Epidemiology is a discipline both old and young.It's not until the 1970 s-1980 s,theoretical framework of epidemiology,as well as its study design and analysis methods were systematically summarized and improved.Since 1990s,modern epidemiology has made considerable progress,which is constantly updating our health concept and health model.Meantime,it's been continuously converging with other relevant discipline,gradually forming new branches and expanding its application.This paper summarizes the trends of epidemiology in recent decades,and explores the future direction of development.

In line with the worldwide trend in population aging, China has stepped into an aging society since 2000. The outstanding features of aging, including a large proportion of the older population, rapid growth, dramatic expansion of the oldest-old, and uneven aging distribution, have put China in a unique position. Besides, older population is expanding in parallel with the escalating burden of disease, high prevalence of disability, and low social involvement. However, China is not prepared to solve these problems in terms of the economy, awareness, geriatric care system, geriatric team, social security, or age-friendly environment. From the perspective of public health, we summarized the major challenges and proposed the following policy recommendations: (1) strengthening the top-level design and building a "government-leading, multi-sectoral-cooperating, and society-participating" pattern; (2) enhancing health services by implementing the "comprehensive health" strategy; (3) developing home and community care, coordinately enhance institutional care, promote integration of medical and care systems, and establish a multidimensional tailored care system; (4) optimizing geriatric the supporting system, included the construction of geriatric team and the long-term care insurance system; and (5) establishing a physical and socially age-friendly environment.

Objective:To investigate the associations of major depressive disorder with coronary heart disease (CHD)and stroke in Chinese adults aged 30 -79 years.Methods:In 2004 -2008,China Ka-doorie Biobank was conducted in 1 0 geographically defined regions (5 urban and 5 rural)of China.A to-tal number of 51 2 891 participants aged 30 -79 years were recruited in the baseline survey.A laptop-based electronic questionnaire was administrated face-to-face by trained health workers,collecting the general demographic and socio-economic status,dietary and other lifestyle behaviours (e.g.smoking,al-cohol drinking,physical activity),medical history and family history of common chronic diseases.Major depressive episodes (MDE)in the past 1 2 months were assessed with the World Health Organization composite international diagnostic interview-short form (CIDI-SF).The physical measurements included the heights and weights,which were used to calculate the body mass indexes (BMI).Chi squared and t test were used to compare the differences in participants characteristics according to their major depressive disorder.Logistic models were employed to estimate the odds ratios (OR)and 95% CI of their major de-pressive disorder with prevalent coronary heart disease and stroke.Results:Among the 51 2 891 partici-pants,3 281 (0.6%)showed an MDE in the preceding 1 2 months,1 5 472 (3.0%)reported prevalent CHD,and 8 884 (1 .7%)reported prevalent stroke.Major depressive disorder was significantly associa-ted with an increased risk of CHD and risk of stroke.Age-and gender-adjusted ORs (95% CI)were 1 . 80 (1 .53 -2.1 2)for CHD and 2.53 (2.09 -3.05)for stroke.The associations were significant after further adjustment for potential confounders,such as other socio-demographic status,smoking,alcohol drinking,physical activity,and BMI,prevalent hypertension,diabetes as well as family history of cardio-vascular diseases (OR =1 .83,95% CI =1 .54 -2.1 8 for CHD;OR =2.1 9,95% CI =1 .79 -2.69 for stroke).Moreover,gender significantly interacted with MDE on prevalent stroke (P for multiplicative in-teraction =0.01 3).The men with an MDE in the past 1 2 months had the highest risk of stroke in the joint analyses of gender and depression disorder (OR =5.02,95% CI =3.70 -6.82).Conclusion:The findings from this large cross-sectional study suggest that the presence of MDE is a risk factor for both CHD and stroke in Chinese adults aged 30 -79 years,but further prospective studies are warranted to validate the results.

Cardiovascular disease (CVD) is the leading cause of death in both urban and rural areas of China. The current evidence regarding CVD risk factors was primarily established in Western countries, with limited generalizability to the Chinese population. In China, a growing number of population-based prospective cohort studies have emerged that have yielded substantial research data on CVD risk factors in the past five years. The research studies have covered biological risk factors (e.g., blood lipids, blood pressure, blood glucose, adiposity), lifestyle risk factors (e.g., smoking, alcohol, diet, physical activity), environmental risk factors (e.g., ambient and indoor air pollution), and risk prediction. This study aimed to systematically review the research progress on CVD risk factors in the Chinese population in the past five years. Prospective studies in China have identified biological, lifestyle, and environmental risk factors for CVD and its main subtypes, along with some protective factors unique to the Chinese (e.g., spicy food and green tea). This review aimed to provide high-quality evidence for achieving the Outline of Healthy China 2030, developing disease prevention guidelines and measures, and deepening efforts for popularization of health knowledge.

Objective To investigate the varying variances of the genetic components in birth cohorts.Methods Twin samples used in the current study were collected from the Chinese National Twin Registry and a two-wave study was conducted,in Qingdao and Lishui regions.Samples were broken down by birth cohort to create four subgroups:-1958,1959-1961,1962-1970 and 1970-.Structural equation models were fitted in each subgroup to estimate the genetic and environmental variances.Results From each birth cohort,weight and body mass index in 2012 appeared higher than those in 2001.Twins of 1971-cohort subgroup showed lower weight than in the other cohort subgroups.Except for the 1959-1961 cohort subgroup,the later birth cohorts were inversely related to the body mass indexes.Genetic factors might explain 54％-76％ of the total variations on the body mass index.Heritability of body mass index of twins born during 1959-1961 was increasing along with age.Conclusion Genetic factors might explain the main portion which related to the phenotypic variance of body mass index.Effects of genetic factors on body mass index of twins born during 1959-1961 might have increased along with age.

Background Printing and copying equipment is likely to release a large amount of particulate matter, thereby endangering human health. However, there is insufficient research on the level of particulate matter released by printers in offices and its influencing factors. Objective This study is designed to investigate the usage of printing equipment in college teachers' offices and the level of indoor particulate matter during printing, and to explore the influence of printer location and indoor ventilation on the particulate matter pollution level released during printer operation. Methods From 9:00 to 16:00 on January 4 to 6, 2021, 20 faculty offices in a university in Beijing were selected by convenient sampling to measure the indoor particulate matter level during printing, and to investigate the printing equipment usage of 31 users in the offices. Besides, experiments were designed to explore the influence of position and distance from a printer, ventilation, and the distance between a printer and a nearby window during ventilation on the number concentration of particulate matter released by the printers. Results Except one printer being placed on the ground, the other 30 printers were placed on office desks (0.71±0.16) m above the ground. Among them, 65% of the printers (n=20) were less than 1 m away from the users horizontally, and 74% of the users (n=23) accessed the printers 1-5 times a week, printing (7.03±4.07) pages per time. The peak mass concentrations in users' offices during printing of PM₁₀, PM_2.5, and PM₁ were (21.96±12.96), (7.92±5.54), and (5.77±5.00) μg·m⁻³, respectively, and the peak number concentration of PM_0.25−0.28 was (40941±36926) P·L⁻¹. The experiments showed that when the particle sizer was located in the front, side, and back of the printers, the peak values of PM_0.25−0.28 number concentration during printing were (24257±551), (12588±1354), and (11192±249) P·L⁻¹, respectively, and the difference among them was statistically significant (F=214.9, P<0.01); when the particle sizer was placed 0.1, 0.2, and 0.3 m away from the printers, the peak values of PM_0.25−0.28 number concentration during printing were (24257±551), (19847±1426), and (16480±878) P·L⁻¹, respectively, and the difference among them was statistically significant (F=44.66, P<0.01); when the experiment room was ventilated or not, the peak values of PM_0.25−0.28 number concentration during printing were (18595±488) and (24257±551) P·L⁻¹, respectively, and the difference between them was statistically significant (F=192.6, P<0.01); when the distance between the printer and the window was 1, 2, 3 m, the peak values of PM_0.25-0.28 number concentration during printing were (16780±823), (18347±348), and (18595±488) P·L⁻¹, respectively, and the difference among them was statistically significant (F=8.407, P<0.05). Conclusion The overall printer workload is small and the concentration of particulate matter in the faculty offices is low when the printers are working. Printer position, distance, ventilation, and the distance from a nearby window under ventilation conditions are factors affecting the concentration of particulate matter released by the printers.

BACKGROUND AND PURPOSE: Large cohort studies on relationship between family history of stroke (FHS) and stroke risk are lacking in Asians. We aimed to systematically evaluate the association of FHS with stroke risk in a cohort study of 0.5 million Chinese adults. METHODS: Information about FHS was self-reported. The median follow-up time was 7.16 years and the end-point of follow-up was incident stroke, which was entered directly into the China Kadoorie Biobank system. Multivariate analyses were performed with Cox proportional hazards model, and interaction analyses were carried using likelihood-ratio tests. RESULTS: Compared with participants without FHS, the hazard ratio (HR) (95% confidence interval, CI) of stroke for participants with FHS was 1.50 (1.46-1.55). The HRs increased with the number of first degree relatives with stroke (HRs=1.41, 1.98 and 2.47 for 1, 2 and ≥3 relatives, respectively, P(trend) <0.001). The HRs were 1.57 (95% CI: 1.50-1.66) and 1.49 (95% CI: 1.45-1.54) for sibling history and parental history, respectively. Similar associations with offspring stroke risk were observed between paternal history (HR=1.48, 95% CI: 1.43-1.54) and maternal history (HR=1.49, 95% CI: 1.43-1.55). Moreover, significant interactions were detected between FHS and health-risk behaviors (tobacco smoking and alcohol drinking). CONCLUSIONS: FHS is an independent risk factor for stroke in Chinese. The more first degree relatives are affected by stroke, the higher are individuals’ risk of suffering from stroke. The management of the health-risk behaviors for reducing stroke should be highlighted, especially for the individuals with FHS.
Adult ; Asian Continental Ancestry Group ; China* ; Cohort Studies* ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Parents ; Proportional Hazards Models ; Risk Factors ; Siblings ; Smoke ; Smoking ; Stroke*

Objective: To explore the association between DNA methylation and body mass index (BMI) using Mendelian randomization analysis. Methods: A total of 469 participants were selected from the Chinese National Twin Registry in 2013, who were living in Shandong, Jiangsu, Zhejiang, and Sichuan provinces, and at least 18 years of age. A questionnaire survey and physical examination were conducted to collect demographic, clinical, and behavioral information. Peripheral blood cells were collected to detect genotype and methylation status. Association analyses between DNA methylation and BMI and between CpGs and cis-SNP were conducted. With rs748212 as the instrumental variable, the association between cg15053022 and BMI was explored using the Mendelian randomization method. Results: A total of 469 participants were selected. The mean age of participants was (44.8±13.2) years and the BMI was (25.0±3.8) kg/m². Nine BMI-related DNA methylation sites were found and DNA methylation site cg15053022 in the ATP4A gene was negatively associated with cis-SNP rs748212 (β=-0.020); the mean methylation level of AA, AC, and CC were 0.212±0.025, 0.242±0.024, and 0.264±0.028, respectively. rs748212 was associated with BMI (β=0.04, P=0.007) and closely related to cg15053022 (F=237.66, P=0.143). Mendelian randomization analysis showed lower methylation levels at cg15053022 were associated with higher BMI (β=-1.97, P<0.001). Conclusion This study supported the impact of cg15053022 methylation in the ATP4A gene on BMI using Mendelian randomization analysis and provided the basis for using Mendelian randomization analysis in methylation studies.

Objective Through systematically reviewing the reliability and validity of depression scales of Chinese version in adults in China to evaluate the psychometric properties of depression scales for different groups.Methods Eligible studies published before 6 May 2016 were retrieved from the following database:CNKI,Wanfang,PubMed and Embase.The HSROC model of the diagnostic test accuracy (DTA) for Meta-analysis was used to calculate the pooled sensitivity and specificity of the PHQ-9.Results A total of 44 papers evaluating the performance of depression scales were included.Results showed that the reliability and validity of the common depression scales were eligible,including the Beck depression inventory (BDI),the Hamilton depression scale (HAMD),the center epidemiological studies depression scale (CES-D),the patient health questionnaire (PHQ) and the Geriatric depression scale (GDS).The Cronbach's coefficient of most tools were larger than 0.8,while the test-retest reliability and split-half reliability were larger than 0.7,indicating good internal consistency and stability.The criterion validity,convergent validity,discrimination validity and screening validity were acceptable though different cut-off points were recommended by different studies.The pooled sensitivity of the 11 studies evaluating PHQ-9 was 0.88 (95％CI:0.85-0.91) while the pooled specificity was 0.89 (95％CI:0.82-0.94),which demonstrated the applicability of PHQ-9 in screening depression.Conclusion The reliability and validity of different depression scales of Chinese version are acceptable.The characteristics of different tools and study population should be taken into consideration when choosing a specific scale.

BACKGROUND AND PURPOSE: Self-rated health (SRH) is a consistent and strong predictor of all-cause and cardiovascular mortality in various populations. However, the associations between SRH measures and risk of first-ever or recurrent stroke were rarely explored. We thus aim to prospectively investigate the associations between SRH measures and risk of total and subtypes of stroke in Chinese population. METHODS: A total of 494,113 participants from the China Kadoorie Biobank without prior heart diseases or cancer (486,541 without stroke and 7,572 with stroke) were followed from baseline (2004 to 2008) until December 31, 2013. General and age-comparative SRH were obtained from baseline questionnaires. First-ever stroke or recurrent events were ascertained through linkage to disease registry system and health insurance data. RESULTS: We identified 27,662 first-ever stroke and 2,909 recurrent events during an average of 7.0 years of follow-up. Compared with excellent general SRH, the hazard ratios (HRs) and 95% confidence intervals (CIs) for first-ever stroke associated with good, fair, and poor general SRH were 1.04 (1.00 to 1.08), 1.19 (1.15 to 1.23), and 1.49 (1.42 to 1.56) in the multivariate model, respectively. Compared with better age-comparative SRH, the HRs (95% CIs) of same and worse age-comparative SRH were 1.13 (1.10 to 1.17) and 1.51 (1.45 to 1.58), respectively. The relations of SRH measures with ischemic stroke, hemorrhagic stroke, and recurrent stroke were similar to that with total first-ever stroke. However, the magnitude of associations was much stronger for fatal stroke than for non-fatal stroke. CONCLUSIONS: This large-scale prospective cohort suggests that self-perceived health status is associated with incident stroke, regardless of stroke subtype.
Adult* ; Asian Continental Ancestry Group* ; China* ; Cohort Studies ; Follow-Up Studies ; Heart Diseases ; Humans ; Insurance, Health ; Mortality ; Prospective Studies ; Stroke*