explore the influencing factors of abnormal ALT in middle school students.@*Results@#Among 884 915 candidates,5 354 candidates had abnormal ALT,accounting for 0.61%. The rate of abnormal ALT showed an upward trend from 2009 to 2018(P<0.05).The rate of abnormal ALT was 0.95% in males and 0.23% in females,5.09% in obese candidates and 0.18% in non-obese ones,0.70% in urban area and 0.48% in rural area,and the differences between gender,obesity and residence were all statistically significant(P<0.05). From 2009 to 2018,the rates of abnormal ALT among the candidates in Changping District remained the highest;the rate in Shunyi District and Daxing District showed an increasing trend;the rates in Haidian District,Chaoyang District and Fengtai District were relatively high,the rates in Miyun District and Pinggu District were relatively low,while the trend of them were not obvious. The results of the Bayesian space-time model showed that the risk of abnormal ALT increased by 5.706 times for each unit increase of regional male percentage and increased by 8.679 times for each unit increase of regional obesity percentage.@*Conclusion@#The rate of abnormal ALT among candidates for the high school entrance examination in Beijing shows a upward trend. The rates of abnormal ALT among the candidates in Changping District,Haidian District,Chaoyang District and Fengtai District are relatively high,and the rates in Shunyi District and Daxing District tend to rise. Males and obese students are the high risk groups of abnormal ALT.
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Objective: To analyze the effect of air quality index (AQI) on the incidence of tuberculosis (TB) in Beijing, and to provide evidence for setting up a better program regarding prevention and control of tuberculosis. Methods: Generalized additive model (GAM) was used to analyze the association between AQI and the incidence of tuberculosis in Beijing, from January 1, 2014 to November 9, 2016. Confounding factors as meteorological conditions and time trends were under control. Results: In Beijing, a total of 14 533 TB cases with definite dates of onset were collected during the study period, with 36 children excluded from the study. Finally, 14 497 cases were included in the study, including 9 513 men and 4 984 women, with 11 290 adults (15-59 years old) and 3 207 elderly (≥60 years old). Data from the optimal single-day lag effect of GAM showed that,with every 10 increase of AQI, the percent of increase on the onsets of overall, male, female and adult; tuberculosis cases were 0.85% (95%CI: 0.26%-1.44%), 0.83% (95%CI: 0.24%-1.42%), 0.93% (95%CI: 0.24%-1.62%) and 0.88% (95%CI: 0.29%-1.46%), respectively. The optimal lag time of the single-day effects were 15 days (lag15), but 16 days (lag16) for male. The optimal cumulative lag effect showed that with every 10 AQI increase, the percent of increase on the onsets of overall, male, female and adult tuberculosis cases were 1.92% (95%CI: 0.23%-3.16%), 1.94% (95%CI:0.15%-3.72%), 2.04% (95%CI: 0.10%-3.97%) and 2.00% (95%CI: 0.30%-3.69%), respectively, with the optimal lag time of cumulative delayed effects as 17 days (lag0_17), 18 days (lag0_18), 16 days (lag0_16) and 17 days (lag0_17), respectively. However, there were no statistical significances noticed in the elderly cases. Conclusion: There was a positive correlation between AQI and the number of TB cases in Beijing, and the effects of AQI on the number of TB cases in different genders and age groups were different.
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Adolescent , Adulte , Sujet âgé , Enfant , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Polluants atmosphériques/effets indésirables , Pollution de l'air , Pékin , Incidence , Matière particulaire/effets indésirables , Tuberculose/épidémiologieRésumé
Objective@#To clarify the situation of the detection of upper gastrointestinal cancer and precancerous lesions in the Feicheng city and discuss the possible influencing factors.@*Methods@#A cluster sampling method was used to determine the participants. A unified questionnaire was used to investigate the basic information including history of alcohol intake, smoking and chinese tea, as well as other eating habits, medical history of digestive tract and cancer. Endoscopy was used to to screen the patients with upper gastrointestinal cancer and precancerous lesions. Influential factors were explored by non-conditional logistic regression model.@*Results@#911 of 7 291participants were positive, and the total detection rate was 12.49%. The total positive detection rate of male and female was 17.94% and 8.71%, respectively (P<0.001). Multivariate logistic regression analysis showed that the sex (OR=0.527, 95%CI: 0.440-0.631), age (OR=2.037, 95%CI: 1.849-2.245), smoking (OR=1.240, 95%CI: 1.014-1.516) and alcohol consumption (OR=1.232, 95%CI: 1.012-1.500) , meat and protein intake (OR=0.794, 95%CI: 0.638-0.987) and drink tea (OR=1.233, 95%CI: 1.056-1.440) may be influencing factors of the total detection rate of upper gastrointestinal cancer and precancerosis.@*Conclusions@#In Feicheng city, intake of meat and protein is the protective factor of the upper gastrointestinal cancer and precancerous lesions. Men, aged, smoking, drinking and tea will increase the risk of upper gastrointestinal cancer and precancerous lesions.
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Objective To analyze the effect of air quality index (AQI) on the incidence of tuberculosis (TB) in Beijing,and to provide evidence for setting up a better program regarding prevention and control of tuberculosis.Methods Generalized additive model (GAM) was used to analyze the association between AQI and the incidence of tuberculosis in Beijing,from January 1,2014 to November 9,2016.Confounding factors as meteorological conditions and time trends were under control.Results In Beijing,a total of 14 533 TB cases with definite dates of onset were collected during the study period,with 36 children excluded from the study.Finally,14 497 cases were included in the study,including 9 513 men and 4 984 women,with 11 290 adults (15-59 years old) and 3 207 elderly (≥60 years old).Data from the optimal single-day lag effect of GAM showed that,with every 1 0 increase of AQI,the percent of increase on the onsets of overall,male,female and adult;tuberculosis cases were 0.85% (95%CI:0.26%-1.44%),0.83% (95%CI:0.24%-1.42%),0.93% (95%CI:0.24%-1.62%) and 0.88% (95%CI:0.29%-1.46%),respectively.The optimal lag time of the single-day effects were 15 days (lagl5),but 16 days (lag16) for male.The optimal cumulative lag effect showed that with every 10 AQI increase,the percent of increase on the onsets of overall,male,female and adult tuberculosis cases were 1.92% (95%CI:0.23%-3.16%),1.94% (95%CI:0.15%-3.72%),2.04% (95%CI:0.10%-3.97%) and 2.00% (95%CI:0.30%-3.69%),respectively,with the optimal lag time of cumulative delayed effects as 17 days (lag0_17),18 days (lag0_18),16 days (lag0_16) and 17 days (lag0_17),respectively.However,there were no statistical significances noticed in the elderly cases.Conclusion There was a positive correlation between AQI and the number of TB cases in Beijing,and the effects of AQI on the number of TB cases in different genders and age groups were different.
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Objective To study the effect of octreotide combined with lactulose enema therapy in the treatment of acute pancreatitis .Methods 80 cases with acute pancreatitis were selected as the research subjects , they were randomly divided into two groups , 40 cases in each group .The control group was treated with octreotide , and the observation group was given octreotide combined with lactulose enema treatment .The clinical total effective rate ,symp-toms time,hospitalization time and inflammatory cytokines were compared in the groups .Results The total effective rate of the observation group was significantly higher than that of the control group (95.00% vs.80.00%,χ2 =4.114,P<0.05).The remission time of abdominal discomfort ,intestinal function recovery time ,serum amylase recov-ery time and hospitalization time in the observation group were (2.19 ±0.82)d,(2.96 ±1.15)d,(4.67 ±1.43)d, (10.37 ±2.14) d,respectivel,which were significantly shorter than those in the control group ( t=8.266,5.516, 8.084,8.376,all P<0.05).After treatment,the levels of TNF -alpha,IL-6,hs-CRP in the observation group were (36.78 ±14.67)ng/L,(109.53 ±36.29)pg/mL,(10.32 ±3.89)mg/L,respectivel,which were significantly lower than those in the control group (t=4.424,4.386,4.622,all P<0.05).Conclusion The curative effect of octreotide and lactulose enema in the treatment of acute pancreatitis is significant , it can effectively improve the patients'clinical symptoms ,also can inhibit the inflammatory cytokines and improve the prognosis .
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Objective To investigate the risks of self-rated health in the ≥55-year elderly in Beijing and the occurrence of stroke.Methods The subjects (n=2 101;aged ≥55) from Beijing longitudinal study of aging (BLSA) were collected by Xuanwu Hospital,Capital Medical University from January 1992 to December 2016.One hundred and twenty-one subjects with stroke at baseline and 92 with incomplete information were excluded,and finally,1 888 elderly patients without cerebrovascular disease at baseline were included in the analysis.Based on the actual situation,the self-rated health was to identify an item that matched their current state from good,general to poor.The deadline for the survey was December 31,2012.The competitive risk model was used to assess the health self-rated status and the risk of stroke.Non-stroke deaths,including cancer and car accidents were treated as competitive events.Results Of the 1 888 subjects enrolled,946 (50.1%) self-rated health were good,616 (32.6%) were general,and 326 (17.3%) were poor;438 (23.2%) had stroke,751 (37.8%) had non-stroke death,and 699 (37.0%) were right censored data.Using the competing risk model and adjusting the age,sex,living area,marital status,education level,smoking,alcohol consumption,physical exercise,hypertension,diabetes mellitus,coronary heart disease,and body mass index,the occurrence of stroke in patients with poor self-rated health was 1.44 times (95%CI 1.11-1.87,P<0.01) as good as those who were good.Conclusion In the self-rated health of the elderly ≥55 years old in Beijing,the people with poor self-rated health increased the occurrence of stroke after considering the competitive risks.
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Objective To understand the impact of meteorological factors on the incidence of hand,foot and mouth disease (HFMD) and the epidemiological characteristics of HFMD in China.Methods Bayesian hierarchical model[Besag,York,and Mollie' (BYM) model] was used to fit the data.The fitting effects of uncorrelated heterogeneity (UH) model,correlated heterogeneity (CH) model and spatial and temporal interaction model were compared and the best model was selected to analyze the meteorological factors influencing the incidence of HFMD.Results The UH +CH model with spatial and temporal interaction had best fitting effect (DIC=35 507.2).Rainfall(RR=1.051 7,95% CI:1.050 4-1.052 5),average temperature (RR=1.089 6,95% CI:1.078 1-1.106 9),average relative humidity (RR=l.089 0,95%CI:1.082 1-1.091 2),average air pressure (RR=l.076 4,95% CI:1.074 8-1.077 9) and hours of sunshine (RR=1.0851,95% CI:1.0798-1.0875) were the meteorological factors influencing the incidence of HFMD.Conclusion The incidence of HFMD had spatial and temporal clustering characteristics.The meteorological factors were closely related with the incidence of HFMD.
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Objective To observe the changes of learning function and neuron-specific enolase (NSE)protein of both brian and serum in rats after intermittent hypoxia,and explore the relation between NSE protein and learning and memory function.Methods Male Wistar adult rats(n=48)were randomly divided into control group (UC group) and 7.5% chronic intermittent hypoxia group (7.5%CIH group).7.5% chronic intermittent hypoxia model in rats were simalated by using the self-made cabin of intermittent hypoxia.At the 2nd,4th,6th,and 8th week respectively,learning and memory function in rat was tested by Morris water maze in two groups.The level of NSE protein in hippocampal CA1 region was detected by immunohistochemical method,and was detected in serum of rats by using enzyme-linked immunosorbent adsorption method.Results Compared with the control group,7.5% CIH group at the 2nd,4th,6th,and 8th week in rats from the second week of the escape latency time was 44.13± 2.84) s,(50.35 ± 1.96) s,(57.47 ± 1.66) s,(62.85 ± 1.80) s,and across the target quadrant time was 48.81 ± 2.09) s,(42.04± 1.84) s,(36.82± 2.07) s,(31.81 ± 1.68) s.From the first two weeks,the longer the hypoxia time prolonged,the longer the rat's escapedlatency (P<0.05) and the shorter the rats acrossed the target quadrant (P <0.05).7.5% CIH group of hippocampal CA1 neurons NSE protein at the 2nd,4th,6th,and 8th week was (9.69±1.37),17.10± 1.87),(24.79± 3.51),(34.16±5.35),respectively,and serum NSE protein at the 2nd,4th,6th,and 8th week respectively was (6.03±0.91) μg/L,(11.04± 1.89) μg/L,(16.39± 1.00) μg/L,(24.22±3.73) μg/L,both of which were more than the control group.The difference was statistically significant (P<0.05).7.5% CIH group of hippocampal CA1 neurons and serum NSE protein expression were significant time differences,and gradually increased over time.The difference was statistically significant (P<0.05).Positive NSE protein expression in hippocampal CA1 region relative NSE and serum protein expression values were positively correlated (r=0.94,P <0.01).But in control group NSE protein expression did not exist time difference (P>0.05).Conclusion Intermittent hypoxia can cause NSE levels significant increase in serum and brain tissue,and the dynamic changes of them can reflect severity of learning and memory impairement in rat.
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Objective To investigate the trend of length of stay (LOS) and identify variables that predict LOS for inpatient rehabilitation after stroke. Methods A total of 3049 inpatients who completed the stroke rehabilitation program at Beijing Bo'ai Hospital from January 2002 to December 2011 were reviewed and analyzed with nonparametric rank sum test and binary Logistic regression analysis. Results The median of LOS was 82 days, and tended to decrease obviously in 2010 and 2011. On Logistic regression analysis, there were 13 variables as-sociated with LOS, in which operation, muscle spasm, gain of activities of daily living (ADL), onset admission interval, nosocomial infec-tion, complications, speech disorder, the type of stroke, the number of hospitalization, methods of payment were the risk factors, and age, functional ambulation classificateion and Fugl-Meyer Assessment were protect factors. Conclusion Reducing LOS must base on rehabilita-tion efficacy, and the improvement of hospital management process, the prevention of complications and nosocomial infection control, and early rehabilitation intervention can reduce the LOS.
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Objective To obtain the data of injury among children aged 0~6 years in Haidian area and Pinggu area of Beijing.Methods A total of 2970 children aged 0~6 years in Haidian District(city area) and 2558 in Pinggu District (rural area)were investigated by cluster sampling method.Results A total of 5528 children were investigated,the incidence of injury was 8.64%.The incidence rate of aged 0~6 years child injury in Haidian District was10.54%,which was much higher than that in Pinggu District (6.45%).The top five causes of injury were falls,animal bites,burn/scalds,injury by sharp articles and struck/hit by falling object in Pinggu District.The top five causes of injury were falls,animal bites,injury by sharp articles,burn/scalds and blunt in Haidian District.the sequences of injury were similar between the two districts.The incidence rate of burns/scalds was higher in Pinggu District than that in Haidian District.The types of injury were little different between children who lived at home and children who lived in kindergarten.The types of injury were not too different between genders.Falls was the leading cause of injury for all children(in cities or in countries,boys and girls,in different age group).Conclusion The incidence rates of injury and types of injury are different in different areas,genders and age groups.So the intervention of injury should be different.
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Objective To study the effect of traditional Chinese medicine on survival time in children solid tumors with chemotherapy. Methods 76 children with solid tumors, which were collected from January 2005 to March 2006, were randomly divided into treatment group (35 cases), control group (41 cases). The treatment group was treated with chemotherapy + self-dispensing Fuzheng Jianpi Chinese medicine. The control group was treated with chemotherapy alone. Results The survival rate of the treatment group was higher than that of the control group, the difference was statistically significant (P = 0.0024). The average survival time after chemotherapy in the treatment group was (31± 2) months (95 % CI 27-34 months), the control group was (21±2) months (95 % CI 16-25 months), which was shorter than the treatment group.Conclusion Chinese medicine and chemotherapy can prolong the survival time of children with solid tumors.
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In order to improve bilingual teaching in clinical epidemiology,a multidimensional teaching mode with flexible method was constructed.And it was proposed that based on the student-centered learning,the content of teaching should be adjusted,English should be used logically and clinical courses and practice should be closely connected.The new teaching method was proved successful.
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The concept of the health promoting hospital, a modern mode of medical service that has turned from the formerly unitary pattern of medical treatment to the health promoting and life quality improving pattern of medical treatment, prevention and health care, was proposed by modern medical institutions so as to keep up with the change in medical modes and medical socialization. In recent years, many countries in the world have adopted the advanced service ideas of the health promoting hospital and conducted active research on various specific subjects. The paper gives an account of the concept, basic theories, development history, and latest progress both at home and abroad of the health promoting hospital so as to give an impetus to health education and health promotion in China.