Objective: To investigate the rates on prevalence, awareness, treatment and control of hypertension in population older than 15 years of age in Beijing, 2013-2014. Methods: A cross-sectional survey was conducted in Beijing between 2013-2014. Stratified multistage random sampling method was used to select representative sample of 13 057 Chinese individuals aged over 15 years, from the general population. Blood pressure was measured for three readings at sitting position after resting for at least five minutes with an average reading recorded. A standardized structured questionnaire was developed to collect history of hypertension and antihypertensive treatment. Results: A total of 4 663 community residents aged over 15 years were hypertensive among the 13 057 individuals, with the standardized prevalence rate as 32.7%, in Beijing area. The age-standardized prevalence rates of hypertension appeared 34.6% in men and 30.8% in women. The age-and sexstandardized prevalence of hypertension rates were 33.3% in urban and 24.6% in rural areas. The prevalence of hypertension increased with age and appeared higher in men than in women, in urban than in rural residents. Among the hypertensive patients, rates of awareness, treatment and control were 66.8%, 64.6% and 31.6%, respectively. Conclusion: High prevalence of hypertension with low rates on awareness and treatment and control, appeared in the general population of Beijing. Related strategies should be developed regarding prevention, control and management of hypertension, to reduce the burden of this disease.
Adolescent ; Adult ; Age Distribution ; Aged ; Antihypertensive Agents/therapeutic use* ; Asian People/statistics & numerical data* ; Awareness ; Blood Pressure ; Blood Pressure Determination ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hypertension/epidemiology* ; Male ; Middle Aged ; Prevalence ; Rural Population ; Sex Distribution ; Surveys and Questionnaires ; Urban Population ; Young Adult

In the studies of modern epidemiology, exposure in a short term cannot fully elaborate the mechanism of the development of diseases or health-related events. Thus, lights have been shed on to life course epidemiology, which studies the exposures in early life time and their effects related to the development of chronic diseases. When exploring the mechanism leading from one exposure to an outcome and its effects through other factors, due to the existence of time-variant effects, conventional statistic methods could not meet the needs of etiological analysis in life course epidemiology. This paper summarizes the dynamic path analysis model, including the model structure and significance, and its application in life course epidemiology. Meanwhile, the procedure of data processing and etiology analyzing were introduced. In conclusion, dynamic path analysis is a useful tool which can be used to better elucidate the mechanisms that underlie the etiology of chronic diseases.
Chronic Disease/epidemiology* ; Epidemiologic Studies ; Humans ; Models, Theoretical ; Risk Factors ; Time

Objective: To carry out a quantitative estimate that related to the effects of short-term exposure to PM(2.5) on all-cause mortality and emergency visits in China by using the systematic review and Meta-analysis. Methods: We selected all the studies published before March 2018 from China National Knowledge Infrastructure, Wanfang database, PubMed and EMBASE and data on relative risk (RR), excess risk (ER) and their 95%CIs: appeared in these papers were extracted. According to the differences in the size or direction (heterogeneity) of the results, we computed summary estimates of the effect values using a random-effect or fixed effect model. We also conducted the subgroup analysis and Meta-analysis to have assessed the selected studies for the evidence of study bias. Results: A total of 33 original studies, indexed in databases, were identified. Among those studies, 39 sets of data on mortality and 4 sets of data on emergency were valid to show that within the daily concentration range from 47.7 to 176.7 μg/m(3), for 10 μg/m(3) increases in PM(2.5) concentrations, it would increase the daily numbers of deaths by 0.49% (95%CI: 0.39%-0.59%) and 0.30% (95%CI: 0.10%-0.51%) for all-cause deaths and all-cause emergency-room visits, respectively. For subgroup analysis, the combined effect of PM(2.5) in causing short-term all-cause deaths in the northern areas (ER=0.42%, 95%CI: 0.30%-0.54%) seemed lower than that in the southern areas (ER=0.63%, 95%CI: 0.44%-0.82%). The combined effect of PM(2.5) concentration below 75 μg/m(3) (ER=0.50%, 95%CI: 0.37%-0.62%) was higher than that of PM(2.5) concentration ≥75 μg/m(3) (ER=0.39%, 95%CI: 0.26%-0.52%). Conclusion: Within the concentration range from 47.7 to 176.7 μg/m(3), short-term exposure to current level of PM(2.5) might increase both the all-cause daily mortality and daily emergency visits in China.
Air Pollutants ; Air Pollution/statistics & numerical data* ; China ; Databases, Factual ; Emergency Service, Hospital/statistics & numerical data* ; Environmental Exposure/statistics & numerical data* ; Female ; Humans ; Male ; Particulate Matter/toxicity* ; Time Factors

Cross-Sectional Studies ; Depression/epidemiology* ; Humans ; Job Satisfaction ; Occupational Stress/epidemiology* ; Oil and Gas Fields ; Stress, Psychological ; Surveys and Questionnaires

The search for a parameter representing left ventricular relaxation from non-invasive and invasive diagnostic tools has been extensive, since heart failure (HF) with preserved ejection fraction (HF-pEF) is a global health problem. We explore here the feasibility using patient-specific cardiac computer modeling to capture diastolic parameters in patients suffering from different degrees of systolic HF. Fifty eight patients with idiopathic dilated cardiomyopathy have undergone thorough clinical evaluation, including cardiac magnetic resonance imaging (MRI), heart catheterization, echocardiography, and cardiac biomarker assessment. A previously-introduced framework for creating multi-scale patient-specific cardiac models has been applied on all these patients. Novel parameters, such as global stiffness factor and maximum left ventricular active stress, representing cardiac active and passive tissue properties have been computed for all patients. Invasive pressure measurements from heart catheterization were then used to evaluate ventricular relaxation using the time constant of isovolumic relaxation Tau (s). Parameters from heart catheterization and the multi-scale model have been evaluated and compared to patient clinical presentation. The model parameter global stiffness factor, representing diastolic passive tissue properties, is correlated signif-icantly across the patient population with s. This study shows that multi-modal cardiac models can successfully capture diastolic (dys) function, a prerequisite for future clinical trials on HF-pEF.

Objective: To understand the characteristics and dynamic of HIV-1 subtype distribution in men who have sex with men (MSM) in Guangzhou between 2008 and 2015. Methods: HIV-1 RNAs were extracted from serum samples of the individuals newly diagnosed with HIV-1 infection among MSM living in Guangzhou between 2008 and 2015. The pol gene segments of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and were sequenced. Subsequently, the phylogenetic tree was reconstructed using pol sequences of samples and references together and the subtype of HIV-1 was determined. The distributions of HIV-1 subtypes detected in MSM with different demographic characteristics in different years were compared. Results: A total of 2 210 pol gene segments were successfully obtained from 2 473 serum samples of the MSM. The average age of 2 210 MSM was 30.19 years with standard deviation of 8.22 years, the unmarried MSM and those in Han ethnic group accounted for 73.39% and 90.81%, respectively. The proportion of subtype CRF07_BC (38.10%) was highest, followed by CRF01_AE (34.84%), CRF55_01B (14.62%), B (6.06%), URFs (3.58%), CRF59_01B (2.17%) and other subtypes (0.63%). The annual proportions of subtype B (P=0.000, 99%CI:0.000-0.000), CRF07_BC (χ(2)=14.965, P=0.036), CRF55_01B (χ(2)=18.161, P=0.011) and URFs (P=0.001, 99% CI: 0.000-0.001) were significantly different. The proportion of subtype B showed a gradual decrease from 14.08% to 4.33% (P=0.000, 99%CI: 0.000-0.000), while the proportion of URFs rapidly increased from 0% to 6.40% (P=0.000, 99% CI: 0.000-0.000). The rate of URFs was significantly higher in farmers and migrant workers than in other groups (P=0.017, 99%CI: 0.014- 0.020) and the rate of URFs was higher in individuals who had multi sexual partners (χ(2)=5.733, P=0.017). Conclusions: CRF07_BC and CRF01_AE were the predominant HIV-1 subtypes and multiple subtypes co-circulated among MSM in Guangzhou between 2008 and 2015. The recombinations of HIV-1 continue to occur in MSM. Strengthening behavioral intervention for farmers, migrant workers and individuals who have multi sexual partners has the important epidemiological significance against the emerging and circulating of the novel recombinant virus among MSM in Guangzhou.
China/epidemiology* ; Genes, pol ; Genotype ; HIV Infections/virology* ; HIV Seropositivity/genetics* ; HIV-1/isolation & purification* ; Homosexuality, Male ; Humans ; Male ; Phylogeny ; Polymerase Chain Reaction ; RNA, Viral/blood* ; Sexual Behavior

Objective: To understand the prevalence of drug resistance in treatment-naive HIV infected men who have sex with (MSM) in Guangzhou. Methods: HIV-1 RNA were extracted from the serum specimens of the MSM newly confirmed to be HIV-1 positive, living in Guangzhou and receiving no anti-viral therapy from 2008 to 2015. HIV-1 pol gene segments, including full protease and part reverse transcriptase, were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and sequenced by Sanger. Subsequently, the sequence data were submitted to Stanford University HIV Drug Resistance Database for drug resistance analysis. Results: Among 2 283 HIV infected MSM, HIV-1 pol gene segments were obtained from the serum samples of 1 986 HIV infected MSM aged 16-84 (30.18±8.24) years. Among them, the unmarried accounted for 74.17% (1 473/1 986), those of Han ethnic group accounted for 90.64% (1 800/1 986), those with education level of college or above accounted for 49.65% (986/1 986), those with education level of senior high school or secondary school accounted for 27.14% (539/1 986), those with education level of junior high school or below accounted for 20.89% (415/1 986). The distribution of subtypes was predominated by CRF07_BC (38.22%, 759/1 986) and CRF01_AE (34.49%, 685/1 986). The overall prevalence of drug resistance was 3.32% (66/1 986). The prevalence of resistance to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) were 1.36%(27/1 986), 0.65% (13/1 986) and 1.61% (32/1 986), respectively. Subtype B had higher resistance to PIs, NRTIs and NNRTIs and subtype CRF55_01B had highest resistance to NNRTIs compared with other subtypes. In subtype B, the resistant rates to D4T, EFV and NVP were highest (all 4.17%, 5/120), followed by those to NFV, AZT and RPV (all 3.33%, 4/120). In subtype CRF55_01B, the resistant rates to EFV and NVP were highest (all 5.50%, 16/291), followed by those to ETR and RPV (all 5.15%, 15/291). Conclusions: The prevalence of drug resistance in treatment-naive HIV infected MSM in Guangzhou remained at low level and current antiretroviral drugs are generally effective. However, subtype B and CRF55_01B have higher drug resistance.
Adolescent ; Adult ; Child ; Drug Resistance, Viral ; Genotype ; HIV Infections/ethnology* ; Homosexuality, Male/statistics & numerical data* ; Humans ; Male ; Phylogeny ; Prevalence ; RNA, Viral/genetics* ; Sexual and Gender Minorities ; Young Adult

Objective: Data from the surveillance program was collected, to analyze the situation of hospitalization and cases of death with recorded causes, in Shenzhen, from 1995 to 2014. Situation of hospitalization and causes of deaths were studied in Shenzhen which had been a fast-developing city with growing number of immigrants so as to provide reference for decision-making on related prevention and control strategies. Methods: Data on hospitalizations and deaths collected from the surveillance program, were classified by both International Classification of Diseases (ICD)- 9 and ICD-10. A database was constructed with methods on related descriptive and trend analysis. Results: Around 6.3 million inpatients were seen in the past two decades in Shenzhen. The top five diseases for hospitalization were pregnancy childbirth and puerperium complications, respiratory diseases, injury and poisoning, digestive system diseases and circulatory system diseases, that accounting for 68.4% of all the hospitalization burden. The number of inpatients increased annually, with an 11 times increase during the past two decades. Proportions for pregnancy childbirth and puerperium complications, circulatory system diseases and urinary system diseases all showed increasing (χ(2)=53 806.94, 6 893.95 and 15 383.14, P<0.01), while proportions for injuries and poisoning, respiratory diseases, digestive system diseases showed a declining trend (χ(2)=131 480.09,1 711.84 and 11 367.66, P<0.01). Number of cumulative inpatient deaths exceeded 60 000, with the top five causes as malignant tumor, circulatory system diseases, injury and poisoning, respiratory system diseases and digestive system diseases, that accounting for 82.28% of all the inpatient deaths. Deaths due to circulatory system diseases, injury and poisoning increased and then decreased. Malignant tumor and respiratory diseases-induced deaths showed an increasing trend (χ(2)=1 546.48, 309.55, P<0.01), while induced deaths from disease of the other systems showed slight changes. The overall case fatality rate showed an annual decline (χ(2)=4 378.63, P<0.01), from 2.23% in 1995 to 0.74% in 2014, with mortality attribute to tumor, circulatory system disease decreased significantly. Conclusions: Shenzhen had been under an ageing transition, with relatively young population living in the city. Chronic diseases such as tumor gradually had become the major causes for heavy hospitalization burden on the population of Shenzhen.
Cardiovascular Diseases/epidemiology* ; Cause of Death ; China/epidemiology* ; Female ; Global Burden of Disease ; Hospitalization/statistics & numerical data* ; Humans ; Neoplasms/epidemiology* ; Pregnancy ; Pregnancy Complications/epidemiology* ; Respiratory Tract Diseases/epidemiology*

Objective: To know the situation of extramarital sexual behaviors and HIV infection in middle-aged and elderly people in Chongqing, and provide reference for AIDS prevention and treatment. Methods: From October to December 2017, a multi-stage sampling method was used to recruit middleaged and elderly people aged ≥50 years who lived in Dazu and Hechuan districts of Chongqing for at least one year, with a sample size of 410. Face-to-face questionnaires survey and HIV antibody test were conducted. Results: A total of 408 people were surveyed, including 313 males and 95 females aged 50-88 (64.93±9.03) years. The HIV infection rate was 1.47% (6/408), with the rate of 1.28% (4/313) in males and 2.11% (2/95) in females. The awareness rate of AIDS related knowledge was 37.50% (153/408). And 18.87% (77/408) of subjects surveyed reported extramarital sexual behaviors, 7.60% (31/408) reported extramarital sexual behaviors in the past half year, the constant condom use rate was 19.35% (6/31). The results of multivariate logistics model analysis on extramarital sexual behaviors showed that the prevalence in males were 39.51 times higher than that in females (OR=39.51, 95%CI: 5.03-310.30), 4.60 times higher in those who were unmarried, divorced or widowed than that in the married or cohabitants (OR=4.60, 95%CI: 1.50-14.05), 2.03 times higher in those with outside activities than those with individual activities (OR=2.03, 95%CI: 1.08-3.81) and 3.94 times higher in those with self-evaluation of emptiness of living state than that in those with engaged life (OR=3.94, 95%CI: 1.86-8.36). Conclusions: The prevalence of extramarital sexual behavior in middle-aged and elderly people in some counties and districts in Chongqing is high. The factors such as gender, marital status, leisure activities, and self-evaluation of living state were related to the prevalence of extramarital sexual behaviors in this population. The condom use rate in extramarital sexual behavior was low. It is necessary to take effective interventions in this population.
Aged ; Aged, 80 and over ; China/epidemiology* ; Condoms ; Extramarital Relations ; Female ; HIV Infections/transmission* ; Humans ; Male ; Marital Status ; Middle Aged ; Risk Factors ; Sexual Behavior ; Surveys and Questionnaires

Objective: To understand the prevalence of drug resistance in treatment-naive injecting drug users (IDUs) infected with HIV-1 in Guangzhou. Methods: HIV-1 RNA were extracted from the serum specimens of the newly confirmed HIV-1 positive IDUs living in Guangzhou, being infected through injecting drug use and receiving no antiretroviral therapy at the time of confirmation during 2008-2015. Full sequence of pol protease (PR) gene and partial sequence of reverse transcriptase (RT) gene were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and sequenced. After that, data were submitted to the HIV resistance database of Stanford University for drug resistance analysis. Results: Among the 518 HIV-1 infected IDUs, HIV-1pol gene segments were successfully obtained from the serum samples of 407 HIV-1 infected IDUs (78.57%) aged 18-64 (37.44±8.14) years. Among them, males accounted for 89.68% (365/407), those of Han ethnic group accounted for 89.93% (366/407), the unmarried accounted for 55.28% (225/407), and those with education level of junior high school or below accounted for 83.78% (341/407). The distribution of subtypes was predominated by CRF07_BC (47.18%, 192/407), followed by CRF01_AE (23.83%, 97/407), CRF08_BC (22.85%, 93/407), and other subtypes (6.14%, 25/407). The overall prevalence of drug resistance was 3.44% (14/407). The prevalence of drug resistance to protease inhibitors, nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors were 1.47%(6/407), 0.25% (1/407) and 1.72% (7/407) respectively. The mutation rate was 12.29% (50/407). No major drug resistance mutation was detected in protease and nucleoside reverse transcriptase regions. Higher rate of V179E mutation in the non-nucleoside reverse transcriptase region was detected in other subtypes and subtype CRF07_BC. Mutation seemed to have occurred in all 8 cases of subtype CRF55_01B in other subtypes. The highest mutation rate of E138A was detected in subtype CRF08_BC (3.23%). Two cases were resistant to all four drugs of NNRTIs. Conclusions: The prevalence of drug resistance in treatment-naive HIV-1 positive IDUs remained at a relatively low level during 2008-2015, in Guangzhou. Most infections were sensitive to existing antiviral drugs. However, drug resistance surveillance in IDUs infected with HIV should be strengthened to prevent the prevalence of multi-drug resistance and cross drug resistance.
Adolescent ; Adult ; Child ; Drug Resistance, Viral/genetics* ; Drug Users ; Genes, pol/genetics* ; Genotype ; HIV Infections/psychology* ; HIV-1/isolation & purification* ; Humans ; Male ; Mutation ; Prevalence ; RNA, Viral/genetics* ; Young Adult