OBJECTIVE:To put forward suggestions for the guaranteeing of the supply of the essential medicines in China. METHODS:The problems occurred in the production,circulation and application of essential medicines as well as the policies issued in the medical reform including the assigned production,centralized purchasing,direct distribution and standard application were discussed.RESULTS & CONCLUSION:The essential medicines can be produced by selectively assigned production,and the continuity of the production of the essential medicines calls for efforts of multiple means.It is better for medicare agency to be responsible for centralized purchasing and the construction of the delivering and distributing system of medicines should be strengthened.The system of enforcement use and incentive measures should be established to ensure that the essentials medicines be used by clinicians.

Objective To understand the hypertension prevalence and its influencing factors in Yongchuan district of Chongqing to provide the suggestion for the prevention and control of hypertension .Methods The permanent residents aged above 18 years old were sampled from 3 towns and 1 street by adopting the stratified clustered random sampling method and performed the questionnaire survey ,physical examination and detection of fasting glucose and postprandial 2‐h glucose .The data were analyzed to calculate the hypertension prevalence by the SPSS16 .0 software .The influencing factors of hypertension were analyzed by chi‐square and the multivariate Logistic regression analysis .Results A total of 1 202 persons were investigated .The survey found that the cognition level on hypertension in the residents was below 30 .00% .21 .46% of residents smoked every day .31 .78% of them did exercise .The proportions of overweight and obesity were 24 .63% and 6 .07% respectively ,the hypertension prevalence rate was 23 .88% .The multivariate Logistic regression analysis results indicated that the independent influencing factors of hypertension prevalence included age (OR=1 .95 ,95% CI:1 .74-2 .17) ,cognition level on hypertension(OR=2 .11 ,95% CI:1 .18-3 .79) ,oil in‐take per person per day(OR=0 .80 ,95% CI:0 .64-0 .99) ,body weight(OR=1 .97 ,95% CI:1 .58-2 .46) and blood glucose(OR=0 .63 ,95% CI:0 .50 -0 .78) .Conclusion The hypertension prevalence among the residents in Yungchuan district is high .The knowledge about the prevention and treatment of hypertension is deficient .The high risk factors of smoking ,drinking ,irrational diet and insufficient body movement are common .The comprehensive prevention and treatment work of hypertension should be practi‐cally strengthened .

Objective To understand diabetes prevalence and its factors is to provide the suggestion for diabetes prevention and control in Yongchuan district .Methods Residents aged above 18 years old from 3 towns and 1 street were sampled by stratified clustered random sampling method .Residents were investigated with the questionnaire and physical examination and taken blood sample to test fasting glucose ,2‐h glucose .The data were analyzed to calculate diabetes prevalence by SPSS17 .0 .The factors of dia‐betes was compared by chi‐square and the independent influencing factors of diabetes were identified by step backward logistic re‐gression .Results A total of 1 202 were investigated .The rate of cognition about diabetes was below 30% .21 .46% of residents smoke every day .31 .78% of them do exercise .The prevalence of overweight ,obesity and diabetes was 24 .63% ,6 .07% and 10 .48% .The result of multi‐variant logistic regression indicated that the independent influencing factors of diabetes prevalence in‐cluded age(OR=1 .41 ,95% CI=1 .24-1 .62) ,the rate of cognition about the dose of salt intake per person per day recommended by Chinese guideline of diet(OR= 2 .12 ,95% CI= 1 .13 -3 .96) ,smoking at present(OR= 1 .44 ,95% CI= 1 .10 -1 .89) ,body weight(OR=1 .06 ,95% CI= 1 .00 -1 .12) ,blood pressure(OR=0 .76 ,95% CI=0 .59 -0 .98) .Conclusion Diabetes prevalence was high in Yongchuan district .The risk factors such as unhealthy diet ,smoking ,physical inactivity were common .Government should take the major role for diabetes prevention and control .

Objective To estimate the cancer incidence and mortality in Chongqing in 2014.Methods On basis of the methods and criteria of data quality control made by NCCR,authors compiled and summarized the 2014 tumor registration data reported by 11 registries in Chongqing.The datas which were stratified by area (urban/rural),gender,age and cancer type,incidence and mortality were calculated combined with national population.Results All 11 cancer registries reported 24 506 new cancer cases (14 610 were male and 9 896 were female)in 2014.The crude incidence in Chongqing was 244.66/105 (male was 289.01/105,female was 199.47/105).Sex ratio was 1.45:1.00,male was significantly higher than female.The incidence of lung cancer,colorectum,liver,esophagus,breast,stomach were the top six tumor.The incidence rate of all age groups in 2014 increased with age,the incidence rate increased from 40-44 years old group,and reached the highest incidence rate in the 80-84 years old group.Conclusion The data quality and representativeness in Chongqing tumor registration are gradually improved.Cancer registration as the basis of cancer prevention and control work,play an irreplaceable role.

Objective To investigate the prevalence of smoking, smoking cessation, passive smoking and awareness of the dangers of tobacco in population in Chongqing and provide evidence for developing prevention and control measures.Methods A total of 5 400 residents aged ≥ 18 years were selected from 9 districts/counties in Chongqing through stratified multi-stage cluster sampling and face-to-face interviews were conducted among them.Indicators as current smoking rates, smoking cessation rates and passive smoking rates were calculated by the weight of age proportions from 2010 population census.The analytical method was based on complex sampling design.Results The current smoking rate of the residents aged ≥ 18 years was 27.4％ (male: 53.5％ and female: 1.1％), which was highest in age group 40-50 years (58.4％) for males.The current smoking rate among rural residents was higher than that in urban residents.The prevalence of daily cigarette smoking was 27.5％, which was significantly higher in southeastern Chongqing.The rate of passive smoking was 52.4％.Among daily smokers, the mean number of cigarettes smoked was 17.5 per day (men: 17.6 per day;women: 13.5 per day).The daily smoked cigarette number in males was higher in age group 40-50 years (20.1 per day) and those with junior middle school education level (18.9 per day).The proportion of the current smokers who smoked more than 20 cigarettes per day (the rate of heavy smoker) was higher in males than in females and in rural residents than in urban residents.The proportion of heavy smokers was 59.3％, which was highest in age group 40-50 years (66.8％),followed by those with junior middle school educational level (65.2％).The average age of smokers when they stared to smoke was 20.8 years old, which was low in males and rural residents.About 80.2％ of the smokers stared to smoke under 25 years old, and 70.3％ of the smokers stared to smoke between 15 and 25 years old.The overall rate of smoking cessation was 20.1％ and the successful smoking cessation rate was 13.7％.The two rates increased with age, the successful smoking cessation rate was lowest in age group 18-40 years (4.8％).The awareness of the tobacco risk related knowledge seemed poor among the residents, only 19.6％ of the residents were aware that smoking could cause serious diseases (stoke, heart disease and lung cancer).21.9％ of the residents were aware that passive smoking could cause serious diseases (heart disease, lung disease and lung cancer).Conclusion Current prevalence of smoking in males in Chongqing remains at a high level,indicating that the publicity programs on the tobacco risk related knowledge needs to be strengthened and the tobacco control needs more efforts.The tobacco control in Chongqing is still facing serious challenge.

Objective: To investigate the changes of ³¹P-MRS in denervated skeletal muscle at 7.0 T MR system. Methods: In the experiment group, a total of 18 male Sprague-Dawley rats aged 6-8 weeks old and weighing 200-250 g were obtained. The right posterior femoral nerve were transected, and the proximal stumps were ligated by using 5-0 nylon stitches to preclude spontaneous repair. A sham surgery (incision and exploration of the nerve) was performed at the same time (n=6). Before rat model established and at varying times after initial surgery (3 d, and 1, 2, 4, 6, and 8 weeks). ³¹P-MR spectra of rat quadriceps femoris were acquired on 7.0 T Agilent small animal MR imaging system. We quantified the phosphocreatine (PCr), adenosine triphosphate(β-ATP), and inorganic phosphate (Pi) using Creatine phosphate disodium salt(10 mmol/L) as an external standard. The ratios, include PCr/Pi, Pi/β-ATP, PCr/β-ATP, PCr/(PCr+Pi) and Pi/(PCr+Pi) were quantified in jMRUI. All data were analyzed by one way analysis of variance (ANOVA) with posttest inter-group comparisons using Bonferroni test. Comparative analysis methods between the experimental and control group were performed via independent samples t test. P<0.05 was considered as statistically significance. Results: The average measured concentrations of β-ATP, PCr, and Pi in control groups were (6.654±0.178) μmol/g, (25.656±0.738) μmol/g, and (1.594±0.096) μmol/g, respectively. There were significant statistically differences in β-ATP, PCr, Pi, PCr/Pi, PCr/PCr+Pi,Pi/PCr+Pi between the study and control group(P<0.05) at any measurement time point after denervation. Pi/β-ATP,PCr/β-ATP and pHi in the experimental group significantly statistically differed from those of the control group (all P<0.05)at each time point except on day 3 after operation. The total concentrations of β-ATP and PCr were reduced by 11.5% and 19.7% respectively on day 3. Thereafter, β-ATP and PCr declined rapidly by 63.1% and 68.8% at week 4 respectively, then decreased slowely by 74.0%和82.3% till week 10. The change of PCr/Pi is similar to β-ATP and PCr, but more remarkable. Pi, Pi/PCr+Pi, Pi/ATP showed a progressively increase till week 10. The intra-cellular pH (pHi) of normal rat muscles was 7.033±0.017, While the pHi gently in experiment rat muscles decreased during the entire experiment. Conclusion ³¹P-MRS with 7.0 T can quantify the temporal changes of energy metabolism and pHi in normal and denervated rat muscles. It shows that the dysfunction of energy metabolism are progressive with time and that they begin within a short period following the nerve section, the change of β-ATP, PCr, PCr/Pi take place primarily within 4 weeks after denervation. β-ATP, PCr, and PCr/Pi may be potential biomarkers of energy metabolism in the evaluation of denervated muscle atrophy.

Objective: To analyze the premature death probability and cause-eliminated life expectancy of cardiovascular disease, cancer, chronic respiratory disease and diabetes in Chongqing residents in 2016 so as to provide recommendation for non-communicable diseases (NCDs) prevention and control in Chongqing. Methods: Death cases of Chongqing Municipality between January 1^st and December 31^st, 2016 were reported through death case registry system of national center for disease prevention and control. Death cases were sorted by international classification of disease (ICD-10). Mortality rate, standardized mortality rate, constituent ratio, premature death probability, life expectancy, and cause-eliminated life expectancy of four major NCDs were analyzed. Results: A total of 218 004 death cases were reported in Chongqing, 2016, and the mortality rate was 731.73/100 000. Of them, a total of 179 637 death cases of the four major NCDs including cardiovascular disease, cancer, chronic respiratory disease and diabetes were reported, accounting for 82.40% of all death cases. The mortality rate and standardized mortality rate of four major NCDs was 602.95/100 000 and 455.82/100 000, respectively. The premature death probability of four major NCDs was 15.96%, and males (25.39%) had a higher premature death probability than females (10.78%). The premature death probability of cardiovascular disease, cancer, chronic respiratory disease, and diabetes were 6.01%, 8.32%, 2.05%, and 0.43%, respectively. Life expectancy would increase by 6.02, 3.19, 1.89, and 0.19 years, after eliminating cardiovascular disease, cancer, chronic respiratory disease and diabetes respectively. Conclusion The premature death probability of major NCDs was high in Chongqing, and males had a higher premature death probability than females did. Intervention and health management of the population should be conducted according to different gender-based risk factors to reduce the premature death probability.

OBJECTIVETo evaluate the impact of health educators' intervention on knowledge, attitude and behavior among rural residents and the feasibility of this intervention mode.

METHODSUsing stratified cluster random sampling method, three towns and five villages in Yongchuan district, Chongqing municipality were selected from February to November, 2013. One or two health educators from each village were recruited by recommendation or voluntary registration. A total of 30 health educators were recruited and trained. Health educators who passed the exam of the training conducted the intervention and training of knowledge and skill about non-communicable disease (NCD) prevention and control for over 30 rural residents who lived nearby aged over 18 years old, could take care of themselves and complete questionnaire independently. 900 residents were selected as the study samples before and after the intervention. Questionnaire surveys were conducted before and after the intervention to evaluate the effect. Changes of knowledge and behavior among participants were compared by Chi-square test. Changes of attitude towards NCD prevention and control among participants were compared by two independent t-test.

RESULTSBefore and after the intervention, the cognition rate about diagnostic criteria of hypertension among rural adults was 29.8% (268/900) and 67.9% (611/900), respectively(χ(2)=261.58, P<0.001). The cognition rate about risk factors of hypertension was 22.9% (206/900) and 78.2% (704/900), respectively(χ(2)=551.19, P<0.001). The cognition rate about the prevention measure of hypertension was 37.2% (335/900) and 88.0% (792/900) , respectively(χ(2)=495.64, P<0.001). The cognition rate about complications of hypertension was 15.4% (139/900) and 68.9% (620/900), respectively(χ(2)=527.07, P<0.001). The cognition rate about diagnostic criteria of diabetes was 12.9% (116/900) and 50.3% (453/900), respectively(χ(2)=291.85, P<0.001). The cognition rate about the criteria of risk population of diabetes was 8.6% (77/900) and 62.0% (558/900), respectively(χ(2)=562.94, P<0.001). The cognition rate about the symptom of diabetes was 29.8% (268/900) and 83.3% (750/900), respectively(χ(2)=525.31, P<0.001). The cognition about the preventive measure of diabetes was 44.7% (402/900) and 89.3% (804/900), respectively(χ(2)=406.06, P<0.001). The cognition rate about 6 g salt intake per person per day among rural adults was 28.0% (252/900) and 84.3% (759/900), respectively(χ(2)=580.04, P<0.001). The cognition about 25 g oil intake per person per day among rural adults was 26.7% (240/900) and 71.4% (643/900), respectively(χ(2)=361.04, P<0.001). The cognition about self-perception of body weight among rural adults was 62.9% (566/900) and 91.9% (827/900), respectively (χ(2)=216.28, P<0.001). The cognition about self-circumference among rural adult was 54.8% (493/900) and 87.7% (789/900), respectively(χ(2)=237.49, P<0.001). The cognition rate of self-blood pressure was 60.5% (544/900) and 70.4% (634/900), respectively(χ(2)=14.92, P<0.001). Before and after the intervention, the scores of the necessity about conducting health education for the public among rural adults was (3.1±0.9 ) and (3.7±0.5 ), respectively(t=20.09, P<0.001). The score of the necessity about unhealthy lifestyle change among rural adults was (3.0±0.9 ) and (3.7±0.6), respectively(t=20.84, P<0.001). The score of the necessity about testing blood pressure and blood glucose regularly among rural adults was (3.0±0.9) and (3.7±0.6), respectively(t=21.07, P<0.001). The score of the necessity about body weight control was (2.9±1.0) and (3.6± 0.8), respectively(t=20.04, P<0.001). The score of the necessity about conducting hypertension screen among high risk population was (3.0±0.9) and (3.7±0.5), respectively(t=22.99, P<0.001). The score of the necessity about conducting diabetes screen among high risk population was (3.0 ± 0.9) and (3.7 ± 0.5), respectively(t=23.22, P<0.001). The score of the necessity about providing instruction service of diet and physical activity for high risk population was (3.0±0.9) and (3.7±0.5), respectively(t=22.41 and 22.87, P< 0.001). Before and after the intervention, the proportion of rural adults seeking counseling service about NCD was 44.0% (396/900) and 64.9% (584/900), respectively(χ(2)=79.17, P<0.001). The proportion of rural adults testing blood pressure in the recent six months was 43.4% (391/900) and 63.1% (568/900), respectively(χ(2)=69.92, P<0.001). The proportion of rural adults who tested blood glucose in the recent six months was 28.6%(257/900) and 48.1% (433/900), respectively(χ(2)=72.80,P<0.001). The proportion of rural adults who controlled body weight consciously was 34.7%(312/900) and 29.3% (264/900), respectively(χ(2)= 5.88,P<0.05).

CONCLUSIONHealth educators' intervention could raise rural participants' awareness and confidence about NCD significantly, but this intervention mode might have little impact on healthy behaviors change in a short time.

Adult ; Blood Glucose ; Blood Pressure ; Body Weight ; China ; Diabetes Mellitus ; Diet ; Health Behavior ; Health Education ; Health Educators ; Health Knowledge, Attitudes, Practice ; Humans ; Hypertension ; Life Style ; Risk Factors ; Rural Population ; Self Concept ; Surveys and Questionnaires

BACKGROUND: We aim to explore the association between self-reported snoring and hypertension among adults aged 30-79 in Chongqing, China. METHODS: A total of 23,342 individuals aged 30-79 were included at baseline from August 2018 to January 2019, and the final sample size for the analysis was 22,423. Face-to-face interviews and physical examinations were conducted by trained investigators. Logistic regression was performed to study age-specific and gender-specific associations between snoring and hypertension. RESULTS: Frequent snoring was associated with the risk of hypertension for each age and gender group, and the frequency of snoring was positively correlated with the risk for hypertension. For the three age groups (< 45, 45-59, ≥ 60), compared with the non-snoring group, those who snore often had a 64.5%, 53.3%, and 24.5% increased risk of hypertension (< 45: OR = 1.65, 95%CI 1.34-2.02; 45-59: OR = 1.53, 95%CI 1.37-1.72; ≥ 60: OR = 1.25, 95%CI 1.09-1.42), respectively. For men and women, those who snore often had a 46.8% and 97.2% increased risk of hypertension, respectively, than the non-snoring group (men: OR = 1.47, 95%CI 1.33-1.63; women: OR = 1.97, 95%CI 1.75-2.23). CONCLUSIONS People who snore frequently should pay close attention to their blood pressure levels in order to achieve early prevention of hypertension, particularly for snorers who are female and aged under 45; importance should be attached to their blood pressure control.
Adult ; Aged ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Hypertension/etiology* ; Male ; Middle Aged ; Self Report ; Snoring/complications*

OBJECTIVE: To evaluate the effect of health self-management on self-efficiency of diabetes patients.
 METHODS: A total of 184 eligible and voluntary diabetes patients were recruited for 6 consecutive weeks of knowledge and skills intervention, and interviewed with questionnaire by diabetes self-efficacy scale (DSES) before and after the intervention. The changes in self-efficiency were compared with two paired sample McNemar test.
 RESULTS: After the intervention, the total scores of self-efficiency on diet, medication, blood sugar monitoring, foot care and complications management were all increased significantly compared with those before the intervention (P<0.05).
 CONCLUSION The intervention model of health self-management for self-efficiency in diabetes patients is effective, and the quality of patients' life can be improved.
Diabetes Mellitus ; psychology ; therapy ; Disease Management ; Humans ; Self Care ; Self Efficacy ; Surveys and Questionnaires