中国社区老年人脑认知相关生活方式对早期认知功能下降的影响

目的 了解中国社区老年人脑认知相关生活方式的分布特征,并探讨其综合评分对早期认知功能下降的影响。方法 研究对象来自老年期重点疾病预防和干预项目。纳入2015年基线调查及2017年随访调查均完成认知功能状况评定,且基线未患痴呆的2 537名≥60岁的社区老年人。通过问卷调查收集其脑认知相关生活方式信息（体育锻炼、社会交往、脑力休闲活动、睡眠质量、吸烟状况与饮酒状况）并计算综合评分。通过多因素logistic回归模型分析脑认知相关生活方式综合评分与早期认知功能下降的关联。结果 2 537名社区老年人群中,评分5~6分者占28.7%,6项脑认知相关生活方式因子均健康者仅占4.8%。男性与女性的健康生活方式因子分布存在差异。多因素logistic回归模型结果显示,与评分0~3分组相比,评分4分和5~6分组早期认知功能下降的风险降低（OR=0.683,95%CI：0.457~1.019;OR=0.623,95%CI：0.398~0.976;趋势P=0.030）。在女性中,与评分0~3分组相比,评分4分和5~6分组的早期认知功能下降的风险降低（OR=0.491,95%CI：0.297~0.812;OR=0.556,95%CI：0.332~0.929;趋势P=0.024）。结论 脑认知相关综合健康生活方式与早期认知功能下降风险降低密切相关,在女性群体中尤为显著。     

Characteristics of pediatric invasive pneumococcal diseases and the pneumococcal isolates in Suzhou,China before introduction of PCV13

BackgroundData on characteristics of invasive pneumococcal diseases (IPD) is limited in China. We aimed to understand the clinical features and explore the molecular characteristics of the pneumococcal isolates in China.MethodsSince 2010, we prospectively collected the pneumococcal isolates and the IPD patients’ demographic and clinical information in Suzhou University Affiliated Children’s Hospital (SCH). The antibiotic susceptibility, serotypes, genotypes of Streptococcus pneumoniae strains were identified by E-test, quellung reaction and/or multiplex PCR, and multi-locus sequence typing, respectively.ResultsDuring the period from January 2010 to December 2015, a total of 80 IPD patients were identified. They were diagnosed as meningitis (31.3%), septicemia (27.5%), pneumonia (21.3%) and others (20.0%). About half of them required vancomycin treatment, 42.5% were admitted to ICUs, 36.2% had complications and 6.2% were hospitalized for over 1 year. The most common serotypes of the pneumococcal isolates were serotypes 6B and 14, the coverage of PCV13 was 92.5%, and CC236s and CC199s were the most common clone complexes.ConclusionsPediatric IPD patients had severe clinical symptoms, demanded intensive treatment, suffered poor prognosis and substantial burden. The pneumococcal isolates’ serotype coverage of PCV13 vaccine was high, which leads to implication of PCV vaccine usage among children in China.     

山西营养与慢性病家庭队列人群体质指数与死亡率的关系

目的 分析山西营养与慢性病家庭队列人群BMI与总死亡率的关系。方法 以"2002年中国居民营养与健康状况调查"山西省调查人群为基线建立队列，于2015年12月至2016年3月对研究对象进行随访调查，对逝者进行死因回顾调查。2002年基线信息完整的≥ 18岁研究对象7 007人，随访到5 360人，随访率为76.5%。将研究对象按BMI分为8组，计算死亡率，以死亡率最低组作为参照，采用Cox比例风险回归模型估计全人群、分性别、年龄（≥ 60岁、<60岁）的各组死亡风险比（HR）及95% CI，模型调整基线年龄、性别、吸烟、饮酒、文化程度等因素，并进行敏感性分析。结果 共随访67 129人年，平均随访12.5年，死亡615人，队列总死亡率为916/10万人年。BMI为26.0~27.9 kg/m²组死亡率最低，以该组为参照组，多因素调整后，BMI<18.5、18.5~19.9、22.0~23.9和≥ 30.0 kg/m²组的死亡风险明显升高，调整HR值（95% CI）分别为1.90（1.26~2.86）、1.68（1.15~2.45）、1.49（1.08~2.06）和1.72（1.07~2.76）。对于≥ 60岁老年人，BMI<18.5 kg/m²组的死亡风险明显升高，调整HR值（95% CI）为1.94（1.20~3.15）。结论 BMI ≤ 19.9、22.0~23.9及≥ 30.0 kg/m²均会增加全因死亡风险。除关注肥胖外，低体重营养不良造成的老年人高死亡风险应特别引起重视。     

Interaction of poor sleep quality,family history of type 2 diabetes,and abdominal obesity on impaired fasting glucose: a population-based cross-sectional survey in China

This study aims to explore the interaction of sleep quality, family history of type 2 diabetes, and obesity in relation to impaired fasting glucose in a Chinese population. A representative population-based cross-sectional study was conducted, and 15,145 residents aged between 18 and 75 years were selected from 11 districts of Xuzhou City, Jiangsu Province. The Pittsburgh Sleep Quality Index was used to evaluate sleep conditions, with categories of good and poor. Impaired fasting glucose (IFG) was assessed by fasting blood glucose. Interaction of sleep quality, obesity, and family history of diabetes (FHD) on IFG was analyzed by logistic regression. Relative excess risk due to interaction (RERI) and the synergy index (SI) were applied to evaluate the additive interaction between the two factors. Either poor sleep or positive FHD was independently associated with an increased odds ratio (OR) for IFG. Those with both poor sleep and positive FHD had a significantly increased risk compared with those without poor sleep and FHD (OR 20.6, 95 % confidence interval (CI) 16.4–29.0, P?<?0.001). The corresponding RERI and SI was 14.6 (8.6–20.6) and 3.7 (1.4–5.1), respectively. Both abdominal obesity and FHD significantly increased the risk of being IFG. The synergistic effect of abdominal obesity and FHD on IFG was statistically significant (OR 40.1, 95 % CI 28.8–61.5). The results suggest that additive interactions exist between poor sleep quality, abdominal obesity, and family history of diabetes in relation to impaired fasting glucose.     

Abdominal Obesity and Its Attribution to All-cause Mortality in the General Population with 14 Years Follow-up: Findings from Shanxi Cohort in China

Objective This study aimed to assess the association of waist circumference(WC) with all-cause mortality among Chinese adults.Methods The baseline data were from Shanxi Province of 2002 China Nutrition and Health Survey. The death investigation and follow-up visit were conducted from December 2015 to March 2016. The visits covered up to 5,360 of 7,007 participants, representing a response rate of 76.5%. The Cox regression model and floating absolute risk were used to estimate hazard ratio and 95% floating CI of death by gender and age groups(≥ 60 and 60 years old). Sensitivity analysis was performed by excluding current smokers; participants with stroke, hypertension, and diabetes; participants who accidentally died; and participants who died during the first 2 years of follow-up.Results This study followed 67,129 person-years for 12.5 years on average, including 615 deaths. The mortality density was 916 per 100,000 person-years. Low WC was associated with all-cause mortality among men. Multifactor-adjusted hazard ratios(HR) were 1.60(1.35–1.90) for WC 75.0 cm and 1.40(1.11–1.76) for WC ranging from 75.0 cm to 79.9 cm. Low WC( 70.0 cm and 70.0–74.9 cm) and high WC(≥ 95.0 cm) groups had a high risk of mortality among women. The adjusted HRs of death were 1.43(1.11–1.83), 1.39(1.05–1.84), and 1.91(1.13–3.22).Conclusion WC was an important predictor of death independent of body mass index(BMI). WC should be used as a simple rapid screening and predictive indicator of the risk of death.     

The influence of sex on cardiovascular outcomes associated with diabetes among older black and white adults

AimsIt is unknown whether sex differences in the association of diabetes with cardiovascular outcomes vary by race. We examined sex differences in the associations of diabetes with incident congestive heart failure (CHF) and coronary heart disease (CHD) between older black and white adults.MethodsWe analyzed data from the Cardiovascular Health Study (CHS), a prospective cohort study of community-dwelling individuals aged ≥ 65 from four US counties. We included 4817 participants (476 black women, 279 black men, 2447 white women and 1625 white men). We estimated event rates and multivariate-adjusted hazard ratios for incident CHF, CHD, and all-cause mortality by Cox regression and competing risk analyses.ResultsOver a median follow-up of 12.5 years, diabetes was more strongly associated with CHF among black women (HR, 2.42 [95% CI, 1.70–3.40]) than black men (1.39 [0.83–2.34]); this finding did not reach statistical significance (P for interaction = 0.08). Female sex conferred a higher risk for a composite outcome of CHF and CHD among black participants (2.44 [1.82–3.26]) vs. (1.44 [0.97–2.12]), P for interaction = 0.03). There were no significant sex differences in the HRs associated with diabetes for CHF among whites, or for CHD or all-cause mortality among blacks or whites. The three-way interaction between sex, race, and diabetes on risk of cardiovascular outcomes was not significant (P = 0.07).ConclusionsOverall, sex did not modify the cardiovascular risk associated with diabetes among older black or white adults. However, our results suggest that a possible sex interaction among older blacks merits further study.     

2008-2012年中国肿瘤登记地区脑及神经系统肿瘤发病与死亡分析

目的 描述中国肿瘤登记地区2008-2012年脑及神经系统肿瘤发病与死亡水平。方法 对全国135个肿瘤登记处的数据进行汇总,计算脑及神经系统肿瘤的发病率与死亡率。结果 2008-2012年全国肿瘤登记地区脑及神经系统肿瘤发病率为6.21/10万,中国人口标化率（以下简称中标率）为3.93/10万,世界人口标化率（以下简称世标率）为3.87/10万,占全部恶性肿瘤发病的2.19%,位居全部恶性肿瘤发病的第11位。男性发病率为9.45/10万（中标率为6.31/10万）,女性发病率2.88/10万（中标率1.72/10万）。城市和农村地区,脑及神经系统肿瘤发病率分别为7.59/10万和4.07/10万（发病中标率分别为4.60/10万和2.78/10万）。2008-2012年,全国肿瘤登记地区脑及神经系统肿瘤死亡率为2.48/10万（中标率和世标率都为1.40/10万）,在各种恶性肿瘤死亡原因中排列第12位。男性的死亡率为3.71/10万,女性为1.21/10万。城市和农村地区脑及神经系统肿瘤死亡率分别为2.91/10万和1.81/10万（中标死亡率分别为1.53/10万和1.16/10万）。结论 脑及神经系统肿瘤是危害中国居民主要恶性肿瘤之一,城市发病率高于农村,男性高于女性。应加强脑及神经系统肿瘤的预防与控制工作。     

2010年和2015年江西省恶性肿瘤疾病负担研究

目的 分析比较2010年和2015年江西省恶性肿瘤的疾病负担。方法 从2015年中国分省份疾病负担研究中选取江西省恶性肿瘤的发病数、死亡数、过早死亡损失寿命年（years of life lost,YLL）、伤残损失寿命年（years lived with disability,YLD）和伤残调整寿命年（disability-adjusted life year,DALY）等数据资料,使用2010年全国人口普查数据作为标准人口,计算标化发病率、死亡率、YLL率、YLD率和DALY率,以此评价该省恶性肿瘤疾病负担的变化情况。结果 2015年江西省恶性肿瘤的总体发病数、死亡数、YLL、YLD和DALY高于2010年,且男性>女性,但标化发病率下降了3.25%、标化死亡率下降了8.42%、标化DALY率下降了8.64%。2010年和2015年,YLL/DALY为97.78%和97.58%;2010年和2015年,≥ 50岁人群标化DALY率分别占总体的88.19%和88.14%;2010年和2015年标化DALY率前五位的恶性肿瘤均为肺癌、肝癌、胃癌、结直肠癌和白血病。结论 江西省2015年的恶性肿瘤疾病负担相比2010年有所下降但仍维持在较高水平,应重点做好男性和≥ 50岁人群肺癌、肝癌、胃癌、结直肠癌和白血病的防治工作。     

天津市2010-2014年急性冠心病发病者吸烟情况分析

目的 分析天津市急性冠心病事件患者中吸烟的流行特征及趋势分布。 方法 利用天津市主要慢性病发病登记监测系统中的吸烟信息,分析2010-2014年天津市急性冠心病事件的流行情况,并分析患者中吸烟与非吸烟的流行特征及趋势分布。 结果 2010-2014年间,天津市共报告居民急性冠心病事件38 805次,平均粗发病率为77.76/10万,男性(24 343人)多于女性(14 462人),且男性平均发病年龄小于女性,差异有统计学意义(t=54.31,P=0.00)。天津市急性冠心病事件的患者主要为急性心肌梗塞患者,占总发病人数的96.6%。不同性别急性心肌梗塞患者的吸烟率(男:55.0%;女:22.8%)高于冠心病猝死的患者(男:43.4%;女:12.3%),差异有统计学意义(男:χ²=48.96,P=0.00;女:χ²=52.43,P=0.00)。在冠心病猝死和急性心肌梗塞的患者中男性的吸烟率随年龄增加而呈现下降趋势,差异有统计学意义(χ²=46.56,P=0.00)。两种疾病的女性患者的吸烟率分别在>69~79和>59~69岁年龄组达到高峰,随后开始下降,仅在急性心肌梗塞患者中差异有统计学意义(χ²=112.76,P=0.00)。2010-2014年间,男性患者吸烟率整体呈现下降趋势,其中冠心病猝死患者的吸烟率下降的趋势有统计学意义(χ²=29.22,P=0.00),而女性患者吸烟率整体呈现上升趋势(χ²=10.73,P=0.00)。 结论 冠心病急性事件发病例数及发病率逐年增加,是严重危害居民健康的重要疾病。且冠心病急性事件患者的吸烟率较高,特别是60岁以下的人群,这是导致冠心病急性事件发病呈现年轻化的主要原因,因此应及时开展干预措施,降低吸烟率,提高戒烟率,应加大在女性中开展控烟宣传,以减少其吸烟相关疾病的发生。