Report on Childhood Obesity in China （4） Prevalence and Trends of Overweight and Obesity in Chinese Urban School-age Children and Adolescents, 1985-2000

Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students' constitution and health (CNSSCH) between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China (WGOC) was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to socioeconomic status (SES) of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children's life styles.     

Trends in the major causes of death in China, 1982–2010

Since the introduction of a series of reform and open policies in its economic system in 1976,China has been in a boom period of social and economic fields.Rapid development in economy and the consequent improvement in living conditions,nutrition,and health care help to decrease infant mortality and deaths from infectious diseases,and notably effected the patterns of mortality.For example,respiratory diseases,acute infectious diseases,and tuberculosis were the leading causes of death in 1957,while diseases of heart,cerebrovascular disease,and malignant neoplasm were the fifth,sixth,and seventh leading causes of death.1 Up to 1975,cerebrovascular diseases,diseases of heart,and malignant neoplasm were the top three death causes,followed by respiratory diseases,digestive diseases,and pulmonary tuberculosis.1 A prospective cohort study involving a representative sample of the adult Chinese population was conducted in 2005,which revealed that the five leading causes of death were malignant neoplasm,diseases of heart,cerebrovascular disease,accidents,and infectious diseases among men and diseases of heart,cerebrovascular disease,malignant neoplasm,pneumonia and influenza,and infectious diseases among women.     

Molecular Spectrum of α- and β-Thalassemia among Young Individuals of Marriageable Age in Guangdong Province,China

Thalassemia is a group of genetically heterogeneous diseases characterized by hemolytic anemia. To investigate molecular characteristics ofα- and β-thalassemia among young individuals of marriageable age in Guangdong Province, 24,788 subjects with suspected thalassemia were genetically tested for α- and β-thalassemia by Gap-PCR and reverse dot blot during 2018–2019. For suspected rare thalassemia cases, DNA sequencing was performed to identify rare and unknown thalassemia gene mutations. A total of 14,346 thalassemia carriers were detected, including 7,556 cases of α-thalassemia with 25 genotypes and 8 α-gene mutations identified, 5,860 cases of β-thalassemia with 18 genotypes and 18 β-gene mutations identified, and 930 cases of compoundα/β-thalassemia. Among them, the frequency of --SEA deletion was the highest in α-thalassemia (66.01％), followed by -α3.7 (17.98％) and -α4.2 (8.22％), and the frequency of CD41-42 (-TCTT) mutation was the highest in β-thalassemia (38.38％), followed by IVS-II-654 (C > T) (25.67％), -28 (A > G) (15.76％), and CD17 (10.01％). In addition, 5 rare mutations (--THAI and HKαα, CD113, -90, and CD56) were found in the study population. Our results revealed molecular epidemiological background of α- and β-thalassemia in Guangdong Province, which can support optimization of thalassemia prevention and control strategies. We demonstrated that thalassemia is heterogeneous with significant geographical differences and population specificity.     

Cardiothoracic Surgery in China: Past, Present and Future

Many interesting stories in this book tell how Chinese cardiothoracic surgery developed from its embryonic stage to maturity or to the present status after overcoming numerous difficulties which were partly due to the political and socioeconomic conditions. To the present, the prevailing techniques for cardiothoracic surgery in China are comparable to those in many developed countries.     

The Antimutagenic and Anticarcinogenic Effects of Tea,Garlic and Other Natural Foods in China：A Review

It is well known that there are huge geographic variations in cancer rates in mainland China.For example,The National Cancer Control Office of the Ministry of Public Health(1979)reported that in the 1970s,cancer mortality rates for most cancers were found to be more than 20-fold greater in some counties in others(Table l).Esophageal cancer rates for males are a few hundred fold greater in the highest county when compared with the lowest county.The mortality rate for all cancers combined for males is 21 fold greater in the county with the highest mortality than in the county with the owest rate.According to Doll and Peto(1981),about one third of human cancer death is avoidable by appropriate modification of the diet.Teherefore,diet is very likely to have an important part in causing these huge geographic ariations.The possible role of various mutagens and carcinogens(e.g.aflatoxin,N-nitroso compounds)in locally produced and consumed food has been strongly suggested and widely acknowledged,although much more evidence would be required to confirm their actual functions in human cancer.On the other hand,there are a few reports stating that the human diet also contains powerful antiumtagens and anticarcinogens(Ames,1983).The possible role of these two types of substances in causing the huge geographic variation of cancer risks remains elusive and inadequately explored.In order to make better use of these natural anticarcinogens in cancer prevention,it is important to elucidate their effects and mechanisms.The purpose of this paper is to summarize the available information on the antimutagenic and anticarcinogenic effects of natural foods in the Chinese diet.exeluding the effects of essential nutrients,e.g.dietary fibers.vitamins and minerals.Most of the literature cited in this review was published by Chinese scientists.     

Surveillance of Hand,Foot,and Mouth Disease in Mainland China （2008-2009）

Objective Since HFMD was designated as a class C communicable disease in May 2008,18 months surveillance data have been accumulated to December 2009.This article was to describe the distribution of HFMD for age,sex,area,and time between 2008 and 2009,to reveal the characteristics of the epidemic.Methods We analyzed weekly reported cases of HFMD from May 2008 to December 2009,and presented data on the distribution of age,sex,area and time.A discrete Poisson model was used to detect spatial-temporal clusters ...     

Survey of the patients with cleft lip and palate in China who were funded for surgery by the Smile Train Program from 2000 to 2002

Background Cleft lip （CL） and cleft palate （CP） are two of the most frequent congenital malformations. Many epidemiologic studies on this deformity have been conducted worldwide, often producing inconsistent results. This study assessed epidemiology and some genetic aspects of cleft lip and palate in a Chinese sample from the Smile Train Program and to compare with other methodologically sound surveys. Methods The general information, family history, classification of cleft and associated malformations of 8000 CL and CP surgery patients were analyzed. Results Of the 8000 cases, 7812 had complete data. The distribution of cleft types is 17.04% with CP, 23.39% with CL and 59.58% with cleft lip and palate （CLP）. Unilateral clefts were more common than bilateral, with unilateral to bilateral ratios bein 10.4 ： 1 for CL, and 3.42 ： 1 for CLP. The overall male： female ratio was 2.01 ： 1. Left sided defects were more common than right sided regardless of sex, 1.90 ： 1 for CL and 1.96 ： 1 for CLP. CLP and CL were more common in males than in females with sex ratios （SR） of 2.88 ： 1 and 1.85 ： 1 respectively, whereas CP was more common in females with SR of 0.76 ： 1. Associated malformations （2.89%）, involved 29 CP cases, 41 CL and 156 CLP. The frequency of associated malformations in CLP （3.35%） was higher than CL （2.24%） and CP （2.22%） （P〈0.05）. Patients with CP or CLP were born less often in the winter than in the summer （P〈0.05）. A history of family members having clefts occurred in 6.84% of patients. The proportion of CLP cases （7.56%） was significantly higher than that of CL cases （5.64%） （P〈0.05）. Conclusions The different types of clefts appeared in the highest proportion in CLP and lowest proportion in CP. Males are more common with CL and CLP and less common with CP. These characteristics are the same as those of other Chinese surveys but different from some European reports.     

Health Inequalities during 20 Years of Rapid Economic Development in China （1980-2000）：A Mortality Analysis

Objective To examine the influence of China's economic reforms on population health and regional mortality rates.Methods Longitudinal study measuring the mortality trends and their regional variations.Using data from the three most recent national censuses,we used the model life table to adjust the mortality levels within the population for each census,and to calculate life expectancy.We then examined the variation in patterns of mortality and population health by economic status,region and gender from 1980...     

Physical Growth of Children in Urban,Suburban and Rural Mainland China：A Study of 20 Years＇ Change

Objective To describe secular trends on physical growth of children in China during the year of 1985‐2005 and to analyze the urban‐suburban‐rural difference and its change. Methods The measurements of height, weight and chest circumference obtained from two serial national cross‐sectional surveys for children aged 0 to 7 years in China were used to analyze the secular trends, and the growth differences among urban, suburban and rural children were compared. Results The average weight and height for both boy...     

Understanding the Unique Characteristics of Suicide in China： National Psychological Autopsy Study

Objective To compare the characteristics of suicides in the four main demographic groups： urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China. Methods A detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country. Results Pesticide ingestion accounted for 58% （519） of all suicides and 61% （3181519） of deaths were due to unsuccessful medical resuscitation. A substantial proportion （37%） of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% （76/563） received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion （79%）, the lowest prevalence of mental illness （39%）, and the highest acute stress from precipitating life events just prior to the suicide. Contusion Many suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.     

江阴市2006-2010年细菌性食物中毒检测结果分析

目的掌握导致江阴市细菌性食物中毒的致病菌,为食源性疾病及食品污染物主动监测提供科学的依据。方法对2006-2010年细菌性食物中毒资料进行统计分析。结果细菌性食物中毒样本中致病菌的检出率为23.24%。中毒细菌主要为溶藻性弧菌、副溶血性弧菌、变形杆菌。二、三季度致病菌检出率较高。责任单位中,家庭和熟食店致病菌的检出率高于餐饮服务企业和集体食堂。各类样本中,肛拭的检出率最高。结论江阴市细菌性食物中毒中致病菌的检出率较低,应进一步提高食源性致病菌的检测能力,加强对条件致病菌的检测,为食物中毒的诊断提供实验室依据。     

云南省2012—2019年乌头类植物中毒流行特征

目的 了解2012—2019年云南省乌头类植物中毒流行特征,为制定防控措施提供依据。方法 利用食源性疾病暴发事件监测报告系统,收集云南省2012—2019年乌头类植物中毒事件数据,从乌头类植物中毒的基本情况、发病趋势以及时间分布、地区分布、场所分布、中毒原因等因素来进行统计分析。结果 云南省乌头类植物中毒呈逐年增加趋势,从2012年的6起增加到2019年的67起,发病人数从2012年的48例到2019年的308例。8年间共报告乌头中毒事件273起,发病人数1 499例,死亡人数65例,累计发病率、死亡率和病死率分别是3.12/10万,0.14/10万和4.34%,平均每次事件的患者数为5例。45.79%的报告事件主要集中在10—12月份,报告起数前五位主要集中在楚雄州（78起）、大理州（40起）、保山市（30起）、曲靖市（22起）和玉溪市（21起）,273起报告事件中,60.07%起事件发生在农村,252起（92.31%）以家庭暴发为主,事件发生原因主要为乌头类植物加工不当（事件起数占82.05%）。结论 云南省应将乌头类植物中毒作为食源性疾病防控工作的重点,在冬季前加强知识宣传工作,同时对农村家庭进行卫生监督。     

安徽枞阳县农村居民急性农药中毒及防护措施研究

目的 分析农村居民急性农药中毒发生情况及研究有效的防护措施，以期今后安全使用提供依据。方法 1993年和2001年在安徽枞阳县采用随机整群抽样方法调查15岁以上农村居民急性生产性农药中毒情况，并对其相关因素进行非条件logistic回归分析。结果 1993年男、女性的农药中毒发生率分别为2．04％和1．83％，2001年男、女性的农药中毒发生率分别为4，00％和6．02％，女性间差异有显著性。分析表明喷洒农药时不戴口罩、喷洒农药时的衣物不清洗继续穿或不清洗待下次喷洒农药时再穿以及喷洒农药结束后不洗手是发生农药中毒主要危险因素。结论 农村居民农药中毒发生率较高，应加强防范；在现行生产体制下，应加强农药安全使用和个人防护措施知识与技能的宣传及普及。     

广州市越秀区2006-2011年疑似细菌性食物中毒的情况分析

目的探讨广州市越秀区2006—2011年细菌性食物中毒发生的特征及分布规律,为预防和控制细菌性食物中毒提供科学依据。方法对2006—2011年本中心对疑似细菌性食物中毒的样品进行细菌分离鉴定,资料采用Excel2003等软件进行统计分析。结果2006—2011年共发生疑似细菌性中毒事件112起,检出致病菌阳性69起（检出率为61．61％）。细菌性食物中毒全年均有发生,7—10月份检出频数最高的细菌性食物中毒的场所以餐饮业为主。检出的致病病原菌最常见的是副溶血性弧菌,其次是金黄色葡萄球菌、变形杆菌、沙门氏菌。副溶血性弧菌以污染环境为主;金黄色葡萄球菌以污染饭菜为主;变形杆菌以污染用具为主。结论本区细菌性食物中毒的防控重点应以餐饮业为主,应着重加强对环境、用具的卫生监管。     

我国儿童急性中毒临床流行病学现状:1994年至2006年发表论文的荟萃分析

目的:研究我国儿童急性中毒的临床流行病学特点。方法:通过文献检索和搜集,采用Meta(荟萃)分析,对我国1994年至2006年间中国医院知识仓库(CHKD)发表的有关研究儿童急性中毒的临床流行病学调查结果进行汇总、归纳和统计分析。结果:共检索到文献142篇,有62篇进入Meta分析,总计报告9335例;男女比例为1.46:1,城乡比例为1:1.95。急性中毒患儿1岁～3岁占36.03%,4岁～6岁占34.51%。中毒物种以农药、药物和灭鼠药三类为主,共占73.03%。中毒原因以误服误食为主(76.13%);中毒途径以消化道为主(88.19%)。死亡率达4.38%,死亡中毒毒种以灭鼠药为主(70.27%);中毒致残率为6.07%。结论:本报告提供了近期我国儿童急性中毒的临床流行病学模式,为今后制定儿童急性中毒临床快速诊治和预防措施具有重要意义。     

三亚市2010-2016年微生物性食物中毒情况分析

目的 探讨三亚市2010-2016年微生物性食物中毒的规律,为预防控制食物中毒的发生提供依据.方法 对三亚市2010-2016年微生物性食物中毒资料进行统计分析,对1706份标本进行致病菌分离培养、鉴定和血清分型,并采用RT-PCR方法检测诺如病毒核酸.结果 2010-2016年微生物性食物中毒共64起,中毒人数1065例,检出病原微生物44起,致病因子共7种,以副溶血性弧菌为主,占45.31％(29/64),送检标本1706份,检出病原微生物214株,发生时间以第二、第三季度为主,分别占35.9％(23/64)和31.3％(20/64);发生场所以餐饮单位为主,占73.44％(47/64).结论 卫生监督人员应加强卫生教育和监管工作,以减少微生物性食物中毒事故的发生.     

Acute carbon monoxide poisoning in Shandong,China: an observational study

Background:Carbon monoxide (CO) poisoning remains a major cause of accidental injuries and multiple studies have indicated that CO is also associated with significantly severe or long-term toxicity to the central nervous system. Given that CO poisoning causes serious morbidity and mortality, a better understanding of epidemiological features and clinical characteristics of acute CO poisoning in China is crucial.Methods:We collected the clinical data of acute CO poisoning in patients between November 2019 and April 2020 across Shandong province, China and analyzed its characteristics focusing on the weekly amount and the severity of the confirmed cases.Results:A total number of 21,088 acute CO poisoning cases were diagnosed. The overall incidence of acute CO poisoning was approximately 0.021%. On severity rankings, 63% of confirmed cases (n = 13,378) were mild, 27% (n = 5635) were moderate, and 10% (n = 2075) were severe. Interestingly, the coastal cities had more confirmed cases than the inland/suburban areas in Shandong. Meanwhile, the number of confirmed cases was negatively correlated with the local mean daily temperature (P = 0.0167).Conclusions:Mild acute CO poisoning cases accounted for the majority of all confirmed cases during the winter of 2019. In Shandong province, which is located in east China, residents of the coastal cities are more susceptible to CO poisoning than residents of inland cities.     

C反应蛋白在两种中毒患者血清中的变化及意义

目的研究急性有机磷农药中毒(AOPP)、急性一氧化碳中毒(ACOP)患者血清C反应蛋白(CRP)水平的变化及其临床意义。方法根据50例AOPP、45例ACOP患者入院时中毒的程度分别各设轻度中毒组、中度中毒组和重度中毒组,并各另设健康对照组(各45例)。中毒患者在入院的第1天治疗前、第3天、第7天或第5天抽静脉血进行血清CRP检测。结果AOPP、ACOP患者入院第1、3天,中度中毒组和重度中毒组血清CRP水平明显高于健康对照组(P<0.01);轻度中毒组与健康对照组比较差异无显著性(P>0.05);AOPP第7天和ACOP第5天,其中度中毒组CRP水平与健康对照组比较差异无显著性(P>0.05);而第7天AOPP重度中毒组和第5天ACOP重度中毒组CRP水平明显高于健康对照组(P<0.01);AOPP重度中毒组第1、3、7天与ACOP重度中毒组第1、3、5天CRP水平与各自中度中毒组相对应入院天数比较,差异有高度显著性(P<0.01)。结论AOPP、ACOP患者血清中CRP水平与中毒的程度有关,可作为AOPP、ACOP患者诊疗的重要参考指标之一。