Objective:To evaluate outcomes and differences of the equality indexes of health and health service utilization in different living standard indicators. Methods: Using multi-phase stratified random sampling to select samples of rural families in Ningxia region and collect data about sample families' income, consumption, wealth and some relevant data on family members' health status and health services utilization. Using concentration index to measure the equality of health and health services utilization with income, consumption or wealth index as living standard indicators respectively and discuss the differences of the outcomes. Results:For different living standard in-dicators, the correlation between each other was weak. The differences of concentration indexes with different living standard indicators between 0. 01 to 0. 21 , and most of whichweresignificant on the level of 0. 05. Conclusion: The impact of choice of living standard indicators on the equality index of health and health service utilization was signifi-cant. In a limited area, living standards measured by wealth index could be more accurate and objective than by in-come or consumption, but the condition of this method wasmore strict.

Objective: To study the agreement of wealth index constructed using different methods, and the comparison of living standard measurements by the wealth index and traditional indicators. Methods:The data used in the study come from Rural Household Survey in Ningxia region, and the sample of this household survey included 6612 households, 28886 people. Using different weighting methods, such as principal component analysis and equal weighting, and data coded in different ways to construct 4 wealth indexes, and analyzing the agreement of these 4 wealth indexes. Respectively comparing the wealth indexes with the living standard measurements by total, per cap-ital and per adult household consumption. Results:The wealth indexes showed strong agreement with each other, and similarly weak agreement with consumption indicators. Conclusion: the indicators of living standard measurements each had advantages and disadvantages, and there was weak agreement between these indicators. Thus, when living standard was the main study result or the social determinant of study results, the appropriate indicator in the study should be selected according to the study results by different indicators and professional knowledge and experiences.

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Objective To explore the relationship among depression,anxiety and social support in elderly patients in community outpatient clinic. Methods A total of 551 elderly outpatients from two com-munity health service centers of Hongkou District in Shanghai were evaluated with patient health question-naire-9 (PHQ-9),generalized anxiety disorder-7 (GAD-7),perceived social support scale( PSSS) for de-pression,anxiety,physical health and social support. Results The prevalence rates of depression and anxiety were 26. 1% and 17. 2%,respectively. The scores of PHQ-9 and GAD-7 were 2. 0(4. 0) and 1. 0(2. 0). There were statistically significant differences in the scores of family support,friend support,other support and social support among the elderly patients with different degrees of depression or anxiety (P<0. 01). Fam-ily support(B=-0. 196) and friend support(B=-0. 171) were protective factors of depression in elderly pa-tients in community outpatient clinic. Age,family support and friend support were protective factors of anxiety in elderly patients,while gender and fluctuation of physical diseases were protective factors of anxiety(P<0. 05). Con-clusions The depression and anxiety is intimately related to social support in elderly outpatients. Appropriate measures should be taken to optimize social support,mitigate bad mood negative improve their quality of life.

OBJECTIVEChronic hypoxia at high altitude might result in cardiopulmonary adaptations including pulmonary arterial hypertension and cardiac remodeling. But little is known about the adaptive changes in healthy children born and living at high altitude. We compared the echocardiographic measurements between the healthy children living at 16 m (Shanghai, n = 220) and 3 700 m (Qinghai, total 257, Han children 117, Tibetan children 140).

METHODSChildren's age ranged from 15 d to 14 years. Echocardiography measurements were performed, values of the left and right ventricular dimensions and wall thickness, systolic and diastolic function including cardiac output index (CI), as well as mean pulmonary arterial pressure (mPAP) were obtained.

RESULTSmPAP and right heart dimension, CI, right ventricular anterior wall thickness were significantly higher while ventricular systolic and diastolic function were significantly lower in 3 700 m group than in 16 m group (all P < 0.05). Left ventricular dimension was similar between the two groups. There were no differences on above measured parameters between the Han and Tibetan children from 3 700 m group (all P > 0.05).

CONCLUSIONSChildren born and living at high altitude in China have significantly higher mPAP, dilated right heart and lower systolic and diastolic function of both ventricles and higher CI compared to children born and living at see-level. Above parameters were similar between the Han and the Tibetan childen born and living at high altitude. Present study provides reference values for the healthy children living at high altitude.

Adolescent ; Altitude ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; China ; Diastole ; Echocardiography ; Heart ; Heart Ventricles ; Humans ; Hypertension, Pulmonary ; Hypoxia ; Infant ; Infant, Newborn ; Lung ; Systole