With socioeconomic development and scientific and technological progress,there has(emerged) a gap between clinical medicine and public health.The priority of the former is research on the mechanism of disease while the priority of the latter is research on the effect of the environment and social factors on disease and health.Separation of the two has made it hard for the system of medical and health services to fit in with social development.The best way to fill in the gap that has existed for years between the treatment of disease(clinical medicine) and the prevention of disease(public health) is to develop general practice and community health services.At the same time,it is necessary to enhance public health education of the management,teachers and students of medical and public health colleges,physicians,health administrative management personnel,and health policy formulators.

Objective To determine relationships between daily activities measured as modified version of Pulmonary Functional status and Dyspnea Questionaire (PFSDQ-M) and functional capacity and symptoms experienced in patients with chronic obstructive pulmonary disease (COPD). Methods Convenience sample of 94 COPD patients with stable condition were assessed by interview with PFSDQ-M Chinese version and modified Medical Research council dyspnea scale (MMRC) respectively. Pulmonary function test (PFT) and 6-minute walking test (6MWT) were undergone on the same day or within one week as interview. PFSDQ-M has three subscales,i.e.,change experienced by patient with activities (CA),dyspnea with activities (DA) and fatigue with activities (FA). Results Scores of CA,DA and FA correlated to 6-minute walking distancer= (-0.37)- (-0.42),FEV_1 r=(-0.27)-(-0.32),FEV_1/FVC r= (-0.27)- (-0.32),dyspnea rated by MMRC (r=0.55-0.60) and BODE index (r=0.35-0.40),respectively (all P<0.01). dyspnea explained 26% of the variance in changes of activities. Conclusions Physical activities moderately changed in patients with stable COPD;Dyspnea is the best predictor of limitation of daily activities.

Objective To evaluate whether an intervention with a health promotion program can reduce prevalence of the health risk factors of non-communicable chronic diseases (NCD) and improve the knowledge awareness of NCD prevention of employees from a security corporation in Beijing selected by the study team. Methods A cross-sectional study was conducted by selecting 157 employees of a security corporation in Beijing, and a quasi-experiment method and a self-developed Questionnaire of Intervention for Health Risk Factors were used. Based on the results of the distribution of risk factors for NCD and the focus-group discussion, one year health promotion program intervention was performed. According to the comparison of prevalence of risk factors between baselines and after intervention of the studied employees, the intervention effectiveness was evaluated. Results After the health intervention, rate of reported unhealthy diet reduced from 75.0%to 56.8%, which showed statistically significant (?2=8.53, P<0.05);rate of reported less physical activity reduced from 35.5%to 17.4%, with statistical significance (?2=19.60, P<0.05);rate of reported cigarette smoking reduced from 16.8%to 11.6%with statistically significance. There was no statistically significant reduction in the rate of the other health risk factors (P>0.05). The median value of health knowledge awareness of the studied employees was significantly improved from 10.20 to 11.33(S=-2 545, P<0.05) and awareness of recommended daily intake of dietary salt increased significantly from 46.20%to 67.09%after intervention (χ2=17.85, P<0.05). Conclusion The non-communicable chronic diseases intervention program can reduce the health risk factors and improve health knowledge awareness of the studied population.

Objectives To evaluate the association between serum cystatin C and carotid atherosclerosis.Methods Medical data,including physical examinations,serum levels of cystatin C,bilirubin,uric acid and other biochemical markers and duplex ultrasonographic scanning for the carotid artery,of 1741 healthy adults (1193 men and 548 women) who sought physical check-up at Peking Union Medical College Hospital during January 2010 and December 2011 were collected,and those with hypertension,diabetes and liver or renal function failure were excluded.Based on the results of carotid duplex uhrasonography,all the adults checked were assigned to two groups,one with thickened intima-media and atherosclerotic plaque (group A),the other with non-thickened intima-media and non-atherosclerotic plaque (group B).Difference in serum cystatin C,bilirubin,uric acid and other biochemical markers between the two groups was analyzed by using Student's t test.The correlation between the markers and carotid plaque was analyzed by using Spearman correlation analysis.The correlated factors of the carotid thickness and plaque appearance were analyzed by using unconditional Logistic regression analysis.Results Serum level of cystatin C was significantly increased in group A (t =-8.85,P ＜ 0.05).Thickness of carotid intima was positively correlated with serum cystatin C (r =0.21,P ＜ 0.05).In multivariate Logistic regression analysis,high level of serum cystatin C was not an independent risk factor of carotid atherosclerosis.Conclusion Relationship between serum cyatatin C and carotid atherosclerosis was not confirmed in our populations,which should be explored further in cohort studies.

Objective To understand the affecting factors of health and health promotion needs of one company staff so as to provide evidence for effective health intervention.Methods A convenience sampling method was used to enroll subjects in this cross-sectional study.All the participants were required to fill in a questionnaire to learn their demographics,health related factors and health promotion needs in the 2 work days of June 2012 had been studied.Chi-square test and unconditional logistic regression were used for data analysis.Results More males showed higher risk of disease than females (x2 =5.394,P ＜ 0.05).In conditional logistic regression,age was the main factor affecting health (odds ratio (OR) =3.127,95％ (confidence interval) CI 1.020-9.591,P ＜ 0.05) when gender,marital status,educational level and occupation were adjusted.Dietary nutritional knowledge (69.6％) and physical check-up (64.6％) were urgent needs among those surveyed.Conclusion Staff with varied demographic characteristics have different health related factors and physical check-up may provide a tool to meet their urgent needs of health promotion.

Objective To explore the status and economic burden of falls in elderly people living in an urban community and tO provide evidence for prevention of falls in the elderly. Methods A cross-section study was conducted in a community in Beijing.A total of 1512 persons aged 60 years and over were selected with stratified cluster sampling,and the data about falls within the past 12months,the consequences and the direct economic burden were collected by face-to-face interview.Results The overall incidence of falls was 18.0%within 1 year among 1512 interviewees.Of the participants,8.7%(131 cases)suffered from injuries of falls(143 times)and 77.6%(111 times)adopted the corresponding treatments.Direct economic burden caused by falls totaled 741.82 yuan per fall,including direct medical cost 650.77 yuan per fall,and 244.76 yuan per fall should be paid by the elderly themselves.In 143 times of falls,74.8%recovered and a few(5 cases)had complications and disability accordingly. Conclusions The incidence of fall in an urban elderly community of Beijing is high and will cause huge economic burden.

ObjectiveTo explore the treatment and economic burden of urine incontinence (UI) in the rural elderly,and provide evidences for preventive intervention.MethodsA cluster sampling was carried out in 743 people (aged 60 years and over) from 5 villages dominated by Yanliu and Dafengshang health centers,Jixian County,Tianjin from 2007 to 2008.The information about general state of health,treatment and economic burden of disease were analyzed. Results The prevalence of UI was 33.4％ (248 cases) among the 743 elderly people.Only 12 patients (4.8％) with UI ever visited community health-care service centers or hospitals for diagnosis and treatment,among whom only 1 case visited hospital within 1 year,8 cases during 1 to 5 years,and 3 cases over 5 years.And the method of treatment was all drug therapy.Among 248 cases with UI,there were 227 cases (91.5％) without any treatment,9 cases (3.6％) buying medicines by themselves.The direct cost for treatment of UI was 80-12000 yuan RMB,including 2 cases below 100 yuan RMB,2 cases 100-1000 yuan RMB,7 cases 1001-5000 yuan RMB and 1 case over 10000 yuan RMB. Conclusions Prevalence of UI is high while hospital-visiting rate is very low,and the financial burden of disease is serious,thus intervention measures for UI should be taken for the elderly people in rural areas of Jixian County,Tianjin.

Objective To explore the relationship of chronic diseases and the history of gestation and delivery with urinary incontinence (UI) among elderly people of rural areas, so as to lay a scientific foundation for formulating strategies of prevention and treatment for UI. Methods A cross-sectional study was carried out in two towns of Jixian county, Tianjin. A total of 743 people aged 60 years and over were selected with cluster sampling, and all information were collected with a standardized structured questionnaire by face-to-face interview. The relationships of chronic diseases and the history of gestation and delivery with UI were analyzed with univariate analysis and multivariate Logistic regression method. Results Prevalence of UI was 33. 4% among the people aged 60 years and over in two towns of Jixian, and it was higher in females than in males (43. 2% vs. 22.8%, χ~2= 34.70, P<0.0001). Logistic regression analysis revealed that the chronic respiratory diseases, prostate disease, neurological diseases or motor system diseases were all associated with UI in men, and the elderly men who suffered from prostate disease and neurological diseases had the highest risk of UI (OR=11. 47, OR=11. 76). Constipation, chronic respiratory diseases, diabetes mellitus and motor system diseases were all associated with UI in women, and the elderly women with chronic respiratory diseases had the highest risk of UI (OR = 4. 84). Elderly women who had more gravidity (OR = 1. 03), more parity (OR= 1.02), perineal laceration (OR = 1.72) and wound infection (OR= 1. 65) during delivery had higher prevalence of UI. Conclusions Prevalence of UI is higher among the elderly people in rural areas of Jixian county, and several chronic diseases and gestation and delivery history in women are all associated with UI in the elderly. For the prevention of UI, the elderly should actively look for treating their chronic diseases and the medical workers should strengthen health education or health care for pregnant women.

ObjectiveTo understand the prevalence of urinary incontinence (UI) and its epidemiological characteristics in rural elderly people and to lay a scientific foundation for formulating the strategies oI prevention and treatment for UI. MethodsA cross-sectional study was carried out in two townships of Jixian County, Tianjin. People aged 60 years and over were selected with cluster sampling, and the prevalence of UI and its epidemiological characteristics were collected with a standardized structured questionnaire by face-to-face interview. ResultsPrevalence of UI was 33.4% among the people aged 60 years and over in two townships, and it was increased with ageing.The elderly women had a higher prevalence of UI than the elderly man (43.2% vs. 22.8%, P<0.0001). The prevalences of UI in groups of 60-, 65-, 70-, 75-, 80-, 85-95 years old were 28.6%,32.1%,34.1%,35.5%,47.8%and 30.0%, respectively, and increased with ageing (X2for trend=2.19,P=0.029). Mixed UI (MUI) was the most common in different types of UI, and the constitution ratios of stress UI (SUI), urge UI (UUI), MUI and other type of UI were 27.4%, 1.2%, 60.9%,10.5%, respectively. The prevalence of MUI was the highest among the four types of UI in each age group. In all age groups, the prevalences of SUI and UUI were the highest in 60～ age group, and the prevalence of MUI was the highest in 80 ～ 95 age group. ConclusionsPrevalence of UI is high among the elderly people in rural areas of Jixian County, Tianjin.

BACKGROUNDUnhygienic blood collection in the early 1990s led to blood-borne infections in Central China. This study aimed to estimate human immunodeficiency virus (HIV) co-infection with hepatitis C and B viruses (HCV and HBV) and their risk factors in a rural area of Shanxi Province with a history of commercial blood donation.

METHODSA cross-sectional study was conducted in 2004. All adult residents in the target area were invited to participate in the study. Face-to-face interviews were completed and blood specimens were tested for HIV, HCV, and HBV surface antigen (HBsAg).

RESULTSPrevalence rates of HIV, HCV, and HBsAg were 1.3% (40/3 062), 12.7% (389/3 062), and 3.5% (103/2982), respectively. Of the 40 HIV-positive specimens, 85% were HCV positive and 2.5% were HBsAg positive. The history of commercial blood donation was positively associated with HIV, HCV, and HIV/HCV co-infections, but was negatively associated with HBsAg seropositivity. Migration for employment in the last 5 years was positively related to HIV, HBsAg, and HIV/HCV co-infections. Univariate logistic analysis showed that illegal drug use, number of sex partners, extramarital sex behavior, commercial sex behavior, and condom use rate were not related to anti-HIV, anti-HCV, HBsAg seropositivity or their co-infections.

CONCLUSIONThe history of commercial blood donation was the main risk factor for HIV, HCV, and HIV/HCV co-infections in this former commercial blood donation area. HIV and HCV prevention and treatment interventions are important in this area.

Adolescent ; Adult ; Blood Donors ; China ; epidemiology ; Cross-Sectional Studies ; Female ; HIV Infections ; epidemiology ; etiology ; Hepatitis B ; epidemiology ; etiology ; Hepatitis C ; epidemiology ; etiology ; Humans ; Male ; Middle Aged ; Transfusion Reaction ; Young Adult