INTRODUCTIONElectrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH), such as the Cornell and Sokolow-Lyon voltage criteria were derived from Western populations. However, their utility and accuracy for diagnosing echocardiographic LVH in Asian populations is unclear. The objective of this study was to assess the accuracy of ECG criteria for LVH in Asians and to determine if alternative gender-specific ECG cut-offs may improve its diagnostic accuracy.

MATERIALS AND METHODSECG and echocardiographic assessments were performed on 668 community-dwelling Asian adults (50.9% women; 57 ± 10 years) in Singapore. The accuracy of ECG voltage criteria was compared to echocardiographic LVH criteria based on the American Society of Echocardiography guidelines, and Asian ethnicity and gender-specific partition values.

RESULTSEchocardiographic LVH was present in 93 (13.6%) adults. Cornell criteria had low sensitivity (5.5%) and high specificity (98.9%) for diagnosing LVH. Modified gender specific cut-offs (18 mm in women, 22 mm in men) improved sensitivity (8.8% to 17.5%, 0% to 14.7%, respectively) whilst preserving specificity (98.2% to 94.2%, 100% to 95.8%). Similarly, Sokolow-Lyon criteria had poor sensitivity (7.7%) and high specificity (96.1%) for diagnosing LVH. Lowering the cut-off value from 35 mm to 31 mm improved the sensitivity in women from 3.5% to 14% while preserving specificity at 94.2%. A cut-off of 36 mm was optimal in men (sensitivity of 14.7%, specificity of 95.5%).

CONCLUSIONCurrent ECG criteria for LVH derived in Western cohorts have limited sensitivity in Asian populations. Our data suggests that ethnicity- and gender-specific ECG criteria may be needed.

Aged ; Asian Continental Ancestry Group ; statistics & numerical data ; Dimensional Measurement Accuracy ; Echocardiography ; methods ; Female ; Humans ; Hypertrophy, Left Ventricular ; diagnosis ; ethnology ; Male ; Middle Aged ; Sensitivity and Specificity ; Sex Factors ; Singapore ; epidemiology

OBJECTIVETo provide the foundation for reasonable utilization by analysing the essential oils from Serissa serissoides in different seasons.

METHODEssential oils were obtained by steam distillation. The chemical components were separated and identified by gas chromatography-mass spectrometer (GC-MS). The relative content of each component was determined by area normalization.

RESULTForty-three peaks were identified from autumn material, representing 78.91% of the total oil. Main constituents of the essential oil from the autumn material were found to be 1b,5,5,6a-tetramethyl-octahydro-1-oxa-cyclopropa [a] inden-6-one (7.32%); methyl linolenate (4.14%); cubenol (5.97%); 2-methoxy-4-vinylphenol (10.87%); delta-9(10)-tetrahydrocostunolide-1-keto (35.51%). Seventy-two peaks were identified from spring material, representing 79.88% of the total oil. Main constituents of the essential oil from the spring material were found to be caryophyllene (3.315%); ethylbenzene (3.523%); 3-hexen-1-ol (4.537%); 2-methoxy-4-vinylphenol (6.513%); 5-propionyl-2-chlorobenzeneacetic acid, methyl ester (8.541%), germacrene D (12.311%).

CONCLUSIONThe same compounds in both materials are as follows: 2,2-dimethyl-6-methylene-cyclohexanepropanol; 2-methoxy-4-vinylphenol; 3,7-dimethyl-1,6-octadien-3-ol; cubenol; docosane and eicosane. It seems that they are the diagnostic components in these medicinal materials. Essential substances are different in quantity and quality in different seasons.

Alkanes ; analysis ; isolation & purification ; Oils, Volatile ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Rubiaceae ; chemistry ; Seasons ; Terpenes ; analysis ; isolation & purification

Objective: To understand the prevalence of biomass fuel exposure in women aged ≥40 years in China during 2014-2015, and provide evidence for the prevention and control of bio-fuel exposure. Methods: All participants were selected from a national representative cross-sectional survey during 2014-2015 in the mainland of China. A multi-stage stratified cluster sampling strategy was used. A total of 37 795 women aged ≥40 years received a face-to-face questionnaire survey at 125 surveillance points in 31 provinces. The level of biomass fuel exposure was analyzed after complex sample weighting to represent the overall Chinese women aged ≥40 years. Results: A total of 37 777 women were included in the analysis. With complex weighting, the rate of biomass fuel exposure in Chinese women aged ≥40 years was 35.8% (95%CI: 29.6%-42.1%), the exposure rate was higher in rural women than in urban women (P<0.001). The biomass fuel exposure rate was highest in northeastern and lowest in northern areas of China (χ(2)=17.03, P=0.009). The estimated biomass fuel exposure rate decreased with the increase of educational level (P<0.001). Conclusion: The prevalence of biomass fuel exposure is high in women aged ≥40 years in China, especially in those in rural areas. The exposure level differs with age and area. Appropriate measures should be taken to reduce the level of biomass fuel exposure in Chinese women.
Adult ; Aged ; Air Pollutants/toxicity* ; Air Pollution, Indoor/statistics & numerical data* ; Asian People ; Biomass ; China/epidemiology* ; Cooking/methods* ; Cross-Sectional Studies ; Female ; Fossil Fuels/toxicity* ; Humans ; Inhalation Exposure/statistics & numerical data* ; Middle Aged ; Prevalence ; Risk Factors ; Rural Population ; Surveys and Questionnaires

Objective: To investigate the epidemiological characteristics of measles outbreak caused by genotype D8 virus in Pinghu city of Zhejiang province, and provide evidence for the control of the outbreak. Methods: The measles outbreak data were collected through National Measles Surveillance System. The outpatient records and admission records were checked, field investigation and outbreak response were conducted. Blood samples in acute phase and swab specimens were collected from the patients for laboratory testing, including serology test, RNA extraction and amplification, measles virus isolation and genotype identification. Software SPSS 17.0 and Excel 2016 were used for data analysis. Results: A total of 10 confirmed measles cases were reported in Pinghu city, and 8 cases were aged >40 years. Six blood samples were collected, in which 5 were measles D8 virus positive and 1 was negative in measles virus detection. There were epidemiological links among 10 cases which occurred in a factory, a hospital and a family at the same time. There was no statistical difference in symptoms among cases caused by D8 virus and H1a virus. After the emergent measles vaccination, the measles outbreak was effectively controlled. Conclusion: Untimely response due to the uneasy detection of measles cases in the early stage, nosocomial infection and weak barrier of measles immunity in adults might be the main reasons for this outbreak. Measles vaccination is effective in the prevention of measles D8 virus infection. It is necessary to strengthen measles genotype monitoring for the tracing of infection source and control of outbreaks.
Adult ; Amplified Fragment Length Polymorphism Analysis ; Child ; Cross Infection ; Disease Outbreaks ; Genotype ; Hospitalization ; Humans ; Measles/virology* ; Measles virus/isolation & purification* ; Outpatients ; Population Surveillance ; RNA, Viral/genetics* ; Sequence Analysis, DNA

COPD refers to a group of chronic respiratory diseases which seriously influence the people's health and life quality. The national COPD surveillance in China has been implemented since 2014 with the goal of monitoring the prevalence and trend of COPD and related risk factors in China. The paper summarizes the item and method of national COPD surveillance in China.
Aged ; China/epidemiology* ; Chronic Disease/psychology* ; Female ; Humans ; Male ; Middle Aged ; Population Surveillance/methods* ; Prevalence ; Pulmonary Disease, Chronic Obstructive/psychology* ; Quality of Life ; Risk Factors

Objective: Smoking is the most important risk factor for COPD. Understanding the smoking rate, current smoking rate, average age to start smoking and average daily consumption of cigarettes among people aged ≥40 years in China can provide scientific evidence for the effective control and prevention of COPD. Methods: Data were from COPD surveillance in China (2014 to 2015) which covered 31 provinces, autonomous regions and municipalities. A total of 75 107 adults aged ≥40 years selected through multi-stage stratified cluster sampling from 125 surveillance sites (county/district) were surveyed by electronic questionnaire during face to face interviews. The smoking rate and other smoking index were estimated by using weighting complex sampling design. Results: The smoking rate and current smoking rate were 40.0% (95%CI: 38.5%-42.0%) and 31.0% (95%CI: 29.7%-32.0%), respectively, among the Chinese aged ≥40 years in 2014. The smoking rate and current smoking rate in males (74.1% and 57.6%) were much higher than those in females (5.4% and 4.0%). And the two rates were significantly higher in rural area (41.2% and 32.4%) than in urban area (38.8% and 29.5%). The mean age of smokers to start smoking was 20.1 (95%CI: 19.7-20.5) years. The younger the smokers were, the earlier their average age to start smoking was (The ages to start smoking for smokers aged 40-, 50-, 60-, ≥70 years were 18.3, 19.2, 20.9 and 23.1 years, respectively). Average daily cigarette consumption of current daily smokers was 18.9 (95%CI: 18.1-19.7) cigarettes, and the daily cigarette consumption was higher in males (19.3 cigarettes) than in females (12.5 cigarettes). Conclusion: The smoking rate in males aged ≥40 years is high in China. Compared with urban area, the smoking rate in rural area is higher, posing a big challenge for COPD control and prevention.
Adult ; Aged ; Asian People/statistics & numerical data* ; China/epidemiology* ; Female ; Humans ; Male ; Prevalence ; Risk Factors ; Smoking/psychology* ; Smoking Cessation ; Surveys and Questionnaires ; Young Adult

Objective: To describe and analyze the passive smoking exposure level in adults aged ≥40 years in China. Methods: A total of 75 107 adults from 125 sites of COPD surveillance points in China were surveyed by electronic questionnaire during face to face interviews. After comprehensive weighting of the samples, the passive smoking exposure level was analyzed. Results: The passive smoking exposure rate of the adults aged ≥40 years was 44.9% (95%CI: 42.3%-47.5%). The exposure rate was highest in those aged from 40 to 49 years (51.0%, 95%CI: 47.9%-54.1%) in term of age groups, in those with senior high school education level and above (48.6%, 95%CI: 44.9%-52.2%) in term of education level, and in office workers (57.7%, 95%CI: 51.8%-63.7%) in term of occupation. The adults reporting passive smoking exposure every days in a week accounted for 27.7% (95%CI: 25.5%-29.8%), and those reporting household passive smoking exposure accounted for 28.3% (95%CI: 26.2%-30.5%). Logistic regression analysis showed that the passive smoking exposure level was different in different age groups and occupation groups. Conclusion: The passive smoking exposure level is still high in adults in China. Age and occupation are the influencing factors of passive smoking exposure level.
Adult ; Aged ; Asian People/statistics & numerical data* ; China/epidemiology* ; Environmental Exposure ; Family Characteristics ; Female ; Humans ; Male ; Middle Aged ; Population Surveillance/methods* ; Smoking/epidemiology* ; Surveys and Questionnaires ; Tobacco Smoke Pollution/statistics & numerical data*

Objective: To understand the current status of dust and/or harmful gas exposure in adults aged ≥40 years and corresponding protection in China, and provide evidence for strengthening the occupational protection against dust and harmful gas exposure. Methods: The data were obtained from 2014-2015 COPD surveillance in China. A total of 75 107 adults aged ≥40 years selected through multi-stage stratified cluster sampling from 125 surveillance points in 31 provinces (autonomous regions and municipalities) were surveyed in face to face interviews. Occupational exposure was defined as occupational exposure to dust and/or harmful gas for more than 1 year. The weighted percentages of exposure were estimated by using complex sampling design. Results: Among eligible 71 061 participants, the exposure rate of dust and/or harmful gas was 46.3%. The exposure rate in rural area (51.7%) was significantly higher than that in urban area (40.3%), and the exposure rate in the western area was higher than those in the eastern and central areas (P<0.001). Among the groups with different education level, the exposure rate in those with education level of primary school and below was highest (49.7%, P<0.001). The exposure protection rate was 26.7%, and the exposure protection rate was highest in the eastern area (29.9%), followed by that in the central area (27.0%) and that in the western area (22.9%) The exposure protection rate in urban area was significantly higher than that in rural area, and the exposure protection rate was lowest in those with education level of primary school and below. The regular exposure protection was taken by only 50.7% of the adults surveyed. Conclusion: The exposure rate of dust and/or harmful gas is high in China, while the exposure protection rate is very low. Health education, occupational protection and supervision should be strengthened among those with low education level, and those living in rural area and in the western area.
Adult ; China/epidemiology* ; Dust ; Female ; Gases/toxicity* ; Humans ; Male ; Middle Aged ; Occupational Diseases/epidemiology* ; Occupational Exposure/statistics & numerical data* ; Residence Characteristics ; Rural Population ; Surveys and Questionnaires ; Urban Population

Objective: To analyze the status and distribution characteristics of household polluting fuel use in China. Methods: The data were collected from the adults aged ≥40 years who were recruited through multi-stage stratified cluster sampling in 2014-2015 COPD surveillance conducted in 31 provinces (autonomous regions and municipalities) in China. A total of 75 107 adults aged ≥40 years in 125 surveillance points were surveyed in face to face interview. Polluting fuels included biomass fuels (wood, dung, crop residues and charcoal), coal (including coal dust and lignite) and kerosene. The weighted percentage of family using polluting fuels, combustion method for cooking or heating and ventilation installation with 95%CI were estimated by complex sampling design. Results: According to the survey results from 75 075 adults, the percentage of family using polluting fuels for cooking or heating was 59.9% (95%CI: 54.2%-65.7%), the percentage in rural areas was significantly higher than that in urban areas (P<0.001). As for different polluting fuels, the percentage of using only biomass fuels for cooking or heating was 25.9% (95%CI:20.5%-31.3%), the percentage of using only coal (including kerosene) was 18.9% (95%CI: 13.2%-24.7%), and the percentage of using both biomass fuels and coal was 15.1% (95%CI: 10.8%-19.4%). Among seven geographic areas in China, the percentages of using biomass fuels ranged from 53.8% in southern China to 23.0% in northern China (P=0.039), the percentages of using coal (including kerosene) ranged from 59.5% in northwestern China to 22.3% in southern China (P=0.001). Among the families using polluting fuels, the percentages of mainly using traditional open fires and stoves were 21.3% (95%CI: 16.9%-25.8%) and 31.5% (95%CI: 25.8%-37.2%), respectively; the percentage of having ventilation installation was72.7% (95%CI: 66.9%-78.5%). Conclusions: Household polluting fuel use is common in China, but differs with area, traditional fuel combustion method is widely used, the coverage of ventilation installation need to be improved. In order to promote COPD prevention and control, it is necessary to develop strategies on fuels and fuel combustion method improvement to reduce indoor air pollution resulted from household fuel combustion.
Adult ; Aged ; Air Pollution, Indoor/prevention & control* ; Biomass ; China/epidemiology* ; Coal/adverse effects* ; Cooking ; Environmental Pollutants/adverse effects* ; Family Characteristics ; Female ; Heating/methods* ; Humans ; Male ; Middle Aged ; Wood

Objective: To understand the distribution and characteristics of people aged ≥40 years who are at high risk of COPD in China and provide evidence for COPD prevention and control. Methods: The survey was conducted among the subjects selected through multi-stage stratified cluster sampling from 31 provinces (autonomous regions and municipalities) in China for 2014-2015 national chronic obstructive pulmonary disease surveillance. A total of 75 107 people aged ≥40 years in 125 surveillance points were surveyed in face to face interviews. Subjects who met at least one of the following conditions, including chronic respiratory symptoms, exposure to risk factors, medical history of respiratory diseases, and family history, were defined as population at high risk. The weighted proportion of the population at high risk of COPD and 95%CI were estimated by using complex sampling design. Results: Among eligible 74 296 subjects, the proportion of population at high risk of COPD was 89.5% (95%CI: 87.8%-91.2%). The proportion significantly increased with age (P<0.001). The proportion of the population at high risk was significantly higher in men than in women (P<0.001), and in rural area than in urban area (P<0.001). The highest proportion of population at high risk was observed in men in rural area in western China. The proportion of population at high risk of COPD who met at least two conditions was 32.0% (95%CI:29.7%-34.2%), the proportion of those who met at least three conditions was 7.4% (95%CI: 6.6%- 8.3%), and the proportion of those who met all the conditions was 1.5% (95%CI: 1.2%-1.8%). Among population at high risk of COPD, those who only had exposure to one risk factor accounted for 61.7% (95%CI: 59.8%-63.7%). Conclusion: About 90% of people aged ≥40 years in China are at high risk for COPD. It is necessary to conduct population-based screening for COPD and take comprehensive measures to reduce prevalence of risk factors.
Adult ; Asian People/statistics & numerical data* ; China/epidemiology* ; Female ; Humans ; Male ; Prevalence ; Pulmonary Disease, Chronic Obstructive/ethnology* ; Risk Factors ; Rural Population ; Surveys and Questionnaires ; Urban Population