1.Design and baseline characteristics of a population-based birth cohort in Shanghai
Huiting YU ; Xin CUI ; Zhou LIANG ; Renzhi CAI ; Lan CHEN ; Naisi QIAN ; Weixiao LIN ; Shan JIN ; Chunfang WANG ; Chen FU
Shanghai Journal of Preventive Medicine 2024;36(1):11-15
ObjectiveTo introduce the basic design, development plan and objectives of a population-based birth cohort in Shanghai, and further present the main data and baseline characteristics of enrolled participants in the cohort, and to provide key information for reproductive health-related studies. MethodsThe Shanghai population-based birth cohort initiated on January 1, 2005, included newborns born in Shanghai every year and their parents, and collected information on reproductive health, reproductive treatment, birth characteristics, growth and development status, as well as the incidence, treatment and death of diseases by employing data linkage technology and investigations. This formed a birth cohort spanning the entire life cycle. ResultsAs of October 2022, a total of 2 978 538 newborns and their parents were included in the cohort. Among them, 2 905 135 (97.54%) were naturally conceived (NC), and 73 403 (2.46%) were born through assisted reproductive technologies (ART). The average age of parents was (32.56±4.12) years old for females and (34.62±5.34) years old for males in the ART group, which was higher than (28.02±4.71) years and (30.07±5.54) years for parents in the NC group. Among parents, females and males aged 30 and above accounted for 77.12% and 85.08%, respectively, which were higher than that of parents (35.28% for females and 49.66% for males) in the NC group. Furthermore, the percentage of parents with a college degree or above in the ART group was 73.23% for females and 73.66% for males, which were higher than those in the NC group (49.98% and 50.91%, respectively). The multiple births rate in the ART group was 33.81%, which was higher than that in the NC group (1.88%). The incidence of premature birth and low birth weight in the ART group were 24.47% and 19.08%, respectively, which was higher than that in the NC group (5.47% and 3.73%). ConclusionThe comprehensive collection of reproductive health-related information in the birth cohort in Shanghai can provide essential resources to determine the influence of genetics, environment, reproductive treatment and other related factors on the health of offspring after birth.
2.Overview of the establishment of Shanghai twin birth cohort
Shan JIN ; Naisi QIAN ; Weixiao LIN ; Liping FANG ; Lei CHEN ; Bo FANG ; Tian XIA ; Chunfang WANG ; Huiting YU
Shanghai Journal of Preventive Medicine 2024;36(1):16-20
ObjectiveTo establish the Shanghai twin birth cohort (STBC) and analyze the effects of genetic factors, shared environment, and non-shared environment interactions on birth health and growth and development of newborns. MethodsBased on the population-wide birth cohort in Shanghai, a comprehensive survey was conducted on the families with double and multiple babies born after January 1, 2015 to collect information on birth health, growth and development, and the family environment of the babies. ResultsBy December 31, 2021, a total of 7 195 pairs (14 405 cases) of twins were successfully included in the STBC survey. The average birth length of twins was 47.2 cm and average birth weight was 2 465.3 g. Heterozygous twins accounted for 69.05% and preterm babies accounted for 57.07%. The average age of the mothers of twins was 31.82 years, and the average age of the fathers was 33.87 years, with more than 80% of the parents having a college degree or above. 44.50% of the mothers used assisted reproductive technologies, 7.40% had illnesses during pregnancy, and 15.90% were exposed to passive smoking during pregnancy. During the survey period, the average monthly increase in the length of the twin infants was 2.09 cm, and the average monthly weight gain was 0.53 kg. ConclusionThe incidence of adverse outcomes such as maternal cesarean section rate, preterm birth, and low birth weight is higher in the twin birth population. Information on birth health as well as growth and development in childhood and adolescence in the twin birth population is collected based on STBC, which can provide a solid data foundation for studying children’s chronic non-communicable diseases, psychological and behavioral disorders and other complex health problems caused by the combined effects of genetics and the environment.
3.Nested case-control study on children with severe birth defects in Shanghai
Naisi QIAN ; Shan JIN ; Wenwei ZHENG ; Lei CHEN ; Bo FANG ; Chunfang WANG ; Tian XIA ; Huiting YU
Shanghai Journal of Preventive Medicine 2024;36(5):463-468
ObjectiveTo design a prospective nested case-control study based on a city-wide birth cohort of Shanghai, so as to understand their health status and explore the influencing factors of birth defects. MethodsBased on the birth registration covering the entire city of Shanghai, the nested case-control study of children with severe birth defects was designed. Children born with severe birth defects were selected as the case group, and healthy children were matched as the control group. Basic information, health status, maternal pregnancy history, and survival outcome of children both in the case group and the control group were collected through medical history review and home visits. The logistic regression model was used for multivariate analysis. ResultsA total of 18 875 infants born between January 1, 2011, and December 31, 2021, were included, among which 11 500 (60.93%) were children with severe birth defects and 7 375 (39.07%) were healthy children. The logistic regression model analysis showed that being male (OR=1.20, 95%CI:1.13‒1.29), non-Shanghai residency (OR=1.16, 95%CI: 1.06‒1.25), multiple births (OR=8.41, 95%CI:6.25‒11.30), artificial insemination (OR=2.31, 95%CI:1.34‒3.99), in vitro fertilization (IVF) (OR=1.85, 95%CI:1.44‒2.38), maternal exposure to radiation (OR=1.83, 95%CI:1.07‒3.14), maternal illness during pregnancy (OR=1.61, 95%CI:1.49‒1.74), experiencing a traumatic event during pregnancy (OR=2.34, 95%CI:1.88‒2.92), paternal chemical exposure (OR=1.88, 95%CI:1.32‒2.69), paternal radiation exposure (OR=1.65, 95%CI: 1.18‒2.33), family history of birth defects (OR=8.18, 95%CI: 3.96‒16.89), being overweight before pregnancy (OR=1.16, 95%CI: 1.07‒1.27), being obese before pregnancy (OR=1.15, 95%CI:1.03‒1.30), and being excessively obese before pregnancy (OR=1.52, 95%CI:1.26‒1.83) were risk factors for the occurrence of birth defects. Analysis by type of birth defect found that prematurity was a risk factor for cardiac malformations and cheilopalatoschisis (OR=27.87, 95%CI: 20.84‒37.27), especially ranking first in cardiac malformations. ConclusionAfter controlling for influencing factors, maternal overweight, obesity, and excessive obesity before pregnancy, artificial insemination, and IVF are independent risk factors for the occurrence of birth defects. Choosing a healthy lifestyle, improving physical and mental health during pregnancy, and controlling BMI during pregnancy are beneficial in reducing the risk of birth defects.
4.Dynamic relationship between changes of mortality rate and urban development level in Shanghai
Shan JIN ; Bo FANG ; Renzhi CAI ; Naisi QIAN ; Huiting YU ; Jiaying QIAO ; Lei CHEN ; Chunfang WANG
Shanghai Journal of Preventive Medicine 2023;35(7):654-659
ObjectiveTo analyze the dynamic response relationship between urban development and mortality rate in Shanghai, and to predict the trend of mortality rate changes. MethodsBy analyzing the total mortality rate (TMR), gross domestic product (GDP) and socio-demographic index (SDI) in Shanghai from 1978 to 2017, a vector autoregressive (VAR) model was constructed to evaluate the impact of urban development on the mortality rate. ResultsThe fitted
5.Succinate dehydrogenase deficiency renal cell carcinoma: a case report
Xingli SHAN ; Chunfang HU ; Dong WANG ; Shan ZHENG ; Changling LI
Chinese Journal of Urology 2023;44(3):222-223
Succinate dehydrogenase (SDH) defective renal cell carcinoma (RCC) is a new subtype of renal carcinoma newly identified by WHO(2016). Until now, only a few samples and a few cases have been reported retrospectively. This article reported a young female patient who was found to have a small tumor in the left kidney by physical examination and underwent left partial nephrectomy. The postoperative pathological result was SDH-RCC. There was no recurrence and metastasis of the tumor 3 months after operation.
6.Trend and gender difference of mortality rate of senile dementia: based on the method of annual percent change
Naisi QIAN ; Lei CHEN ; Bo FANG ; Huiting YU ; Jiaying QIAO ; Shan JIN ; Qi LI ; Chunfang WANG
Shanghai Journal of Preventive Medicine 2023;35(2):132-136
ObjectiveTo investigate the characteristics of gender difference and the trend of the mortality rate of senile dementia in registered population in Shanghai from year 2002 to 2018, and to provide the basis for formulating relative intervention measures before and after senile dementia from an public-health view. MethodsBased on the collected data of death registration, focused on the senile dementia disease codes F03,G30.0,G30.1,G30.8,G30.9 according to The International Classification of Diseases 10th revision (ICD-10). We analyzed the characteristics of gender difference in the mortality rate of senile dementia in registered population in Shanghai from year 2002 to 2018. According to ASR, we calculated the standardized mortality rate of senile dementia, and used the chi-square test to compare the difference between the gender mortality rates. The trend and the turning point of the mortality rate of senile dementia were determined by linear regression analysis by Join-point. ResultsThe crude mortality rate of senile dementia in the registered population in Shanghai from year 2002 to 2018 was 5.46/105, 3.50/105 in males and 7.43/105 in females. The standardized mortality rate of senile dementia was 2.61/105, 1.67/105 in males and 3.56/105 in females. The trend of the standardized mortality rate of senile dementia in 17 years decreased [APC=-5.5(-6.5,-4.5)%,P<0.01]. The trend of the standardized mortality rate of senile dementia decreased in both males [APC=-4.9(-6.2,-3.6)%,P<0.01] and females [APC=-5.9(-6.9,-4.9)%,P<0.01]. The trend of the gender difference decreased [APC=-6.8(-8.2,-5.3)%,P<0.01]. The mortality rate of senile dementia was higher in females than in males [(χ2=33.63,P<0.01)]. ConclusionThe mortality rate of senile dementia in females is higher than in males in Shanghai, though the trend of the gender difference decreased. This gender difference is worth of attention.
7.Analysis on the difference between life expectancy and healthy life expectancy in Shanghai
Huiting YU ; Tian XIA ; Chunfang WANG ; Bo FANG ; Renzhi CAI ; Lei CHEN ; Shan JIN ; Chen FU
Chinese Journal of Epidemiology 2021;42(6):1018-1023
Objective:To analyze the difference of life expectancy and healthy life expectancy among Shanghai residents of different gender and age groups.Methods:Compare the trends of life expectancy among Shanghai and other longevity countries/regions. With the disability weights of GBD, Sullivan method was applied to calculate the healthy life expectancy in Shanghai and analyze the loss of healthy life years among the population of different age groups and genders.Results:In the past 40 years, life expectancy had increased by 10.86 years in Shanghai. In 2016, the life expectancy of Shanghai residents was 83.18 years old, and 80.83 years old for males and 85.61 years old for females. The healthy life expectancy of Shanghai residents was 69.46 years, and 68.68 years for males and 70.23 years old for females. The gap with life expectancy was 13.72 years old, 12.15 years old and 15.38 years old, respectively. They account for 16.49%, 15.02% and 17.97% of life expectancy, respectively. The healthy life expectancy of women in all age groups is higher than that of men with the average gap of 1.76 years. The difference between the two is as small as 1.36 years at 20-24 years old, and as large as 2.24 years at 70-74 years old. The loss rate of healthy life expectancy increases with age, with women higher than men before age 65 and vice versa after age 65 years old.Conclusions:The life expectancy in Shanghai has reached the world leading level, but the healthy life loss is still large. It is necessary to further improve the life quality with the reducing mortality rate, especially for women and men over 65 years old.
8. Comparison on the 10 years risk for ischemic cardiovascular disease among Han, Uygur, Kazak population from Xinjiang Uygur Autonomous Region
Xing LI ; Chunfang SHAN ; Fen LIU ; Jun WANG ; Xiaomei LI ; Yitong MA ; Xiang XIE ; Zixiang YU ; Yining YANG
Chinese Journal of Cardiology 2019;47(6):486-491
Objective:
To compare the 10 years risk for ischemic cardiovascular disease among Han, Uygur, Kazak nationality residents of Xinjiang Uygur Autonomous Region.
Methods:
From October 2007 to October 2010,14 618 adult (aged ≥35 years) Han (
9.The status and related factors of health promotion behavior of cancer patients with PICC during tube indwelling period
Jinghua WEN ; Chunfang GU ; Yuying SHAN
Journal of Clinical Medicine in Practice 2018;22(12):58-61
Objective To investigate the status of health promotion,influencing factors,and health promotion level of cancer patients with PICC during tube indwelling period.Methods A total of 125 PICC cancer patients were investigated by using general information questionnaire and Health Promoting Lifestyle Scale (HPLP-Ⅱ R) according to convenience sampling.Results The average score of health promotion lifestyle in cancer patients was(100.70 ± 18.42)scores during PICC,and the overall level was at the middle level.There was a negative correlation between health promotion behavior and age in cancer patients during PICC detention (P < 0.01),and positively correlated with education,family income and catheterization days (P < 0.05).Multivariate analysis showed that age,education level,diagnosis and catheterization days were influencing factor of health promotion behavior level of cancer patients during PICC indwelling.Conclusion The health promotion behavior of cancer patients during PICC stay is in general level.In clinical nursing work,these patients with elder age,low education level and short timne of catheterization should be paid much attention,so as to improve their health promoting behavior.
10.The status and related factors of health promotion behavior of cancer patients with PICC during tube indwelling period
Jinghua WEN ; Chunfang GU ; Yuying SHAN
Journal of Clinical Medicine in Practice 2018;22(12):58-61
Objective To investigate the status of health promotion,influencing factors,and health promotion level of cancer patients with PICC during tube indwelling period.Methods A total of 125 PICC cancer patients were investigated by using general information questionnaire and Health Promoting Lifestyle Scale (HPLP-Ⅱ R) according to convenience sampling.Results The average score of health promotion lifestyle in cancer patients was(100.70 ± 18.42)scores during PICC,and the overall level was at the middle level.There was a negative correlation between health promotion behavior and age in cancer patients during PICC detention (P < 0.01),and positively correlated with education,family income and catheterization days (P < 0.05).Multivariate analysis showed that age,education level,diagnosis and catheterization days were influencing factor of health promotion behavior level of cancer patients during PICC indwelling.Conclusion The health promotion behavior of cancer patients during PICC stay is in general level.In clinical nursing work,these patients with elder age,low education level and short timne of catheterization should be paid much attention,so as to improve their health promoting behavior.

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