Objective: To understand the current overall status of implementation on the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases. Methods: According to the scheme design of the questionnaires, all the National Demonstration Areas were involved in this study. For each National Demonstration Areas, eight departments were selected to complete a total of 12 questionnaires. Results: Scores related to the implementation of the National Demonstration Areas accounted for 71.8% of the total 170 points. Based on the scores gathered from this study, the 23-items-index-system that represented the status of project implementation was classified into seven categories. Categories with higher percentile scores would include: monitoring (88.0%), safeguard measures (75.0%), health education and health promotion (75.0%). Categories with lower percentile scores would include: the national health lifestyle actions (67.7%), community diagnosis (66.7%), discovery and intervention of high-risk groups (64.7%), and patient management (60.9%). There were significant differences noticed among the eastern, central and western areas on items as safeguard measures, health education/promotion, discovery and intervention of high-risk groups. In all, the implementation programs in the eastern Demonstration Areas seemed better than in the central or western regions. As for the 23 items, five of the highest scores appeared on policy support, mortality surveillance, tumor registration, reporting system on cardiovascular/cerebrovascular events, and on tobacco control, respectively. However, the lowest five scores fell on healthy diet, patient self-management program, oral hygiene, setting up the demonstration units and promotion on basic public health services, respectively. The overall scores in the eastern region was higher than that in the central or the western regions. The scores in the central and western regions showed basically the same. Conclusions: The overall status of implementation on the National Demonstration Areas was satisfactory. Future attention should be focusing on patient management as well as discovery and intervention of high-risk groups, which also presented the lowest scores, in this survey.
China/epidemiology* ; Chronic Disease/epidemiology* ; Delivery of Health Care ; Health Promotion/organization & administration* ; Humans ; National Health Programs ; Noncommunicable Diseases/prevention & control* ; Outcome Assessment, Health Care ; Population Surveillance ; Preventive Health Services/organization & administration* ; Program Evaluation ; Public Health ; United States

Objective: To understand the current situation on management of diabetes mellitus patients aged 35 and above in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases, in China. Methods: Local residents, aged 18 years and above were randomly selected by a complex, multistage, probability sampling method. Face-to-face questionnaire survey was carried out between November and December 2016. Rates regarding prevalence, treatment and management of diabetes were calculated, and influencing factors of diabetes were analyzed by using the non-conditional logistic regression model. Results: A total of 3 213 residents aged ≥35 years were included in this study, of which 11.48% (369/3 213) reported that they had ever been informed by a doctor or other health worker that their blood sugar level was high or being diabetic. The rate of self-reported treatment among the diabetic patients was 83.20% (307/369). Rates on overall management and standardized management were 69.92% (258/369) and 53.66% (198/369), respectively. Higher rates were seen in residents aged 55 to 64 years, 76.32% for overall management and 59.65% for standardized management. Through multiple logistic regression analysis, we found that standardized management for diabetes was much higher in the Demonstration Areas located in the eastern areas (OR=2.942, 95%CI: 1.547-5.594), or patients with characteristics including high implementation score (OR=3.499, 95%CI: 1.865-6.563), already signed family doctors (OR=5.661, 95%CI: 3.237-9.899), or without hypertension (OR=1.717, 95%CI: 1.010- 2.920). Residents who were living in the first and second batch areas of implementation or responding to the NCDs with positive attitude were more likely to accept standardized management. Conclusion: Prevention and management programs on diabetes had met the requirements set for the Demonstration Areas which had promoted the specific implementation and further development of standardized management on diabetes.
Adult ; Aged ; Asian People/statistics & numerical data* ; China/epidemiology* ; Diabetes Mellitus/therapy* ; Humans ; Hypertension/epidemiology* ; Logistic Models ; Middle Aged ; Noncommunicable Diseases/prevention & control* ; Population Surveillance ; Prevalence ; Risk Factors ; Self Care ; Surveys and Questionnaires

Objective: To assess the implementation and impact of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases. Methods: Both sociological and epidemiological methods were used to collect qualitative and quantitative data in November and December, 2016 in order to conduct on process and outcome evaluation of the above mentioned objective. In the meantime, case study was also conducted. Results: All the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were found well implemented across the country, with health education and health promotion, surveillance and safeguard measures in particular. A government-led and inter-sector coordination and communication mechanism had been well established, with more than 16 non-health departments actively involved. 28.7% of the residents living in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were aware of the key messages related to chronic diseases. Among the residents, 72.1% of them consumed vegetables and 53.6% consumed fruits daily, with another 86.9% walked at least 10 minutes per day. Over 70% of the patients with hypertension or diabetes reported that they were taken care of by the Community Health Centers, and above 50% of them were under standardized management. Residents, living in the National Demonstration Areas under higher ranking of implementation scores, were more likely to be aware of relevant knowledge on chronic disease control and prevention (OR=6.591, 95%CI: 5.188-8.373), salt reduction (OR=1.352, 95%CI: 1.151-1.589), oil reduction (OR=1.477, 95%CI: 1.249-1.746) and recommendation on physical activities (OR=1.975, 95%CI: 1.623- 2.403). Conclusion: The implementation of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases had served a local platform for the control and prevention of non-communicable diseases, and thus become an important 'carrier' for chronic disease prevention and control programs in China.
China/epidemiology* ; Chronic Disease/epidemiology* ; Delivery of Health Care ; Health Promotion/organization & administration* ; Humans ; National Health Programs ; Noncommunicable Diseases/prevention & control* ; Outcome Assessment, Health Care ; Population Surveillance ; Preventive Health Services/organization & administration* ; Program Evaluation ; Public Health

Objective: To investigate the current status of prevalence, treatment, and management on hypertension among Chinese adults from the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases. Methods: We selected a total of 4 000 residents aged ≥18 years for this questionnaire-based survey by multi-stage clustering sampling in 10 National Demonstration Areas between November and December, 2016. Results: There were 3 891 effective questionnaires. The self-reported prevalence of hypertension among aged ≥35 years was 31.47% (1 011/3 213). For the past two weeks, the self-reported treatment of hypertension was 86.75%(877/1 011), with the rates of guidance as 56.87% (575/1 011) on physical activity, 40.95% (414/1 011) on diet, 38.33% (385/1 011) on weight management, and 22.75% (228/1 011) on smoking cessation. For the past 12 months, 74.68% (755/1 011) of the residents aged ≥35 years were under the proper management and 62.12% (628/1 011) of them were under the standardized management programs. The follow-up program lasted for 4 (P(25)-P(75): 4-12) times per year, with 15 (P(25)-P(75): 10-20) minutes per each visit. Hypertensive patients would mainly visit the outpatient clinics (53.51%), followed by home visits (22.91%) and telephone calls (13.64%). Rate of satisfaction on management services was 94.83% (716/755) from the hypertensive patients. Multivariate analysis showed that the rate of self-reported treatment (OR=1.986, 95%CI: 1.222-3.228) and self-reported standardized management (OR=2.204, 95%CI: 1.519-3.199) on hypertension were higher in the Demonstration Areas with higher implementation scores of self-reported non-communicable diseases management. Conclusions: Prevention and management on hypertension in the Demonstration Areas had met the requirement set for the Demonstration Areas during the "12th Five-Year Plan" . Projects on setting up the National Non-communicable Diseases Demonstration Areas had played an active role in promoting the standardized management program on hypertension.
Adult ; Asian People/statistics & numerical data* ; Diet ; Exercise ; Humans ; Hypertension/therapy* ; Noncommunicable Diseases/prevention & control* ; Population Surveillance ; Prevalence ; Risk Factors ; Surveys and Questionnaires

Objective: To investigate the consumption of vegetables and fruits and related influencing factors among residents from the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases. Methods: From November to December, 2016, a total of 4 000 residents, aged 18 or above, from ten Demonstration Areas, were selected as participants for this study by multi-stage cluster random sampling method. Information on vegetables, fruits consumption and related influencing factors was collected via questionnaire. Results: A total of 3 891 residents were involved in the final analysis. Daily consumption of vegetables and fruits accounted for 72.1% and 53.6% of the residents under study. The residents who were aware of the National Demonstration Areas activities were more willing to have adequate intake of vegetables (OR=3.017, 95%CI: 2.426-3.753) and fruits (OR=1.261, 95%CI: 1.007-1.580). Residents with higher degree of participation activities of the demonstration areas were more likely to have adequate fruits intake (high degree: OR=1.431, 95%CI: 1.210-1.694; medium degree: OR=1.573, 95%CI: 1.315- 1.882). Conclusions: The implementation of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases has improved the adequate vegetables and fruits intake among residents. Relevant activities carried out in the Demonstration Areas appeared conducive to the healthy lifestyle of the residents.
Diet/statistics & numerical data* ; Fruit ; Humans ; Middle Aged ; Noncommunicable Diseases/prevention & control* ; Population Surveillance ; Surveys and Questionnaires ; Vegetables

Precision medicine became the key strategy in development priority of science and technology in China. The large population-based cohorts become valuable resources in preventing and treating major diseases in the population, which can contribute scientific evidence for personalized treatment and precise prevention. The fundamental question of the achievements above, therefore, is how to construct a large population-based cohort in a standardized way. The Chinese Preventive Medicine Association co-ordinated experienced researchers from Peking University and other well-known institutes to write up two group standards Technical specification of data processing for large population-based cohort study (T/CPMA 001-2018) and Technical specification of data security for large population-based cohort study (T/CPMA 002-2018), on data management. The standards are drafted with principles of emphasizing their scientific, normative, feasible, and generalizable nature. In these two standards, the key principles are proposed, and technical specifications are recommended in data standardization, cleansing, quality control, data integration, data privacy protection, and database security and stability management in large cohort studies. The standards aim to guide the large population-based cohorts that have been or intended to be established in China, including national cohorts, regional population cohorts, and special population cohorts, hence, to improve domestic scientific research level and the international influence, and to support decision-making and practice of disease prevention and control.
China ; Cohort Studies ; Delivery of Health Care ; Humans ; Population Surveillance ; Quality Control ; Reference Standards

Objective: To study the relations between famine exposure and the risk of chronic diseases as diabetes mellitus, obesity, hypertension, coronary heart disease and stroke in the population of Harbin. Methods: Our data was collected from the baseline survey-the China Kadoorie Biobank project (CKB) in Harbin. Retrospective cohort study design was used. Related risks on chronic diseases including diabetes mellitus, obesity, hypertension, coronary heart disease and stroke, were compared among the famine exposed or non-exposed people, respectively by logistic analysis method. Results: After adjusted for factors as age, sex, physical activity, smoking, alcohol intake, diet, family history of diseases, it appeared that the factor 'famine exposure' had increased the risks of diseases as obesity (OR=1.204, 95%CI: 1.104-1.313, P<0.01), hypertension (OR=1.315, 95%CI: 1.210-1.429, P<0.01) and coronary heart disease (OR=1.495, 95%CI: 1.369-1.632, P<0.01). The lower the age of population being exposed to famine, the greater the risk of the development of all kinds of chronic diseases. Conclusions: Famine exposure appeared a risk factor for obesity, hypertension, and coronary heart disease. It is of great significance to ensure the life-long nutrition of the people, especially in the early and adolescent stages, to prevent obesity, hypertension, and coronary heart disease in their later lives.
Adolescent ; China/epidemiology* ; Chronic Disease/epidemiology* ; Coronary Disease/epidemiology* ; Diabetes Mellitus/epidemiology* ; Female ; Humans ; Hypertension/epidemiology* ; Obesity/epidemiology* ; Pregnancy ; Prenatal Exposure Delayed Effects/epidemiology* ; Retrospective Studies ; Socioeconomic Factors ; Starvation/epidemiology*

Objective: To investigate the utilization of antibiotics in emergency departments (EDs) of class Ⅲ general hospitals in China. Methods: Data from a national monitoring network for rational use of drugs was used. The data included prescriptions of EDs from 114 class Ⅲ general hospitals in 30 provinces (autonomous regions, municipalities) of China. A total of 10 260 595 prescriptions from October 1, 2014 to December 31, 2016 were extracted. The Anatomical Therapeutic Chemical Classification/Defined Daily Dose (DDD) system was used for the classification of antibiotics and calculation of antibiotic use intensity. An auto-regression model was used to analyze the trend over time and seasonal variation of antibiotic use in EDs. Results: The rate of antibiotic prescriptions was 27.82% in EDs, among the antibiotics prescribed, 25.58% were for the combination therapy with 2 or more antibiotic agents, and injectable antibiotic prescriptions accounted for 60.59%. Besides, the number of DDDs per 100 patient visits was 81.84. Broad-spectrum agents were the most commonly used antibiotics, among which the second and third generation cephalosporins, quinolones and macrolides accounted for 23.83%, 21.68%, 19.17% and 7.89% of all prescribed antibiotics, respectively. The use of antibiotics, including prescription frequency and use intensity, in EDs had a slight but significant increase tendency (P<0.05), and the seasonal variation of antibiotic use in EDs was obvious, characterized by the highest frequency and intensity of antibiotic use in winter, the differences were significant (P<0.05). Conclusion: The antibiotic prescription rate in EDs of classⅢ general hospitals in China was controlled at a low level, but the proportions of broad-spectrum antibiotics and injectable antibiotics were high, and a significant increase trend in antibiotic use in EDs was found.
Anti-Bacterial Agents/therapeutic use* ; China ; Drug Prescriptions ; Drug Utilization ; Emergency Service, Hospital ; Hospitals ; Hospitals, General ; Humans

Humans ; Female ; Receptors, Estrogen/metabolism* ; Breast Neoplasms/metabolism* ; Receptors, Progesterone/metabolism* ; Immunohistochemistry ; Estrogen Receptor alpha

Objective: To evaluate the association of family history with risk of major coronary events (MCE) and ischemic heart disease (IHD). Methods: After excluding participants with heart disease, stroke or cancer at baseline survey, a total of 485 784 participants from the China Kadoorie Biobank, who had no missing data on critical variables, were included in the analysis. Cox regression analysis was used to estimate the hazard ratios (HR) and 95% CI. Subgroup analyses were performed according to the baseline characteristics. Results: During a median of 7.2 years of follow-up, we documented 3 934 incident cases of MCE and 24 537 cases of IHD. In multivariable-adjusted models, family history was significantly associated with risk of MCE and IHD. The adjusted HRs (95%CI) were 1.41 (1.19-1.65) and 1.25 (1.18-1.33), respectively. History of disease among siblings was more strongly associated with early-onset MCE than parental history (HR=2.97, 95%CI: 1.80-4.88). Moreover, the association of family history with MCE and IHD was stronger in persons who were overweight or obesive, and the association between family history and MEC was stronger in smokers. Conclusion: This large-scale, prospective study indicated that family history was an independent risk factor for MCE and IHD in China. The intervention targeting major known lifestyle risk factors and the management of chronic diseases should be strengthened for Chinese population, especially for the individuals with family history were at high risk.
Asian People/statistics & numerical data* ; China/epidemiology* ; Coronary Disease/genetics* ; Humans ; Incidence ; Myocardial Ischemia/genetics* ; Overweight/ethnology* ; Proportional Hazards Models ; Prospective Studies ; Risk Assessment ; Risk Factors ; Smoking/ethnology*