“一带一路”沿线国家登革热流行情况及变化趋势研究

目的分析2019年"一带一路"沿线国家登革热流行现状及2013-2019年登革热发病率变化趋势。方法利用2019年全球疾病负担研究(GBD)登革热年龄标准化发病率(ASR)数据, 描述2019年"一带一路"区域登革热流行现状, 并计算2013-2019年ASR的年估计百分比变化(EAPC)评估流行趋势。结果 2019年GBD登革热数据显示145个"一带一路"沿线国家中93个(64.14%)国家有登革热流行。2019年登革热发病率>3 000.00/10万的国家共有11个, 9个国家在大洋洲;其次16个国家发病率在1 000.00/10万～2 999.99/10万, 10个国家在亚洲。非洲(58.14%, 25/43)、北美洲(72.73%, 8/11)及南美洲(66.67%, 4/6)等区域的多数国家发病率在500.00/10万～999.99/10万。大洋洲90.00%(9/10)的国家登革热发病率为上升趋势, 斐济上升趋势最明显(EAPC=18.22, 95%CI:12.91～23.77);其次亚洲18.18%(4/22)的国家登革热发病率呈上升趋势, 菲律宾上升趋势最明显(E...     

“一带一路”沿线国家HIV/AIDS流行现状及变化趋势研究

目的了解"一带一路"沿线国家HIV/AIDS的流行现状及变化趋势, 为防范HIV/AIDS跨境传播提供依据。方法选取与我国签署了共建"一带一路"合作文件的145个国家为本研究的"一带一路"沿线国家;145个国家2013-2019年HIV/AIDS年龄标化的发病率、患病率数据来源于2019年全球疾病负担研究。使用2019年年龄标化的发病率、患病率描述145个国家HIV/AIDS的流行现状。通过计算年估计百分比变化(EAPC), 分析HIV/AIDS发病率在2013-2019年的变化趋势。结果 2019年, 在非洲、亚洲、欧洲、北美洲、南美洲和大洋洲中, HIV/AIDS发病率≥40.00/10万的国家占比最高的地区是非洲, 为56.86%(29/51);最低的是亚洲, 为5.41%(2/37)。145个国家中, HIV/AIDS患病率≥100.00/万的国家多数位于非洲, 占20.69%(30/145)。2013-2019年, HIV/AIDS发病率呈上升趋势的国家共50个(34.48%, 50/145);呈下降趋势的国家共69个(47.59%, 69/145);无显著变化的国家共26个...     

“一带一路”沿线国家耐多药结核病流行情况及变化趋势研究

目的分析"一带一路"沿线国家2019年耐多药结核病流行现状及2013-2019年该病的发病率变化趋势。方法选择与我国签署了共建"一带一路"合作文件的145个国家为研究对象, 其2013-2019年耐多药结核病的年龄标准化发病率和患病率资料来源于2019年全球疾病负担研究。采用145个国家2019年耐多药结核病的发病率及患病率描述流行现状;计算年估计百分比变化来分析耐多药结核病发病率在2013-2019年的变化趋势。结果 2019年, 145个国家中, 索马里的耐多药结核病的发病率(30.42/10万)和患病率(48.86/10万)最高, 斯洛文尼亚的发病率(0.01/10万)和患病率最低(0.01/10万)。2013-2019年, 在六大洲中, 非洲有14个(27.45%)国家耐多药结核病发病率呈上升趋势, 22个(43.14%)国家呈下降趋势;北美洲有2个(18.18%)国家发病率呈上升趋势, 有3个(27.27%)国家发病率呈下降趋势;亚洲有2个(5.41%)国家发病率呈上升趋势, 23个(62.16%)国家发病率呈下降趋势;欧洲、大洋洲、南美洲耐多药结核病发病率均无上升趋势, 欧...     

全球204个国家地区1990至2019年尘肺病发病率和患病率的趋势分析

目的分析全球尘肺病发病率和患病率的变化趋势, 为卫生政策制定提供科学依据。方法于2022年6月, 通过全球健康数据交换(GHDx)查询工具(http://ghdx.healthdata.org/gbd-results-tool)下载并整理尘肺病发病率和患病率数据。应用年估计变化百分比(EAPC)和年龄标化率(ASR)估算1990至2019年尘肺病的趋势变化。基于ASR应用线性回归模型估算EAPC。结果在1990至2019年间, 全球尘肺病发病率和患病率的ASR均呈下降趋势, EAPC分别为-0.85%(95%CI:-1.11%～-0.60%)和-0.78%(95%CI:-1.08%～-0.49%)。1990至2019年, 不同社会人口指数(SDI)地区尘肺病发病率和患病率均呈下降趋势, 高SDI地区尘肺病发病率和患病率下降速度均最快, EAPC分别为-1.46%(95%CI:-1.76%～ -1.15%)和-1.99%(95%CI:-2.44%～-1.53%)。110个国家/地区的尘肺病年龄标化发病率(ASIR)呈上升趋势, 伊朗和格鲁吉亚的ASIR呈上升趋势最明显, EAPC分别为5...     

亚洲5国居民1990—2019年特应性皮炎发病趋势年龄–时期–队列分析

目的 了解中国和亚洲4个发达国家居民1990—2019年特应性皮炎(AD)的发病趋势及年龄、时期、出生队列对AD发病率的影响，为我国AD的预防控制提供参考依据。方法 收集2019年全球疾病负担研究(GBD2019)数据库中1990—2019年中国、日本、韩国、以色列和新加坡亚洲5国居民AD发病率相关数据，采用年估计变化百分比(EAPC)描述AD发病率的变化趋势，并构建年龄–时期–队列(APC)模型分析AD发病率的年龄、时期、出生队列效应及其对发病率的风险。结果 1990—2019年中国居民AD年龄标化发病率逐年递增，EAPC值为0.021 2%(95%CI=0.007 7%～0.034 7%)；而日本、韩国、以色列和新加坡居民AD年龄标化发病率均逐年递减，EAPC值依次为-0.043 3%(95%CI=-0.065 5%～-0.021 1%)、-0.020 6%(95%CI=-0.038 0%～-0.003 2%)、-0.007 3%(95%CI=-0.007 7%～-0.006 9%)和-0.027 6%(95%CI=-0.045 2%～-0.009 9%)。APC模型分析结果显示，...     

关注传染病流行，防范跨境传播风险

2013年我国提出共建"一带一路"的重大倡议, 截至2021年12月9日, 我国已与145个国家签署合作协议。这些国家分布范围遍及六大洲, 由于经济发展水平及自然条件等因素的差异, 其传染病流行及其跨境传播风险不同。本期重点号简述HIV/AIDS、耐多药结核病、登革热及疟疾4种传染病的全球流行现状及防控难点, 重点报告"一带一路"沿线国家这4种疾病的流行情况及变化趋势, 为"一带一路"项目建设及我国公共卫生安全政策制定提供流行病学证据。     

南京2007—2013年恶性肿瘤死亡流行趋势分析

目的了解江苏省南京市户籍居民2007—2013年恶性肿瘤死亡特征及其流行趋势,为政府制定恶性肿瘤防制规划提供依据。方法分析南京市2007—2013年全部户籍人口死亡资料,描述死因构成和顺位,采用年估计变化百分比(EAPC)分析死亡率的时间变化趋势。结果 2007—2013年,南京市恶性肿瘤平均死亡率为182.96/10万(178.80/10万~186.78/10万),其中胰腺癌(EAPC=5.93%)、肠癌(EAPC=3.28%)和肺癌(EAPC=2.09%)的死亡率逐年上升,而胃癌(EAPC=-2.95%)、肝癌(EAPC=-2.28%)的死亡率逐渐下降。结论南京市户籍人口的恶性肿瘤死亡率保持稳定,但不同癌肿的构成有变化。在重视各种癌症防制的基础上,政府部门更应加强对胰腺癌、肠癌和肺癌等死亡率逐年升高的癌肿的防制。     

上海市长宁区甲状腺癌发病率时间趋势分析

目的分析上海市长宁区甲状腺癌发病现状及长期时间变化趋势,为甲状腺癌防治策略的制定提供参考依据。方法采用上海市肿瘤登记处收集的长宁区1973—2013年甲状腺癌发病资料,计算粗发病率和年龄调整标化发病率。应用Joinpoint软件分析甲状腺癌发病率趋势变化,计算年均变化百分比。通过构建年龄–时期–队列模型,分析年龄、时期、队列对发病趋势变化的影响。结果 1973—2013年,长宁区男性甲状腺癌新发病例492例,女性1 483例,粗发病率分别为4.51/10万和13.81/10万;在41年间,男、女性甲状腺癌发病率先小幅下降,再上升,然后大幅上升。男性标化率3个阶段年度变化百分比分别为–13.3%(95%CI=–20.8%～–5.1%)、7.0%(95%CI=3.8%～10.3%)和32.6%(95%CI=21.5%～44.64%);女性标化率3个阶段年度变化百分比分别为–11.8%(95%CI=–16.3%～–7.1%)、6.3%(95%CI=3.4%～8.9%)和18.7%(95%CI=15.7%～22.2%)。年龄–时期–队列模型结果显示,年龄、时期、队列效应对甲状腺癌发病趋势的变化存在不同程度的影响。结论上海长宁区女性甲状腺癌发病率为男性的3倍,两者自上世纪80年代初均呈上升趋势。     

年估计百分比变化与平均增长速度在公共卫生领域中的应用比较

目的本文采用年估计百分比变化(the estimated annual percentage change,EAPC)和平均增长速度分析和探讨咸阳市2005-2012年乙肝、流行性腮腺炎发病率的动态变化规律,旨在寻找最佳的统计预测指标。方法采用描述性流行病学方法进行资料收集,经线性拟合计算乙肝和流行性腮腺炎发病率的年估计百分比变化(EAPC)和平均增长率,比较其各自的优缺点。结果乙肝发病率EAPC(%)=100×(e-0.127-1)=-11.93%,EAPC 95%CI为-13.13%~-10.71%(P0.05);流行性腮腺炎发病率EAPC(%)=100×(e0.083-1)=8.65%,EAPC 95%CI为-3.26%~19.86%(P0.05)。结论公共卫生及统计实践中,进行预测时应选择科学的方法,可首选年估计百分比变化(EAPC)。     

中国居民焦虑症疾病负担变化趋势分析

目的 我国焦虑问题日益普遍,影响越来越多的中国居民,本研究旨在描述和分析1990—2019年中国居民焦虑症疾病负担的长期变化趋势。方法 数据来源于2019年全球疾病负担研究,选取发病率、标化发病率及伤残调整生命年(Disability Adjusted of Life Year, DALY)率等指标,并利用Joinpoint回归模型分析长期变化趋势。结果 1990—2019年中国儿童青少年14岁及以下人群焦虑症发病率和DALY率呈显著上升态势,15岁以上人群焦虑症发病率和DALY率呈现出下降趋势,其中发病率下降最快的是20～24岁年龄段,平均年度变化百分比(Average Annual Percentage Change, AAPC)为-1.13%(95%CI:-1.23%～-1.02%,P<0.05),DALY率下降最快的年龄段是25～29岁(AAPC=-0.88%,95%CI:-0.94%～-0.81%,P<0.05)。1990—2019年中国居民焦虑症发病率和DALY率的AAPC分别为-0.19%(95%CI:-0.33%～-0.05%)和-0.29%(95%CI:-...     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

骨钙素与儿童生长发育

骨钙素是成骨细胞分泌的骨蛋白 ,骨钙素水平与成骨细胞活性成正相关 ,是一项很好的反映骨形成与骨转化的生化指标。小儿骨生长发育有自身特点 ,骨钙素水平的改变类似儿童身高生长曲线 ,可以很好地应用于评价儿童生长发育及监测生长障碍患儿对治疗的反应     

Cholesterol and Egg Intakes with Cardiometabolic and All-Cause Mortality among Chinese and Low-Income Black and White Americans

We examined the associations of dietary cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Included were 47,789 Blacks, 20,360 Whites, and 134,280 Chinese aged 40–79 years at enrollment. Multivariable Cox models with restricted cubic splines were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes using intakes of 150 mg cholesterol/day and 1 egg/week as the references. Cholesterol intake showed a nonlinear association with increased all-cause mortality and a linear association with increased cardiometabolic mortality among Black Americans: HRs (95% CIs) associated with 300 and 600 mg/day vs. 150 mg/day were 1.07 (1.03–1.11) and 1.13 (1.05–1.21) for all-cause mortality (P-linearity = 0.04, P-nonlinearity = 0.002, and P-overall < 0.001) and 1.10 (1.03–1.16) and 1.21 (1.08–1.36) for cardiometabolic mortality (P-linearity = 0.007, P-nonlinearity = 0.07, and P-overall = 0.005). Null associations with all-cause or cardiometabolic mortality were noted for White Americans (P-linearity ≥ 0.13, P-nonlinearity ≥ 0.06, and P-overall ≥ 0.05 for both). Nonlinear inverse associations were observed among Chinese: HR (95% CI) for 300 vs. 150 mg/day was 0.94 (0.92–0.97) for all-cause mortality and 0.91 (0.87–0.95) for cardiometabolic mortality, but the inverse associations disappeared with cholesterol intake > 500 mg/day (P-linearity ≥ 0.12; P-nonlinearity ≤ 0.001; P-overall < 0.001 for both). Similarly, we observed a positive association of egg intake with all-cause mortality in Black Americans, but a null association in White Americans and a nonlinear inverse association in Chinese. In conclusion, the associations of cholesterol and egg intakes with cardiometabolic and all-cause mortality may differ across ethnicities who have different dietary patterns and cardiometabolic risk profiles. However, residual confounding remains possible.