Epidemiology is a traditional subject mainly based on principles and concepts, and its teaching method needs further improving to meet the requirement of the new trend of education reform. Lecture-based teaching, problem-based teaching, case-based teaching, and internet based teaching, such as flip class, massive open online course and micro-lecture, all have its own unique merits in the practice of epidemiology teaching. So the combination of traditional teaching and online teaching is the most promising mode. "Rain class" , a mixed mode, is an efficient tool to present the epidemiology case more actually in class. Thus, teaching design and application of "rain class" are worth research.
Computer-Assisted Instruction ; Epidemiology/education* ; Humans ; Internet ; Online Systems ; Research ; Teaching

This study aimed to examine the distribution of lower limb atherosclerotic lesions in a multi-ethnic Asian cohort with chronic limb threatening ischemia (CLTI) from Singapore. The Society for Vascular Surgery Vascular Quality Initiative registry database was used to identify 265 CLTI patients who underwent percutaneous angioplasty between June 2019 and December 2019, of whom 171 (64.5%) were male, and the mean age was 67.9±11.0 years. The majority were diabetic (84.5%) and 145 (54.7%) had chronic kidney disease (CKD). The majority of the lower limb atherosclerotic lesions were de novo lesions (598/797, 75.0%), predominantly TransAtlantic Inter-Society Consensus II C/D (451/797, 56.6%), and were moderately to severely calcified (76.3%). The anterior tibial artery and femoral-popliteal artery were the most commonly affected vessels. The mean length of the treated lesions was 14.5±13.7 cm. There was a tendency, albeit insignificant, of multi-level disease in those who were diabetic or had CKD.

This study aimed to examine the distribution of lower limb atherosclerotic lesions in a multi-ethnic Asian cohort with chronic limb threatening ischemia (CLTI) from Singapore. The Society for Vascular Surgery Vascular Quality Initiative registry database was used to identify 265 CLTI patients who underwent percutaneous angioplasty between June 2019 and December 2019, of whom 171 (64.5%) were male, and the mean age was 67.9±11.0 years. The majority were diabetic (84.5%) and 145 (54.7%) had chronic kidney disease (CKD). The majority of the lower limb atherosclerotic lesions were de novo lesions (598/797, 75.0%), predominantly TransAtlantic Inter-Society Consensus II C/D (451/797, 56.6%), and were moderately to severely calcified (76.3%). The anterior tibial artery and femoral-popliteal artery were the most commonly affected vessels. The mean length of the treated lesions was 14.5±13.7 cm. There was a tendency, albeit insignificant, of multi-level disease in those who were diabetic or had CKD.

Objective: To evaluate the acceptability of oral quick HIV self-testing in men who have sex with men (MSM). Methods: From April 2013 to April 2014, MSM in Beijing and Nanning of China were recruited for an observational study including baseline survey and follow-up, including questionnaire survey, oral HIV self-testing and clinic-based HIV confirmation testing. The sensitivity and specificity of oral quick self-testing were evaluated through comparing the results of oral quick testing with blood testing. The acceptability and associated factors were evaluated by logistic model. Results: A total of 510 MSM were recruited at baseline survey and 279 accepted follow-up. The sensitivity of the oral self-test was 86.00% (43/50) and specificity was 98.23% (445/453) at baseline survey. At baseline survey, 78.63% (401/510) of the MSM showed willingness to use oral quick HIV self-testing. The associated factors included unprotected anal intercourse with a regular male partner in the past 6 months (aOR=0.30, 95%CI: 0.10-1.00) and preference of oral quick HIV self-testing (aOR=7.32, 95%CI: 1.61- 33.31). At baseline survey, 34.51% (176/510) of the MSM reported that oral quick HIV self-testing was the preferred testing method rather than blood testing, which was associated with their birth places-urban area. Conclusion: The acceptability of oral quick HIV self- testing in MSM in the two cities was high.
Adolescent ; Adult ; China/epidemiology* ; Cross-Sectional Studies ; HIV Infections/prevention & control* ; Homosexuality, Male/statistics & numerical data* ; Humans ; Male ; Patient Acceptance of Health Care ; Patient Participation ; Sexual and Gender Minorities

Automobiles ; Hearing Loss, High-Frequency ; Hearing Loss, Noise-Induced/etiology* ; Humans ; Male ; Noise, Occupational/adverse effects* ; Occupational Diseases/epidemiology* ; Occupational Exposure

Objective: To evaluate the prevalence and trend of diabetes mellitus among Chinese adults during the past thirty years. Methods: Papers, published before October 1, 2017 and related to the prevalence of diabetes mellitus among Chinese adults, were searched through PubMed, China Knowledge Resource Integrated Database, Wanfang Digital Database and VIP Citation Databases. Stata 13.0 software was used to estimate the prevalence of diabetes mellitus, with pooled prevalence calculated based on random effects. Subgroup analysis was conducted based on time, sex, areas and body mass index groups of investigation. Continuous fractional polynomial regression model on the midpoint of each survey period, weighted by the number of participants in each study, was used to estimate and illustrate the trends of prevalence of diabetes over the years. Results: In total, 15 studies were included and two of them were excluded in the primary analysis with the age limitation of participants as ≥40 years old, for recruitment. The average prevalence of diabetes among Chinese adults was 6.3% (95%CI: 4.6%-8.0%), during the past thirty years. The pooled prevalence appeared higher in urban than in rural areas and higher in men than in women. Between 1980 and 2013, the increase of Chinese diabetes prevalence did not follow the linear trend. Before 2000, the average prevalence showed as 3.5% (95%CI: 2.0%-4.9%), with an annual increase rate as 0.17%. Since 2000, the average annual prevalence of diabetes mellitus had appeared around 8.0% (95%CI: 6.0%-10.1%), with an annual growth rate of 0.72% (95%CI: 0.34%-1.10%). Conclusion: The prevalence of diabetes in Chinese adults had been rapidly increasing since the year 2000, indicating that efforts should be strengthened for diabetes prevention, in China.
Adult ; Asian People/statistics & numerical data* ; Body Mass Index ; China/epidemiology* ; Diabetes Mellitus/ethnology* ; Female ; Humans ; Male ; Models, Statistical ; Prevalence ; Rural Population ; Sex Distribution ; Surveys and Questionnaires ; Urban Population

Objective: To investigate the effect of baseline CD(4)(+) T cell count (CD(4)) on drop-out of antiretroviral therapy (ART) in HIV infected persons. Methods: Retrospective cohort was conducted in this study. HIV infected persons aged≥18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System, with follow-up conducted till May 30, 2016. Cause-specific Cox proportional hazard models were used to evaluate effect of different CD(4) on the drop-out of ART in the HIV infected persons. Results: A total of 58 502 eligible study participants were included in this retrospective cohort study. The average drop-out ratio was 4.8/100 person-years. After controlling the following baseline covariates: age, sex, marital status, route of HIV infection, WHO clinical stage before ART, initial/current ART regiment, ART regiment adjustment, and year of initiating ART for potential confounding, the adjusted HR of drop-out for HIV infected persons with 200- cells/μl, 351-cells/μl and ≥500 cells/μl were 1.110 (95%CI: 1.053-1.171, P<0.001), 1.391 (95%CI: 1.278-1.514, P<0.001) and 1.695 (95%CI: 1.497-1.918, P<0.001), respectively, in risk for drop-out compared with those with baseline CD(4)<200 cells/μl. Among the HIV infected persons, 56.0% (1 601/2 861) of drug withdrawal was due to poor compliance with medication. Conclusions: With the increase of baseline CD(4) when initiating ART, the risk for the drop-out in HIV infected persons increased significantly. To further reduce the drop-out of ART, it is important to take CD(4) into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.
Adolescent ; Anti-Retroviral Agents/administration & dosage* ; CD4 Lymphocyte Count ; China/epidemiology* ; HIV ; HIV Infections/virology* ; Humans ; Incidence ; Medication Adherence ; Retrospective Studies ; T-Lymphocytes

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 understand the seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China. Methods: This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout 7 geographic areas in the mainland of China (northeast, north, central, east, south, northwest and southwest). The numbers of asthmatic patients and total inpatients of the respiratory department of each hospital were recorded. The monthly ratio of asthmatic patients to the total inpatients in every area was calculated and compared. Results: During the study period, 6 480 patients were admitted for asthma exacerbation, accounting for 3.14% of all the 206 135 patients admitted to the respiratory departments in the 29 hospitals. The ratio of asthmatic patients to total inpatients in the northeast area (5.61%) was highest, and the ratio in east area was lowest (1.97%). Statistical analysis showed that the difference among different areas was significant (P<0.000 1). In most areas, both the number and proportion of hospitalized asthmatic patients peaked in spring (February-April) and autumn (September-October). In the northeast area, east area and south area, the peaks in spring were more obvious, while in the north area and southwest area, the peaks in autumn were more obvious. In the northwest area the peaks occurred in winter (December-January) and summer (June-August), respectively. The differences in hospitalization due to asthma among different months were significant in the northeast, north, and southwest areas (P<0.005). Conclusion: The number of patients hospitalized for asthma exacerbation fluctuated with season in different areas in China. In most areas, more asthmatic patients were admitted to hospitals in spring and autumn.
Asthma ; China/epidemiology* ; Hospitalization/statistics & numerical data* ; Humans ; Retrospective Studies ; Seasons

Family-based cohort study is a special type of study design, in which biological samples and environmental exposure information of the member in a family are collected and related follow up is conducted. Family-based cohort study can be applied to explore the effect of genetic factors, environmental factors, gene-gene interaction, and gene-environment interaction in the etiology of complex diseases. This paper summarizes the objectives, methods and results, as well as the opportunities and challenges of the family-based cohort study on common chronic non-communicable diseases in rural population in northern China.
China/epidemiology* ; Chronic Disease/ethnology* ; Cohort Studies ; Female ; Gene-Environment Interaction ; Humans ; Male ; Middle Aged ; Noncommunicable Diseases/ethnology* ; Research Design ; Rural Population