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Background Stress urinary incontinence (SUI) is defined as involuntary leakage of urine from the external urethra due to increased abdominal pressure, for example, upon sneezing, coughing, or exercise. Acupuncture is an effective therapy for patients with SUI, although objective evidence of its benefits or mechanism of action is limited. Patients with SUI often harbor structural changes of pelvic floor, the parameters of which are measurable from various perspectives and in multiple dimensions, dynamically and comprehensively, through transperineal ultrasound (TPUS). The status of such changes may then be assessed following acupuncture procedures. In the present investigation, TPUS serves to gauge the immediate effects of acupuncture on pelvic floor structures in female patients with SUI. Methods This protocol calls for a prospective, randomized, controlled, and single-blinded study of 72 female patients with SUI, each randomly assigned as test or control group members. The test group is subjected to one-time acupuncture at the Zhongji (RN3) acupoint for a period of 10 min, whereas the control group undergoes sham acupuncture in the same manner. In both groups, TPUS imaging of pelvic floor is performed before, during, and immediately after acupuncture procedures. Bladder neck mobility (BND), urethral rotation angle (URA), retrovesical angle (RVA), lowest point of bladder (BN-S), and presence/absence of urethral funneling or bladder bulging are then recorded as outcome measures. Discussion Above efforts are intended to assess real-time pelvic floor structural changes in women undergoing acupuncture for SUI. The subsequent findings may help objectively document the efficacy of acupuncture in this setting and clarify its mechanism of action. Trial registration Registration with the Chinese Clinical Trial Registry (ChiCTR200041559) (http:// www.chictr.org.cn/edit.aspx?pid=64591&htm=4), was effective December 29, 2020. Dates of study 12/19/2020 to 06/30/2022.

Background Previous studies have shown negative relationships between ambient temperature and blood pressure (BP). However, few studies estimated temperature-adjusted hypertension prevalence and control rate in different population. Objective To estimate the effects of temperature on BP, and further calculate temperature-adjusted hypertension prevalence and control rate. Methods Meteorological and BP data in Guangdong Province from 2004 to 2015 were collected. There were 31 351 participants aged 18 years and over. Based on 2018 European society Arterial Hypertension Guidelines, participants were divided into normotensive patients (n = 23 046), known hypertensive patients (n = 2807), and newly detected hypertensive patients (n = 5498). We first used generalized additive model to establish the nonlinear relationship between daily mean temperature and BP, and then calculated the linear effects of temperature on BP among populations with different hypertension status. Finally, we calculated the temperature-adjusted hypertension prevalence and control rate. Results Generally, there is an inverse relationship between temperature and BP. For a 1 °C increase in temperature, the decreased SBPs for normotensive patients, newly detected hypertensive patients, and known hypertensive patients were 0.37 [95% confidence interval (CI): -0.40, -0.33] mmHg, 0.21 (95% CI: -0.32, -0.10) mmHg and 0.81 (95% CI: -1.02, -0.59) mmHg, while reduced DBPs were 0.19 (95% CI: -0.21, -0.16) mmHg, 0.01 (95% CI: -0.06,0.08) mmHg, and 0.44 (95% CI: -0.56, -0.32) mmHg, respectively. At 5, 10, 15, 20, and 25 °C, the hypertension prevalence rates were 32.5, 29.7, 27.7, 26.0, and 25.0%, respectively, and the control rates were 12.0, 17.5, 23.5, 30.1, and 37.1%, respectively. Conclusion Low temperature increased BP for all populations, especially for known hypertensive patients, which makes hypertension prevalence increase and control rate decrease if temperature reduce. Our findings suggest that temperature should be considered in hypertension clinic management and epidemiological survey.

Background As the fourth leading cause of death, injury is an important public health concern in Guangdong Province, China. The epidemiological characteristics of injury mortality is changing along with the social development. This study described the epidemiological characteristics of injury mortality in Guangdong Province by analyzing the death surveillance data in a few areas in Guangdong Province in 2015. Methods Using the mortality data from the Disease Surveillance Points (DSP) system, injury deaths were classified according to the International Classification of Disease-10th Revision (ICD-10). The data were stratified by areas (urban/rural), gender, age groups, injury types, and then overall and type-specific injury mortality rates were estimated for the whole Guangdong Province, China. Results We estimated that about 38,200 individuals died from injury in Guangdong Province in 2015, producing a mortality rate of 43.11/100,000. The overall age-standardized injury mortality in men was higher in rural areas compared with urban areas (41.29/100,000 versus 24.89/100,000). In terms of injury intent, unintentional injuries were the commonnest injury type, which accounted for 83.93% of the overall injury deaths, however, the deaths caused by suicide should not be ignored, which occupied 12.67% of the total injury deaths. In terms of injury cause type, falls, road-traffic accidents, suicide, drowning, and accidental poisoning were the top five leading types of injury deaths. Conclusions In Guangdong Province, injury is an important cause of death. Road-traffic accidents, falls, suicide, drowning, and accidental poisoning should be the priorities of intervention. Moreover, in rural areas, the men were the most targeted subpopulation of the prevention activities.

Hematopoietic stem cell transplantation is an important method for the treatment of hematological malignancies. The hematopoietic recovery after transplantation, graft-versus-host disease (GVHD) prevention and treatment are the key to affect transplant success. Umbilical cord mesenchymal stem cells (hUC-MSC) can improve the hematopoietic microenvironment, promote hematopoietic stem cell homing and hematopoietic recovery, support hematopoiesis. In aduition, the hUC-MSC have immune function for a variety of immune cells, can avoid and alleviate the host immune response, have a certain effect on the treatment of GVHD. This article reviews the research advances on umbilical cord mesenchymal stem cells in hematopoietic stem cell transplantation.

Domestic incense burning is a common activity in China. Although it generates serious air pollution and has been linked to various health outcomes, it remains unknown whether it is associated with blood pressure and hypertension. A community-based survey including 1153 hypertensive subjects and 4432 normotensive participants in Guangdong (China) was used to examine this question. Two-level logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI). The analyses showed that, compared with non-users, OR of hypertension was 1.24 (95% CI: 1.03-1.50) for users, and 1.37 (95% CI: 1.04-1.80) for daily users with a clear dose-response relationship. The estimated increases in systolic and diastolic blood pressures were 1.02 mmHg (95% CI: 0.06-1.99) and 1.26 mmHg (95% CI: 0.69-1.83) for users, 0.67 mmHg (95% CI: -0.35-1.68) and 1.25 mmHg (95% CI: 0.66-1.85) for occasional users, and 2.09 mmHg (95% CI: 0.79-3.39) and 1.28 mmHg (95% CI: 0.52-2.05) for daily users, respectively. The results remained after adjusting for potential confounders and more pronounced associations were found among females. This study suggests that domestic incense burning may increase the risk of hypertension and blood pressure in the study population, and women are more vulnerable to these effects than men.

Microwaves represent an alternative way of power input into distillation process. Through dielectric heating, reaction mixtures are homogenously heated without contact to a wall. Reaction times are significantly reduced compared to conventionally (thermally) heated systems while maintaining selectivity. In this paper, microwave field select heating on two-phase system has been investigated numerically and experimentally. Temperature increasing, heat transfer and evaporation during heating process were analyzed. The possibility of microwave used for distillation was examined and proposed.

Objective : Cervical cancer is the second most common cancer among women worldwide, and over 85% of cervical cancers occur in developing countries such as China. Lack of resources for nationwide cervical cancer screening in China makes vaccination against oncogenic strains of HPV particularly important. Knowledge of age at sexual debut and sexual behavior is essential prior to implementation of a national vaccination program. Methods and materials : A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China to assess age at sexual debut and sexual behavior. 98.6% of the 11,852 recruited women aged 15–59 years were included in the analysis. Data were collected using a short, nurse-administered questionnaire and analyzed using standard descriptive statistics and survival analysis. Results : In urban areas, more than ten percent of the 15–19 year old age group were already sexually active at the time of interview; this number increased to nearly 44% in the 20–24 year old age group. Chinese young women with an occupation were more likely to be sexually active compared to female students of the same age, irrespective of area of residence. The crude median sexual debut age for the youngest age group was 17 years, earlier than the sexual debut age reported by older cohorts. Younger age cohorts had an earlier menarche age than older cohorts and were more likely to have more sexual partners than older women, and more likely to have partners with more than one female partner. Conclusion : There is a trend towards earlier sexual debut and riskier sexual behaviors in younger age groups of Chinese women. These findings suggest that HPV vaccination of women between the ages of 13 and 15 years, before the completion of national compulsory education, is likely to contribute to the prevention of HPV infection and cervical cancer in China.

Insoluble starch xanthate (ISX) is made with the potato starch and can be used for the treatment of cadmium-containing waste water. The performance of treatment and the influence factors with ISX made in this experiment are studied in this paper. It is shown that the removal rate of cadmium ion in wastewater can reach over 96%, when pH value of reaction liquid is 8.0, the adsorption time is 0.5h, and the concentration of cadmium ions in waste water is 30 mg·L-1.The adsorption mechanism was also discussed. It is shown that ISX promises to be a new treatment adsorbent to wastewater containing the low concentration cadmium. There are some merits with ISX: the smaller recruitment; better processing effect and so on. It is with chemical adsorption that wastewater containing cadmium is treated by insoluble starch xanthate.

After activated carbon is oxidized and modified with nitric acid (1:1), its cation exchange capacity can amount to 1.840 mmol • g-1. The modified activated carbon is used as adsorbent for the treatment of Cr (Ⅵ)-containing wastewater at room temperature, and its removal mechanism is discussed in this paper. It is shown that: when the pH value of the aqueous solution being 2.5-3.0;the adsorption time being 3.0h, the removal rate of Cr (Ⅵ) in the aqueous solution can reach 97% and its adsorption capacity can amount to 45.66 mg • g-1. From the results, it can be also seen that the adsorption curve to chromium in wastewater by the modified activated carbon better meets the Freundlich isotherm, and ion exchange adsorption mainly does its work.

INTRODUCTION China has a higher household secondhand smoke exposure rate than other countries. This study aims to estimate the prevalence rate of households implementing smoking bans in Guangdong and to identify factors correlated with household smoking bans. METHODS A cross-sectional, stratified random cluster sampling survey was conducted in Guangdong in 2010. A total of 2,114 adults aged 15 and older completed the face-to-face interviews with a response rate of 70%. The survey employed an adapted and validated questionnaire from the China Global Adult Tobacco Survey. Household smoking policy was divided into 3 groups: full ban, partial ban, and no ban. A multiple logistic regression model was employed to explore factors related to a full household smoking ban. RESULTS The survey found 14.2% of respondents reported a full ban, 23.6% reported a partial ban, and 62.2% reported no ban of smoking at home. Current smoking status was the strongest predictor for less restrictive household smoking policies (odds ratio [OR] = 4.9, 95% CI = 2.634-8.999). Our study suggested that people with a high level of education were more likely to implement a full household smoking ban (OR = 4.4, 95% CI = 2.388-8.178). Additionally, urban residents were significantly more likely to report a full household smoking ban than rural residents (OR = 1.67, 95% CI = 1.202-2.322). CONCLUSIONS Household smoking bans were not sufficiently established in Guangdong, China. Intensified efforts were called to promote home smoking bans, especially for those with a lower education level, with lower income, and living in rural areas.

Background In many parts of the world, including in China, extreme heat events or heat waves are likely to increase in intensity, frequency, and duration in light of climate change in the next decades. Risk perception and adaptation behaviors are two important components in reducing the health impacts of heat waves, but little is known about their relationships in China. This study aimed to examine the associations between risk perception to heat waves, adaptation behaviors, and heatstroke among the public in Guangdong province, China. Methods A total of 2,183 adult participants were selected using a four-stage sampling method in Guangdong province. From September to November of 2010 each subject was interviewed at home by a well-trained investigator using a structured questionnaire. The information collected included socio-demographic characteristics, risk perception and spontaneous adaptation behaviors during heat wave periods, and heatstroke experience in the last year. Chi-square tests and unconditional logistic regression models were employed to analyze the data. Results This study found that 14.8%, 65.3% and 19.9% of participants perceived heat waves as a low, moderate or high health risk, respectively. About 99.1% participants employed at least one spontaneous adaptation behavior, and 26.2%, 51.2% and 22.6% respondents employed 7 adaptation behaviors during heat waves, respectively. Individuals with moderate (OR=2.93, 95% CI: 1.38-6.22) or high (OR=10.58, 95% CI: 4.74-23.63) risk perception experienced more heatstroke in the past year than others. Drinking more water and wearing light clothes in urban areas, while decreasing activity as well as wearing light clothes in rural areas were negatively associated with heatstroke. Individuals with high risk perception and employing Conclusions There is a large room for improving health risk perception and adaptation capacity to heat waves among the public of Guangdong province. People with higher risk perception and fewer adaptation behaviors during heat waves may be more vulnerable to heat waves.

To investigate the risk perception of heat wave, and further explore its related factors in Guangdong province.A total of 2183 adults were selected by a multi-stage sampling method in Guangdong province. Each subject was interviewed in their home with a structured questionnaire by a well trained investigator from September to November, 2010. The questionnaire contained socio-demographic characteristics, heat wave related knowledge, risk perception of heat wave, etc. Chi-square test and multivariate logistic regression were employed in this study.The average age of total 2183 participants was (39.31 ± 14.16) years, among which 53.37% (1165/2183) were males, and 48.74% (1064/2183) were selected from urban. About 38.11% (832/2183) of participants heard about heat wave, and 38.52% (841/2183) of subjects thought the heat wave had higher impact on their health (risk perception score of heat wave ≥ 5 points). About 81.91% (1788/2183) of all participants thought the weather in most recent years was hotter than several years ago. Among these people, 30.48% (545/1788) thought the main reason of weather becoming hotter was due to emission of carbon dioxide, and 26.51% (474/1788) thought it was due to air pollution. Results from the multivariate logistic regression showed that the risk perception score of heat wave were higher in subjects with higher education (OR = 2.16, 95%CI: 1.41 - 3.30), from urban(OR = 1.37, 95%CI: 1.10 - 1.72), with higher score of trust(OR = 1.08, 95%CI: 1.01 - 1.14) and participants with higher score of heat wave related knowledge (OR = 1.39, 95%CI: 1.27 - 1.52). Furthermore, compared to hierarchist, egalitarian (OR = 1.73, 95%CI: 1.30 - 2.29), individualist (OR = 1.93, 95%CI: 1.41 - 2.65) and fatalist (OR = 1.80, 95%CI: 1.41 - 2.29) also had higher risk perception score of heat wave.There is a lack of knowledge and risk perception to heat wave among the residents in Guangdong province. Risk perception of heat wave was higher in people who were from urban, had higher level of trust on government, experts and media, had higher health-related knowledge score, and non-hierarchists.

To explore the prevalence of weight misperception and related influencing factors among adult residents in Guangdong province so as to provide information for prevention and control on weight misperception.A multi-stage stratified random sampling method was used to select the sample. Forty-two streets/villages were selected from 21 counties/districts through randomly sampling. Four communities were then chosen from every selected town or district, followed by 40 families chosen from every village or community. Questionnaire was used to collect data on weight perception and its related risk factors. SPSS 16.0 was used for data analysis.There were 6625 respondents participating in the study. Out of them, 50.2% participants misperceived their weight status, among which 35.9% of them underestimated while 14.3% overestimated their weights. Females aged 15 - 24 were more likely to overestimate weights than males in the same age group (38.6% vs. 18.5%), while males were more likely to underestimate weights than females (25.8% vs. 8.5%). The prevalence of underestimation on weights increased with the increase of age in both males and females but the prevalence of overestimation on weights decreased. Data from multivariate results from logistic analysis showed that rural residents, males, being elderly, residents with low education level, manual occupations (agriculture, forestry, animal husbandry and fishery), low family income and with anxiety were the major risk factors on underestimation of weight. However, factors as being urban residents, females, adolescents, minority and never having received weight measurement etc. were the major risk factors of overestimated on weight.Misperceptions of weight status in Guangdong province exhibited a high prevalence with complicated influencing factors, calling for more psychological research to be carried out to prevent and reduce the misperceptions on weight status.

BackgroundThe American Diabetes Association and World Health Organization have recently adopted the HbA1c measurement as one method of diagnostic criteria for diabetes. The change in diagnostic criteria has important implications for diabetes treatment and prevention. We therefore investigate diabetes using HbA1c and glucose criteria together, and assess the prevalent trend in a developing southern Chinese population with 85 million residents.MethodsA stratified multistage random sampling method was applied and a representative sample of 3590 residents 18 years of age or above was obtained in 2010. Each participant received a full medical check-up, including measurement of fasting plasma glucose, 2-hour post-load plasma glucose, and HbA1c. Information on history of diagnosis and treatment of diabetes was collected. The prevalence of diabetes obtained from the present survey was compared with the data from the survey in 2002.ResultsThe prevalence of diabetes based on both glucose and HbA1c measurements was 21.7% (95% CI: 17.4%-26.1%) in 2010, which suggests that more than 1 in 5 adult residents were suffering from diabetes in this developing population. Only 12.9% (95% CI: 8.3%-17.6%) of diabetic residents were aware of their condition. The prevalence of pre-diabetes was 66.3% (95% CI: 62.7%-69.8%). The prevalence of diabetes and pre-diabetes which met all the three diagnostic thresholds (fast plasma glucose, 2 hour post-load plasma glucose, and HbA1c) was 3.1% and 5.2%, respectively. Diabetes and pre-diabetes as determined by HbA1c measurement had higher vascular risk than those determined by glucose levels. The prevalence of diabetes increased from 2.9% (95% CI: 2.0%-3.7%) in 2002 to 13.8% (95% CI: 10.2%-17.3%) in 2010 based on the same glucose criteria.ConclusionsOur results show that the diabetes epidemic is accelerating in China. The awareness of diabetes is extremely low. The glucose test and HbA1c measurement should be used together to increase detection of diabetes and pre-diabetes.

Objectives: To assess knowledge of HPV and attitudes towards HPV vaccination among the general female population, government officials, and healthcare providers in China to assist the development of an effective national HPV vaccination program. Methods: A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China using a short questionnaire. 763 government officials, 760 healthcare providers, and 11,681 women aged 15-59 years were included in the final analysis. Data were analyzed using standard descriptive statistics and logistic regression. Results: Knowledge of HPV among the general female population was low; only 24% had heard of HPV. Less than 20% of healthcare providers recognized sexually naive women as the most appropriate population for HPV vaccination. There was high acceptance of the HPV vaccine for all categories of respondents. Only 6% of women were willing to pay more than US $300 for the vaccine. Conclusions: Aggressive education is necessary to increase knowledge of HPV and its vaccine. Further proof of vaccine safety and efficacy and government subsidies combined with increased awareness could facilitate development and implementation of HPV vaccination in China.

To explore the relationship between distorted weight perception and suicide ideation among normal weight adolescents in Guangdong province.This study used the data of Guangdong Provincial Youth Health Risk Behavior Survey in 2004 and 2007. To identify the association between distorted weight perception and suicide ideation, a logistic regression analysis was performed. The effects of age, economic status, mother's education, mental health, and depression were also adjusted.A total of 12 729 people participated in this study, 6096 males and 6633 females. The prevalence of suicide ideation among normal weight adolescents was 13.58% (1729/12 729) in the past 12 months, with higher prevalence in girls (16.15%, 1071/6633) than that in boys (10.79%, 658/6096) (χ(2) = 77.71, P = 0.00). It was common that the adolescents misperceived their weight. Only 44.93% (5719/12 729) of normal weight students correctly perceived their body weight while 43.52% (5540/12 729) of them overestimated their weight and 11.43% (1455/12 729) underestimated their weight. The distorted weight perception in girls (65.58%, 4350/6633) was higher than that in boys (43.39%, 2645/6096) (χ(2) = 993.91, P = 0.00). Distorted weight perception was significantly associated with suicide ideation after controlling for factors age, economic status, mother's education, mental health, and depression. The students who overestimate their body weight were more likely to have suicide ideation than that who correctly perceived their weight (OR = 1.43, 95%CI: 1.27 - 1.61).The prevalence of distorted weight perception was high and it significantly associated with suicide ideation.

To compare the magnitude of inequities in health-related behaviors among males in Guangdong province, and to investigate the extent of the disparities.Data sets available from the Guangdong Chronic Diseases and Risk Factors Survey 2007 are used. Concentration index (C) and concentration curve are employed to measure the differential of males' health-related behaviors across urban and rural areas in Guangdong. Odds ratios of 6 health-related behaviors among different areas are derived from 4 logistic models, after adjusting for age, married state, educational status, occupation and income.Results from Cs reveal that the inequality gradients disadvantageous to men in rural areas are:smoking (C = -0.075, P = 0.000), alcohol intake (C = -0.023, P = 0.002), blood pressure (C = 0.106, P = 0.000), blood sugar (C = 0.114, P = 0.000) and weight (C = 0.107, P = 0.000), while lack of physical activity (C = 0.044, P = 0.000)concentrates in the more affluent areas. The magnitudes of these inequalities appear to be higher on health-seeking behaviors than on health-risk behaviors. After adjusting for age and marital status, there is still strong evidence showing the rural-urban differences in the health related behaviors among males in Guangdong province. When educational status, occupation and income are added to the logistic model as control factors, the results have led to a loss of statistical significance on such rural-urban inequalities, indicating that socioeconomic factors play an important role on these health-related behaviors which leads to the inequalities among males in Guangdong province.To reduce the gaps in health-related behaviors seen in the rural and urban areas, effective policies should be developed to change the social determinants of rural-urban differences in health and to strengthen the implementation of health-related programs on those vulnerable groups.

To understand the prevalence of suicide attempts and its related risk factors in Guangdong province to provide scientific basis information for suicide intervention.Multi-stage stratified random sampling method was used to select the sample. 42 streets or towns were selected from 21 counties or districts through randomly sampling. 4 communities were then chosen from every selected town or district, followed by 40 families chosen from every village or community. Questionnaire was used to collect data on suicide attempts and its related risk factors. SPSS 16.0 was used for data analysis.6625 peoples were participated in the study. The 12-month incidence of suicidal attempts was 0.8%. It was higher for females (1.1%) than that for males (0.5%), and the 25 - 35 years (1.6%) age group was among the highest. There was no significant difference between the prevalence rates in urban or rural residents.from multivariate analysis showed that factors as: being female (OR = 2.1), experienced negative events of life (OR = 15.5), in poor sleeping condition (OR = 1.6), feeling lonely (OR = 1.5) and anxiety (OR = 1.8) were high risk for suicide attempts.Suicide attempts in Guangdong province exhibited a high prevalence with complicated influencing factors. Comprehensive countermeasures are needed to prevent and reduce suicidal behaviors.

To evaluate the outcome of health education program on drowning prevention among primary and secondary school children in rural areas.A township was selected and all the students from grade 3 to 5, grade 7 to 8, and grade 10 to 11 were selected to take part in the program. Twelve intervention measures on natural water safety and drowning prevention were carried out for one year. Information was collected using the same questionnaire before and after the intervention program.One year after the intervention was carried out, children's knowledge on drowning prevention improved significantly (13.21, 95%CI: 12.51 - 13.90), and a positive effect was also noticed among boys (12.77, 95%CI: 11.77 - 13.77), girls (13.80, 95%CI: 12.82 - 14.78), and among primary school children(15.51, 95%CI: 14.30 - 16.72), senior high school children (10.78, 95%CI: 9.50 - 12.05) and junior high school children (12.77, 95%CI: 11.84 - 13.71). Overall rates on risk behaviors dropped from 41.4% to 32.2% (by 22.2%) including 15.6% for boys, 35.2% for girls and 13.8%, 29.3%, 26.3% for primary school children, senior high school children, junior high school children, respectively. The incidence rates for non-fatal drowning decreased by 58.9% (from 5.6% to 2.3%). The person-times for treatment on sight, in emergency settings, in outpatient clinic or in the hospitals had a reduction from 399, 78, 36 to 175, 32, 14, respectively.Health education program could improve children's perception on water safety, and reduce their risk behaviors as well as on the incidence of non-fatal drowning in the rural areas.

To understand the incidence and characteristics of nonfatal drowning among primary and middle school students in rural area and to provide basic information for intervention.A rural town was selected and all students from 3th-8th grades, 10th grade and 11th grade were studied. All data were collected, using a self-administrated questionnaires which was guided by investigator.The overall incidence rate of nonfatal drowning was 5.65% (549/9732) and were 7.69%, 5.80%, 2.39% for primary, secondary and high school students, respectively. Male students had a higher rate (7.14%) than that of females (4.03%). The incidence rates of non-treated, treated in emergency and under hospitalization were 4.52%, 0.77% and 0.35%. The major reasons of drowning were swimming (46.88%), falling into waters (15.67%), diving (13.79%) and rescuing others (6.24%). The proportion of drowning occurred in the afternoon, evening, at noon or in the morning were 59.94%, 15.64%, 14.77% and 9.65% respectively. The common sites of drowning were river/lake (42.48%), swimming pool (19.56%), reservoir (11.39%) and pond (4.38%). 66.76% of the drowning cases were witnessed by other person, and 17.86% were conscious when being removed from waters.The incidence of nonfatal drowning among students in rural areas was high, and the natural body of waters was the most common site causing drowning while swimming was the major reason of drowning. Intervention targeting on primary and middle school students in rural should be carried out to reduce the incidence.

Background Drowning is a major cause of morbidity and mortality for children, yet non-fatal drowning remains poorly understood. The aim of this study was to explore potential modifiable risk factors of non-fatal drowning among children in rural areas of China. Methods A cross-sectional survey was first conducted to obtain non-fatal drowning cases, and 7432 students in grades three to eight from 17 schools participated in the cross sectional survey. Of these, 805 students reported that they experienced non-fatal drowning in the previous year. Then 368 cases were selected randomly to participate in a 1:1 matched case-control study. Each drowning case was matched by one control with the same sex and similar age (the gap less than 2 years) who was selected randomly from the same class. Results Boys were more likely to be involved in non-fatal drowning. Non-fatal drowning most often happened in the afternoon (65.1%) and natural bodies of water were the most common sites of drowning (71.1%). Swimming, diving and playing in natural waters were the leading activities that preceded non-fatal drowning. The significant risk factors for non-fatal drowning were swimming in natural waters without adult supervision (OR = 3.40, 95% CI: 1.92-6.03), playing in or beside natural waters (OR = 2.08, 95% CI: 1.17-3.70) and poor swimming skills (OR = 2.74, 95% CI: 1.14-6.62). However, the following variables were protective factors: supervisor aged 30 years or over (OR = 0.20, 95% CI: 0.09-0.49) and no water activities (OR = 0.36, 95% CI: 0.18-0.70). Conclusions The reduction in dangerous water activities, swimming training and enhancement in supervision among children might decrease the risk of non-fatal drowning.