<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">中国艾滋病流行模式的变化为疫情防控带来了重大挑战,高危人群预防成为当务之急。本文梳理了国外艾滋病预防的理论措施,总结了中国女性工作者、注射吸毒者和男男性行为者3类高危人群艾滋病的流行情况、预防措施和研究进展。尽管中国已经广泛实施了多项干预措施,高危人群预防获得了积极成果,"治疗即预防"策略也在国内开始试验研究,但是中国尚未构建起多层次的干预模式,防控体系有待进一步完善。</span>

Objective To analyze the international comparison of the situation of China's cancer incidence and mortality and the status of primary cancer, and to discuss the global cancer burden of China. Method Collected Chinese cancer data in 2012 obtained from National Central Cancer Registry (NCCR) and global cancer data in 2012 (GLOBOCAN 2012) obtained from International Agency for Research on Cancer (IARC), so as to compare the situation of cancer incidence and mortality between China and the world. Result The age-standardized cancer incidence rate in China by world standard population was 187.8/105 (males 214.3/105, females 163.8/105), which was higher than the world level and in the 65th ranking all over the world. The age-standardized cancer mortality rate in China by world standard population was 111.3/105 (145.6/105 in male and 78.9/105 in female), which was higher than the world level and in the 45th ranking all over the world. The mortality to incidence ratio of 0.62 was higher than the world level and in the 83rd ranking all over the world (89th in male and 58th in female). The incidence of cancer of lung, stomach, liver, esophageal, pancreatic, brain and central nervous system among the male in China were higher than the world level, and the incidence of cancer of lung, stomach, liver, esophageal and thyroid among the female in China were higher than the world level. The mortality of cancer of lung, stomach, liver, esophageal, pancreatic, brain and central nervous system among the male in China were higher than the world level, and the mortality of cancer of lung, stomach, liver, esophageal and brain and central nervous system among the female in China were higher than the world level. The estimates of new cancer cases in China accounted for about 25.5%of the world. New incidence cases of lung cancer, liver cancer, stomach cancer, esophageal cancer, thyroid cancer, brain and central nervous system cancer in China accounted for over 34.0%of the world. The estimates of cancer deaths in China accounted for about 26.7%of the world. The cancer deaths of lung cancer, liver cancer, stomach cancer, esophageal cancer in China accounted for over 35.0%of the world. Conclusion In China, cancer has become a serious public health problem threating Chinese inhabitant's health and social development, and government should increase cancer registry coverage and enhance data quality, so as to improve the capacity of cancer prevention and control.

Objectives To analyze the information of health communication through different media from Wuhan CDC ,in order to provide the gist for the future health communication .Methods Information of different media in heath communication in 2012 and 2013 were collected .Content analysis method was used to analyze the time distri‐bution、transmission media distribution and subject distribution of the disseminate information .Results 1 012 infor‐mation through different media were transmited in recent 2 years ,while in 2012 the number was 397 and in 2013 595 .There was a disproportion in time distribution due to the health events .The proportion of the traditional media in the media distribution of health communication was 24 .80% (among them ,the newspaper was 72 .11% ) ,the new media was 75 .20% (among them ,Microblog was 88 .31% ) .The main issues were health factors and preven‐tion knowledge (78 .26% ) .Conclusions The traditional media is the important carrier of health communication , and the new media is the emerging carrier of health communication .The emphasis of the health communication is“to popularize the health knowledge and promote behavior change of the public” .When facing with a public heath e‐mergency ,we must seize the opportunity to develop health communication .

[Purpose] To evaluate incidence and mortality of brain,nervous system cancer in China in 2009.[Methods] On basis of the criteria of data quality from The National Central Cancer Registry(NCCR),data were form 104 registries were evaluated. There were 72 registries’ data qualified and accepted for cancer registry annual report in 2009. Incidence and mortality of Brain ,nervous system cancer stratified by areas(urban/rural),gender and age group were analyzed. Chinese population census in 1982 and Segi’s population were used for age-standardized incidence/mortality rates. [Results] All 72 caner registries covered a total of 85 470 522 population (57 489 009 in urban area and 27 981 513 in rural areas). The total new cases and deaths of brain,nervous system Cancer were 5 509 and 3 311 respectively. The morphology verified cases accounted for 51.01% , death certifications only cases accounted for 3.41% ,and mortality to incidence ratio was 0.60. The crude incidence in Chinese cancer registration areas was 6.45/10 5 ,age-standardized incidence rates by Chinese standard population(ASR China) and world standard population were 4.11/10 5 and 4.88/ 10 5 with the cumulative incidence rate (0～74 years old) of 0.50%. The cancer mortality in Chinese cancer registration areas was 3.87/10 5 ,age-standardized mortality rates by Chinese standard population and world standard population were 2.29/10 5 and 2.81/10 5 with the cumulative incidence rate (0～74 years old) of 0.29%. [Conclusion] Brain,nervous system cancer has become the significant cancer bringing a serious impact on the residents’ health. The prevention and control for brain, nervous system cancer must be strengthened.

[目的]评价中国脑瘤发病和死亡的分布特点及流行趋势。[方法]利用2003～2007年全国32个肿瘤登记处脑瘤的数据,分析不同地区、不同年龄脑瘤发病和死亡的特点,并与同时期全球各国脑瘤发病和死亡的资料进行比较。[结果]2003～2007年全国脑瘤发病率为6.60/10万,在恶性肿瘤发病构成中位居第9位,男性发病率低于女性,脑瘤发病率呈上升趋势。全国脑瘤死亡率为3.82/10万,在恶性肿瘤死亡构成中位居第10位,男性的脑瘤死亡率高于女性,城市地区脑瘤发病率明显高于农村地区,城市地区脑瘤死亡率低于农村地区。我国男性脑瘤发病率和死亡率高于世界和发展中国家的平均水平,略低于发达国家平均水平,我国女性脑瘤的发病率和死亡率高于世界、发达以及发展中国家的平均水平,已经成为女性脑瘤高发病率的国家。[结论]脑瘤发病率在我国呈明显上升趋势,成为严重危害人民健康的重要肿瘤,应加强脑瘤的预防与控制工作。

Objectives To explore the application of Structural Equation Modeling in the analysis of health literacy,and provide reference for the construction of appropriate evaluation indexes of health literacy.Methods The survey data of evaluation indexes of health literacy of Wuhan residents was used to make the structural equation modeling to assess the value of that model in the analysis of health literacy.Results The structural equation modeling has good reliability,it interprets the linkage between the potential variable and metrical variable.The relationships between potential variables are reflected by the structural equation modeling,the health literacy is mainly interpreted by the metrical variables,so the potential variables can indicate the health literacy effectively.Conclusions The structural equation modeling has good prospect in the analysis of health literacy.

颈椎位于胸椎和头颅之间,具有支持头部重量使之保持平衡,保护脊髓,通行神经血管,支配身躯等功能,起着"承上启下"的重要作用.因其运动幅度较大,活动频繁,比腰部运动更为灵活多用,且存在运动的多样性,故脊柱损伤中,多以颈椎为先,易于发生病变--颈椎病.临床上将颈项部软组织损伤或发生慢性退行性变,引起颈项部神经、血管、肌腱、韧带或椎间盘等受到刺激或压迫,造成颈肩臂痛、手臂麻木、头痛、眩晕,甚则引起肢体不全性瘫痪等相关综合症状,称为颈椎综合征或颈神经综合征,有的称为颈项部慢性筋伤"[1].

To evaluate the indicators of health literacy,and to provide basic data for the establishment of the indicator system of health literacy and the investigation of health literacy of the citizens.Methods Delphi method,entropy method and difficulty distinguish method were used for the evaluation and analysis of the indicators of health literacy.Results The reliability and validity of questionnaire for expert consultation and the quality of population survey both have good results.Most indicators have high importance,good coordination and significance comparisons.Almost half of the indicators met the requirements in difficulty and discrimination.Conclusions The indicator system of health literacy has strong guidance and good operability.

OBJECTIVE To understand the current epidemiological characteristics as well as the trends of stomach cancer deaths in China. METHODS The data of stomach cancer mortalities in 2004 - 2005, from 158 sampling areas in the Third National Retrospective Sampling Survey of Death Causes in China, were analyzed and compared with the results from previous two national surveys. RESULTS The crude and age-standardized death rates of stomach cancer were 24.71/100 000 (35 250/142 660 482) and 16.16/100 000, respectively, accounted for 18.19% (35 250/193 841) and ranking third of cancer causes in the national sampling areas of China in 2004 - 2005. Those crude death rate increased by 42.01% while the age-standardized death rate decreased by 8.70% compared to the results in 1973 - 1975 (17.40/100 000 and 17.70/100 000), and both decreased 1.79% and 25.74% from 1990 - 1992 (25.16/100 000 and 21.76/100 000), respectively. For urban residents of the sampling areas, the crude and age-standardized death rates of stomach cancer were 22.98/100 000 (11 005/47 899 806) and 13.63/100 000, accounted for 15.03% (11 005/71 936) of cancer causes in 2004 - 2005, which increased by 18.21% and decreased by 31.16% from 1973 - 1975 (19.44/100 000 and 19.80/100 000), and increased by 18.21% and decreased by 11.15% from 1990 - 1992 (19.44/100 000 and 15.34/100 000), respectively. While for rural residents in the sampling areas, the crude and age-standardized death rates were 25.59/100 000 (24 245/94 760 676) and 17.64/100 000, accounted for 19.89% (24 245/121 905) of cancer causes, both increased by 53.97% and 3.76% from 1973 - 1975 (16.62/100 000 and 17.00/100 000), and both decreased by 5.78% and 27.59% from 1990 - 1992 (27.16/100 000 and 24.36/100 000), respectively. CONCLUSION The current stomach cancer is still one of predominant cancers in China. The consistently substantial decreases in age-standardized death rates of stomach cancer might prompt the beneficial impact on reducing the risks for that cancer by the social economical development during recent decades in China.

目的将我国恶性肿瘤死亡率水平和主要恶性肿瘤状况与国际状况进行比较分析。方法按世界标化调整死亡率,比较死因回顾抽样调查中国恶性肿瘤死亡率数据和国际癌症研究中心Globocan 2002和WHO世界卫生统计年报数据。结果我国恶性肿瘤死亡率高于世界平均水平,为世界国家的第58位;男性比世界平均水平高16%,为世界国家的第36位;女性比世界平均水平低8%,为世界国家的第112位。我国男性高于全球平均水平的恶性肿瘤有:肺癌、胃癌、肝癌、食管癌和脑瘤;女性高于全球平均水平的有:肺癌、肝癌、胃癌、食管癌、脑瘤。结论恶性肿瘤已成为严重威胁我国人类健康和社会发展的重大疾病。

Objective To study the prevalence of hypertension in rural adults in Wuhan,and to provide scientific basis for preventing hypertension and cerebrovascular diseases in rural area.Methods With stratified group randomly sampling,2257 Wuhan rural residents,aged over 18 and living in Wuhan for at least 1 year,were collected for this study.SPSS 13.0 software was used for statistical analysis.Results The prevalence rate of hypertension was 22.0%,and the standardized prevalence rate was 18.8%.With the increase of age,the prevalence rate went obviously upward,especially the prevalence rate for people aged ≥35 years was 29.6%.Conclusion The prevalence rate of hypertension in Wuhan rural area was at a relatively high leve1.Comprehensive lifestyle modifications,such as weight reduction,limitation of salt intake should be performed,so as to decrease the incidence of hypertension,and further prevent them from suffering hypertension,cardiovascular and cerebrovascular diseases.

饮用地下水是农村居民饮水中的重要组成部分,关系着农村居民的身体健康.我国部分地区均存在着饮用地下水的安全问题.为了解湖北省武汉市农村地下饮用水的卫生学状况,于2007年8月～11月对武汉市新洲、黄陂、蔡甸、江夏、洪山5个远城区的农村地下饮用水进行调查.

[Objective] To investigate the epidemiologic characteristics of metabolic syndrome(MS)in the general pop-ulation of Wuhan.[Methods] 1 979 residents including 792 male and 1 187 female who lived in Wuhan at lest for 20 years were recruited from investigation on the chronic diseases and its related risk factors in Wuhan in 2006,the information about their fasting plasma glucose,blood lipids,and blood pressure were collected.The mean±standard deviation standardization at-tack rate of every factors of patients with MS were calculated,and single-factor and multiple factors logistic regression analysis were performed to analyze the risk factors of risk factors of MS.[Results] The standardized prevalence of patients with MS of Wuhan in 2006 was 18.37%(male for 16.25% and female for 20.26%),and it increased with age.Age,smoking,drinking,triglyceride,systolic pressure,diastolic pressure,blood sugar,BMI,and high waist circumference might be the risk factors of metabolic syndrome.[Conclusion] Metabolic syndrome has significant association with the unhealthy life style,and high TG,wide waist circumference and high hyperglycemia were the influencing factors for MS,moreover,people over the age of 40 years was also a risk factor for MS.Other influencing factors for MS included smoking,cardiovascular disease,and family his-tory of diabetes.

近年来在政府的大力倡导与支持下,全国的主要大中城市都建立了大批社区卫生服务机构.社区卫生服务中心数量的快速增加、机构职能的不断完善以及机构管理工作的逐渐规范,一方面在逐步解决城市居民看病难等问题上发挥了积极有效的作用,另一方面,社区卫生服务的崛起对基层疾控机构的功能与职责形成了严峻挑战.在许多城市的社区卫生服务中心开设的公共卫生科在弥补和充实公共卫生"三级预防网"网底的同时,因其大量开展基层实际惠民工作而吸引了政府的高度

WHO在全球疾病负担危险度比较评估的基础上,采用了专家Pooled方法对"可改变的"环境因素的归因分值进行了估计与量化分析。结果表明,24%的疾病负担和23%的所有死亡可归因于环境因素。就各类疾病状况的环境因素而言,各个地区有很大差异,发展中地区全部死亡的25%可归因于环境原因,而在发达地区,只有17%的死亡是出于此类原因。最大疾病负担归因于可改变环境因素的疾病包括:腹泻、下呼吸道感染、意外伤害和疟疾。儿童承担了过分沉重的环境性健康负担。

Objective To forecast diabetes mellitus (DM) mortality trend in Wuhan through the study on the feature of DM mortality during 1975—2006. Methods With 1975—2006 resident death data of Wuhan city, epidemiological method and Grey dynamic model GM (1,1) were introduced to analyze this data and to forecast DM mortalities during 2007—2012. Results DM mortality was 19.97 per 100 000 in 2006, up to 11.61 times compared with it in 1975. The mean annual increasing rate of DM mortality was 8.23% and higher than those of angiocardiopathy and cerebrovascular disease, respiratory disease and malignant tumor. DM mortality was much higher among female than male, and sex ratio was 1: 0.63. The highest mean annual DM mortality among Wuhan City was 12.56 per 100 000 in Jianghan district, and the lowest was 3.23 per 100 000 in Hannan district. If no effective measures were taken to prevent its development,DM mortality would rise to 34.42 per 100 000 in 2012 by calculated with the equation that we found and validated (Y(t)=26.43e0.07735(t-1)-24.71). Conclusion Due to the trend of DM mortality increasing quickly in Wuhan, government should pay more attention to the prevention of DM.Grey dynamic model GM (1,1) may be applied to forecast DM mortality in the near future.

Objective To study the correlation of blood pressure,plasma glucose and lipid with adult waistline in Wuhan city.Methods 1 879 adults from 11 districts in Wuhan city were selected by stratified-cluster sampling.each participant received standardized questionnaire,physical examination and laboratory test.Results The prevalence rate of abdominal obesity was 51.8%,blood pressure,lipid and plasma glucose increased with the waistline circumstance value(P0.01).There was significant difference between normal waist circumstance group and abnormal group(P0.01).HDL cholestral had negative correlation with waistline,while other values were of positive correlation.The detection rate of hypertension,hyperlipidemia and diabetes increased with the waist circumstance.Conclusion Special attention should be paid to the high prevalenceof abdominal obesity.Individuals with abnormal waist circumstance had a higher risk of hypertension,hyper lipidemia and diabetes.

目的探讨武汉地区18岁以上常住居民腰围与血压、血脂及血糖的水平与关系。方法采用分层整群抽样法对武汉市11个区的1879名成年人进行了问卷调查、体格检查、测量血压和血液生化指标检测，描述不同腰围组中血压、血脂、空腹血糖水平并用趋势卡方分析其组间关系。结果腹部肥胖率为51．8％，腹部肥胖组与腰围正常组的血压、血脂、血糖指标均有显著性差异（P〈0．01）。HDL—C与腰围水平呈负相关，腰围与其余生化指标呈正相关。高血压检出率、血脂异常检出率、糖尿病患病率随腰围增加明显上升（P〈0．01）。结论武汉市18岁以上常住居民腹部肥胖情况严重应引起重视；高血压、血脂异常、糖尿病的患病风险随腰围增加而上升。

OBJECTIVE To study the present situations of lung cancer in Wuhan and to explore the relationship between the potential years of life lost of lung cancer and air pollution, especially vehicle emissions. METHODS Data gathered between 1986 and 1995 in Wuhan city, including air pollution and tobacco production and data on lung cancer between 1991 and 2000 were collected extensively. Simple Correlation and Grey Relational Analysis were used to analyze the relationship of them. RESULTS There was a ascending tendency in variance of oxides of nitrogen (NOx). The degree of grey incidence (DGI) between the concentration of air pollutants and the male's or female's potential years of life lost of lung cancer (PYLL) were calculated respectively. In males, the values of DGI were 0.6702, 0.7071, 0.6199 on sulfur dioxide (SO2), NOx, total suspensions (TSP) respectively. In females,the values of DGI were 0.6188, 0.8555, 0.5842 according to the same order as listed above. Significant positive correlation was found between the concentration of NOx and with lung cancer in both males and females by spearman correlation test (rmale = 0.63523, P = 0.0484; rfemale = 0.76396, P = 0.0101). CONCLUSION With the fast growing speed of the quantity of vehicles, pollution of vehicle emission-caused air pollution posed an important risk factor for lung cancer, despite the fact that tobacco smoking still played the leading role.