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工具变量法在环境流行病学因果推断中的应用与进展

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环境与职业医学 2024年第2期41卷 219-225页

作者：石慧郑古峥玥赵星黄守瑞艾宝卓吴佳隆林华亮中山大学公共卫生学院流行病学系广东广州510080 四川大学华西公共卫生学院四川成都610041

环境流行病学研究中环境暴露广泛而非随机、混杂偏倚较为复杂,对其因果推断带来了巨大的挑战。近年来,随着因果推断方法引入观察性研究中,其为环境流行病学因果推断研究提供了更多统计方法的选择。工具变量法(Ⅳ)作为一种能够很好控制... 详细信息

环境流行病学研究中环境暴露广泛而非随机、混杂偏倚较为复杂,对其因果推断带来了巨大的挑战。近年来,随着因果推断方法引入观察性研究中,其为环境流行病学因果推断研究提供了更多统计方法的选择。工具变量法(Ⅳ)作为一种能够很好控制未测量混杂因素的因果推断方法,逐渐应用在环境流行病学研究领域中。本研究介绍了Ⅳ的基本原理,归纳了目前应用Ⅳ进行环境流行病学因果推断的研究进展与局限性。当前环境流行病领域应用Ⅳ方法进行因果推断研究尚处于初级阶段,合理使用Ⅳ并与其他因果推断方法的有效整合将成为环境流行病学因果推断的发展重点。本研究旨在为我国环境暴露的人群健康效应的因果推断研究提供方法学上的参考和依据。

关键词：工具变量法因果推断环境流行病学环境暴露健康效应应用

妊娠期糖尿病、孕期增重和喂养方式对其子代神经发育迟缓的影响

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实用医学杂志 2024年第8期40卷 1108-1113页

作者：刘雨诗林青梅何曼苏阳杨音林华亮蔡赞怡郭晓玲南方医科大学第二临床医学院广州510000 佛山市妇幼保健院广东佛山528000 中山大学公共卫生学院广州510000

目的探讨妊娠期糖尿病、孕期增重和喂养方式对其子代神经发育迟缓的影响。方法采用回顾性队列研究,对纳入队列的8 023例产妇及其子代的基本信息进行描述性分析,在调整协变量后分析妊娠期糖尿病、孕期增重和喂养方式和其子代神经发育... 详细信息

目的探讨妊娠期糖尿病、孕期增重和喂养方式对其子代神经发育迟缓的影响。方法采用回顾性队列研究,对纳入队列的8 023例产妇及其子代的基本信息进行描述性分析,在调整协变量后分析妊娠期糖尿病、孕期增重和喂养方式和其子代神经发育迟缓的关联。结果研究对象妊娠年龄为(29.46±4.57)岁,孕前体质量指数(BMI)为(21.38±3.09)kg/m2。纳入子代中,男性4 450例(55.5%),采用母乳喂养4 351例(54.2%),出生时有735例(9.2%)为低体重新生儿。在校正了协变量后的logistic模型中,人工喂养与神经行为发育迟缓呈正相关[OR=1.70,95%CI:1.24~2.33]。在校正了协变量的多元线性回归模型中,妊娠期糖尿病、孕期增重不足,人工喂养与总发育商呈负相关(β=-0.44,95%CI:-0.87~-0.008;β=-0.73,95%CI:-1.25~-0.22;β=-0.80,95%CI:-1.34~-0.26)。母体妊娠糖尿病对其子代大运动和社交能力发育迟缓有明确影响(P <0.05);产妇增重不足对其子代五大能区的神经迟缓的影响均有统计学意义(P <0.05);人工喂养对其子代五大能区的神经迟缓有明确影响(P <0.05)。结论产妇妊娠期增重不足以及采用人工喂养的方式是子代神经发育迟缓的危险因素,母体妊娠糖尿病是其子代大运动和社交能力发育迟缓的危险因素。

关键词：妊娠期糖尿病神经发育喂养方式孕期增重

Physical Activity and Different Recommendations Associated with the Dynamic Trajectory of Cardiometabolic Diseases-UK,2006-2021

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China CDC weekly 2022年第51期4卷 1154-1160,I0001-I0004页

作者： Lan Chen Miao Cai Hongtao Zou Shiyu Zhang Xiaojie Wang Haitao Li hualiang lin Zilong Zhang Department of Epidemiology School of Public HealthSun Yat-sen UniversityGuangzhouGuangdongChina Department of Social Medicine and Health Service Management Health Science CenterShenzhen UniversityShenzhenGuangdongChina

What is already known about this topic?Previous studies have illustrated the benefits of physical activity on cardiometabolic multimorbidity(CMM),while limited studies have concentrated on the trajectory of CMM *** is added by this report?Through multi-stage regression analysis,we found that physical activity could reduce the risk of CMM *** initially free of cardiometabolic diseases(CMDs)may benefit more from engaging in recommended physical *** are the implications for public health practice?Adults,especially those initially free of CMDs,should engage in WHO-recommended physical activity as early as possible to prevent CMD incidence and further progression.

关键词： CMD CMM Dynamic

The impact of EV71 vaccination program on hand,foot and mouth disease in Zhejiang Province,China:A negative control study

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Infectious Disease Modelling 2023年第4期8卷 1088-1096页

作者： Dashan Zheng lingzhi Shen Wanqi Wen Feng ling Ziping Miao Jimin Sun hualiang lin Department of Epidemiology School of Public HealthSun Yat-sen UniversityGuangzhouGuangdong510080China Zhejiang Provincial Center for Disease Control and Prevention HangzhouZhejiang310051China

Objective:To estimate the potential causal impact of Enterovirus A71(EV71)vaccination program on the reduction of EV71-infected hand,foot,and mouth disease(HFMD)in Zhejiang ***:We utilized the longitudinal surveillance dataset of HFMD and EV71 vaccination in Zhejiang Province during *** estimated vaccine efficacy using a Bayesian structured time series(BSTS)model,and employed a negative control outcome(NCO)model to detect unmeasured confounding and reveal potential causal ***:We estimated that 20,132 EV71 cases(95%CI:16,733,23,532)were prevented by vaccination program during 2017-2019,corresponding to a reduction of 29%(95%CI:24%,34%).The effectiveness of vaccination increased annually,with reductions of 11%(95%CI:6%,16%)in 2017 and 66%(95%CI:61%,71%)in *** under 5 years old obtained greater benefits compared to those over 5 *** with higher vaccination coverage experienced a sharper EV71 reduction compared to those with lower *** NCO model detected no confounding factors in the association between vaccination and EV71 cases reduction.

关键词： Hand,foot,and mouth disease(HFMD) Bayesian structure time series model Enterovirus A71(EV71)vaccine Negative control outcome

Associations of Ambient NO2 with Daily Hospitalization,Hospitalization Expenditure and Length of Hospital Stay of Cause-Specific Respiratory Diseases-Shanxi,China,2017-2019

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China CDC weekly 2022年第35期4卷 779-782,I0002-I0004页

作者： Dashan Zheng Dawei Cao Shiyu Zhang Huiqing Shen Yi Liu Qiyong Liu Jimin Sun Guangyuan Jiao Jianzhen Wang Xiaoran Yang Xinri Zhang hualiang lin School of Public Health Sun Yat-sen UniversityGuangzhou CityGuangdong ProvinceChina Department of Respiration First Hospital of Shanxi Medical UniversityTaiyuan CityShanxi ProvinceChina Key Laboratory of Infectious Disease Prevention and Control Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesNational Institute for Communicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijingChina Key Laboratory of Vaccine Prevention and Control of Infectious Disease of Zhejiang ProvinceZhejiang Provincial Center for Disease Control and PreventionHangzhou CityZhejiang ProvinceChina Department of Ideological and Political Education School of MarxismCapital Medical UniversityBeijingChina Department of Standards and Evaluation Beijing Municipal Health Commission Policy Research CenterBeijing Municipal health Commission Information CenterBeijingChina

Summary What is already known about this topic?Numerous epidemiological studies have documented the association between ambient nitrogen dioxide(NO2)and mortality and morbidity of respiratory diseases,however,research on the effect of NO2 on the length of hospital stay(LOS)and hospitalization expenditure is *** is added by this report?This study collected the respiratory hospitalization,hospital expenditure,and LOS for respiratory diseases from 2017-2019 in Shanxi,China,and comprehensively evaluated the association between ambient NO2 exposure and respiratory hospitalization,expenditure,and *** are the implications for public health practice?This study provides evidence on the association between ambient NO2 and respiratory burden,suggesting that continuously reducing the NO2 concentrations could prevent respiratory diseaseassociated hospital admissions and decrease the relative burden in Shanxi Province and other similar regions.

关键词： ambient Shanxi burden

Temporal trend of mortality from major cancers in Xuanwei, China

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Frontiers of Medicine 2015年第4期9卷 487-495页

作者： hualiang lin Bofu Ning Jihua Li Guangqiang Zhao Yunchao Huang linwei Tian Guangdong Provincial Institute of Public Health Guangdong Provincial Center for Disease Control and Prevention Guangzhou 511430 China Xuanwei Center for Disease Control and Prevention Xuanwei 655400 China Qujing Center for Disease Control and Prevention Qujing 655000 China Yunnan Province Tumor Hospital and The Third Affiliated Hospital of Kunming Medical University Kunming 650106 China School of Public Health The University of Hong Kong Hong Kong China

Although a number of studies have examined the etiology of lung cancer in Xuanwei County, China, other types of cancer in this county have not been reported systematically. This study aimed to investigate the temporal trend of eight major cancers in Xuanwei County using data from three mortality surveys （1973-1975, 1990-1992, and 2004-2005）. The Chinese population in 1990 was used as a standard population to calculate age- standardized mortality rates. Cancers of lung, liver, breast, brain, esophagus, leukemia, rectum, and stomach were identified as the leading cancers in this county in terms of mortality rate. During the three time periods, lung cancer remained as the most common type of cancer. The mortality rates for all other types of cancer were lower than those of the national average, but an increasing trend was observed for all the cancers, particularly from 1990-1992 to 2004-2005. The temporal trend could be party explained by changes in risk factors, but it also may be due to the improvement in cancer diagnosis and screening. Further epidemiological studies are warranted to systematically examine the underlying reasons for the temporal trend of the major cancers in Xuanwei County.

关键词： cancer mortality Xuanwei temporal trend

Association Between Ambient Temperature and Years of Life Lost from Stroke—30 PLADs,China,2013–2016

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China CDC weekly 2021年第23期3卷 485-489,I0001-I0006页

作者： Jinlei Qi Fei Tian Siqi Ai Peng Yin Maigeng Zhou Lijun Wang hualiang lin National Center for Chronic and Noncommunicable Disease Control and Prevention Chinese Center for Disease Control and PreventionBeijingChina Department of Epidemiology School of Public HealthSun Yat-sen UniversityGuangdongChina

What is already known about this topic?Previous studies have mainly focused on the relationship between temperature and mortality from stroke,but analysis on the effects on years of life lost(YLL)is *** is added by this report?YLLs were used as the health outcome,and cold and hot weather were found to be significantly associated with an increase in YLLs from stroke and for different groups,with a stronger effect found to be associated with low *** are the implications for public health practice?These findings could help identify vulnerable regions and populations that have a more serious temperaturerelated burden and to guide the practical and effective measures for stroke control from a YLL perspective.

关键词： temperature. mortality finding

健康教育在社区高血压预防控制中的应用效果分析

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中国医药指南 2023年第6期21卷 78-80页

作者：林华樑尤溪县城东社区卫生服务中心公共卫生科福建尤溪365100

目的在社区高血压的疾病管理工作中,实施健康教育,并分析其应用效果。方法选取60例高血压患者作为观察对象,分组方式为随机,将其分为两组,即对照组(n=30)和观察组(n=30),实施常规干预者为对照组,在常规干预基础上增加健康教育为观察... 详细信息

目的在社区高血压的疾病管理工作中,实施健康教育,并分析其应用效果。方法选取60例高血压患者作为观察对象,分组方式为随机,将其分为两组,即对照组(n=30)和观察组(n=30),实施常规干预者为对照组,在常规干预基础上增加健康教育为观察组。实施不同的干预方式后对比两组人员的血压水平、疾病自我管理能力、生活质量以及疾病知识知晓情况。结果两组社区高血压患者分别接受不同的干预方式后,对其进行全面的评估,由此可从结果中看到观察组的血压水平控制较好;在疾病自我管理能力的对比中,发现对照组的评分均低于观察组;两组生活质量的对比,可明显看到观察组的生活质量高于对照组;与对照组相比,疾病知识知晓情况相对来说观察组处于较高水平(P <0.05)。结论在社区高血压患者的管理中,增加健康教育作为干预,能够显著改善患者对高血压疾病知识的知晓率,进而改变日常生活中的不良习惯,有助于血压水平的改善,能够协助患者获得较好的治疗效果,可有效避免疾病恶化给机体带来严重影响,有着重要的实施意义。

关键词：健康教育社区高血压预防控制应用效果

Ambient air pollution and low temperature associated with case fatality of COVID-19: A nationwide retrospective cohort study in China

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The Innovation 2021年第3期2卷 86-93页

作者： Fei Tian Xiaobo Liu Qingchen Chao Zhengmin(Min)Qian Siqi Zhang Li Qi Yanlin Niu Lauren DArnold Shiyu Zhang Huan Li hualiang lin Qiyong Liu Department of Epidemiology School of Public HealthSun Yat-sen UniversityGuangzhou 510080China State Key Laboratory of Infectious Disease Prevention and Control Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesWHO Collaborating Centre for Vector Surveillance and ManagementNational Institute for Communicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing 102206China Laboratory for Climate Studies National Climate CenterChina Meteorological AdministrationBeijing 100081China Department of Epidemiology and Biostatistics College for Public Health&Social JusticeSaint Louis University3545 Lafayette AvenueSaint LouisMO 63104USA

The evidence for the effects of environmental factors on COVID-19 case fatality remains controversial,and it is crucial to understand the role of preventable environmental factors in driving COVID-19 *** thus conducted a nationwide cohort study to estimate the effects of environmental factors(temperature,particulate matter[PM2.5,PM10],sulfur dioxide[SO2],nitrogen dioxide[NO2],and ozone[O3])on COVID-19 case fatality.A total of 71,808 confirmed COVID-19 cases were identified and followed up for their vital status through April 25,*** to ambient air pollution and temperature were estimated by linking the city-and county-level monitoring data to the residential community of each *** each participant,two windows were defined:the period from symptom onset to diagnosis(exposure window I)and the period from diagnosis date to date of death/recovery or end of the study period(exposure window II).Cox proportional hazards models were used to estimate the associations between these environmental factors and COVID-19 case ***-19 case fatality increased in association with environmental factors for the two exposure *** example,each 10 mg/m^(3) increase in PM2.5,PM10,O3,and NO2 in window I was associated with a hazard ratio of 1.11(95%CI 1.09,1.13),1.10(95%CI 1.08,1.13),1.09(95 CI 1.03,1.14),and 1.27(95%CI 1.19,1.35)for COVID-19 fatality,respectively.A significant effect was also observed for low temperature,with a hazard ratio of 1.03(95%CI 1.01,1.04)for COVID-19 case fatality per 1C *** analysis indicated that these effects were stronger in the elderly,as well as in those with mild symptoms and living in Wuhan or ***,the sensitivity analyses also yielded consistent ***-term exposure to ambient air pollution and low temperature during the illness would play a nonnegligible part in causing case fatality due to *** exposures to high concentrations of PM2.5,PM10,O3,SO2,and NO2 and low

关键词： temperature air pollution COVID-19 fatality cohort study