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Dynamic physical examination data can provide both cross-sectional and time-series characteristics of cardiovascular health. However, most physical examination databases containing health and disease information have not been fully utilized in China. Hence, this study aimed to analyze dynamic physical examination indicators for cardiovascular health to provide evidence for precise prevention and control of cardiovascular diseases in the primary prevention domain among healthy population with different demographic characteristics in Shanghai. Three-year continuous data were collected from the physical examination center of a hospital in Shanghai from 2018 to 2020, which included a total of 14,044 participants with an average age of 46.51±15.57 years. The cardiovascular status of overall healthy individuals may have a decreasing trend, which is manifested as a significant year-on-year decrease in high-density lipoprotein cholesterol; a significant year-on-year increase in total cholesterol, low-density lipoprotein cholesterol, and blood glucose levels; and a possible increasing trend of diastolic blood pressure, body mass index, and triglycerides. Healthy population with different sex and age groups have various sensitives to cardiovascular physical examination indicators. To conduct more accurate cardiovascular health management and health promotion for key populations in primary prevention, focusing on the dynamic trends of blood pressure, blood lipids, blood glucose, and body mass index in men and changes in total cholesterol in women over time is especially important. The age group of 50–69 years is key for better prevention and control of cardiovascular health. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the risk factors for chronic diseases and to identify the potential influencing mechanisms from the perspectives of lifestyle and dietary factors. The findings could provide updated and innovative evidence for the prevention and control of chronic diseases. Design: A cross-sectional study. Setting: Shanghai, China. Participants: 1005 adults from Yangpu district of Shanghai participated in the study, and responded to questions on dietary habits, lifestyle and health status. Results: Residents suffering from chronic diseases accounted for about 34·99 % of the respondents. Logistic regression analysis showed that age, diet quality, amount of exercise and tea drinking were related to chronic diseases. Age > 60 and overeating (Diet Balance Index total score > 0) had negative additive interaction on the occurrence of chronic disease, while overexercise (Physical Activity Index > 17·1) and tea drinking had negative multiplicative interaction and negative additive interaction on the occurrence of chronic disease. Diet quality, physical activity and tea drinking were incomplete mediators of the relationship between types of medical insurance residents participating in and chronic diseases. Conclusions: The residents in Yangpu District of Shanghai have a high prevalence of chronic diseases. Strengthening access of residents to health education and interventions to prevent chronic diseases and cultivating healthy eating and exercise habits of residents are crucial. The nutritional environment of the elderly population should be considered, and the reimbursement level of different types of medical insurance should be designed reasonably to improve the accessibility of medical and health services and reduce the risk of chronic diseases. [ABSTRACT FROM AUTHOR]

Background: With the increasing risk of infectious disease outbreaks around the world, the role of community health centres (CHCs) in the prevention and control of epidemics has become increasingly prominent. This study aimed to examine the capacities, vulnerabilities, and obstacles related to coping with infectious disease epidemics in Chinese CHCs. Methods: A cross-sectional study was conducted in Shanghai CHCs. Stratified random sampling was used to select 48 CHCs, and 2460 medical staff members responded to questionnaire surveys. ANOVA and multivariate analysis were used to evaluate the current situation and main obstacles regarding CHC medical staff members' perceptions of their capacity to cope with infectious disease epidemics. Results: The scores for regulation awareness (mean= 3.64, SD= 0.02) and detection/reporting ability (mean= 3.66, SD= 0.02) were lower than the score for the ability to handle an epidemic (mean= 3.79, SD= 0.02). After controlling for covariates, working in a traditional Chinese medicine (β= − 0.63, P= 0.002) or medical technology department (β= − 0.60, P= 0.002), not having participated in emergency exercises (β= − 0.78, P< 0.001), and not having participated in emergency training (β= − 0.59, P= 0.01) were associated with lower scores on all three domains. Those with senior professional titles reported relatively high levels of ability to handle an epidemic (β= 0.21, P= 0.01). Female workers reported relatively low regulation awareness (β= − 0.11, P= 0.02) and detection/reporting ability (β= − 0.11, P= 0.01). Conclusion: The three emergency response abilities of CHC medical workers differed based on the medical worker's sex, department, and title, indicating the need for targeted scientific emergency exercises and training for infectious disease outbreaks. Moreover, there is a need to improve the relevant policies and equipment. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to use the hospital information system to analyze the cancer profile and compare demographics, hospitalization, status of surgery and treatment cost of various cancer categories based on the electronic health record (EHR) of outpatient children with tumors in Shanghai, China. Patients and Methods: Information was collected from 3834 inpatients aged 0– 18 who were diagnosed with malignant tumors in all 17 hospitals with pediatric wards in the Pudong New District of Shanghai from 2011 to 2016. All patients were classified according to the International Classification of Childhood Cancer-3 (ICCC-3). The chi-squared test was used to compare demographics, hospitalization information, status of surgery and treatment cost according to inpatients' cancer category. Results: In both the malignant non-solid tumor and solid tumor groups, males and those aged 0– 4 years were the dominant groups. Lymphocytic leukemia was the most common cancer in all inpatients (n=994, 25.93%), and the acute myeloid leukemia had the longest length of stay of inpatients (median=26.00 days). In both the non-solid and solid tumor groups, patients who received only one type of surgery had an advantage. The highest proportion of patients who had undergone surgery was found in non-Hodgkin lymphoma patients. In terms of total cost, surgical cost and medicine cost, the expenditure of central nervous system tumor patients was the highest. Astrocytoma had the highest total cost. Conclusion: Leukemia is common in children with cancer in Pudong and should be given attention. Because the highest financial burden falls on patients with central nervous system tumors and acute myeloid leukemias, the government should take immediate and targeted measures for these cancers in particular. [ABSTRACT FROM AUTHOR]

Background: This study aims to establish a multi-agent system model to provide accurate suggestions for the policy proposal of controlling the unreasonable growth of medical expenses charged by public hospitals in China.Methods: A multi-agent system model was employed in this study. Agents of this model were divided into patients, doctors, medical institutions, the government, and medical insurance agencies. The model was composed of two subsystems: the disease and medical-seeking subsystem, and the medical expenses subsystem. Policy intervention experiments were conducted on patients' medical-seeking preferences, doctors' public welfare behaviors, and the government's financial investment.Results: At present, medical expenses in China are unreasonable and keep increasing, and the proportion of medicine and physical examination expenses to total medical expenses for public hospitals is unreasonable. Intervention experiments suggested that expanding the promotion and application of the community first-visit system could rationalize patients' medical-seeking preferences, increasing doctors' incomes and reducing workload could significantly restrict doctors' over-prescription behaviors. Also, improving the government's financial investment could guide public hospitals to strengthen their commitment to public welfare responsibilities. These interventions could decrease the unreasonable growth of medical expenses of public hospitals. The combined intervention effects on suppliers, demanders, and the government were better than the effect of these agents independently.Conclusions: The main reasons for the unreasonable increase in patient medical expenses at public hospitals could be attributed to patients' unreasonable medical-seeking preferences, doctors' weak public welfare incentives, and the government's inadequate financial investment. Policy-makers should consider proposals to restrict and guide the behaviors of suppliers, demanders, and the government, simultaneously. The government should consider the feasibility, response speed, and implementation cost of policies as well. [ABSTRACT FROM AUTHOR]

Objectives: Emergency medical system for mass casualty incidents (EMS-MCIs) is a global issue. However, China lacks such studies extremely, which cannot meet the requirement of rapid decision-support system. This study aims to realize modeling EMS-MCIs in Shanghai, to improve mass casualty incident (MCI) rescue efficiency in China, and to provide a possible method of making rapid rescue decisions during MCIs. Methods: This study established a system dynamics (SD) model of EMS-MCIs using the Vensim DSS program. Intervention scenarios were designed as adjusting scales of MCIs, allocation of ambulances, allocation of emergency medical staff, and efficiency of organization and command. Results: Mortality increased with the increasing scale of MCIs, medical rescue capability of hospitals was relatively good, but the efficiency of organization and command was poor, and the prehospital time was too long. Mortality declined significantly when increasing ambulances and improving the efficiency of organization and command; triage and on-site first-aid time were shortened if increasing the availability of emergency medical staff. The effect was the most evident when 2,000 people were involved in MCIs; however, the influence was very small under the scale of 5,000 people. Conclusion: The keys to decrease the mortality of MCIs were shortening the prehospital time and improving the efficiency of organization and command. For small-scale MCIs, improving the utilization rate of health resources was important in decreasing the mortality. For largescale MCIs, increasing the number of ambulances and emergency medical professionals was the core to decrease prehospital time and mortality. For super-large-scale MCIs, increasing health resources was the premise. [ABSTRACT FROM AUTHOR]

Introduction: To identify key intervention factors and reduce road traffic injury (RTI)-associated mortality, this study compared outcomes and influencing factors of single and multiple road traffic injuries (RTIs) in Shanghai. Methods: Based on the design of National Trauma Data Bank, this study collected demographic, injury, and outcome data from RTI patients treated at the four largest trauma centers in Shanghai from January 2011 to January 2015. Data were analyzed with descriptive statistics, univariate analysis, and hierarchical logistic regression analysis. Results: Among 2397 participants, 59.4% had a single injury, and 40.6% had multiple injuries. Most patients’ outcome was cure or improvement. For single-RTI patients, length of stay, body region, central nervous system injury, acute renal failure, multiple organ dysfunction syndrome, bacterial infection, and coma were significantly related to outcome. For multiple-RTI patients, age, admission pathway, prehospital time, length of stay, number of body regions, body region, injury condition, injury severity score, and coma were significantly related to outcome. Conclusions: Emergency rescue in road traffic accidents should focus on high-risk groups (the elderly), high-incidence body regions (head, thorax, pelvis) and number of injuries, injury condition (central nervous system injury, coma, complications, admission pathway), injury severity (critically injured patients), and time factors (particularly prehospital time). [ABSTRACT FROM AUTHOR]