目的 分析自我管理干预中情绪变化在老年2型糖尿病患者管理行为与生存质量之间的中介效应,为改善老年糖尿病患者情绪状态及以后的社区自我管理干预提供参考.方法 2016-2020年杭州市共组建69个自我管理小组,每组招募10～15例2型糖尿病患者.依托医联体建设及家庭医生签约服务资源,组建干预团队,以小组为单位开展系列团体自我管理活动.在干预前、后及干预后6个月,通过问卷调查方式收集患者基本人口学信息、疾病状况、情绪、生存质量及自我管理行为情况,评估干预效果,并分析情绪、自我管理行为、生活质量变化的相关性,采用Bootstrap进行中介效应检验.结果 最终707例老年糖尿病患者纳入研究.干预前、后及干预后6个月焦虑自评量表(SAS)得分、抑郁自评量表得分(SDS),健康调查简表(SF-36)的生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康、生理健康、心理健康维度得分,2型糖尿病自我管理行为量表(2-DSCS)的饮食控制、规律锻炼、遵医嘱服药、血糖监测、足部护理、预防与处理高低血糖维度得分及2-DSCS总分差异均有统计学意义(均P＜0.05).除干预后血糖监测维度变化值与情绪变化值无明显相关外,干预后、干预后6个月较干预前SAS、SDS变化值及生理健康、心理健康变化值与2-DSCS各维度变化值均呈相关(r=-0.336～0.333,P＜0.05).老年2型糖尿病患者自我管理行为对生存质量的直接效应为0.159,自我管理行为通过情绪对生存质量产生的间接效应为0.229,中介效应占总效应的59.02％.结论 社区团体自我管理活动可有效改善老年糖尿病患者情绪、管理行为,并提升生存质量,且情绪变化在自我管理行为与生存质量改善之间存在一定中介作用.

目的 了解2006-2020年杭州市居民脑血管病死亡趋势,为完善脑血管病防控策略提供依据.方法 通过杭州市县级及以上医院和社区卫生服务中心(乡镇卫生院)填报的户籍居民死亡卡收集2006-2020年杭州市居民脑血管病死亡资料,采用2010年全国人口普查数据标化;计算年度变化百分比(APC)分析脑血管病粗死亡率和标化死亡率.结果 2006-2020年杭州市居民脑血管病死亡109 891例,占总死亡人数的17.72％,粗死亡率和标化死亡率分别为105.83/10万和65.15/10万,均呈下降趋势,APC值分别为-0.80％(t=-3.832,P=0.002)和-4.69％(t=-24.084,P＜0.001)o 2006-2020年出血性脑卒中粗死亡率呈下降趋势,APC值为-7.97％(t=-30.704,P＜0.001);缺血性脑卒中和脑血管病后遗症粗死亡率呈上升趋势,APC值分别为5.76％(t=6.106,P＜0.001)和13.20％(t=18.103,P＜0.001).男性脑血管病粗死亡率为110.15/10万,高于女性的101.51/10万(x2=183.078,P＜0.001),均呈下降趋势,APC值分别为-0.90％(t=-4.669,P＜0.001)和-0.70％(t=-2.658,P=0.020).城市居民脑血管病粗死亡率为101.95/10万,呈下降趋势,APC值为-1.19％(t=-3.655,P=0.003);农村居民脑血管病粗死亡率为112.46/10万,未见明显变化趋势(t=-0.719,P=0.485).随年龄增长居民脑血管病粗死亡率呈上升趋势(x2趋势=502 711.682,P＜0.001),≥35岁居民脑血管病粗死亡率均呈逐年下降趋势(P＜0.05).结论 2006-2020年杭州市居民脑血管病死亡率呈下降趋势;农村居民、男性和老年人脑血管病死亡率较高.

Background: There is accumulating evidence of aberrant expression of miR-143 and miR-145 and their target gene KRAS in colorectal cancer (CRC). We hypothesize that single nucleotide polymorphisms (SNPs) within or near mRNA-microRNA (miRNA) binding sites may affect miRNA/target gene interaction, resulting in differential mRNA/protein expression and promoting the development and progression of CRC. Methods: We conducted a case-control study of 507 patients with CRC recruited from a tertiary hospital and 497 population-based controls to assess the association of genetic polymorphisms in miR-143/145 and the KRAS 3' untranslated region (3'UTR) with susceptibility to CRC and patients' survival. In addition, genetic variations of genomic regions located from 500 bp upstream to 500 bp downstream of the miR-143/miR-145 gene and the 3'UTR of KRAS were selected for analysis using the Haploview and HaploReg software. Results: Using publicly available expression profiling data, we found that miR-143/145 and KRAS expression were all reduced in rectal cancer tissue compared with adjacent non-neoplastic large intestinal mucosa. The rs74693964 C/T variant located 65 bp downstream of miR-145 genomic regions was observed to be associated with susceptibility to CRC (adjusted odds ratio (OR): 2.414, 95% CI: 1.385-4.206). Cumulative effects of miR-143 and miR-145 on CRC risk were observed (Ptrend=0.03). Patients having CRC carrying variant genotype TT of KRAS rs712 had poorer survival (log-rank P=0.044, adjusted hazard ratio (HR): 4.328, 95% CI: 1.236-15.147). Conclusions: Our results indicate that miRNA-related polymorphisms in miR-143/145 and KRAS are likely to be deleterious and represent potential biomarkers for susceptibility to CRC and patients' survival.

目的 了解杭州市二级以上公立医院肿瘤登记人力资源现况,为完善肿瘤登记工作和优化医院卫生人力资源管理提供依据.方法 采用普查方式对杭州市所有二级以上公立医院肿瘤登记工作人员进行问卷调查,同时导出杭州市2016年肿瘤登记数据,评价每家医院全年肿瘤登记工作质量.应用Excel表格建立调查数据库进行描述性统计分析.结果 2016年杭州市72家二级以上公立医院共有113名肿瘤登记人员,平均每家医院配置1.57人,女性占83.19％,年龄≥45岁占46.90％,工龄≥20年占66.37％,护理专业占54.87％,大学本科及以上学历占69.03％,中级职称占55.75％.医院肿瘤登记人员以兼职为主,税前平均收入超过15万元仅占1.39％.三级医院在人员年龄、学历、职称和薪酬水平方面优于二级医院,采用系统对接报告方式的比例、报告数量、报告及时率、身份证号码填写完整率和病理学类型填写完整率也均高于二级医院.结论 杭州市二级以上公立医院肿瘤登记人员数量有保障,但结构不合理,应加强适应肿瘤大数据时代的人力资源建设,全面提升工作质量.

Abstract Background To evaluate the effectiveness of community health management of elderly hypertension, and to describe the status and related risk factors of blood pressure control. Methods This was a cross-sectional study. Hypertensive patients aged 60 years and above who took part in community health management in Hangzhou were selected. Data on lifestyle, obesity, blood lipids, fasting plasma glucose, and blood pressure were collected. Systolic blood pressure ≥140 and/or diastolic blood pressure ≥90 mm Hg were used to calculate the blood pressure control rate. Results There were 209,768 subjects with mean age (70.7 ± 7.1) years in the present study. The mean value of systolic and diastolic blood pressures was (141.4 ± 16.9) and (80.2 ± 10.0) mm Hg, respectively. The blood pressure control rate was 48.39%. The rate of the subjects with unhealthy lifestyles, obesity (or central obesity), dyslipidemia, and abnormal fasting plasma glucose was 86.27%, 38.20%, 58.16%, and 14.72%, respectively. The unhealthy lifestyle, obesity, abnormal fasting plasma glucose, and dyslipidemia, affected blood pressure control rate, with an odds ratio (95% confidence interval) of 1.18 (1.15–1.21), 1.23 (1.21–1.25), 1.44 (1.40–1.48), and 1.10 (1.09–1.11), respectively. When 4 risk factors were combined, odds ratio (95% confidence interval) was 1.96 (95% confidence interval 1.83–2.09) for poor blood pressure control. Overall, the percentage of isolated systolic hypertension was 34.87% and increased with age. Conclusions The blood pressure control rate of the elderly hypertension patients in the community health management by national essential public health service was 48.39%. Obesity, unhealthy lifestyle, abnormal fasting blood glucose, and dyslipidemia are risk factors of poor blood pressure control and have cumulative effects.

ObjectiveTo analyze the mortality rate of chronic obstructive pulmonary disease (COPD) and its trend in residents in Hangzhou from 2006 to 2018, and provide scientific basis for COPD prevention and control. MethodsThe data of death cause surveillance in Hangzhou from 2006 to 2018 were collected from the chronic diseases surveillance system of Zhejiang to calculate the crude mortality rate and the standardized mortality rate of COPD in residents in Hangzhou. The annual percentage change (APC) was used to analyze the changing trend of COPD mortality. ResultsThe crude mortality rate and the standardized mortality rate of COPD were 74.17/100 000 and 44.55/100 000 respectively in residents in Hangzhou from 2006 to 2018. The standardized mortality rate showed a decreasing trend from 2006 to 2018 and the APC was −9.52% (P＜0.001). The crude mortality rate was 82.65/100 000 in males and 65.67/100 000 in females（χ2＝860.713, P＜0.001). The standardized mortality rate showed decreasing trends in both males and females, the APC were −9.24% and −9.88%, respectively. The standardized mortality rate was 49.14/100 000 in rural areas and 41.54/100 000 in urban areas ( χ2＝8 487.052, P＜0.001), showing decreasing trends, the APC were −8.06% and −10.15%, respectively. Except those aged below 35 years and 35–44 years, the standardized mortality rate of COPD in all age groups showed a downward trend from 2006 to 2018 (P＜0.001). ConclusionThe COPD mortality in residents in Hangzhou decreased from 2006 to 2018. More efforts are needed to reduce COPD mortality in rural residents, males and elderly population.

目的 评价诊室血压(OBP)联合动态血压监测(ABPM)诊断高血压的价值.方法 于2015-2018年选取诸暨市和杭州市的4个社区161名无高血压病史,且首日OBP为120～159 mm Hg/80～99 mm Hg的35 ～ 79岁常住居民为研究对象,测量ABPM(1周内)和非同日3次OBP(4周内),采用ROC曲线评价OBP(一日血压升高和三日血压均升高2种标准)联合ABPM (24 h、白天时段、夜间时段、任一时段平均血压升高4种标准)诊断隐蔽性高血压(MH)和白大衣高血压(WCH)的效果.结果 以三日OBP为金标准,一日OBP联合4种ABPM标准诊断MH的ROC曲线下面积(A UC)为0.79 ～ 0.81,灵敏度为57.58％～62.77％,特异度为100.00％;诊断WCH的AUC值为0.95 ～0.98,灵敏度为100.00％,特异度为88.96％～96.80％.Kappa值均＜0.6,一致性不高.以任一时段ABPM升高为金标准,联合相同OBP标准时,24h、白天时段和夜间时段标准诊断MH的AUC值为0.90～ 0.92,灵敏度为79.17％ ～ 83.90％,特异度为100.00％,Kappa值均＞0.6,一致性较好;联合一日OBP标准时,Kappa值＞0.8,一致性极好;诊断WCH的AUC值为0.95～1.00,灵敏度为100.00％,特异度为89.54％～99.37％,白天时段与任一时段ABPM标准的Kappa值＞0.6,一致性较好.结论 一日OBP可替代三日OBP用于排除MH和诊断WCH,但准确性不如三日OBP;24 h或白天时段替代任一时段ABPM标准是可行可靠的.

Objective:To evaluate the effect of self-management model of community diabetes patients under the guidance of general practitioners.Methods:A total of 22 communities in Hangzhou were selected as intervention pilot from 2016 to 2017, and 10-15 diabetic patients were recruited to form a self-management team in each community. Relying on the construction of medical alliance and there sources of contracted service of family doctors, intervention teams were set up to conduct regular, personalized and continuous self-management interventions on patients. Intervention continued for 4-6 months. Before, after and 6 months after the intervention, the basic information of patients, knowledge of diabetes, faith in managing disease, self-management behavior, self-management ability of patients, and quality of life were collected through questionnaire survey, body mass index (BMI), 2-hour postprandial blood glucose and glycosylated hemoglobin were detected uniformly, and statistical analysis was conducted.Results:A total of 292 patients were involved in the self-management group, the average age was (66.38±7.90) years old, most of them were female (64.73%). Six months after the intervention, the awareness rate of basic knowledge, risk factors and prevention and treatment knowledge about diabetes in patients (68.64%, 78.75%, 63.41%) were significantly higher than those before the intervention (28.08%, 48.29%, 39.38%), the proportion of patients with reasonable diet, moderate exercise, active problem-solving, management plan making and action according to the plan increased (from 65.41%, 28.76%, 39.04%, 31.85%, 27.74% to 86.76%, 60.28%, 65.16%, 78.05%, 73.17%)(all P<0.05).In terms of time effect, the scores of physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional and mental health in SF-36 after intervention and 6 months after intervention were all increased step by step (all P<0.05). Before the intervention, BMI, 2-hour postprandial blood glucose and glycosylated hemoglobin were (24.20±3.11) kg/m 2, (9.29±2.23) mmol/L, (6.81±1.01)% respectively. After the intervention, the three indexes all showed a downward trend, which were (22.89±2.98) kg/m 2, (8.81±1.61) mmol/L, (6.57±0.76)% respectively ( F=14.832, 6.828, 9.667; all P<0.05). Conclusion:Under the guidance of general practitioners, the self-management model of community diabetes patients can effectively improve the level of recognition, belief and behavior of patients, improve their self-management ability and quality of life, and improve BMI and blood glucose control level.

目的 以家庭血压测量(HBPM)为基准,探讨一日诊室血压和非同日三次诊室血压对社区人群白大衣性高血压(WCH)和隐蔽性高血压(MH)诊断率的影响.方法 于2015-2018年在浙江省4个社区纳入既往无高血压病史,首日诊室血压为正常高值或1级高血压水平的常住居民,于4周内完成2日诊室血压复查和连续7 d HBPM.诊室一日法的高血压诊断标准为首日诊室收缩压≥140和(或)舒张压≥90mmHg;诊室三日法的高血压诊断标准为3日诊室血压均达到收缩压≥140和(或)舒张压≥90 mm Hg.HBPM的高血压诊断标准为后6日平均血压值达到收缩压≥135和(或)舒张压≥85 mm Hg.诊室血压为高血压但HBPM诊断为非高血压者定义为WCH;诊室血压为非高血压但HBPM诊断为高血压者定义为MH.160例调查对象具有完整的血压监测数据.结果 依据首日诊室血压、三日诊室血压、家庭血压分别诊断高血压75(46.9％)、23(14.4％)和78例(48.8％).基于首日诊室血压和家庭血压检出WCH 39例(24.4％),MH 42例(26.3％);基于三日诊室血压和家庭血压检出WCH 11例(6.9％),MH 66例(41.3％),诊室一日法和三日法对于高血压、WCH、MH的诊断率差异有统计学意义(均P＜0.05).诊室血压存在日间差异,首日血压较高,而心率无日间差异.结论 以连续7d家庭血压为基准,在同一人群中,与诊室一日法相比,诊室三日法明显降低WCH的诊断率,而增加MH的诊断率.

目的 了解杭州市成人农药管理行为危险因素的现况,为减少农药中毒,保护身体健康提供科学依据.方法 2013年9-11月,采用多阶段随机抽样的方法,人户问卷面访调查的方式进行调查.应用X2检验进行数据分析.结果 12.3％的调查对象表示家中常备农药.家里经常保存农药比例随着学历的增高而减少.不同职业家里保存农药比例不同,农林牧渔水利业生产人员家中保存农药比例最高(X2 =499.9,P ＜0.05).6.3％的家庭将农药保存在任何人都可拿到的地方,59.9％的家庭将农药保存在一般人不易拿到的地方.农村家庭家中保存农药的比例高于城市.结论 为减少成人农药伤害,建议政府加大人群农药知识健康教育,引导居民妥善进行农药管理.

目的 了解杭州市15～69岁居民自我伤害意识和行为情况,为今后预防相关人群的自我伤害、保护身心健康提供数据支持.方法 以多阶段分层随机整群抽样的方法,依托浙江省卫生监测区抽样框架,在14个区县中共抽取15～69岁人群3335人,对自杀或其他自我伤害情况进行问卷调查.对数据进行Epidata软件双录入核查比对,并采用SPSS 19.0软件进行数据分析.统计方法采用χ2检验.检验水准α=0.05.结果 调查对象男女比例为1:1.07.调查对象以50～60岁为主(28.04％).民族以汉族居多(98.89％);文化程度以初中居多(31.90％).自我伤害情况多以连续三个月以上使用安眠药、镇痛药、抗焦虑药、麻醉剂、兴奋剂为主(2.46％).药物使用的发生率在年龄组间的差异有统计学意义(χ2=7.398,P=0.025)."有过自杀或其他自我伤害的行为"发生率方面,城乡间有统计学差异(χ2=4.606,P=0.032)."想过自杀或其他自我伤害方式"发生率的性别间差异、年龄组间差异、文化程度间的差异均没有统计学意义(P>0.05)、"有过自杀或其他自我伤害的行为"发生率的性别间差异、年龄组间差异、文化程度间差异均没有统计学意义(P>0.05).结论 目前杭州市15～69岁居民自我伤害主要表现为连续服用药物,不同人群自我伤害的行为各有不同,农村是开展自我伤害干预的重点地区.

目的 了解2009—2018年杭州市15～49岁女性妊娠糖尿病(GDM)发病趋势,为GDM防控提供依据.方法从浙江省慢性病监测信息系统中收集2009—2018年杭州市户籍15～49岁女性GDM发病资料,统计GDM发病率,并采用2000年全国标准人口进行标化.采用年度变化百分比(APC)和平均年度变化百分比(AAPC)分析不同年龄和地区GDM发病趋势.结果2009—2018年杭州市报告新发GDM 45519例,粗发病率和标化发病率分别为248.04/10万和158.52/10万,粗发病率和标化发病率的AAPC分别为59.7％和56.4％,均呈逐年上升趋势(P<0.05).其中2009—2012年GDM粗发病率和标化发病率的APC分别为139.76％和134.60％,2012—2018年GDM粗发病率和标化发病率的APC分别为30.35％和27.65％,均呈逐年上升趋势(P<0.05).2009—2018年15岁～组、25岁～组、30岁～组、35岁～组和40～49岁组GDM发病率均呈逐年上升趋势(P<0.05),其中40～49岁组GDM发病率的AAPC最高,为65.3％.2009—2018年城市和农村女性GDM标化发病率AAPC分别为53.4％和66.0％,农村高于城市.结论2009—2018年杭州市15～49岁女性GDM发病率呈上升趋势,尤其40～49岁和农村女性GDM发病率的AAPC较大.

目的 分析杭州市居民膳食模式与甲状腺癌的关系,为预防甲状腺癌提供依据.方法 选取浙江省肿瘤医院确诊的原发性甲状腺癌新发病例为病例组,按性别、年龄和居住地1 ︰ 1匹配社区健康人群为对照组.采用自行设计的问卷收集研究对象的人口学信息、疾病史、膳食行为和生活方式等资料,采用因子分析法归纳膳食模式,采用多因素条件Logistic回归模型分析膳食模式与甲状腺癌的关系.结果 调査病例组258例,对照组258人.因子分析得到素食模式、高蛋白模式、腌制蔬菜/藻类模式、水产海鲜杂粮模式和酒茶模式5种膳食模式.多因素条件Logistic回归分析结果 显示,水产海鲜杂粮模式可能降低甲状腺癌的发病风险(OR=0.286,95％CI:0.146～0.561).结论 增加水产海鲜、杂粮类食物的摄人可能有助于降低甲状腺癌的发病风险.

目的 分析2006—2015年浙江省杭州市居民白血病死亡情况及变化趋势,为预防和控制白血病提供依据.方法 从浙江省慢性病监测信息管理系统收集2006—2015年杭州市死因监测资料,计算白血病粗死亡率、 标化死亡率和0～74岁累积死亡率,采用年度变化百分比(APC)分析2006—2015年杭州市居民白血病死亡率变化趋势.结果 2006—2015年杭州市居民白血病粗死亡率为4.38/10万,标化死亡率为3.79/10万,标化死亡率的APC为-2.27％,呈逐年下降趋势(P<0.05).男性白血病粗死亡率为5.15/10万,高于女性的3.62/10万(P<0.05).0岁～组、15岁～组和65岁～组白血病粗死亡率分别为2.00/10万、3.03/10万和15.63/10万,标化死亡率分别为0.45/10万、1.85/10万和1.05/10万.0岁 ～ 组和15岁 ～ 组白血病标化死亡率的APC分别为-9.24％和-3.82％,均呈逐年下降趋势(P<0.05);65岁 ～ 组白血病标化死亡率的APC为3.77％,呈逐年上升趋势(P<0.05).结论 2006—2015年杭州市居民白血病标化死亡率呈下降趋势,男性白血病死亡率高于女性,≥65岁老年人白血病标化死亡率呈上升趋势.

Abstract Background MicroRNAs have important roles in tumorigenesis. There is accumulating evidence of aberrant expression of miR-143 and miR-145 and their target gene KRAS has been described in colorectal cancer (CRC). We hypothesize that single nucleotide polymorphisms (SNPs) within or near mRNA-miRNA binding sites may affect miRNA/target gene interaction, resulting in differential mRNA/protein expression and promoting the development and progression of CRC.Methods We conducted a case-control study of 507 CRC cases recruited from a tertiary hospital and 497 population-based controls to assess the association of genetic polymorphisms in miR-143/145 and the KRAS 3′ untranslated region (3′ UTR) with CRC susceptibility and survival. Deaths and causes of death among the CRC cases were identified using the Hangzhou Cancer Registration System and Death Surveillance System. Genetic variations of genomic regions located from 500 bp upstream to 500 bp downstream of the miR-143/miR-145 gene and the 3′ UTR of KRAS were selected using the Haploview and HaploReg software. Results Using publicly available expression profiling data, we found that miR-143/145 and KRAS expression were all reduced in rectal cancer tissue compared with adjacent normal mucosa. The Rs74693964 C/T variant located 65 bp downstream of miR-145 genomic regions was observed to be associated with CRC susceptibility (adjusted odds ratio 2.414, 95% CI: 1.385–4.206). Among non-smokers, the miR-143 rs41291957 GA genotype and miR-145 rs74693964 CT genotype were borderline significantly associated with an increased risk of rectal cancer. However, there was no interaction effect between selected SNPs and smoking status. Cumulative effects of miR-143 and miR-145 on CRC risk were observed (Ptrend=0.03). CRC cases carrying variant genotype TT of KRAS rs712 had poorer survival (log-rank P=0.044, adjusted hazard ratio 4.328, 95% CI: 1.236–15.147). Conclusions Our results indicate that miRNA-related polymorphisms in miR-143/145 and KRAS are likely to be deleterious and represent potential biomarkers for CRC susceptibility and survival.

目的 分析2014—2018年杭州市富阳区成人伤害的时间分布,并预测2019年成人伤害趋势.方法 收集杭州市富阳区三家医疗机构2014—2018年成人伤害病例资料,建立时间序列求和自回归滑动平均模型(ARIMA)进行分析,并预测2019年富阳区成人伤害趋势.结果 2014—2018年杭州市富阳区3家医疗机构每月成人伤害接诊例数随时间变化较平稳,建立ARIMA(1,0,0)模型,Ljung-Box Q检验无统计学意义(P>0.05),预测2019年1—12月成人伤害接诊病例数以7月最多,1540例占9.76％.2019年1—4月模型预测值与实际观测值相对误差为0.13.结论 2019年1—12月杭州市富阳区成人伤害病例数呈上升趋势,且在7月达到最大值.

Objective To understand middle school students’ current cognition, attitude, self daily behaviors and injury situation of using electronic equipment while walking and to provide a scientific basis for invention strategies. Methods a total of 696 students selected from 4 junior high schools and 4 senior high schools in 4 districts in Hangzhou by multistage random cluster sampling were investigated with a questionnaire survey. Results 89.91% of the students were distracted by using electronic devices while walking. 77.81% of surveyed students were listening to music while walking. 72.70% were on the phone. 71.66% were sending messages. 45.52% were seeking information. 35.06% were playing electronic games, and 25.94% of the students were watching the video. As for the rate of the reported distracted behaviors by electronic equipment, the senior high school students had a higher rate than junior high school students. Girls had a higher reported rate of listening music while walking than that of boys. While boys had a higher rate of playing games while walking than that of girls. 95.40% of students believed that their peers would be distracted by using electronic devices while walking. 50.51% of the surveyed students said they had been hit by a motor vehicle or were almost hit while walking, of which 14.57% were related to the distraction of using electronic devices. 52.61% of students using electronic devices during their daily walk were hit by a motor vehicle or were almost hit, higher than the proportion of non-use electronic device students (30.4%). Conclusion Most of the junior/senior high school students would use electronic equipment frequently in the walk, leading to the distraction, influencing personal safety and certain measures should be taken as soon as possible to reduce the occurrence of related accidents.

Background: Incidences of thyroid cancer (TC) have been increasing worldwide in recent decades. In this research, we aimed to analyze the spatiotemporal pattern of TC and explore relevant environmental risk factors in Hangzhou (HZ), which is rapidly urbanizing and home to the highest TC incidence in China. Methods: Spatial scan statistic was employed to analyze the spatiotemporal pattern of TC in HZ from 2008 to 2012. The geographically weighted regression model (GWR) was implemented to explore environmental risk factors. Its performance was compared to the traditional ordinary least squares model (OLS). Results: A total of 7147 TC cases (5385 female and 1762 male) were diagnosed in HZ from 2008 to 2012. High TC clusters were detected in the northeast, urban areas and expanded outwards while low clusters were located in the southwest rural areas. The GWR model generally performed better than the OLS in analyzing the associations between TC incidence and environmental factors. The industrial density, chemical oxygen demand of wastewater (COD) and the percentage of building area had a strong positive influence on the TC in the northeastern suburb areas of HZ, while the elevation, slope and the percentage of forest area had a significant negative correlation with TC in the middle, rural areas of HZ. Meanwhile, the accessibility to health care might have an impact on the TC incidence. Conclusion: High clusters were mostly located in the northeastern urban areas and showed an expansion process from the center urban area to the suburb area, especially for female TC. Intensive industrial activities and the emission of organic pollutants, which positively correlated with the high TC clusters in the northeast suburb areas of HZ, should get proper attention. (C) 2018 Published by Elsevier B.V.

Background: The obesity-hypertension pathogenesis is complex. From the phenotype to molecular mechanism, there is a long way to clarify the mechanism. To explore the association between obesity and hypertension, we correlate the phenotypes such as the waist circumference (WC), body mass index (BMI), systolic blood pressure (SB), and diastolic blood pressure (DB) with the clinical laboratory data between four specific Chinese adult physical examination groups (newly diagnosed untreated just-obesity group, newly diagnosed untreated obesity-hypertension group, newly diagnosed untreated just-hypertension group, and normal healthy group), and the results may show something. Objective: To explore the mechanisms from obesity to hypertension by analyzing the correlations and differences between WC, BMI, SB, DB, and other clinical laboratory data indices in four specific Chinese adult physical examination groups. Methods: This cross-sectional study was conducted from September 2012 to July 2014, and 153 adult subjects, 34 women and 119 men, from 21 to 69 years, were taken from four characteristic Chinese adult physical examination groups (newly diagnosed untreated just-obesity group, newly diagnosed untreated obesity-hypertension group, newly diagnosed untreated just-hypertension group, and normal healthy group). The study was approved by the ethics committee of Hangzhou Center for Disease Control and Prevention. WC, BMI, SB, DB, and other clinical laboratory data were collected and analyzed by SPSS. Results: Serum levels of albumin (ALB), alanine aminotransferase (ALT), low density lipoprotein cholesterol (LDLC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), alkaline phosphatase (ALP), uric acid (Ua), and TC/HDLC (odds ratio) were statistically significantly different between the four groups. WC statistically significantly positively correlated with BMI, ALT, Ua, and serum levels of glucose (GLU), and TC/HDLC, and negatively with ALB, HDLC, and serum levels of conjugated bilirubin (CB). BMI was statistically significantly positively related to ALT, Ua, LDLC, WC, and TC/HDLC, and negatively to ALB, HDLC, and CB. DB statistically significantly positively correlated with ALP, BMI, and WC. SB was statistically significantly positively related to LDLC, GLU, serum levels of fructosamine (FA), serum levels of the total protein (TC), BMI, and WC. Conclusion: The negative body effects of obesity are comprehensive. Obesity may lead to hypertension through multiple ways by different percents. GGT, serum levels of gamma glutamyltransferase; ALB, serum levels of albumin; ALT, serum levels of alanine aminotransferase; LDLC, serum levels of low density lipoprotein cholesterol; TG, serum levels of triglyceride; HDLC, serum levels of high density lipoprotein cholesterol; FA, serum levels of fructosamine; S.C. R, serum levels of creatinine; IB, serum levels of indirect bilirubin; ALP, serum levels of alkaline phosphatase; CB, serum levels of conjugated bilirubin; UREA, Urea; Ua, serum levels of uric acid; GLU, serum levels of glucose; TC, serum levels of the total cholesterol; TB, serum levels of the total bilirubin; TP, serum levels of the total protein; TC/HDLC, TC/HDLC ratio.

Objective To examine safety condition of walking traffic among high school students in Hangzhou city of Zhejiang province and to provide evidences for intervention on road traffic injury among the students.Methods Using multistage random cluster sampling,we selected 690 students from 4 junior and 4 senior high schools in urban and suburban regions of Hangzhou city for a questionnaire survey between March and July 2015.Results Of all the students,33.19％ reported commuting to school by walking every day and 55.65％ reported waiting for green light before crossing intersections.Among the students,83.33％,90.76％,and 87.97％ reported looking around,using crosswalks,and strictly under the control of traffic light when crossing roads.There were 13.13％ and 21.30％ of the students reporting not using intersection and running frequently when crossing roads.Only 10.90％ of the students had eye contacts with drivers of automobiles approaching when crossing roads.The ratio of the suburban students strictly under the control of traffic light when crossing roads was significantly lower than that of the urban participants (P ＜ 0.05);while the junior high school students reported a significantly higher frequencies of having eye contacts with drivers of automobiles approaching and running when crossing roads than the senior high school students (both P ＜ 0.01).Insufficient management on their school commuting by schools,families,and transportation agencies were addressed by the students;24.38％ of the students indicated that they had never seen personnel engaged in assistant traffic management at intersections;while 86.46％ considered that drivers and pedestrians should take equal responsibilities to promote road traffic safety.Conclusion There are many individual risk factors for road traffic injury among high school students and specific education on traffic safety and behavior intervention should be carried out based on traffic behavior and attitude of the students.