Analysis of the core knowledge level of chronic diseases in Chinese adults and related factors / 中华预防医学杂志

Objective: To understand the core knowledge level and influencing factors of chronic disease prevention and control in Adults in China, and to provide a scientific basis for formulating chronic disease prevention and control measures. Methods: In this study, cross-sectional survey and quota sampling were used to recruit 173 819 permanent residents aged 18 and above from 302 counties of adult chronic diseases and nutrition surveillance in China to conduct an online questionnaire survey, including basic information and core knowledge of chronic diseases. The scores of the core knowledge of chronic disease prevention and control were described by median and interquartile range, the Wilcoxon rank sum test or the Kruskal Wallis test was used for the inter-group comparison, and the correlation factors of the total score were analyzed by the multilinear regression model. Results: A total of 172 808 participants were surveyed in 302 counties and districts, of which 42.60%(73 623) were male and 57.40%(99 185) were female; The proportion of respondents aged 18-44, 45-59, and 60 years old and above was 54.74% (94 594), 30.91% (53 423) and 14.35% (24 791), respectively. The total score of the core knowledge of chronic prevention and control in the total population was 66(13), and the scores of different characteristic groups were different, and the differences were statistically significant: the eastern region had the highest score at 67(11) (H=840.66, P<0.01), the urban 66(12) was higher than the rural 65(14) (Z=-31.35, P<0.01), and the male 66(14) was lower than female 66(12) (Z=-11.66, P<0.01), 18-24 years old 64(13) was lower than other age groups(H=115.80, P<0.01), and undergraduate degree and above had the highest score compared to other academic qualifications, with 68(9) points(H=2 547.25, P<0.01). Multivariate analysis showed that eastern (t=27.42, P<0.01), central (t=17.33, P<0.01), urban (t=5.69, P<0.01), female (t=17.81, P<0.01), high age (t=46.04, P<0.01) and high education (t=57.77, P<0.01) had higher scores of core knowledge of chronic disease prevention and control than other groups, the scores of core knowledge of chronic disease prevention and control of professional and technical personnel (t=8.63, P<0.01), state enterprises and institutions (t=38.67, P<0.01), agriculture, forestry, animal husbandry, fishery and water conservancy production (t=5.30, P<0.01), production, transportation and commercial personnel (t=24.87, P<0.01), and other workers (t=8.89, P<0.01) were higher than those of non-employed people. Conclusion: There are differences in the total scores of the core knowledge of chronic disease prevention and control in different characteristics of people in China, and in the future, health education on the prevention and treatment of chronic diseases should be strengthened for specific groups to improve the knowledge level of residents.

The impact evaluation of a community-based intervention supporting type 2 diabetes mellitus patients in their self-management of the disease / 中华预防医学杂志

Objective@#To evaluate the effect of a community-based intervention supporting type 2 diabetes mellitus patients in their self-management of the disease.@*Methods@#This research was a randomized controlled trial conducted in communities in Fangshan District, Beijing, China. Adult patients with type 2 diabetes from 17 communities in 4 sub-district of Fangshan District were randomly assigned to either the intervention or control group. Participants in the intervention group participated in a three-month group-based diabetes self-management intervention service. Data were collected both in intervention and control group at baseline and after the intervention to evaluate the effect of the intervention. A questionnaire survey was completed by all participants to collect their demographic information, diabetes related health behaviors and skills. A physical examination and lab testing including height, weight, blood pressure, and waist circumference as well as HbA1c, fasting blood glucose, lipid profile were conducted before and after the intervention.@*Results@#A total of 500 valid questionnaires were received, including 259 in the intervention group and 241 in the control group. Patients in the intervention group who learned how to conduct the self-monitoring of blood glucose increased from 56.76% (n=147) to 87.26% (n=226) after the intervention, higher than that of control group (63.07%, n=152) (P<0.001). 69.50% (n=180) patients in intervention group had blood glucose monitor at home, which was 60.62% (n=157) prior to the intervention and higher than that of control group (57.68%, n=139) (P=0.004). After the intervention, 3.09% (n=8) patients in intervention group ceased to take medicine by themselves, which was 16.22% (n=42) before the intervention, while the control group was 8.30% (n=20) after the intervention (P=0.009). Patients in the intervention group made significant improvements in implementing self monitoring on blood glucose (SMBG), which was increased from one day per week to 2 days per week, and foot self-examination, which increased from 2 days per week to 7 days per week. The body weight of patients in the intervention group reduced 1.62 kg on average after the intervention, while it increased 0.88 kg in the control group. Similar improvement was found in waist circumstance between the intervention and control group (-0.83 cm vs -0.16 m). There was a significant reduction on body weight and waist circumstance in the intervention group (P<0.05).@*Conclusion@#The group activities focusing on people with type 2 diabetes resulted in improvement in their lifestyle and self management behaviors, as well as their body weight and waist circumstance.

The design of interrupted time series and its analytic methods / 中华预防医学杂志

Interrupted time series (ITS) is a statistical method for the quasi-experimental design specific to the outcome of time series, in which the effectiveness of an intervening measure is evaluated by examining change in slope and immediate change in level. The key feature of ITS is that the secular trend of time series prior to the intervention can be effectively controlled so as to accurately estimate the intervention effect. The design principle and statistical method for ITS were illustrated by an example of evaluating halving policy for the expert registration fee in the general hospital of a city. The segmented linear regression was used to fit the above time series data and the results were explained in detail. Meanwhile, the study design and model fitting along with explanations of the results with respect to the effects of two types of successive interventions and on different time-points of an intervention were illustrated as well in this paper. The existed upward or downward trend should be taken into account in order to accurately estimate the intervention effect as it exists in most of the public health surveillance data. Two parameters, known as change in slope and immediate change in level, were employed to evaluate the effect of the intervention. The ITS analysis can be widely applied to the program evaluation as it could enrich methods of the evaluation compared to the traditional model of the program evaluation.

Disease burden of diabetes attributable to high body mass index in China,1990-2016 / 中华流行病学杂志

Objective: To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016. Methods: Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI. Measurements for attributable BOD of diabetes included disability adjusted life years (DALY), years of lost life (YLL), years living with disability (YLD), death number and mortality rate. The average world population from 2010 to 2035 was used as a reference. Results: In 2016, death number of diabetes attributable to high BMI was 40 310, which was significantly higher than that in 1990 (15 008). Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016, which showed a more significant increasing trend in both males and people aged 15-49 years. DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years. YLL and YLD also showed increasing trends. The highest increasing rate of YLD was in people aged 15-49 years. High BMI was responsible for 26.01% of the diabetes deaths in 2016 in China, an increase of 39.39% compared with that in 1990 (18.66%). Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016. Inner Mongolia, Xinjiang, Zhejiang, Macao SAR, Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period. Conclusions: There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI, causing a heavy disease burden, in China from 1990 to 2016. The BOD varied in both different age and gender groups. More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.

Effect of intervention programs regarding community "5+1" staged diabetes target management on patients with type 2 diabetes mellitus / 中华流行病学杂志

Objective: To analyze the effect of intervention programs and influencing factors regarding the community "5+1" staged diabetes target management on patients with type 2 diabetes mellitus (T2DM) and to provide evidence for improving the quality of life (QOL). Methods: A total of 12 community health service centers from Shanxi province, Jiangsu province, and Ningxia Hui autonomous region were selected as intervention group and control group, by stratified cluster sampling method. "5+1" model was used in intervention groups and basic public health services model was applied in control groups for this two-year follow-up. Data was collected through a questionnaire on demographic and disease-related information, while the QOL was measured with SF-36. Multiple linear regression and conducted by SAS 9.4. Results: A total of 2 467 subjects were included at baseline and 1 924 had completed a two-year-long management service. After intervention programs being implemented, the net effect of PCS score between the intervention and the control groups was 13.6, with the net effect of MCS score as 29.8. Results from the multiple linear regression showed that the main factors affecting PCS scores included age, type of medical insurance, baseline PCS score and regions of residency. Main factors related to MCS score included age, type of medical insurance, baseline MCS score, hypertension, and region of residency. Conclusion: Community "5+1" staged diabetes target management model presented favorable effect of improving the QOL on T2DM patients.

Disease burden of diabetes attributable to high body mass index in China,1990-2016 / 中华流行病学杂志

Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.

Effect of intervention programs regarding community “5 + 1” staged diabetes target management on patients with type 2 diabetes mellitus / 中华流行病学杂志

Objective To analyze the effect of intervention programs and influencing factors regarding the community “5 + 1” staged diabetes target management on patients with type 2 diabetes mellitus (T2DM) and to provide evidence for improving the quality of life (QOL).Methods A total of 12 community health service centers from Shanxi province,Jiangsu province,and Ningxia Hui autonomous region were selected as intervention group and control group,by stratified cluster sampling method.“5 + 1” model was used in intervention groups and basic public health services model was applied in control groups for this two-year follow-up.Data was collected through a questionnaire on demographic and disease-related information,while the QOL was measured with SF-36.Multiple linear regression and conducted by SAS 9.4.Results A total of 2 467 subjects were included at baseline and 1 924 had completed a two-year-long management service.After intervention programs being implemented,the net effect of PCS score between the intervention and the control groups was 13.6,with the net effect of MCS score as 29.8.Results from the multiple linear regression showed that the main factors affecting PCS scores included age,type of medical insurance,baseline PCS score and regions of residency.Main factors related to MCS score included age,type of medical insurance,baseline MCS score,hypertension,and region of residency.Conclusion Community “5 + 1” staged diabetes target management model presented favorable effect of improving the QOL on T2DM patients.

Trend on mortalities in all-cause and chronic non-communicable diseases among the labor force population in China, 2007-2016 / 中华流行病学杂志

Objective: To analyze the trends on mortalities of all-cause and deaths caused by chronic and non-communicable diseases (NCDs) among Chinese labor force population during 2007 to 2016. Methods: Data on cause-of-death that collected from the National Mortality Surveillance System was used to analyze the age and area-related specific crude mortality rates, age-standardized mortality rates and component ratios of NCDs, among the Chinese labor force population, during 2007 to 2016. Trend of crude mortality rates and mortality component ratios of the three major diseases (infectious diseases, maternal and infant diseases, nutritional deficiency diseases; NCDs; injuries) were analyzed. Age-standardized mortality of cancer, COPD, cardiovascular and cerebrovascular diseases were also analyzed by gender. Age-standardized mortality was calculated based on the Year 2010 Population Census of China. Joinpoint regression model was used to obtain annual percentage change and 95%CI was set for assessing the trend. Results: In 2016, the age-standardized all-cause mortality rate was 217.23 per 100 000 among the Chinese labor force population, but decreased by -2.8% (95%CI: -3.8%- -1.7%) annually from 2007 to 2016. The gap between different gender and regions gradually narrowed. The proportion of deaths caused by NCDs increased annually by 0.8% (95%CI: 0.7%-0.9%). The age-standardized mortality rate of NCDs appeared as 171.89/100 000, among the Chinese labor force population in 2016, showing a downward trend by -2.4% (95%CI:-3.3% - -1.4%). However, in females, there appeared the greatest decrease, with an average annual change of -3.3% (95%CI:-4.0% - -2.5%). Diseases as cancer, COPD, cardiovascular and cerebrovascular diseases all showed downward trends in the whole country, with an average range of -2.0% (95%CI: -2.6%--1.3%), -8.0% (95%CI: -8.9% - -7.1%), -1.5% (95%CI: -2.9% - -0.1%), -2.3% (95%CI: -2.8% - -1.8%) in a ten-year period, respectively. Conclusion: All-cause and age-standardized mortality rates caused by NCDs among Chinese labor force population were decreasing during 2007 to 2016. However, the constituent ratios appeared increasing, year by year. Close attention needs to be paid on NCDs which affecting the health of the labor force population in China.

Blood Oxygen Level-dependent MRI Longitudinal Monitor of Changes in Blood Oxygen Levels in Remaining and Donated Kidney After Receiving Parental Kidney Transplantation / 中国医学影像学杂志

Purpose To discuss the value of longitudinal assessment of the remaining kidney of the donor and kidney blood oxygen level changes after receiving kidney transplantation by applying blood oxygen level-dependent (BOLD) MRI. Materials and Methods Sixty patients underwent parental kidney transplantation from Jul. 2015 to Feb. 2017 in Tianjin First Center Hospital were prospectively collected, including 30 healthy kidney transplant donors and 30 recipients corresponding to them. The donors received renal BOLD examination 3 days before and 2 weeks after unilateral nephrectomy. Recipients received renal BOLD examination 2 weeks after kidney transplantation, of which, 15 pairs of patients underwent parental kidney transplantation received renal BOLD examination again six months after surgery. The apparent transverse relaxation rate (R2*) values of the cortex and medulla at different times before and after transplantation were measured and recorded. The differences of R2* values between 30 donors' cortex and medulla in both kidneys before surgery were compared; the differences of R2* values between 30 pairs of subjects' cortex and medulla in remaining and donated kidney within 2 weeks before and after surgery were compared; variance gained through single factor repeated measurement was applied to analyze and compared the difference of R2* values between 15 pairs of follow-up subjects' cortex and medulla in remaining and donated kidney at different time points before and after surgery. Results All 60 subjects received MRI scan, and there was no statistical difference in R2* values between 30 subjects' cortex and medulla in both kidney before surgery (P>0.05). The difference between the cortex and medulla was statistically significant, with R2* value of medulla higher than that of cortex (P<0.01). R2* values of cortex and medulla of the remaining kidney in 30 subjects two weeks after receiving unilateral nephrectomy were lower than those before surgery. R2* value of cortex and medulla of donated kidney were both lowered before surgery, the difference of which was statistically significant (P<0.01). R2*values of cortex and medulla in remaining and donated kidney of 15 pairs of subjects who have received half a year's follow up were both evidently reduced two weeks after surgery, and R2* values six months after surgery were raised compared with two weeks after surgery, but were still lower than that before surgery, the difference of which were both statistically significant (P<0.05). Conclusion BOLD MRI can be used for longitudinal monitor of changes in blood oxygen levels in remaining and donated kidney after receiving parental kidney transplantation.

The value of blood oxygen level dependence and arterial spin labeling MRI in the early diagnosis of renal allograft dysfunction / 中华放射学杂志

Objective To investigate the value of blood oxygen level-dependent (BOLD) and arterial spin labeling (ASL) MRI in the early diagnosis of renal allograft dysfunction. Methods A total of 53 patients with allograft kidney transplantation from December 2014 to April 2017 in Tianjin First Center Hospital were prospectively collected. In all cases, the serum creatinine value was detected, and the estimated glomerular filtration rate (eGFR) was calculated. All patients were divided into three groups according to the eGFR. There were three groups;continuous renal transplant function group (group A, 19 cases), short term allograft dysfunction group (group B, 17 cases), and continuous renal function damage group (group C, 17 cases). Fifty-three patients were examined by BOLD and ASL MRI at 10 to 14 days after operation. Twenty one patients were reviewed by BOLD and ASL MRI at 10 to 13 weeks after operation (A, B and C group were 7, 6, 8 cases). The values of renal cortex R2* (R2*=1/T2*), renal medullary R2* and renal cortical renal blood flow (RBF) were measured in each group. One-way analysis of variance (ANOVA) was used to compare the differences of eGFR and BOLD, ASL index (renal cortex R2*, renal medulla R2*, renal cortex RBF value) after the first post renal transplant among the 3 groups. Correlations between BOLD and ASL index with eGFR index in the first post renal transplant were assessed by using Pearson correlation analysis. The efficacy of BOLD and ASL in the differential diagnosis of continuous renal transplant function group and short term allograft dysfunction group by the receiver operating characteristic (ROC). Paired samples t test was used to compare the differences of eGFR, BOLD and ASL indexes for the baseline and follow-up. Results The differences of eGFR, cortical R2*value, medullary R2*value and cortical RBF value were statistically significant between the 3 groups (P<0.05). The transplanted kidney medullary R2* value and cortical RBF value were positively correlated with eGFR (r values were 0.553, 0.687; P<0.01). There was no correlation between transplanted kidney renal cortex R2*value and eGFR value (P>0.05). The area under ROC was 0.776 for the renal medullary R2*in the diagnosis of continuous renal transplant function group and the short term allograft dysfunction group;with the threshold of 24.5, the sensitivity of diagnosis of renal allograft short term allograft dysfunction was 58.8%, specificity was 84.2%;the area under ROC for renal cortex RBF was 0.881, with the threshold of less than 277 ml·100 g-1·min-1, the sensitivity was 70.6%, specificity was 89.4%. During follow-up, eGFR, cortical R2*and medullary R2*in group A remained stable, while the renal cortex RBF value went slightly higher, and the differences were statistically significant ( P<0.05). The cortical R2* values in group B remained stable, eGFR, renal medulla R2* and renal cortex RBF decreased, and the differences were statistically significant (P<0.05). The values of eGFR and R2*in group C remained stable, while the renal medullary R2* value and cortex R2* value increased slightly, and the differences were statistically significant (P<0.05). Conclusions This study shows that BOLD and ASL MRI can longitudinally monitor the functional status of the transplanted kidney and detect the abnormality of renal allograft function early. CRBF value shows high diagnostic value.

Trend on mortalities in all-cause and chronic non-communicable diseases among the labor force population in China, 2007-2016 / 中华流行病学杂志

Objective To analyze the trends on mortalities of all-cause and deaths caused by chronic and non-communicable diseases (NCDs) among Chinese labor force population during 2007 to 2016.Methods Data on cause-of-death that collected from the National Mortality Surveillance System was used to analyze the age and area-related specific crude mortality rates,age-standardized mortality rates and component ratios of NCDs,among the Chinese labor force population,during 2007 to 2016.Trend of crude mortality rates and mortality component ratios of the three major diseases (infectious diseases,maternal and infant diseases,nutritional deficiency diseases;NCDs;injuries) were analyzed.Age-standardized mortality of cancer,COPD,cardiovascular and cerebrovascular diseases were also analyzed by gender.Age-standardized mortality was calculated based on the Year 2010 Population Census of China.Joinpoint regression model was used to obtain annual percentage change and 95％CI was set for assessing the trend.Results In 2016,the age-standardized all-cause mortality rate was 217.23 per 100 000 among the Chinese labor force population,but decreased by-2.8％ (95％CI:-3.8％--1.7％) annually from 2007 to 2016.The gap between different gender and regions gradually narrowed.The proportion of deaths caused by NCDs increased annually by 0.8％ (95％CI:0.7％-0.9％).The age-standardized mortality rate of NCDs appeared as 171.89/100 000,among the Chinese labor force population in 2016,showing a downward trend by-2.4％ (95％CI:-3.3％--1.4％).However,in females,there appeared the greatest decrease,with an average annual change of-3.3％ (95％CI:-4.0％--2.5％).Diseases as cancer,COPD,cardiovascular and cerebrovascular diseases all showed downward trends in the whole country,with an average range of-2.0％ (95％CI:-2.6％--1.3％),-8.0％ (95％CI:-8.9％--7.1％),-1.5％ (95％CI:-2.9％--0.1％),-2.3％ (95％CI:-2.8％--1.8％)in a ten-year period,respectively.Conclusion All-cause and age-standardized mortality rates caused by NCDs among Chinese labor force population were decreasing during 2007 to 2016.However,the constituent ratios appeared increasing,year by year.Close attention needs to be paid on NCDs which affecting the health of the labor force population in China.

The disease burden for low back pain in China, 1990 and 2013 / 中华预防医学杂志

Objective@#To assess the disease burden for low back pain in China in 2013 and analyzed the change of it between 1990 and 2013.@*Methods@#Data was from the Global Burden of Disease Study 2013 (GBD 2013). The burden of low back pain (LBP) among age groups, gender groups, provinces (excluding Taiwan China) groups was assessed by years lived with disability (YLD), including YLD, YLD rate, proportion of YLD due to LBP. The change of the YLD for LBP was analyzed between 1990 and 2013 by age-standardized YLD rate using the world standard population of 2000-2025 WHO.@*Results@#In 2013, The YLD for LBP was 16 347 thousand (the leading cause of YLD in China), and the proportion of YLD in age group 30-59 years old was 54.6% (8 929/16 347) . The age-standardized rate in China was 1 072.6/100 000, and the rates in Guangdong (1 742.2/100 000) , Shanghai (1 227.8/100 000) and Beijing (1 136.6/100 000) were higher than in other provinces. The proportion of YLD due to LBP was 11.8%. LBP was the leading cause of YLD in China. Compared with 1990, the growth rates of age-standardized rate, proportion of YLD and YLD, were 5.6%, 25.5% and 72.1%, desperately.@*Conclusion@#Low back pain was the leading cause of YLD in China in 2013. Compared with 1990, the disease burden for low back pain increased rapidly.

Correlation research of renal perfusion and diffusion function using MRI in renal allograft early after renal transplantation / 中华放射学杂志

Objective To explore the correlationships between microperfusion diffusion indexes derived from intravoxel incoherent motion(IVIM)and perfusion values measured by arterial spin labeling (ASL)in renal allograft. Methods A total of 76 renal allograft recipients and 26 age-matched volunteers (group 0)were included in this prospective study. All subjects were underwent conventional MRI, IVIM and ASL MRI which were performed in the oblique-sagittal plane. Seventy-six recipients were divided into two groups based on the estimated glomerular filtration rate(eGFR):recipients with good allograft function(group 1, eGFR≥ 60 ml · min-1 · 1.73m-2,n=44)and recipients with impaired allograft function(group 2, eGFR0.05), but RBF value was significantly lower(P<0.05). The ADCslow, ADCfast, PF and RBF values of renal cortex were significantly lower in allografts with impaired function compared to allografts with good function(all P<0.01). In renal allografts, there were significant positive correlations between cortical ADCslow, ADCfast, PF, RBF value and eGFR(r values were 0.604, 0.552, 0.579 and 0.673, all P<0.01). Cortical ADCfast and PF value exhibited a significant correlation with RBF for recipients(r values were 0.501 and 0.423, all P<0.01). Conclusion Cortical ADCfast and PF values derived from IVIM and RBF measured by ASL show a significant positive correlation in renal allografts.

On National Demonstration Areas: a cluster analysis / 中华流行病学杂志

Objective To understand the'backward'provinces and the relatively poor work among the construction of National Demonstration Area,so as to promote communication and future visions among different regions.Methods Methods on Cluster analysis were used to compare the development of National Demonstration Area in different provinces,including the coverage of National Demonstration Area and the scores of non-communicable disease (NCDs) prevention and control work based on a standardized indicating system.Results According to the results from the construction of National Demonstration Area,all the 29 provinces and the Xinjiang Production and Construction Corps (except Tibet and Qinghai) were classified into 6 categories:Shanghai;Beijing,Zhejiang,Chongqing;Tianjin,Shandong,Guangdong and Xinjiang Production and Construction Corps;Hebei,Fujian,Hubei,Jiangsu,Liaoning,Xinjiang,Hunan and Guangxi;Shanxi,Jilin,Henan,Hainan,Sichuan,Anhui and Jiangxi;Inner Mongolia,Shaanxi,Ningxia,Guizhou,Yunnan,Gansu and Heilongjiang.Based on the scores gathered from this study,24 items that representing the achievements from the NCDs prevention and control endeavor were classified into 4 categories:Manpower,special day on NCD,information materials development,policy/strategy support,financial support,mass media,enabled environment,community fitness campaign,health promotion for children and teenage,institutional structure and patient self-management;healthy diet,risk factors on NCDs surveillance,tobacco control and community diagnosis;intervention of high-risk groups,identification of high-risk groups,reporting system on cardiovascular and cerebrovascular events,popularization of basic public health service,workplace intervention programs,construction of demonstration units and mortality surveillance;oral hygiene and tumor registration.Contents including oral hygiene,tumor registration,intervention on high-risk groups,identification of high-risk population,reporting system on cardiovascular and cerebrovascular events,popularization of basic public health service,workplace intervention programs,construction of demonstration units and mortality surveillance were discerned as the relatively weak areas in the construction programs of National Demonstration Area.Conclusions Western regions,especially in some remote provinces had the poorest performance during the construction of National Demonstration Area.Programs regarding chronic disease surveillance,identification and intervention on high-risk groups showed the lowest scores and these outcome-oriented tasks should be further focused on,during the next term of review,in these areas.

On National Demonstration Areas: a cluster analysis / 中华流行病学杂志

Objective To understand the'backward'provinces and the relatively poor work among the construction of National Demonstration Area,so as to promote communication and future visions among different regions.Methods Methods on Cluster analysis were used to compare the development of National Demonstration Area in different provinces,including the coverage of National Demonstration Area and the scores of non-communicable disease (NCDs) prevention and control work based on a standardized indicating system.Results According to the results from the construction of National Demonstration Area,all the 29 provinces and the Xinjiang Production and Construction Corps (except Tibet and Qinghai) were classified into 6 categories:Shanghai;Beijing,Zhejiang,Chongqing;Tianjin,Shandong,Guangdong and Xinjiang Production and Construction Corps;Hebei,Fujian,Hubei,Jiangsu,Liaoning,Xinjiang,Hunan and Guangxi;Shanxi,Jilin,Henan,Hainan,Sichuan,Anhui and Jiangxi;Inner Mongolia,Shaanxi,Ningxia,Guizhou,Yunnan,Gansu and Heilongjiang.Based on the scores gathered from this study,24 items that representing the achievements from the NCDs prevention and control endeavor were classified into 4 categories:Manpower,special day on NCD,information materials development,policy/strategy support,financial support,mass media,enabled environment,community fitness campaign,health promotion for children and teenage,institutional structure and patient self-management;healthy diet,risk factors on NCDs surveillance,tobacco control and community diagnosis;intervention of high-risk groups,identification of high-risk groups,reporting system on cardiovascular and cerebrovascular events,popularization of basic public health service,workplace intervention programs,construction of demonstration units and mortality surveillance;oral hygiene and tumor registration.Contents including oral hygiene,tumor registration,intervention on high-risk groups,identification of high-risk population,reporting system on cardiovascular and cerebrovascular events,popularization of basic public health service,workplace intervention programs,construction of demonstration units and mortality surveillance were discerned as the relatively weak areas in the construction programs of National Demonstration Area.Conclusions Western regions,especially in some remote provinces had the poorest performance during the construction of National Demonstration Area.Programs regarding chronic disease surveillance,identification and intervention on high-risk groups showed the lowest scores and these outcome-oriented tasks should be further focused on,during the next term of review,in these areas.

Protective effect of Ento-I plastic against cerebral ischemia-reperfusion injury in rats / 国际药学研究杂志

Objective To research the protective effect of Ento-I against cerebral ischemia-reperfusion injury in rats, and to evaluate its analgesic and anticoagulating effects in mice. Methods The ischemic model was established with line embolism to block the middle cerebral artery of male rats. The 56 rats were randomly assigned into 7 groups of sham-operation, blank-matrix, normal saline, Ento-I plastic of 3 doses (6.67, 3.33, 1.67 mg/kg), and ozagrel sodium (8.3 mg/kg, ip). The effect of Ento-I plastic on anti-cerebral ischemia was measured by nervous function scores and the areas of cerebral infarction were determined by TTC staining for the calculation of cerebral infarction rates. The analgesic effect of Ento-I plastic was determined with acetic acid-induced twisting experiment. Sixty KM mice were randomly allocated into blank-matrix, aspirin, aspirin-plastic, and Ento-I plastic of 3 doses (5, 10 and 20 mg/kg), the number of mouse twisting were recorded right after intraperitoneal injection of 0.7% acetic acid solution at the time of 1 h after the last administration. Moreover, the anticoagulant activity of Ento-I plastic was tested by glass capillary method. Results The results of acetic acid-induced twisting experiment displayed that Ento-I plastic of all 3 dose groups (5, 10 and 20 mg/kg) could significantly reduce the number of body torsion and increase the inhibitory rates of twisting, compared with that of blank matrix group (the inhibitory rates of twisting for 3 dose groups were 21.79%, 48.89%, and 56.15%, respectively), with dose-response manner. According to the results of glass capillary test, the clotting time of mouse blood could be significantly prolonged by mid- (10 mg/ kg) and low-dose (5 mg/kg) of Ento-I plastic with corresponding clotting time of (155.20±54.19) s and (155.80±73.84) s, compared with normal saline group at (92.10±24.61) and blank-matrix group at (80.40±48.09, P<0.05). The experiment results of the isch emia-reperfusion injury by line embolism method in rats exhibited that Ento-I plastic in mid-dose (3.33 mg/kg) could significantly re duce the neurological scores after 24 h of reperfusion injury, from (2.33±0.52) of normal saline group to (1.00±0.00) of mid-dose group (P<0.01). The results from TTC staining revealed that the cerebral infarction rates of normal saline group and blank- matrix group were (24.89±7.24) % and (27.72±7.89)%, respectively, whereas those of 6.67 mg/kg and 3.33 mg/kg group of Ento-I plastic were (14.01±2.65) % and (14.73±4.94)%, respectively. Compared to the 2 negative-control groups, both the high- and mid-dose of Ento-I plastic could significantly reduce the cerebral infarction rates after ischemic reperfusion injury in rats (P<0.01). Conclusion Ento-I plastic demonstrates strong analgesic and anticoagulant effects, and could substantially reduce the neurological scores and reduce cerebral infarction rates for ischemia-reperfusion injured rats. These are likely to be the mechanism of action for Ento-I plastic realizing its anti-cerebral ischemia effect.

Evaluation on the status quo of self monitoring of blood glucose and self-efficacy of diabetes patients in community / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the status quo and influence factors of self monitoring of blood glucose (SMBG) and self-efficacy of diabetes patients' that participated in community diabetes self management group.</p><p><b>METHODS</b>Beijing, Shanghai, Chongqing, Jiangsu, Guangdong, and Zhejiang were selected as the study sites considering patients management experiences they had. 1 401 adult diabetes patients were recruited from communities via health records system screening, telephone notification, poster advertisement, letters invitation ways. Face to face questionnaire survey was applied to obtain patients' general information, diabetes history, diabetes knowledge awareness, SMBG, and self-efficacy information. Multiple linear regression was used to analyze the relationship between factors and self efficacy.</p><p><b>RESULTS</b>There were 519 male patients (37.0%) and 882 female patients (63.0%) with an average age of (64.9 ± 8.9) years old. Patients lived in city accounted for 48.0% (672/1 401) and rural patients accounted for 52.0% (729/1 401). Patients who conducted SMBG accounted for 79.9% (1 120/1 401) and 33.3% (446/1 401) patients conducted blood glucose monitoring 1-3 times per month. Rural patients, primary school educated, and new rural cooperative medical system (NCMS) covered patients had a higher proportion of never conducting SMBG which were 21.9% (160/729), 24.2% (160/662), and 26.3% (125/475) , respectively. Scores of self-efficacy was (69.24 ± 16.30) (hundred-mark system) with a relative lower score in monitoring of blood glucose (64.09 ± 20.08) and foot care (63.63 ± 21.40), as well as a highest score in taking medicine and insulin injections (76.10 ± 22.00). Multiple regression analysis on self-efficacy and its related factors show a negative correlation between patients' place of residence and self-efficacy (β' = -0.076) and a positive correlation between education and self-efficacy (β' = 0.114) as well as between diabetes knowledge awareness and self-efficacy (β' = 0.193)(t = -2.46, 3.71, 7.18, P < 0.05).</p><p><b>CONCLUSION</b>Community diabetes patients had a low self-efficacy and it was even lower among low economic and education degree patients. The worst parts were SMBG and foot care. Place of residence, education, and diabetes knowledge awareness are factors that influence patients' self efficacy.</p>