Objective： To evaluate the population attributable risks （PARs） between cigarette smoking and deaths of all causes, all cancers, lung cancer and other chronic diseases in urban Shanghai. Methods： In total, 61,480 ...Objective： To evaluate the population attributable risks （PARs） between cigarette smoking and deaths of all causes, all cancers, lung cancer and other chronic diseases in urban Shanghai. Methods： In total, 61,480 men aged 40-74 years from 2002 to 2006 and 74,941 women aged 40-70 years from 1997 to 2000 were recruited to undergo baseline surveys in urban Shanghai, with response rates of 74.0% and 92.3%, respectively. A Cox proportional hazards regression model was used to estimate relative risks （RRs） and 95% confidence intervals （95% CIs） of deaths associated with cigarette smoking. PARs and 95 % CIs for deaths were estimated from smoking exposure rates and the estimated RRs. Results： Cigarette smoking was responsible for 23.9% （95% CI： 19.4-28.3%） and 2.4% （95% Ch 1.6- 3.2%） of all deaths in men and women, respectively, in our study population. Respiratory disease had the highest PAR in men [37.5% （95% CI： 21.5-51.6%）], followed by cancer [31.3% （95% Ch 24.6-37.7%）] and cardiovascular disease （CVD） [24.1% （95% CI： 16.7-31.2%）]. While the top three PARs were 12.7% （95% CI： 6.1-19.3%）, 4.0% （95% CI： 2.4-5.6%）, and 1.1% （95% CI： 0.0-2.3%）, for respiratory disease, CVD, and cancer, respectively in women. For deaths of lung cancer, the PAR of smoking was 68.4% （95% CI： 58.2- 76.5%） in men. Conclusions： In urban Shanghai, 23.9% and 2.4% of all deaths in men and women could have been prevented if no people had smoked in the area. Effective control programs against cigarette smoking should be strongly advocated to reduce the increasing smoking-related death burden.展开更多
From a regulatory perspective,drug quality consistency evaluation must concern different processes used for the same drug.In this study,an assessment strategy based on quality by design(QbD)was developed for populatio...From a regulatory perspective,drug quality consistency evaluation must concern different processes used for the same drug.In this study,an assessment strategy based on quality by design(QbD)was developed for population pharmaceutical quality evaluation.A descriptive analysis method based on QbD concept was first established to characterize the process by critical evaluation attributes(CEAs).Then quantitative analysis method based on an improved statistical process control(SPC)method was established to investigate the process indicators(PIs)in the process population,such as mean distribution,batch-to-batch difference and abnormal quality probability.After that rules for risk assessment were established based on the SPC limitations and parameters.Both the SPC parameters of the CEAs and the risk of PIs were visualized according to the interaction test results to obtain a better understanding of the population pharmaceutical quality.Finally,an assessment strategy was built and applied to generic drug consistency assessment,process risk assessment and quality trend tracking.The strategy demonstrated in this study could help reveal quality consistency from the perspective of process control and process risk,and further show the recent development status of domestic pharmaceutical production processes.In addition,a process risk assessment and population quality trend tracking provide databased information for approval.Not only can this information serve as a further basis for decisionmaking by the regulatory authority regarding early warnings,but it can also reduce some avoidable adverse reactions.With continuous addition of data,dynamic population pharmaceutical quality is meaningful for emergencies and decision-making regarding drug regulation.展开更多
Background:Solid fuel use is the major source of household air pollution(HAP)and accounts for a substantial burden of morbidity and mortality in low and middle income countries.To evaluate and compare childhood mortal...Background:Solid fuel use is the major source of household air pollution(HAP)and accounts for a substantial burden of morbidity and mortality in low and middle income countries.To evaluate and compare childhood mortality attributable to HAP in four South Asian countries.Methods:A series of Demographic and Health Survey(DHS)datasets for Bangladesh,India,Nepal and Pakistan were used for analysis.Estimates of relative risk and exposure prevalence relating to use of cooking fuel and under-five mortality were used to calculate population attributable fractions(PAFs)for each country.Potential impact fractions(PIFs)were also calculated assessing theoretical scenarios based on published interventions aiming to reduce exposure prevalence.Results:There are an increased risk of under-five mortality in those exposed to cooking fuel compared to those not exposed in the four South Asian countries(OR=1.30,95%CI=1.07-1.57,P=0.007).Combined PAF estimates for South Asia found that 66%(95%CI:43.1-81.5%)of the 13,290 estimated cases of under-five mortality was attributable to HAP.Joint PIF estimates(assuming achievable reductions in HAP reported in intervention studies conducted in South Asia)indicates 47%of neonatal and 43%of under-five mortality cases associated with HAP could be avoidable in the four South Asian countries studied.Conclusions:Elimination of exposure to use of cooking fuel in the household targeting valuable intervention strategies(such as cooking in separate kitchen,improved cook stoves)could reduce substantially under-five mortality in South Asian countries.展开更多
原发性肝癌是世界上常见的恶性肿瘤之一,具有较高的发病率和死亡率。本文详述了目前我国原发性肝癌的流行病学情况、人群归因分值及其相关危险因素。本文通过检索PubMed、Web of Science、中国知网等数据库发现,乙型肝炎病毒和丙型肝炎...原发性肝癌是世界上常见的恶性肿瘤之一,具有较高的发病率和死亡率。本文详述了目前我国原发性肝癌的流行病学情况、人群归因分值及其相关危险因素。本文通过检索PubMed、Web of Science、中国知网等数据库发现,乙型肝炎病毒和丙型肝炎病毒仍是原发性肝癌发病的主要危险因素。随着乙型肝炎病毒疫苗接种以及抗病毒治疗,我国原发性肝癌的发病率略有下降,但代谢性因素如糖尿病、肥胖和非酒精性脂肪性肝病等引起的原发性肝癌的发病率正逐步上升;吸烟、饮酒等也是重要的危险因素。本文综述了原发性肝癌的流行病学特点及危险因素,可为制订原发性肝癌防控措施提供切实有力的循证医学证据。展开更多
目的:分析2014年中国7~18岁儿童青少年学生血压状况的流行病学现状及其与营养状况之间的关联性,为制定儿童血压防控措施提供依据。方法:利用2014年"中国学生体质与健康调研"结果中7~18岁的儿童青少年数据,依据我国儿童青少年...目的:分析2014年中国7~18岁儿童青少年学生血压状况的流行病学现状及其与营养状况之间的关联性,为制定儿童血压防控措施提供依据。方法:利用2014年"中国学生体质与健康调研"结果中7~18岁的儿童青少年数据,依据我国儿童青少年分年龄、性别、身高百分位血压标准来评价血压状况,包括儿童血压偏高前期、血压偏高、单纯性收缩压偏高、单纯性舒张压偏高和混合性血压偏高。按照国际儿童青少年体质量指数(body mass index,BMI)标准评价儿童青少年营养状况,包括消瘦(重度消瘦和轻度消瘦)、正常BMI、超重和肥胖(重度肥胖和轻度肥胖)。利用多因素Logistics回归模型分析血压偏高与营养状况之间的关联性,并计算人群归因危险度评估超重肥胖控制对于预防儿童血压偏高的公共卫生学意义。结果:2014年中国7~18岁儿童青少年血压偏高和血压偏高前期的检出率分别为14.9%和9.2%,儿童青少年血压偏高者中收缩压偏高、舒张压偏高和混合性血压偏高检出率分别为3.1%、8.8%和3.0%。血压偏高状况整体呈现为男生高于女生,乡村高于城市,随年龄逐渐增高,随地区(东部、中部和西部)逐渐降低,随BMI的增加而增加的趋势。重度肥胖组的血压偏高检出率最高,男女生分别为44.2%和38.8%,分别是正常组(15.8%和10.6%)的2.8倍和3.7倍。血压偏高与消瘦(重度消瘦和轻度消瘦)呈负相关,与超重肥胖呈正相关。血压偏高归因于超重肥胖的危险度为16.2%,控制超重肥胖后,血压偏高的期望检出率为12.5%,且对单纯性收缩压偏高和混合性血压偏高影响较大,归因危险度分别为28.7%和35.1%。结论:我国儿童青少年血压偏高检出率较高,且以单纯性舒张压偏高为主。超重肥胖可显著增加血压偏高的风险,尤其是对单纯性收缩压偏高和混合性血压偏高影响较大,通过控制超重肥胖可显著降低全国儿童高血压的发生风险,从而对预防成年期慢性病的发生具有重要意义。展开更多
基金supported by the funds of Key Discipline and Specialty Foundation of Shanghai Municipal Commission of Health and Family Planningthe National Key Basic Research Program "973 project" (2015CB554000)grants from US National Institutes of Health (R37 CA070867, R01 CA82729, UM1CA173640, and UM1 CA182910)
文摘Objective： To evaluate the population attributable risks （PARs） between cigarette smoking and deaths of all causes, all cancers, lung cancer and other chronic diseases in urban Shanghai. Methods： In total, 61,480 men aged 40-74 years from 2002 to 2006 and 74,941 women aged 40-70 years from 1997 to 2000 were recruited to undergo baseline surveys in urban Shanghai, with response rates of 74.0% and 92.3%, respectively. A Cox proportional hazards regression model was used to estimate relative risks （RRs） and 95% confidence intervals （95% CIs） of deaths associated with cigarette smoking. PARs and 95 % CIs for deaths were estimated from smoking exposure rates and the estimated RRs. Results： Cigarette smoking was responsible for 23.9% （95% CI： 19.4-28.3%） and 2.4% （95% Ch 1.6- 3.2%） of all deaths in men and women, respectively, in our study population. Respiratory disease had the highest PAR in men [37.5% （95% CI： 21.5-51.6%）], followed by cancer [31.3% （95% Ch 24.6-37.7%）] and cardiovascular disease （CVD） [24.1% （95% CI： 16.7-31.2%）]. While the top three PARs were 12.7% （95% CI： 6.1-19.3%）, 4.0% （95% CI： 2.4-5.6%）, and 1.1% （95% CI： 0.0-2.3%）, for respiratory disease, CVD, and cancer, respectively in women. For deaths of lung cancer, the PAR of smoking was 68.4% （95% CI： 58.2- 76.5%） in men. Conclusions： In urban Shanghai, 23.9% and 2.4% of all deaths in men and women could have been prevented if no people had smoked in the area. Effective control programs against cigarette smoking should be strongly advocated to reduce the increasing smoking-related death burden.
基金The National Major Scientific and Technological Special Project for‘Significant New Drugs Development’(Grant No.:2017ZX0901001-007)provides support for this study.
文摘From a regulatory perspective,drug quality consistency evaluation must concern different processes used for the same drug.In this study,an assessment strategy based on quality by design(QbD)was developed for population pharmaceutical quality evaluation.A descriptive analysis method based on QbD concept was first established to characterize the process by critical evaluation attributes(CEAs).Then quantitative analysis method based on an improved statistical process control(SPC)method was established to investigate the process indicators(PIs)in the process population,such as mean distribution,batch-to-batch difference and abnormal quality probability.After that rules for risk assessment were established based on the SPC limitations and parameters.Both the SPC parameters of the CEAs and the risk of PIs were visualized according to the interaction test results to obtain a better understanding of the population pharmaceutical quality.Finally,an assessment strategy was built and applied to generic drug consistency assessment,process risk assessment and quality trend tracking.The strategy demonstrated in this study could help reveal quality consistency from the perspective of process control and process risk,and further show the recent development status of domestic pharmaceutical production processes.In addition,a process risk assessment and population quality trend tracking provide databased information for approval.Not only can this information serve as a further basis for decisionmaking by the regulatory authority regarding early warnings,but it can also reduce some avoidable adverse reactions.With continuous addition of data,dynamic population pharmaceutical quality is meaningful for emergencies and decision-making regarding drug regulation.
文摘Background:Solid fuel use is the major source of household air pollution(HAP)and accounts for a substantial burden of morbidity and mortality in low and middle income countries.To evaluate and compare childhood mortality attributable to HAP in four South Asian countries.Methods:A series of Demographic and Health Survey(DHS)datasets for Bangladesh,India,Nepal and Pakistan were used for analysis.Estimates of relative risk and exposure prevalence relating to use of cooking fuel and under-five mortality were used to calculate population attributable fractions(PAFs)for each country.Potential impact fractions(PIFs)were also calculated assessing theoretical scenarios based on published interventions aiming to reduce exposure prevalence.Results:There are an increased risk of under-five mortality in those exposed to cooking fuel compared to those not exposed in the four South Asian countries(OR=1.30,95%CI=1.07-1.57,P=0.007).Combined PAF estimates for South Asia found that 66%(95%CI:43.1-81.5%)of the 13,290 estimated cases of under-five mortality was attributable to HAP.Joint PIF estimates(assuming achievable reductions in HAP reported in intervention studies conducted in South Asia)indicates 47%of neonatal and 43%of under-five mortality cases associated with HAP could be avoidable in the four South Asian countries studied.Conclusions:Elimination of exposure to use of cooking fuel in the household targeting valuable intervention strategies(such as cooking in separate kitchen,improved cook stoves)could reduce substantially under-five mortality in South Asian countries.
文摘原发性肝癌是世界上常见的恶性肿瘤之一,具有较高的发病率和死亡率。本文详述了目前我国原发性肝癌的流行病学情况、人群归因分值及其相关危险因素。本文通过检索PubMed、Web of Science、中国知网等数据库发现,乙型肝炎病毒和丙型肝炎病毒仍是原发性肝癌发病的主要危险因素。随着乙型肝炎病毒疫苗接种以及抗病毒治疗,我国原发性肝癌的发病率略有下降,但代谢性因素如糖尿病、肥胖和非酒精性脂肪性肝病等引起的原发性肝癌的发病率正逐步上升;吸烟、饮酒等也是重要的危险因素。本文综述了原发性肝癌的流行病学特点及危险因素,可为制订原发性肝癌防控措施提供切实有力的循证医学证据。
文摘目的:分析2014年中国7~18岁儿童青少年学生血压状况的流行病学现状及其与营养状况之间的关联性,为制定儿童血压防控措施提供依据。方法:利用2014年"中国学生体质与健康调研"结果中7~18岁的儿童青少年数据,依据我国儿童青少年分年龄、性别、身高百分位血压标准来评价血压状况,包括儿童血压偏高前期、血压偏高、单纯性收缩压偏高、单纯性舒张压偏高和混合性血压偏高。按照国际儿童青少年体质量指数(body mass index,BMI)标准评价儿童青少年营养状况,包括消瘦(重度消瘦和轻度消瘦)、正常BMI、超重和肥胖(重度肥胖和轻度肥胖)。利用多因素Logistics回归模型分析血压偏高与营养状况之间的关联性,并计算人群归因危险度评估超重肥胖控制对于预防儿童血压偏高的公共卫生学意义。结果:2014年中国7~18岁儿童青少年血压偏高和血压偏高前期的检出率分别为14.9%和9.2%,儿童青少年血压偏高者中收缩压偏高、舒张压偏高和混合性血压偏高检出率分别为3.1%、8.8%和3.0%。血压偏高状况整体呈现为男生高于女生,乡村高于城市,随年龄逐渐增高,随地区(东部、中部和西部)逐渐降低,随BMI的增加而增加的趋势。重度肥胖组的血压偏高检出率最高,男女生分别为44.2%和38.8%,分别是正常组(15.8%和10.6%)的2.8倍和3.7倍。血压偏高与消瘦(重度消瘦和轻度消瘦)呈负相关,与超重肥胖呈正相关。血压偏高归因于超重肥胖的危险度为16.2%,控制超重肥胖后,血压偏高的期望检出率为12.5%,且对单纯性收缩压偏高和混合性血压偏高影响较大,归因危险度分别为28.7%和35.1%。结论:我国儿童青少年血压偏高检出率较高,且以单纯性舒张压偏高为主。超重肥胖可显著增加血压偏高的风险,尤其是对单纯性收缩压偏高和混合性血压偏高影响较大,通过控制超重肥胖可显著降低全国儿童高血压的发生风险,从而对预防成年期慢性病的发生具有重要意义。
