北京市通州区某镇成人吸烟及戒烟相关信息分析

目的 了解农村地区成人吸烟现状,为制定适宜农村地区的控烟措施提供依据.方法 于2011年对北京市通州区永乐店地区参加永乐店卫生院年度健康体检的年龄在20岁及以上农村居民进行吸烟相关行为的问卷调查.结果 此次共调查18 238人,男性8 156人,女性10 082人.调查人群总吸烟率29.9％,现在吸烟率28.6％,男性吸烟率64.1％,女性吸烟率2.2％.调查人群开始吸烟的平均年龄为(19.82±7.09)岁;吸烟者平均每天吸(16.53±8.31)支;被动吸烟率61.6％;有38.5％的人有戒烟意愿,戒烟率为4.2％,2.3％的吸烟者知道戒烟门诊.最近一年有21.7％接受卫生服务的吸烟者得到过医生的戒烟建议.结论 吸烟是农村地区面临的一个严重危害居民健康的公共卫生问题,应加强居民控烟健康教育,提高社区医生戒烟技术,减少烟草使用带来的疾病负担.     

老年人吸烟及戒烟与相关死亡的前瞻性研究

目的：前瞻性探讨男性老年人吸烟及戒烟与烟草有关疾病死亡的相互关系。方法：研究对象为1987年西安市22个军队干休所的全部男性离体干部,共计1268人,基线调查时,388人为不吸烟者,419人为吸烟者,461人为戒烟者。终点指标为全死因和与烟草有关疾病死亡。结果：截止1999年,共观察14163人年,平均随访11年。共死亡299人,943人存活,26人失访。在调整了年龄,血压、体重指数,总胆固醇,甘油三酯、饮酒,体育锻炼和既往病史等因素后,多元Cox生存分析模型显示：既往吸烟与该人群相关死亡的对危险度（95％CI）分别为总死亡1．34（1．02－1．76）、慢性阻塞性肺病（COPD）3．23（0．95－10．91）,肺癌、2．31（0．95－5．61）、冠心病1．60（0．81－3．19）。其死亡危险性随既吸烟量的增多和吸烟年限的延长而升高,存在明确的剂量反应关系。与继续吸烟者相比,戒烟总死亡和冠心病死亡和危险性分别下降56％和93％,但COPD的死亡危险却升高了174％。结论：（1）吸烟是中国男性老年人的主要死因之一,而戒烟降低总死亡和心血管病死亡;（2）戒烟者COPD死亡危险高于继续吸烟者的原因可能与“无病吸烟者作用”和“因病戒烟作用有关。     

我国六城市社区居民戒烟服务需求现状

目的　了解我国城市社区居民对戒烟服务的需求情况 ,为吸烟干预提供依据。方法　在北京、上海、天津、长沙、深圳和濮阳六个城市分别选择 1～ 2个社区 ,随机抽取 1 2 0 65名居民进行了现场问卷调查。结果　社区居民的现在吸烟率是 3 0 79% ,打算戒烟率是 2 0 42 % ,1 5 67%的居民曾主动向医护人员寻求戒烟服务 ,周围吸烟者的影响和缺乏意志力是导致其戒烟失败的主要原因 ,2 4 48%的现在吸烟者称医护人员曾主动向其介绍戒烟方法和技巧。结论　促进戒烟在我国刚刚起步 ,提高居民对烟草危害的认识和自我保健意识、动员全社会参与控烟和戒烟是慢性病预防和控制的主要任务之一。     

吸烟,饮酒与食管癌死亡关系的前瞻性定群研究

于１９８２年６月对３个乡镇２９个村的２０岁以上男女村民１５８０３人前瞻性定群观察吸烟、饮酒与死亡的动态情况。结果表明，吸烟者食管癌死亡率１１４．８７／１０万人年，不吸烟者５２．９１／１０万人年，ＲＲ为２．１７，９５％ＣＩ为１．５３～３．０７（χ２＝２０．１１，Ｐ＝０．０００００７３），ＡＲ＝６１．９６／１０万人年，ＡＲ％＝５３．９４％。每日吸烟量与食管癌死亡之间存在明显的剂量－效应关系（Ｐ＜０．００１）。食管癌的死亡率，饮酒者为１０３．６３／１０万人年，不饮酒者为６７．２５／１０万人年，ＲＲ为１．５３，９５％ＣＩ为１．０８～２．１６（χ２＝５．９４，Ｐ＝０．０１４８）。食管癌死亡率随饮酒年限增加而升高（Ｐ＜０．００１），但与饮酒量不呈剂量－效应关系（Ｐ＞０．０５），单纯饮酒而不吸烟也未发现与食管癌有关。     

Smoking cessation or reduction in women attempting to conceive after ectopic pregnancy

The relationship between smoking cessation or reduction and attempt to conceive was studied in 646 women treated for ectopic pregnancy (EP) (Auvergne register of EP, France). Women were prospectively followed. Tobacco consumption was recorded as the mean number of cigarettes smoked per day at the time of interview. Smoking reduction was defined as stopping smoking or decreasing tobacco consumption by at least 3 cigarettes per day. Statistical analysis was performed using conditional logistic regression. The results confirmed that women reduced tobacco consumption when they became pregnant. However, no association was found between smoking reduction and attempting to conceive again. These results suggest that both women and physicians need to be informed about the possible tobacco consumption effects of smoking on fertility.     

队列研究中影响男男性行为者随访率的因素

在男男性行为者(MSM)等特殊人群中,开展队列研究是探讨干预措施、防治危险性行为的一种重要研究方法,但是在针对该人群做队列研究时,如何招募研究对象和队列维持面临重要挑战.此文对在队列研究中影响MSM人群随访率的有关因素进行了讨论.     

A high risk of hyperlipidemia in epilepsy patients: a nationwide population-based cohort study

PurposeThis study evaluated the effect of epilepsy on the development of hyperlipidemia (HL) in Taiwan.MethodsWe conducted a nationwide population-based cohort study based on data obtained from the National Health Insurance Research Database of Taiwan. We identified 990 cases involving patients whose epilepsy was newly diagnosed between 2000 and 2005, and we also selected a comparison cohort comprising 3960 patients without epilepsy. Cox proportional hazards regression models were used to examine the association between epilepsy and HL.ResultsThe mean follow-up period was 6.63 years for the epilepsy cohort and 7.49 years for the comparison cohort. The incidence rate of HL was 1.28-fold higher in the epilepsy cohort than it was in the comparison cohort (34.14 vs. 26.96 per 1000 person-years), with an adjusted hazard ratio of 1.17 (95% confidence interval, 1.01–1.36) after adjusting the model to account for the effects of sex and comorbidities. The most at-risk patients were those aged 50 to 59 years (hazard ratio, 1.35; 95% confidence interval, 1.04–1.79). For the epilepsy patients, the combined effect of ischemic heart disease, hypertension, and diabetes was associated with a significantly higher risk of developing HL compared with the patients with neither epilepsy nor any comorbidity.ConclusionsMiddle-aged epilepsy patients are at a significantly higher risk of developing HL. The results could assist in explaining the high risk of cerebral and cardiac vascular disease in epilepsy patients.     

Alcohol drinking and colorectal cancer: A population-based prospective cohort study in China

Study objective: To asses the association between alcohol consumption and the risk of colorectal cancer (CRC) in the Chinese population. Design: A population-based prospective cohort study was initiated from the colorectal cancer screening population in Jiashan County in 1989–1990. The drinking habits of individuals were investigated with demographic information. Setting: A cohort study was followed-up from 1st May 1990 to 1st January 2001 and censored at the date of diagnosis of CRC, at death from any causes, or at 1st January 2001, whichever came first, and the person-time was computed. Participants: Two hundred and forty two CRC patients were diagnosed during the study period and 64,100 individuals finished the follow-up. Results: The distribution of sex, smoking status, occupation, education level and marital status were all significantly different among different drinking habits at baseline. When the above factors were adjusted, no significant association was observed between alcohol consumption and the risk of CRC. Exclusion of individuals diagnosed cancer less than 1 year after the examination date did not alter the strength of an alcohol–CRC relationship. Further analysis in sex strata also did not show a significant relationship. Conclusions: Alcohol drinking may not be associated with a higher risk of CRC in the Chinese population.This revised was published online in April 2005. In the previous version the article category was missing.     

Factors affecting mortality in a large cohort study with special reference to oral contraceptive use

Background

This analysis updates mortality in the Oxford-Family Planning Association (Oxford-FPA) contraceptive study, with emphasis on oral contraceptive (OC) use.

Study design

The Oxford-FPA study includes 17,032 women recruited from 1968-1974 at contraceptive clinics, aged 25-39 years, using OCs a diaphragm or an intrauterine device. Follow-up has been to March 2009; by then, 1715 women had died.

Results

The rate ratio (RR) for overall mortality was 0.87 (CI 0.79-0.96), comparing ever-users of OCs with never-users. The RR for fatal cervical cancer was increased (7.3), but the CIs were very wide (1.2-305). There was no association between ever-use of OCs and mortality from breast cancer (RR 1.0, CI 0.8-1.2), nor was fatal breast cancer related to duration of OC use. OC use strongly protected against death from other uterine cancer and ovarian cancer; RRs for ever-use of OCs were 0.3 (CI 0.1-0.8) and 0.4 (CI 0.3-0.6), respectively. Protection increased with duration of OC use and persisted more than 20 years after cessation. Circulatory disease mortality was not increased, the RR for ever-use of OCs being 0.9 (CI 0.7-1.1). The overall mortality RR for all women smoking 15+ cigarettes daily was 2.25 (CI 1.99-2.53) and, for all women with a body mass index of 28+ kg/m², was 1.33 (CI 1.07-1.64).

Conclusions

Long-term follow-up strongly suggests that OC use slightly reduces all cause mortality.     

中国肝癌相关队列研究的文献计量分析

目的回顾分析27年来肝癌领域队列研究的应用趋势,展望未来发展方向。方法检索汇总1991年以来中国大陆地区发表的中英文肝癌队列研究文献,对发表时间、科研单位、研究目标与随访调查情况进行统计分析。结果27年来肝癌相关队列研究论文数量明显增长,英文核心期刊群已形成。中英文论文发表数量年平均增长率分别为20.4%与35.2%,52.3%的中文论文与73.5%的英文论文为近5年内发表。49.2%的中文论文发表在核心期刊,47.3%的英文论文发表在影响因子>3分的期刊。国内期刊发表的研究以病因研究为主(41.5%),多为大样本研究;SCI论文研究主要着眼于肝癌预后研究(40.7%),生存分析运用普遍。结论队列研究在我国肝癌研究领域的应用逐渐增多,其中大样本研究与预后分析较为普遍。虽然队列研究的应用得到重视和推广,但仍需进一步提高研究者对于队列研究的认识,提高随访效果、降低失访率,增加生存分析等科学评估手段的应用,更科学地运用队列研究解决临床问题。     

Dementia risk following influenza vaccination in a large veteran cohort

BackgroundTwo Taiwan based studies indicated influenza vaccinations are associated with lower risk for dementia in patient cohorts with chronic disease. We determined if such associations exist in a large, nationally distributed sample of U.S. patients not selected for chronic disease.MethodsData was obtained from Veterans Health Administration medical records (9/1/2009 – 8/31/19). Eligible patients were ≥65 years of age and free of dementia for two years prior to enrollment through the end of the first influenza season (9/1/2009 to 3/1/2012). Competing risk models estimated the risk of dementia in those with influenza vaccination (n = 66,822) compared to those without vaccination (n = 56,925). Propensity scores and inverse probability of treatment weighting controlled for confounding.ResultsOn average, patients were 75.5 (±7.3) years of age, 3.8% were female and 91.6% were white race. After controlling for confounding, patients with influenza vaccination were significantly less likely to develop dementia compared to patients without vaccination (HR = 0.86; 95 %CI:0.83–0.88). Patients with 1, 2 or 3–5 vaccines vs. none had similar risks for dementia and patients with ≥ 6 influenza vaccines vs. none had a significant lower risk for dementia (HR = 0.88, 95 %CI: 0.83–0.94).ConclusionsRepeated receipt of influenza vaccinations, compared to remaining unvaccinated, is associated with lower risk for dementia. This is consistent with the hypotheses that vaccinations may reduce risk of dementia by training the immune system and not by preventing specific infectious disease. If vaccines are identified as causative factors in reducing incident dementia, they offer an inexpensive, low-risk intervention with effects greater than any existing preventive measure.     

中国母婴健康相关队列研究的文献计量分析

目的  回顾分析母婴健康队列研究的应用趋势,展望未来发展方向。 方法  检索中国发表的中文及英文(简称“中英文”)母婴队列研究文献,对发表时间、科研单位、研究目标与随访调查等情况进行统计分析。 结果  自1991年以来,母婴健康队列研究的文献数量明显增加,中英文核心期刊群均已形成。中英文文献发表数量的年平均增长率分别为12.2%和23.2%,54.4%的中文文献与79.3%的英文文献为近5年发表。56.9%的中文文献发表在核心期刊,54.3%的英文文献发表在影响因子>3分的期刊。国内外期刊发表的文献均以病因研究为主,多为大样本研究,回归分析模型运用普遍。 结论  队列研究在我国母婴健康领域的应用逐渐增加,但研究者仍需加强对队列研究的认识,控制失访率、改善随访效果,运用Cox回归分析模型等统计分析方法,更加科学地运用队列研究解决实际问题。     

Association between ChAdOx1 nCoV-19 vaccination and bleeding episodes: Large population-based cohort study

ObjectiveTo compare prevalence of skin, nose and gingival bleedings after receipt of adeno-vectored or mRNA-vaccines against COVID-19. The hypothesis is that milder symptoms indicating altered thrombocyte function may affect a larger proportion of vaccinated individuals than the recently reported severe cases with thrombosis and thrombocytopenia.MethodsUsing an ongoing large, population-based cohort study, more than 80 000 cohort participants were asked through electronic questionnaires about COVID-19 vaccination and potential side effects during weeks 11–13, 2021. The response rate was 58% (81267/138924). Among the vaccinated, 83% were female, 85% health care workers and 80% were aged 40–55 years.The prevalence of self-reported episodes of skin, nose and gingival bleedings were compared after mRNA and adenovirus-vectored vaccination. Estimates were adjusted for age, sex, occupation, previous COVID-19 infection and chronic disease.ResultsFour of the 3416 subjects (0.2%) who were vaccinated with a single dose of mRNA vaccine reported skin bleeding as a side effect, as opposed to 163 of 5132 subjects (3.2%) vaccinated with a single dose of the adenovirus-vectored vaccine, OR (odds ratio) = 16.0 (95% confidence interval (CI) 7.5–34.1). Corresponding ORs for nose and gingival bleeding were 8.0 (4.0–15.8) and 9.3 (4.3–20.0), respectively.ConclusionsThese findings could potentially indicate that the adenovirus-vectored vaccine may lead to mild bleeding episodes in a larger proportion of vaccinated individuals, and not only in rare cases with documented thrombosis and thrombocytopenia. Studies are needed to understand the possible mechanisms behind these observations, and to establish or refute whether they share similarities with the severe thromboembolic bleeding complications.     

Smoking status and adiponectin in healthy Japanese men and women

BACKGROUND: Recent studies promisingly indicate that adiponectin plays an important and fundamental role in the development and progression of metabolic and atherosclerosis disorders. Smoking is known as one of the most important risk factors of atherosclerosis, and its relation with metabolic disorders has also been reported. We therefore investigated the association between cigarette smoking and adiponectin concentration in a large sample of Japanese men and women. METHOD: The cross-sectional study was carried out in 2002. The subjects were 3260 men and 953 women local government workers aged 35 to 59 in Japan. Lifestyle-related variables including detailed smoking history were inquired in a self-administered questionnaire. RESULTS: Significant differences in adiponectin levels related to smoking status were observed in both men and women (p=0.001). A dose-dependent association was found between the intensity of smoking and adiponectin levels in current smokers, and was statistically significant in men (p for trend=0.006 in the multivariate-adjusted model). Men who quit smoking for more than 20 years and women for more than 10 years had an adiponectin concentration similar to that observed in non-smokers. CONCLUSION: We not only revealed that current smoking habit was associated with low adiponectin level but also found a dose-dependent association between smoking intensity and adiponectin level in current smokers. The present finding may provide further evidence of the importance of a causal relationship between smoking status and adiponectin concentrations.     

职业接尘及吸烟致呼吸系统疾病死亡危险度比较的队列研究

目的 比较接尘、吸烟对呼吸系统疾病死亡的影响.方法 在1989年至1992年广州建立职业健康监护档案的基础上对30岁以上、职业接触粉尘和无粉尘接触的80 987名工人进行前瞻性队列研究.结果 （1）队列平均年龄43.5岁,职业性粉尘接触率16.3%,吸烟率43.7%,饮酒率33.5%.（2）队列平均随访8年,35人失访,失访率0.04%,总死亡1 593人中,219人死于肺癌,90人死于非恶性肿瘤性呼吸系统疾病.（3）调整相关因素后,相对于不吸烟者,吸烟者肺癌死亡相对危险度（RR）为3.32,是粉尘接触者相对于无粉尘接触者肺癌死亡RR（1.53）的2.2倍.粉尘接触者非恶性肿瘤性呼吸系统疾病死亡RR为2.41,是吸烟者（1.89）的1.28倍.尤其是矽尘接触者,其非恶性肿瘤性呼吸系统疾病死亡RR为5.72,是吸烟者的3.03倍.既接触粉尘又吸烟,呼吸系统疾病死亡RR增加更明显.（4）男性吸烟者呼吸系统疾病死亡危险分别随日吸烟量、烟龄的增加而增加.结论 职业接触粉尘和吸烟均可引致超额的呼吸系统疾病死亡,两者存在协同作用.吸烟致肺癌死亡RR高于接尘,而致非恶性肿瘤性呼吸系统疾病死亡RR则低于接尘.吸烟与呼吸系统疾病死亡危险存在明显的剂量-效应关系.     

队列研究中的依时混杂偏倚和随访时间偏倚

【导读】未加识别或控制的混杂因素和偏倚会影响流行病学研究中因果关系的准确判断。目前已熟知队列研究中可能出现的选择偏倚及失访偏倚,为此笔者复习了队列研究中可能存在的依时混杂偏倚及其控制方法,并通过实例提出随访时间偏倚的概念及其控制方法。     

河南商丘市910名青年职工吸烟行为特征的流行病学研究

对河南省商丘市医疗卫生、教育系统及四个工厂企业工作年限五年以内，年龄３０岁以下的青年职工进行吸烟行为特征的流行病学调查。研究采用集中自填问卷方式调查，样本选择男女比例约为２：１，样本总量为９２６名。调查共收到９１０份有效答卷，应答率为９８．３％。调查结果：青年职工吸烟率为３２．１％，其中男性为６４．２％，女性为１．５％。男性吸烟率与我国成年男性职工的最高吸烟率接近，远高出在校青少年吸烟率，并且随着工作年限的增加而增高。该人群吸烟行为的突出特点是，约５０％的人在工作以后开始经常吸烟，而且吸烟习惯的形成多是在工作的前４年。吸烟青年职工８０％以上为中轻度吸烟，绝大多数能在禁止吸烟的地方不吸烟。工作单位是主要的吸烟场所，吸烟伙伴多是同事或朋友。     

中国双生子队列研究进展

我国大型人群队列研究方兴未艾,双生子作为一种特殊人群,由于其同时出生、共享母体的宫内环境和早期家庭环境的天然对照优势,可以进行匹配的队列研究,从而很好地控制年龄、性别（同性别双生子）、遗传（同卵双生子）或早期环境（共同抚养的双生子）所带来的混杂,为慢性复杂性疾病病因研究提供不可多得的良好资源。本文将就中国双生子队列的目标、现状、挑战与机遇进行简要介绍,着重呈现双生子不同于一般人群队列的特征。     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。