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We aimed to investigate and interpret the associations between socioeconomic factors and the prevalence, awareness, treatment, and control of hypertension at the provincial level in China. A nationally and provincially representative sample of 179,059 adults from the China Chronic Disease and Nutrition Surveillance study in 2015–2016 was used to estimate hypertension burden. The spatial Durbin error model was fitted to investigate socioeconomic factors associated with hypertension indicators. Overall, it was estimated that 29.20% of the participants were hypertensive nationwide, among whom, 34.32% were aware of their condition, 27.69% had received antihypertensive treatment, and 7.81% had controlled their condition. Per capita gross domestic product (GDP) was associated with hypertension prevalence (coefficient: –2.95, 95% CI : –5.46, –0.45) and control (coefficient: 6.35, 95% CI : 1.36, 11.34) among adjacent provinces and was also associated with awareness (coefficient: 2.93, 95% CI: 1.12, 4.74) and treatment (coefficient: 2.67, 95% CI : 1.21, 4.14) in local province. Beds of internal medicine (coefficient: 2.66, 95% CI : 1.08, 4.23) was associated with control in local province. Old dependency ratio (coefficient: –3.58, 95% CI : –5.35, –1.81) was associated with treatment among adjacent provinces and with control (coefficient: –1.69, 95% CI : –2.42, –0.96) in local province. Hypertension indicators were not only directly influenced by socioeconomic factors of local area but also indirectly affected by characteristics of geographical neighbors. Population-level strategies should involve optimizing supportive socioeconomic environment by integrating clinical care and public health services to decrease hypertension burden. [ABSTRACT FROM AUTHOR]

To estimate the burden of cirrhosis and other chronic liver diseases caused by specific etiologies in China. Data from the Global Burden of Disease Study 2016 (GBD 2016) were used. We evaluated the burden by analyzing age-sex-province-specific prevalence, mortality, and disability-adjusted life-years (DALYs) of 33 provinces in China. From 1990 to 2016, prevalence cases in thousands increased by 73.7% from 6833.3 (95% UI: 6498.0–7180.6) to 11869.6 (95% UI : 11274.6–12504.7). Age-standardized mortality and DALY rates per 100,000 decreased by 51.2% and 53.3%, respectively. Male and elderly people (aged ≥ 60 years) preponderance were found for prevalence, mortality, and DALYs. The number of prevalence cases, deaths, and DALYs due to hepatitis C virus (HCV) increased by 86.6%, 8.7%, and 0.9%, respectively. Also, age-standardized prevalence rates decreased in 31 provinces, but increased in Yunnan and Shandong. The Socio-demographic Index (SDI) values were negatively correlated with age-standardized mortality and DALY rates by provinces in 2016; the correlation coefficients were –0.817 and –0.828, respectively. Cirrhosis and other chronic liver diseases remain a huge health burden in China, with the increase of population and the aging of population. Hepatitis B virus (HBV) remains the leading cause of the health burden in China. [ABSTRACT FROM AUTHOR]

Objective To analyze the changes of mortality and disease burden of stroke in 1990 and 2015 in Tianjin. Methods The results of the Global Burden of Diseases Study 2015 (GBD 2015) for Chinese estimated by province were used to describe the disease burden of stroke in Tianjin. The analysis index included number of death, mortality rate, disability adjusted life year (DALY), years of life lost (YLL) and years lost due of disability (YLD). The change from 1990 to 2015 for all indexes was used to describe the transitions of disease burden of stroke in the past 25 years in Tianjin. Results In 2015, the mortality rate of stroke reached 101.53 per 100 000 people and the age - standardized mortality rate was 117.73 per 100 000 people. The DALY, YLL, and YLD reached 285 558.36, 265 627.77 and 19 930.60 person year, respectively, and the age - standardized DALY rate, YLL rate and YLD rate were 1870.55, 1746.63 and 123.92 per 100 000 people. Compared with the result in 1990, the number of death, DALY, YLL and YLD in 2015 were increased by 26.24%, 9.05%, 5.48% and 98.63%, respectively, while the age - standardized mortality rate, DALY rate, YLL rate and YLD rate in 2015 were decreased by 46.75%, 52.81%, 54.32% and 11.20%, respectively. In different types of stroke, DALY and YLL of hemorrhagic stroke were higher, while YLD was lower than ischemic stroke in 1990 and 2015. Compared with 1990, DALY was decreased by 11.77%, YLL was decreased by 14.75%, and YLD was increased by 96.87% in hemorrhagic stroke in 2015, while DALY was increased by 47.38%, YLL was increased by 44.04% and YLD was increased by 100.08% in ischemic stroke in 2015. Conclusions Disease burden of stroke became more and more serious in Tianjin, of which the ischemic stroke was most serious, and the disease burden of stroke in men was greater than that in women. [ABSTRACT FROM AUTHOR]

Objective This study examined vegetable and fruit (VF) consumption rate and its associated factors among Chinese adults. Methods Nationally representative data from the 2013 China Chronic Disease Surveillance survey were used. Dietary intake data, including VF consumption during the last 12 months, were collected. All analyses were weighted to obtain nationally representative estimates. Associations between VF consumption and other factors (e.g., meal frequency and physical activity) were examined through logistic regression analysis. Results The average fruit consumption was 102.3 g/day (95% CI : 97.0-107.6) and the average vegetable consumption was 350.6 g/day (95% CI : 339.3-361.8). Over half (53.2%, 95% CI : 50.9-55.4) of Chinese adults met the VF consumption of 400 g/day recommended by the World Health Organization (WHO). Rural residents had a higher prevalence of low VF consumption rate than urban residents [49.20% (95% CI : 46.2%-52.2%) vs . 44.0% (95% CI : 41.7%-46.3%) P < 0.01]. Old age ( OR = 1.01, 95% CI : 1.00-1.01), low educational level, low income, minority ethnicity ( OR = 1.41, 95% CI : 1.15-1.74), underweight ( OR = 1.17, 95% CI : 1.03-1.33), single marital status ( OR = 1.20, 95% CI : 1.08-1.33), low health literacy, irregular breakfast ( OR = 1.20, 95% CI : 1.04-1.38) or lunch ( OR = 1.58, 95% CI : 1.26-1.99) habits, and no leisure-time physical activity were associated with low VF consumption. Conclusion Only half of Chinese adults met the VF consumption recommended by the WHO. Low socio-economic status, irregular diet, and poor health literacy were likely associated with low VF consumption. National efforts and programs are needed to promote VF consumption. [ABSTRACT FROM AUTHOR]

Objective To analyze the prevalence and years lived with disability (YLD) from dental caries among children and adolescents and the time trends over the past two decades in Sichuan province, the largest province in west China. Methods Based on the Global Burden of Disease Study 2015 (GBD2015), which systematically assessed the epidemiological characteristics of major diseases and their transitions by country and region from 1990 to 2015, we extracted the estimated results for China. We then used the Bayesian meta-regression method to estimate the sex- and age-specific prevalences and YLDs from dental caries among children and adolescents under 15 years old in Sichuan province and compared them with global and national indicators for the same period. Results In 2015, there were almost 6 million cases of dental caries in children and adolescents (aged < 15 years) in Sichuan province, accounting for 6% of the total cases in China. For children under 5 years, the prevalence of deciduous caries was 55.9%, and the YLDs value was 10.8 per 100,000, while it was 24.3% and 5.1 per 100,000 respectively among 5- to 14-year-olds; for those aged 5 to 14 years, the prevalence of permanent caries was 21.5%, and the YLDs value was 11.5 per 100,000. From 1990 to 2015, the prevalence of dental caries for children under 5 years increased substantially, by 16.2%, and the YLDs increased by 8.7%. Among those aged 5 to 14 years, the prevalence increased and the YLDs decreased. Conclusion Dental caries remains a huge health burden in Western China. In contrast to the global and national data, the trend has increased rapidly over the past 25 years in this region. This work provides suggestions for the prevention and control for oral health in China with the policy of two-child. [ABSTRACT FROM AUTHOR]

Objective To establish the distribution of 10-year atherosclerotic cardiovascular disease (ASCVD) risk among Chinese adults. Methods We estimated the 10-year ASCVD risk by applying the 2013 American College of Cardiology/American Heart Association pooled cohort equations (PCEs) to the data obtained from the 2010 China Chronic Disease and Risk Factor Surveillance that involved 61,541 participants (representing 520,158,652 Chinese adults) aged 40-79 years. We also compared the ASCVD risk with the 10-year ischemic cardiovascular disease (ICVD) risk, which was calculated using the simplified scoring tables recommended by the Chinese Guidelines for Prevention of Cardiovascular Diseases (Chinese model). Results Based on the PCEs, the average 10-year ASCVD risk among adults without self-reported stroke or myocardial infraction was 12.5%. Approximately 247 million (47.4%) and 107 million (20.6%) adults had ≥ 7.5% and > 20% 10-year ASCVD risks, respectively. The 10-year ASCVD risk > 20% was higher among men, less educated individuals, smokers, drinkers, and physically inactive individuals than among their counterparts. Overall, 29.0% of adults categorized using the Chinese model were overclassified with the PCEs. Conclusion Our results define the distribution of 10-year ASCVD risk among Chinese adults. The 10-year ASCVD risk predicted by the PCEs was higher than the ICVD risk predicted by the Chinese model. [ABSTRACT FROM AUTHOR]

This study aims to quantify the impact of typhoon ‘Koppu’ on infectious diarrhea in Guangdong, China in 2009. Rate ratios (RRs) were calculated by comparing person-time of infectious diarrhea cases between typhoon period and reference period. RRs of dysentery and other infectious diarrhea increased to a maximum of 1.12 (95% CI, 0.86-1.47), 1.10 (95% CI, 1.00-1.20) on the fifth lag day respectively. Children under 5 years were more vulnerable to infectious diarrhea, especially to other infectious diarrhea [RR: 1.21 (1.07-1.36) Vs. 1.03 (0.89-1.82)] after typhoon compared with people aged >5 years when RRs were at maximum. A mildly increased risk of infectious diarrhea was not only observed in great damaged regions, but also in other areas. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To understand the current status and trends of tuberculosis mortality rates in China. Methods: In 2010, 161 National Disease Surveillance Points representing all 31 mainland provinces, municipalities, and autonomous regions of China collected tuberculosis mortality surveillance data, including age, sex, region, and type of tuberculosis (all, pulmonary, and extra-pulmonary). The mortality rates of the three types of tuberculosis were compared between 2004 and 2010. Results: In 2010, the mortality rates due to all tuberculosis, pulmonary tuberculosis, and extra-pulmonary tuberculosis were 4.69 (95% CI 4.54–4.84), 4.38 (4.23–4.52), and 0.31 (0.27–0.35) per 100 000 population, respectively. Mortality rates due to all tuberculosis and pulmonary tuberculosis were higher in males, the elderly, and those living in western and rural areas. From 2004 to 2010, the mortality rates due to all tuberculosis and pulmonary tuberculosis decreased by 36.02% and 37.70%, respectively, with an average annual rate of decline of 7.20% and 7.61%, respectively. Conclusion: Mortality rates due to tuberculosis have declined rapidly in China. The target of reducing the 1990 mortality rate by 50% by 2015 has already been achieved. However, the tuberculosis control program should pay more attention to high-risk groups, including the elderly and those living in underdeveloped areas. [Copyright &y& Elsevier]

Limited research exists on factors influencing the place of death (POD) or hospital deaths among lymphoma patients in China, despite the country's significant burden of lymphoid neoplasms. This study aimed to describe the distribution of POD among lymphoma patients and identify the factors associated with hospital lymphoma deaths to provide evidence for developing targeted healthcare policies. Data in this study were obtained from the National Mortality Surveillance System (NMSS). The distribution of POD among individuals who died from lymphoma was analyzed, and factors influencing the choice of dying in the hospital were examined. Chi-square test was employed to analyze the differences in characteristic distributions. Multilevel logistic regression analysis was identify the relationship between hospital deaths due to lymphoma and individual factors, as well as socioeconomic contextual variables. During 2013-2021, there were 66772 lymphoma deaths reported by the NMSS, including 44327 patients (66.39%) who died at home and 21211 (31.77%) died in the hospital. Female patients, those had a higher level of educational attainment, retired individuals, those died of non-Hodgkin lymphoma, residents of urban areas, patients between the ages of 0 and 14, and unmarried individuals had a higher probability of dying in hospitals. Improving health care providers' understanding of palliative care for cancer patients and prioritizing accessible services are essential to enhance the quality of end-of-life care. These approaches ensure the equitable allocation of healthcare resources and provide diverse options for minorities with specific preferences regarding end-of-life care., Competing Interests: None., (AJCR Copyright © 2023.)

Background: The disease burden of gastrointestinal disease (GD) in China is high, with significant variation across provinces. A comprehensive agreed set of indicators could guide rational resource allocation to support better GD outcomes., Methods: This study collected data from multiple sources, including national surveillance, surveys, registration systems, and scientific research. Literature reviews and Delphi methods were used to obtain monitoring indicators; the analytic hierarchy process was used to determine indicator weights., Findings: The China Gastrointestinal Health Index (GHI) system consisted of four dimensions and 46 indicators. The weight of the four dimensions from high to low included the prevalence of gastrointestinal non-neoplastic diseases and gastrointestinal neoplasms (GN) (0.3246), clinical treatment of GD (0.2884), prevention and control of risk factors (0.2606), and exposure to risk factors (0.1264). The highest indicator weight of GHI rank was the successful smoking cessation rate (0.1253), followed by the 5-year survival rate of GN (0.0905), and the examination rate of diagnostic oesophagogastroduodenoscopy (0.0661). The overall GHI for China in 2019 was 49.89, varying from 39.19 to 76.13 across all sub-regions. The top five sub-regions in the total GHI score were in the eastern region., Interpretation: GHI is the first system designed to monitor gastrointestinal health systematically. In the future, data from sub-regions of China should be used to test and improve the GHI system for its impact., Funding: This research was supported by the National Health Commission of China, the First Affiliated Hospital of Naval Medical University (2019YXK006), and the Science and Technology Commission of Shanghai Municipality (21Y31900100)., Competing Interests: Luo-Wei Wang has received research support from the National Health Commission of China, the First Affiliated Hospital of Naval Medical University (2019YXK006), and the Science and Technology Commission of Shanghai Municipality (21Y31900100). All other authors declare no competing interests., (© 2023 Published by Elsevier Ltd.)

Objective: To explore the trend and characteristics of cardiovascular disease mortality in China., Methods: Mortality data from the National disease surveillance system from 2004 to 2010 was used. Underreporting was adjusted and trends were analyzed on the rates of crude mortality, standardized mortality and causes of death fraction among cardiovascular diseases., Results: The total mortality of cardiovascular diseases increased from 240.03 to 268.92 per one hundred thousand during 2004 to 2010, with an average annual increase of 5.50 per one hundred thousand, with the annual increase of 2.17% . Data from all causes of death, ischemic heart disease, hypertensive heart disease, cerebrovascular disease, and other heart disease showed an upward trend, with the annual rise of 5.05%, 2.08%, 1.02% and 2.66% respectively while rheumatic heart disease showed a downward trend, with the declining rate of 7.02% per annum. After eliminating the effect of aging, the trend remained the same but the slope was decreasing. The proportion of national cardiovascular mortality on total deaths increased annually by 37.46% to 40.73% from 2004 to 2010. The proportion of cerebrovascular disease remained unchanging but the proportion of ischemic heart disease showed a significant increase. The proportion of rheumatic heart disease declined while the proportion of other cardiovascular disease mortality showing a slight change., Conclusion: In recent years, the cardiovascular mortality had significantly increased, which was mainly due to the increase of ischemic heart disease mortality.

Objective: To observe the mortality and its changes on liver cancer in the past 30 years as well as to describe the spatial distribution of liver cancer deaths between 2005 and 2010 in Lingbi, Anhui province., Methods: Using the mortality data from 1973-1975 and from 2005 to 2010 in Lingbi to compare with the relative national and historical data, to observe the trend of rapid increase on liver cancer mortality in Lingbi. Using the Poisson model, BYM model and hotspot detection method, standardized mortality ratio(SMR), relative risk(RR)value of liver cancer deaths of each village were calculated and the clustering of high liver cancer deaths was identified., Results: Through an increase of 223.7% on the SMR of liver cancer in the past 30 years, the standardized mortality of liver cancer in Lingbi had an increase of 74.1 percent than the national level in 2005-2010 but it was 22.7% lower than the country level in 1973-1975. The SMR and RR values and their P values were higher in the villages which were located along the Kuisui River. Data from the clustering analysis showed that there had been significantly positive autocorrelation at the altitude of 5300 meters, and a very obvious hot spot of liver cancer deaths existing along the Kuisui River, especially at the bifurcation of the old Sui River and new Sui River was observed., Conclusion: There was an alarming increase of liver cancer mortality in the past 30 years in Lingbi. The high mortality area mainly covered the villages along the Kuisui River, suggesting that there were common risk factors for hepatocellular carcinoma in the population at risk.

Objective: To explore the association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Suzhou, Anhui province., Methods: Using the disease mapping and spatial statistical analysis techniques,we described the spatial distributions of the mortality rate of hepatic carcinoma from 2005 to 2010 in Lingbi county. Taking the distance between villages and polluted rivers as proxy variable of environmental exposure, mortality rate of hepatic carcinoma in each village as dependant variable, and using the Glimmix model and Bayesian spatial model (BYM) to undertake the univariate and multivariate analysis, we investigatived the association between mortality rate of hepatic carcinoma and the water pollution of Suihe River in Lingbi county., Results: Obvious clustering of high mortality rate of hepatic carcinoma along the polluted river was observed in Lingbi county. Results of Glimmix model showed that whether spatial autocorrelation was considered or not, closer to the polluted river has higher mortality rate of hepatic carcinoma. Results of univariate analysis of the BYM model showed that, compared with the villages far from the polluted river more than 12 km (the mortality rate of hepatic carcinoma was 33.12/100 000(1068/3 224 562) ), the RR values of the hepatic carcinoma mortality was 1.38(95%CI:1.06-1.82) for the villages apart from the polluted river within 6 km (the mortality rate of hepatic carcinoma was 42.48/100 000(777/1 829 064)), and 1.13 (95%CI:0.92-1.39) for villages apart from the river between 6 and 12 km (the mortality rate of hepatic carcinoma was 35.65/100 000(651/1 825 848)). In the BYM model multivariate analysis, adding the volume of fertilizer and pesticides used per cultivated area, GDP per capita to do multivariate analysis were, the relation between mortality rate of hepatic carcinoma and distance from polluted rivers remains unchanged., Conclusion: The mortality rate of hepatic carcinoma was associated with the exposure to the polluted river in Lingbi county. The polluted river may increase the hepatic carcinoma mortality of nearby residents.

To develop an automated coding software related to the underlying causes of death, based on the National Registration Information System on deaths, which could improve the quality of coding on the underlying causes of death in the conventional death surveillance system. Following the coding rules of the underlying death cause of ICD-10 and the design on principles of software of underlying death cause automated coding from some other countries, as well as in accordance with the coding strategy table from the USA, we implemented the automatization of the underlying death cause coding. Based on national registration information system on cause of death, an automated coding software of underlying death cause was developed with the coding correction rate closed to 85%. The automated coding software of underlying death cause could code the death cases of underlying death cause with high rate of correction, similar to that of the same kind software developed in other countries.

Objective: To study the characteristics of the effect of different temperatures on mortality of different cities through analyzing the relationship between mortality and meteorology of five Chinese cities., Methods: We get the demography and climate data of Beijing, Tianjin, Shanghai, Nanjing and Changsha cities from National Center of Disease Control and Prevention and Climate net respectively. Then we applied the R software and Distributed Lag Non-linear Models (DLNM) package to analyze our data and find the nonlinear and lag effects on mortality using DLNM., Results: The city of Beijing and Tianjin are located in the temperate zone. And the climate of Shanghai, Nanjing, Changsha belong to subtropical monsoon climate. When the daily mean temperature arrived 30°C and on lag 0 day, the values of relative risk of effect of high mean temperature on mortality in Nanjing (1.31, 95%CI: 1.21 - 1.41) and Changsha (1.25, 95%CI: 1.13 - 1.39) are larger than that in Beijing (1.18, 95%CI: 1.12 - 1.25), Tianjin (1.18, 95%CI: 1.10 - 1.26) and Shanghai(1.15, 95%CI: 1.06 - 1.24). While the relative risk of effect of low mean temperature on mortality is lower and lasts for a longer lag time. During the whole lag time, the relative risk of effect of the lowest daily mean temperature of each city on mortality in Tianjin, Changsha, Beijing, Nanjing, and Shanghai is 3.41, 95%CI: 1.60 - 7.27, 2.15, 95%CI: 1.11 - 4.15, 2.24, 95%CI: 1.12 - 4.48, 2.80, 95%CI: 1.75 - 4.48, 1.53, 95%CI: 1.12 - 2.03, respectively. The cumulative effect of mean temperature on mortality appears like a U-shape. When on lag 0-1 day, the value of relative risk of effect of extremely high temperature and the highest mean temperature on mortality is larger than 1. While the effect of low temperature on mortality becomes obvious after lag 2 days., Conclusion: Depending on this research, extremely low temperature and the lowest mean temperature has a more obvious impact on mortality in the northern area than in the south. Extremely high temperature and the highest daily mean temperature is on the contrary. Meanwhile, different temperatures have different impacts on mortality in the same city: high temperature has an acute impact while there is a longer lag time in low temperature.

To compare the designing effects (DE) among different complex sampling designing programs. Data from the '2002 Chinese Nutrition and Health Survey' was used as an example to generate the sampling population, and statistical simulation method was used to estimate the values of DEs from six complex sampling designing programs. It was found that the values of DEs varied among the six complex sampling designing programs. The values of the DEs were associated with the sample sizes in a positive way, with more sample stages and less stratified categories. Reduction of the numbers of sample stages and detailing stratified categories could decrease the DE values so as to improve the DE.

Objective: To explore the short-term impact of ambient PM(10) on daily non-accidental death, cardiovascular and respiratory death of residents in Beijing., Methods: Mortality data of residents in Beijing during 2006 to 2009 were obtained from public health surveillance and information service center of Chinese Center for Disease Control and Prevention, contemporaneous data of average daily air concentration of PM(10), SO(2), NO(2) were obtained from Beijing Environment Protection Bureau (year 2005 - 2006) and public website of Beijing environmental protection (year 2007 - 2009), respectively, contemporaneous meteorological data were obtained from china meteorological data sharing service system. Generalized addictive model (GAM) of time serial analysis was applied. In additional to the control of confounding factors such as long-term trend, day of the week effect, meteorological factors, lag effect and the effects of other atmospheric pollutants were also analyzed., Results: During year 2006 to 2009, the number of average daily non-accidental death, respiratory disease caused death, cardiovascular and cerebrovascular diseases caused death among Beijing residents were 140.1, 15.0, 65.8, respectively;contemporaneous medians of average daily air concentration of PM(10), SO(2), NO(2) were 123.0, 26.0, 58.0 µg/m(3), respectively;contemporaneous average atmosphere pressure, temperature and relative humidity were 10.1 kPa, 13.5°C and 51.9%, respectively. An exposure-response relationship between exposure to ambient PM(10) and increased daily death number was found as every 10 µg/m(3) increase in daily average concentration of PM(10), there was a 0.1267% (95%CI: 0.0824% - 0.1710%) increase in daily non-accidental death of residents, 0.1365% (95%CI: 0.0010% - 0.2720%) increase in respiratory death and 0.1239% (95%CI: 0.0589% - 0.1889%) increase in cardiovascular death. Ambient PM(10) had greatest influence on daily non-accidental and cardiovascular death of the same day, while its greatest influence on respiratory death occurred 5 days later., Conclusion: The ambient PM(10) pollution increased daily non-accidental, respiratory disease caused, cardiovascular and cerebrovascular diseases caused deaths among residents in Beijing, and lag effect existed as for the effect of ambient PM(10) pollution on respiratory disease caused death.

Objective: To describe the status and characteristics of under-reporting of death cases within national disease surveillance system (DSPs)., Methods: Six villages (communities) were selected in each of the 161 counties of DSPs by multi-stage random cluster sampling methods, the information of resident from 2006 to 2008 was collected, and a survey of the under-reporting deaths cases was carried out which covered 6 422 667 people in all. The under-reporting rate was estimated by ages, genders and regions. The mortality was compared before and after the adjustment of the under-reporting rate., Results: The total crude rate of under-reporting of whole nation was 16.68% (6271/37 603), and after the adjustment by weight the rate was 17.44%; the under-reporting rate of urban areas was a bit lower than rural areas, which were 16.08% and 18.14% respectively (P < 0.01); the under-reporting rate of middle and west regions were higher than the east, which were 19.27%, 18.15% and 15.46% respectively (P < 0.01). The under-reporting rate of children of under-five years old was much higher than that of people of five and above-five years old, which were 34.95% and 16.90% respectively (P < 0.01). The gender difference was especially obvious in age group 0-4, for women 39.36% while 31.93% for men. After adjusted by under-reporting rate, the mortality rate of male raised from 6.38‰ to 7.74‰ and for female raised from 4.66‰ to 5.64‰. In the middle region, the mortality rate of male raised from 6.49‰ to 8.00‰ and for female raised from 4.59‰ to 5.73‰ after the adjustment. And the mortality rate of male in age group 0-4 raised from 2.48‰ to 3.64‰ and for female raised from 1.98‰ to 3.27‰. Of which in urban area, the mortality rate of male was much higher than female before the adjustment, which were 1.76‰ and 1.39‰ respectively; however, the mortality rate of male was a bit lower than female after the adjustment, which were 2.26‰ and 2.41‰ respectively. The mortality in male of five and above-five raised from 6.60‰ to 7.69‰ after the adjustment while in female raised from 4.80‰ to 5.77‰., Conclusion: There are regional and age-group differences of the under-reporting rate of the National Disease Surveillance System. The gender differences mainly shows in age 0-4.

Objective: To better understand and measure the status of hepatitis C virus (HCV) infection, we conducted a sero-epidemiological study using the remaining blood samples and data of the nationwide survey of hepatitis B in Chinese residents which was carried out in 2006., Methods: The anti-HCV reagent was screened out from the reagents by the HCV infection blood serum plate with anti-HCV positives or negatives. This plate recognized the Murex 3.0 and Ortho 3.0 reagents as gold standards. Anti-HCV in the blood samples were tested using this reagent and confirmed by Chiron HCV RIBA 3.0 reagents., Results: Among the population aged 1 year to 59 year-olds, the overall prevalence rate of anti-HCV was 0.43% (95%CI: 0.33% - 0.53%), with the rates of anti-HCV among males and females as 0.46% and 0.40%, respectively. The prevalence rate of anti-HCV in urban area was 0.43%, and in rural area it was 0.43%. The prevalence rate of anti-HCV in the Eastern, Middle and Western areas were 0.37% (95%CI: 0.21% - 0.53%), 0.67% (95%CI: 0.40% - 0.94%) and 0.31% (95%CI: 0.20% - 0.42%) respectively. The prevalence rates of anti-HCV for the three areas did not show significant differences, statistically. The prevalence rate of anti-HCV in the South and North areas were 0.29% (95%CI: 0.21% - 0.52%) and 0.53% (95%CI: 0.38% - 0.64%) respectively., Conclusion: Our data revealed that China was in the low prevalence area for hepatitis C infection and the results also suggested that the comprehensive measures for HCV control and prevention had been successfully achieved in the country.

Objective: To study the association between sulphur dioxide, nitrogen dioxide and daily mortality in urban population from Tianjin., Methods: Data on daily concentration of inhalable particulate matter, sulphur dioxide and nitrogen dioxide, daily mean temperature and relative humidity, daily cause-specific death counts were collected. Generalized additive models was used to explore the relationship between sulphur dioxide, nitrogen dioxide and daily mortality, after adjusting the effects of long-term and seasonal trend, weather conditions, and to analyze the potential effect of particulate matter and model parameters on relative risk estimates., Results: Results showed that the daily concentrations of SO(2) and NO(2) were significantly associated with daily non-accidental and cardiovascular mortality but not associated with daily respiratory mortality. An increase of 10 µg/m(3) in SO(2) was associated with 0.56% (95%CI: 0.23% - 0.89%) non-accidental morality, 0.49% (0.06% - 0.93%) cardiovascular morality, respectively. An increase of 10 µg/m(3) in NO(2) was associated with 0.94% (95%CI: 0.17% - 1.70%) non-accidental morality, 1.29% (0.29% - 2.30%) cardiovascular morality, respectively., Conclusion: Our findings suggested that exposure to SO(2) and NO(2) was significantly associated with daily cardiovascular and respiratory mortality in urban population in Tianjin.

Objective: To study the association between particulate matter less than 10 micron in aerodynamic diameter (PM(10)) and daily mortality among urban population in Tianjin., Methods: We collected data of air quality, daily mean temperature and relative humidity, and daily cause-specific death counts, and used generalized additive models to explore the relationship between ambient particulate matter and daily mortality, after adjusting the effects of long-term and seasonal trend, weather conditions and other gaseous pollutants, such as sulfur dioxide and nitrogen dioxide., Results: An increase of 10 µg/m(3) in PM(10) was associated with 0.45% (95%CI: 0.21 - 0.69) non-accidental morality, 0.60% (0.29 - 0.91) circulatory morality and 0.82% (0.04 - 1.61) respiratory morality, respectively., Conclusion: Our findings indicated that the extent of exposure to PM(10) was significantly associated with daily mortality in urban population in Tianjin, especially with the mortality rates on circulatory and respiratory diseases.