Heavy metal is one of pollutants existed widely in the environment, its relationship with cardiovascular disease has attracted more and more attention. In this review, the concentrations of heavy metals, including lead, cadium and asenic, in the body from several national surveillance networks and the epidemiological studies on the effects of the exposure of three heavy metals on cardiovascular system were summarized. It is suggested to strengthen nationwide surveillance for body concentrations of heavy metals in general population in order to provide baseline data for quantitative evaluation of the risk of heavy metal exposure on cardiovascular disease.
Cadmium ; Cardiovascular Diseases/chemically induced* ; Environmental Exposure/adverse effects* ; Environmental Pollutants/toxicity* ; Epidemiologic Studies ; Humans ; Lead/toxicity* ; Metals, Heavy/toxicity* ; Neoplasms ; Research/trends*

Objective: To understand the survival of HIV/AIDS patients after receiving antiretroviral therapy for 10 year in Henan province and related factors. Methods: The database of national integrated management system of HIV/AIDS was used to collect the basic information and follow-up information of HIV/AIDS patients who received antiretroviral therapy between 2003 and 2005 in Henan province. Software SPSS 23.0 was used to analyze the patients' survival and related factors based on the life-table method and Cox proportional hazards model. Results: Among the 2 448 HIV/AIDS patients who started antiretroviral therapy during 2003-2005, the men accounted for 53.5%, and women accounted for 46.5%. Up to 70.1% of the patients were aged 40-59 years and 95.5% of the patients had blood borne infections. The patients were observed for 10 years after antiviral treatment, and 719 cases died from AIDS related diseases, with a mortality rate of 3.78/100 per year (719/19 010 per year). The cumulative survival rates of patients within 1-year, 3 years, 5 years and 10 years were 0.94, 0.86, 0.78, 0.69 respectively. Compared with the patients aged <40 years, the HRs of the patients aged 40-, 50-, 60- and ≥70 years were 1.417 (95%CI: 0.903-2.222), 1.834 (95%CI: 1.174-2.866), 2.422 (95%CI: 1.539-3.810) and 3.424 (95%CI: 2.053-5.709) respectively. Compared with patients with baseline CD(4+)T lymphocyte >350 unit/ul, the HRs of the patients with CD(4+)T lymphocyte <50 unit/μl, 50-199 unit/ul and 200-350 unit/ul were 7.105 (95%CI: 5.449-9.264), 4.175 (95%CI: 3.249-5.366) and 2.214 (95%CI: 1.691-2.900) respectively. Compared with the women, the HR of the men was 1.480 (95%CI: 1.273-1.172). Compared with the patients who received second line ART therapy, the HR of patients receiving no second line therapy was 11.923 (95%CI: 9.410-15.104). Conclusions: The cumulative survival rate the HIV/AIDS patients after 10 years of antiretroviral therapy reached 0.69 in Henan. Male, old age, low basic CD(4+)T lymphocyte count and receiving no second line therapy were the risk factors for long-term survival of AIDS patients.
Acquired Immunodeficiency Syndrome ; Adult ; Aged ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; China/epidemiology* ; Female ; HIV/drug effects* ; HIV Infections/mortality* ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Risk Factors ; Survival Analysis ; Survival Rate

Objective: To study the prevalence and characteristics of overweight and obesity among Chinese children aged 0-5 years, in 2010-2013. Methods: Data was from the'China Nutrition and Health Surveillance-0-5-Years-Old Children and Lactating Women'project in 2013. Stratified multistage cluster sampling method was used to select 55 districts/counties from 30 provinces (autonomous regions, municipalities) with the sample size of children as 32 862. Definition of overweight and obesity were according to both the WHO 2006 growth standard in children less than 5-year-old and the WHO 2007 growth reference in children of 5-years-old. Results: were calculated by complex weight based on national census from the National Bureau of Statistics in 2010. Results The overall prevalence of overweight was 8.4% among the 0-5-year-old in 2013, with 9.4% in boys and 7.2% in girls. Both of the rates from urban and rural areas were the same, as 8.4%. The prevalence rates of overweight in the 0-, 6-, 12-, 24-, 36-, 48- and 60-71 months age groups appeared as 13.0%, 11.1%, 8.3%, 6.0%, 4.8%, 3.9% and 15.9%, respectively. The rates of overweight in low, medium and high income families were 8.0%, 8.8% and 8.9%, respectively. The prevalence of obesity was 3.1% among the 0-5-year-old, with 3.6% in boys and 2.5% in girls. There was no significant difference seen in urban (3.3%) and rural areas (2.9%). The prevalence rates for obesity in the 0-, 6-, 12-, 24-, 36-, 48- and 60-71 months age groups were 5.8%, 3.8%, 2.5%, 1.6%, 1.2%, 1.3% and 7.8%, respectively. The rates of obesity in low, medium and high income families were 2.8%, 3.3% and 3.5%, respectively. Conclusion: The prevalence rates of both overweight and obesity were increasing among the 0-5-year-olds in China, suggesting that it is necessary to timely conduct the surveillance and intervention programs on overweight and obesity in this target population.
Adolescent ; Asian People/statistics & numerical data* ; Body Mass Index ; Body Weight ; Child ; Child, Preschool ; China/epidemiology* ; Female ; Humans ; Income ; Infant ; Infant, Newborn ; Lactation ; Male ; Nutritional Status ; Obesity/ethnology* ; Overweight/ethnology* ; Prevalence

Objective: To explore the sampling method in China National Human Biomonitoring Program (HBP) and the related errors, so as to calculate and evaluate the study design in sampling. Methods: The sampling method of HBP is of multistage nature. Taking the results of sampling method from Guizhou province as an example, results related to sampling error and variation coefficient were calculated, using the multistage unequal probability sampling error method. Results: The HBP covered 152 monitoring sites in 31 provinces (autonomous regions and municipalities) and with 21 888 residents selected. The replacement rates at various stages were 5.26%, 6.35% and 40.6% respectively. The sampling error in Guizhou province was 3 207 594, and the coefficient of variation was 0.097. Conclusions: According to the multi-stage unequal probability sampling method, the sampling coefficient variability appeared small with high precision, in Guizhou province. However, this method did not consider the weight adjustment of non-sampling errors such as population missing rate and response rate. Methods related to the calculation on multi-stage sampling error among large-scale public health monitoring projects need to be further studied.
China ; Cities ; Environmental Monitoring ; Humans ; Research Design

Objectives: To investigate the association between the dynamics of thyroid volume and the changes of physical growth in school-aged children as well as to compare the applicability of different thyroid volume indexes, so as to explore more reliable methods for the assessment of thyroid volume. Methods: In October 2012, a multi-stage cluster sampling method was used to select a primary school in Minhang district of Shanghai, Haimen city of Jiangsu province and Yuhuan city of Zhejiang province, respectively. In these areas, a total number of 784 students aged 8-10 years were enrolled in the cohort. Demographic data was collected, while height and weight were measured, with BMI and body surface area (BSA) were calculated. Thyroid volume was examined by B-ultrasonography. Height volume index (HVI), weight and height volume index (WHVI), BMI volume index (BMIV) and BSA volume index (BSAV) were all applied to correct the thyroid volume. All students were followed up, one year later. Results: A total of 769 students with complete data on thyroid volume and physical growth were enrolled, including 378 boys (49.16%) and 391 girls (50.84%). Thyroid volume showed an increase with age, while growth of thyroid volume reduced with the increase of age (P<0.001). The thyroid volume showed a correlation with the changes of physical growth. The growth of height appeared as the dominant influencing factor for thyroid volume growth in those aged 8 and 10 years (P<0.05), while the growth of weight, BMI and BSA were all influencing factors for thyroid volume on students aged 9 years (P<0.05). Conclusions: Thyroid volume in school-aged children was a factor not only associated with age but also with physical growth which had not been considered in the currently used criteria. The inclusion of items as iodine intake, age, physical growth into the thyroid volume indexes seemed to be more reliable, in practice. For the assessment of goiter, HVI for students aged 8 and 10 years and BMIV for students aged 9 years might serve as better indicators.
Body Mass Index ; Body Weight ; Child ; China ; Cohort Studies ; Female ; Goiter ; Humans ; Iodine ; Male ; Organ Size ; Thyroid Gland/growth & development*

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 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

Humans ; Erdheim-Chester Disease/diagnostic imaging* ; Histiocytosis, Langerhans-Cell/surgery* ; Tomography, X-Ray Computed

Objective: To analyze the spatial distribution and identify the high risk areas of pulmonary tuberculosis at the township level in Beijing during 2005-2015. Methods: Data on pulmonary tuberculosis cases was collected from the tuberculosis information management system. Global autocorrelation analysis, local indicators of spatial association and Kulldorff's Scan Statistics were applied to map the spatial distribution and detect the space-time clusters of the pulmonary tuberculosis cases during 2005-2015. Results: Spatial analysis on the incidence of pulmonary tuberculosis at the township level demonstrated that the spatial autocorrelation was positive during the study period. The values of Moran's I ranged from 0.224 3 to 0.291 8 with all the P values less than 0.05. Hotspots were primarily distributed in 8 towns/streets as follows: Junzhuang, Wangping, Yongding and Tanzhesi in Mentougou district, Yancun in Fangshan district, Wangzuo town in Fengtai district, Tianqiao street in Xicheng district and Tianzhu town in Shunyi district. Spatiotemporal clusters across the entire study period were identified by using Kulldorff's spatiotemporal scan statistic. The primary cluster was located in Chaoyang and Shunyi districts, including 17 towns/streets, as follows: Cuigezhuang, Maizidian, Dongfeng, Taiyanggong, Zuojiazhuang, Hepingjie, Xiaoguan, Xiangheyuan, Dongba, Jiangtai, Wangjing, Jinzhan, Jiuxianqiao, Laiguangying, Sunhe towns/streets in Chaoyang district, Houshayu and Tianzhu town in Shunyi district, during January to December 2005. Conclusion: Incidence rates of pulmonary tuberculosis displayed spatial and temporal clusterings at the township level in Beijing during 2005-2015, with high risk areas relatively concentrated in the central and southern parts of Beijing.
Beijing ; China ; Cluster Analysis ; Humans ; Incidence ; Spatial Analysis ; Spatio-Temporal Analysis ; Tuberculosis ; Tuberculosis, Pulmonary/ethnology*

Humans ; Sarcoma, Clear Cell/pathology* ; Melanoma/pathology* ; Skin Neoplasms/pathology* ; Diagnostic Errors ; Soft Tissue Neoplasms ; Melanoma, Cutaneous Malignant