目的 了解2012-2021年北京市朝阳区居民脑卒中死亡特征及变化趋势,为脑卒中防治提供参考.方法 收集2012-2021年北京市朝阳区居民脑卒中死亡登记资料和人口资料,计算脑卒中的死亡率、标化死亡率、减寿年数、早死概率和年度变化百分比(APC)等指标来分析脑卒中的死亡特征及变化趋势.结果 2012-2021年北京市朝阳区居民脑卒中粗死亡率55.01/105,标化死亡率25.15/105,男性高于女性(x2=269.18,P＜0.001),2012-2021年脑卒中标化死亡率呈逐年下降的趋势(APC=-4.78％,P＜0.001),60～79岁组脑卒中死亡率逐年降低(APC=-7.50％,P＜0.001);80岁及以上年龄组有2个拐点,2013年比2012年脑卒中死亡率明显增高,2013-2016年脑卒中死亡率逐年下降(APC=-25.92％,P=0.026),2017-2021年逐年上升(APC=4.81％,P=0.019);缺血性脑卒中粗死亡率和标化死亡率均高于出血性脑卒中,P＜0.001;男性脑卒中早死概率高于女性,女性脑卒中早死概率逐年下降(APC=-9.24％,P＜0.001);出血性脑卒中早死概率高于缺血性脑卒中,缺血性脑卒中和出血性脑卒中早死概率均逐年下降(APC=-4.30％,P＜0.001;APC=-2.96％,P=0.02);男性脑卒中减寿年数、平均减寿年数和减寿率均高于女性,女性脑卒中减寿率逐年降低(APC=-2.47％,P＜0.001);缺血性脑卒中减寿率低于出血性脑卒中,缺血性和出血性脑卒中减寿率均逐年下降(APC=-2.76％,P=0.03;APC=-1.98％,P=0.02).结论 朝阳区脑卒中防治取得一定的效果,仍需加强男性、60岁及以上人群脑卒中的防治,重点关注出血性脑卒中对居民寿命损失的影响.

目的 对2012-2017 年北京市朝阳区户籍居民恶性肿瘤的死亡情况进行分析,为制定适合朝阳区居民的恶性肿瘤防控措施提供科学支持.方法 利用北京市卫生防病监测信息资源整合分析平台中的2012-2017 年北京市朝阳区户籍居民死亡登记资料,分析恶性肿瘤死亡率及其年度变化百分比(APC)、标化死亡率、构成比和死因顺位.采用Excel 2013 和SPSS 17.0进行统计分析.结果 2012-2017 年北京市朝阳区户籍居民恶性肿瘤居死因顺位首位,恶性肿瘤死亡23 063人,死亡率为188.63/10万,死亡率呈现上升趋势,有统计学意义(APC=1.40％,P＜0.05),男性死亡率高于女性,差异有统计学意义(x2=841.23,P＜0.01).恶性肿瘤死因顺位前10位依次为肺癌、结直肠肛门癌、肝癌、胃癌、胰腺癌、食道癌、乳腺癌、白血病、膀胱癌和前列腺癌,占全部恶性肿瘤死亡的78.77％.居民0～4 和5～14 岁组恶性肿瘤死因主要以白血病和脑及神经系统恶性肿瘤为主,居民15～44 岁组死因顺位首位为肝癌,45～64 和65 岁及以上组死因顺位首位均为肺癌.2012-2017 年居民各年龄组恶性肿瘤死因顺位基本保持一致.2012-2017 年居民结直肠肛门癌、胰腺癌死亡率呈上升趋势,均有统计学意义(APC 分别为5.34％、4.21％,P＜0.01).结论 北京市朝阳区居民恶性肿瘤死亡率仍呈现上升趋势.应重视肺癌、女性乳腺癌和消化系统恶性肿瘤,特别是结直肠肛门癌的防控.

目的 了解2012-2017年北京市朝阳区居民糖尿病死亡特征及早死概率变化情况.方法 利用北京市全人群死因监测系统中2012-2017年北京市朝阳区居民死亡登记资料,分析糖尿病死亡率、标化死亡率、减寿年数和早死概率.结果 2012-2017年北京市朝阳区居民糖尿病死亡2416人,标化死亡率10.07/10万,男性(21.26/10万)高于女性(18.15/10万),未分型糖尿病(53.19％)为主.糖尿病并发症主要是肾损害(28.10％),从诊断到死亡平均间隔时间为13.52±9.78年.2012-2017年北京市朝阳区居民糖尿病减寿年数为19 474人年,减寿率为1.67‰,早死概率为0.42％.结论 2012-2017年北京市朝阳区居民糖尿病死亡率无明显变化趋势,糖尿病对男性和高龄老人的健康影响更为严重.

目的 了解2018年北京市朝阳区网络直报死亡报告的数据质量,为提高朝阳区死因监测资料质量提供依据.方法 对2018年朝阳区使用死因网络直报系统的医疗机构报告的23 691例死亡报告进行及时性和根本死因编码准确性评价,抽取4 303例死亡病例个案信息进行漏报率分析,分层随机抽取4 839例死亡报告的证明书和对应的报告卡进行完整性、规范性和准确性评价.采用Excel 2016和SPSS 23.0软件进行x2检验和Bonferroni检验.结果 2018年朝阳区网络直报死亡报告漏报率为0.5％,不及时率为0.3％,根本死因编码不准确率为4.7％;证明书填写不完整率为5.3％、基本项不准确率为2.1％,死因链填写不合理率为0.4％;报告卡不完整率为0.3％,基本项目不一致率为3.6％,死因链部分不一致率为0.7％.其中社区卫生服务中心的不及时率(0.6％)、根本死因编码不准确率(10.5％)、证明书基本项不准确率(7.4％)、报告卡基本项目不一致率(9.7％)和死因链部分不一致率(2.6％)最高;2018年报卡数较少(＜100例)的医疗机构的不及时率、根本死因编码不准确率、证明书填写不完整率、基本项不准确率、死因链不合理率、报告卡不完整率、基本项目不一致率和死因链部分不一致率均高于2018年报卡数较多(≥100例)的医疗机构,差异均有统计学意义(P＜0.05).结论 朝阳区医疗机构死亡病例报告及时性、完整性和准确性等需进一步提高,应针对不同特征医疗机构的薄弱环节,开展针对性培训和现场指导.

目的 了解2012-2017年朝阳区居民损伤和中毒死亡状况、死因顺位及减寿年数,为制定公共卫生政策提供参考.方法 对朝阳区居民损伤和中毒死亡信息进行流行病学描述.结果 2012-2017年朝阳区居民损伤和中毒死亡率为21.14/10万;男性(23.44/10万,标化死亡率14.39/10万)高于女性(18.79/10万,标化死亡率10.54/10万),损伤和中毒的前5位死因依次为意外跌落、交通事故、自杀、意外中毒及溺水,累计占损伤和中毒总死亡的78.27％;2012-2017年朝阳区居民损伤和中毒死亡PYLL为34 284人年,AYLL为13.31人年,平均减寿率为2.813‰.结论 损伤和中毒死亡是朝阳区的主要死因之一,应针对不同年龄段损伤和中毒死亡特点,采取不同的防护策略.

目的 分析2010-2015年北京市朝阳区户籍居民心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病和糖尿病的早死概率及其变化趋势,为实现“健康中国2030”重大慢性病早死概率下降目标提供数据支持.方法 利用北京市居民死因监测系统中的2010-2015年北京市朝阳区户籍居民死亡登记资料,分析慢性病标化死亡率和心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病和糖尿病的早死概率及其年度变化百分比(APC).用SPSS17.0进行统计分析,采用对数线性回归法计算率的APC并评价率的时间变化趋势.结果 2010-2015年,北京市朝阳区户籍人口慢性病死亡约占总死亡的91％,慢性病标化死亡率由454.55/10万下降到283.45/10万,APC为-5.918％,变化趋势无统计学意义(P＞0.05).男性4类慢性病的早死概率均高于同期女性4类慢性病的早死概率,4类慢性病合计的早死概率由13.79％下降到10.85％,APC为-5.162％,变化趋势有统计学意义(P＜0.01).按照此变化速度,至2030年男性和女性4类慢性病早死概率均能实现下降30％的目标.结论 北京市朝阳区的4类慢性病早死概率指标已达到世界高收入国家的水平.应针对不同慢性病的危险因素进行干预,尤其是男性人群,以实现“健康中国2030”的目标.

自2004年1月1日始,全国建立了传染病网络直报系统[1].《中国疾病预防控制信息系统》是我国基本的传染病报告系统,成为反映地区传染病疫情的重要依据,及时、准确、完整地将疫情数据进行统计分析是开展传染病监测管理工作的前提和基础[2].传染病报告工作对于准确掌握疫情动态、研判其流行规律并有效制订防治措施具有重要意义,而传染病漏报调查是对常规疫情报告数字的重要补充和修正.为了解和掌握北京市朝阳区传染病报告现状,推算比较接近实际的发病水平,提高和规范传染病报告质量,朝阳区对辖区内医疗机构开展了传染病报告漏报调查.本文对2008-2015年区内医院传染病的漏报情况进行了分析,结果如下.

Objective To evaluate the influence of glycosylated hemoglobin on admission ( HbA1c) on long-term outcomes of patients with acute myocardial infarction treated with primary percutaneous coronary intervention. Methods A total of 305 patients with acute ST-segment elevation myocardial infarction ( STEMI) received primary percutaneous coronary intervention from Dec 2007 to Dec 2012 were enrolled in this study. HbA1c was measured on admission for all patients. Clinic characteristics、biochemical indicator, death and major adverse cardiac events ( MACE) during follow up were recorded. Patients were classified into three groups: group 1(HbA1c≤5. 6%,n=85); group 2 (5. 7%≤HbA1c≤6. 4%,n=117); and group 3 (HbA1c≥6. 5%,n=103). Results The patients were followed up for a mean of (1 075 ± 414) days. 23 patients ( 7. 5%) died and MACE occurred in 37 patients ( 12%) . MACE rate in one year was higher in group 3 ( 8. 7%) than in group 2 ( 2. 6%) and group 1 ( 1. 2%; both p < 0. 05 ) . One-year mortality rate was higher in group 3 ( 5. 8%) than in group 2 ( 0. 9%) and group 1 ( 0 ) %, both p <0. 05). Elevated HbA1c (p =0. 010) was associated with long-term (more than 1 year) MACE. After multivariate analysis, HbA1c (HR:1. 34, 95%CI:1. 099-1. 633, p=0. 004) was independently associated with long-term (more than 1 year) mortality. Conclusions HbA1c is an independent predictor of one-year and long-term outcomes in STEMI patients treated with primary percutaneous coronary intervention.

Objective To evaluate the report quality of death reports in medical institutions of Chaoyang district in Beijing in the second half of 2007 and to provide evidence for improving death report quality and to complete its evaluation system.Methods After simple random sampling,we assessed death report quality by comprehensive index method,RSR method,TOPSIS,close value method,grey related analysis method and optimizational method,using SPSS 11.5 and Excel 2003.The evaluation indicators include network missing report rate,paper missing report rate,network repeated report rate,paper repeated report rate,late report rate,nonstandard rate,network incompleteness rate,paper incompleteness rate,network inaccuracy rate,paper inaccuracy rate,report rate of unknown cause of death.Results From superior to inferior,comprehensive index method and grey related analysis method had the same result:the rank was tertiary,secondary,primary medical institutions;TOPSIS,close-value method and optimizational method had the same result:the rank was secondary,tertiary,primary medical institutions;the result of RSR was:secondary medical institutions was superior,tertiary and primary medical institutions were moderate.Conclusion The rank was judged objectively and roundly by combining eleven sporadic indicators,showing the advantage of comprehensive evaluation.The six comprehensive evaluation methods verified the stability and reliability of results mutually,making the connotation of quality evaluation richer and the results more convincing.The report quality of deaths in medical institutions should be improved.

Objective To evaluate effectiveness of integrated community-based management for hypertensive patients. Methods A total of 673 patients with hypertension participated in the study.Integrated community-based interventions and follow-up were implemented for 4 years , then effectiveness was evaluated. Results After 4-year integrated management , compared to baseline , blood pressure control rate of patients increased 46.1% to 84.0% ( P<0.01 ) .Awareness of hypertension knowledge and rate of prescribed medication increased significantly ( P<0.01 ) .The life style of patients became healthier except high-fat diet.Lipid control rate increased ( P<0.01 ) but the change of glucose control rate was not statistically significant ( P>0.05 ) . Conclusions Integrated community-based management can improve hypertensive patients′awareness of knowledge and blood pressure control rate , reduce their risk behavioral factors.

OBJECTIVE:This study aims to investigate relationship between daily concentration of PM(10), SO(2), NO(2) and daily mortality due to circulatory system diseases in Chaoyang district, Beijing. METHODS:The time-series data of daily mortality from circulatory system diseases of registered residents in Chaoyang were obtained from Chaoyang District Center for Disease Control and Prevention. The daily concentration of sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)), and particulate matter (PM(10)) were collected from Beijing Municipal Environmental Monitoring Center. And the routine monitoring meteorological data were collected from Beijing Meteorological Bureau, including daily mean temperature and daily mean relative humidity. The time-series analysis was then conducted to determine the relationship of mortality from circulatory system diseases with daily concentrations of SO(2), NO(2) and PM(10) by using Poisson regression with generalized additive model (GAM). RESULTS:During January 2004 to September 2008, the cumulative death number from circulatory system diseases of registered residents in Chaoyang district of Beijing was 19 241, the daily average concentration of SO(2), NO(2), PM(10) was 48.7, 63.9, 146.1 µg/m(3), respectively. The single pollutant model showed an increase of daily concentration of PM(10), SO(2) and NO(2) by 10 µg/m(3) will augment the mortality from circulatory system diseases by 0.20% (95%CI: 0.01% - 0.39%), 0.36% (95%CI: -0.13% - 0.85%) and 0.30% (95%CI: -0.34% - 0.94%), respectively. In the multiple air pollutants models, combinatorial effects of PM(10) and SO(2) still positively correlated with increased mortality from circulatory system diseases (P < 0.05), whereas changes of the concentration of NO(2) had no significant effect on mortality from circulatory system diseases (P > 0.05). CONCLUSION:Our findings in this study elucidated that changes of the concentration of PM(10) and SO(2) had a positive correlation with daily mortality from circulatory system diseases among the local residents in Chaoyang District, whereas the daily concentration of NO(2) was irrelevant with that.

Objective To study the relationship between daily concentration of SO2,NO2 and PM10 and daily mortality in Chaoyang district,Beijing.Methods The time-series data of daily mortality of Chaoyang district,Beijing were collected from Chaoyang District Centre for Disease Control and Prevention,and daily concentrations of SO2,NO2 and PM10,the data of daily average temperature and relative humidity were also collected.The time-series analysis was conducted by using Poisson regression with Generalized Additive Model(GAM).Results An increase of 10% μg/m3 of SO2,NO2 and PM10 could increase the total mortality by 0.47%(95%CI:0.03%-0.91%),0.55%(95%CI:-0.02%-1.12%)and 0.25%(95%CI:0.08%-0.42%)respectively;It showed that the air PM10,SO2 of monitoring levels had an adverse effect on the daily mortality of the local residents in Chaoyang district.But the daily concentration of air NO2 was not associated with the daily population mortality statistically.Conclusion The increase of air pollution is a risk factor for the daily mortality of population in Beijing.

Objective To understand the main causes of death and study the YPLL among residents in chaoyang district of Beijing,and to provide basis for prevention and control measures.Methods The death data in chaoyang district of Beijing in 2006 were studied by analysing the death rate,the death orders,life expectancy,cause eliminated life expectancy,YPLL and YPLL‰.Results The number of the death was 9 744,the death rate was 559.13/105,the standardized death rate was 436.37/105.The death rate of male was higher than that of female.The life expectancy was 77.84 years.The first five death causes were as follows:circulatory system diseases,tumor,respiratory diseases,endocrinopathy,injuries and poisonings.Eliminating the circulatory system disease and tumor,the life expectancy heightened 7.02 and 2.99 years respectively.The top five causes of YPLL‰ were as follows: tumor,circulatory system diseases,injuries and poisonings,endocrinopathy,digestive system diseases .Conclusion Prevention and control of early circulatory system diseases and tumor is very important and ecessary.Taking measures to reduce the injuries and poisonings is also very pivotal.

为了解北京市朝阳区二次供水卫生和管理安全情况,于2006年8月-2007年4月,采用分层随机整群抽样方法选取该区12个街、乡全部63家二次供水管理单位和197套二次供水设施,采用问卷调查和深入访谈的方式对其进行卫生学现况调查,并采集二次供水设施处理后最近点的二次供水水样进行检测.结果 显示,197套供水设施以变频泵(61.9%)和高低位水箱(29.5%)为主,249个生活水箱材质以不锈钢(33.3%)和玻璃钢(SMC,20.9%)居多,34.1%的生活水箱与消防水箱共用,20.5%的水箱有锈蚀或防护层脱落,95.4%的供水设施配有消毒设施,8名管水人员(5.06%)未持有有效健康证,58.7%的管理单位有水污染事故应急预案,二次供水水质总合格率为94.74%.建议加大对二次供水设施卫生监督执法力度,保障广大居民的饮水卫生及健康.

为了解北京市朝阳区二次供水卫生和管理安全情况,于2006年8月-2007年4月,采用分层随机整群抽样方法选取该区12个街、乡全部63家二次供水管理单位和197套二次供水设施,采用问卷调查和深入访谈的方式对其进行卫生学现况调查,并采集二次供水设施处理后最近点的二次供水水样进行检测.结果 显示,197套供水设施以变频泵(61.9%)和高低位水箱(29.5%)为主,249个生活水箱材质以不锈钢(33.3%)和玻璃钢(SMC,20.9%)居多,34.1%的生活水箱与消防水箱共用,20.5%的水箱有锈蚀或防护层脱落,95.4%的供水设施配有消毒设施,8名管水人员(5.06%)未持有有效健康证,58.7%的管理单位有水污染事故应急预案,二次供水水质总合格率为94.74%.建议加大对二次供水设施卫生监督执法力度,保障广大居民的饮水卫生及健康.

<正> 随着社会经济和卫生事业的发展,人口老龄化程度日益加重,居民的疾病谱和死亡谱发生了显著变化,恶性肿瘤已经成为危害我国居民健康的主要慢性非传染性疾病之一,其死亡率及在全死因中的顺位呈现上升趋势。笔者对2003—2007年北京市朝阳区的死因资料进行了分析,以便了解当地居民恶性肿

随着我国经济和交通的迅速发展,居民生活节奏的加快,伤害已经成为严重威胁人类健康的重要公共卫生问题,也是世界各国的主要死因之一[1,2],世界卫生组织1995年年度报告中指出:全球每年有500万余人死于伤害和暴力行为[3],近年来我国伤害发生率呈上升趋势,伤害的高发生率、高死亡率不仅给个人和家庭带来严重损失,也给社会造成沉重的经济负担.