Shenzhen Nanshan Center for Chronic Disease Control

Shenzhen, China

Shenzhen Nanshan Center for Chronic Disease Control

Shenzhen, China
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Dib H.H.,Peking University | Sun P.,Dalian Medical University | Minmin Z.,Shenzhen Nanshan Center for Chronic Disease Control | Wei S.,Tsinghua University | Li L.,95 Yong An Road
Health and Place | Year: 2010

Around 58 community health centers (CHCs) were investigated to evaluate their performance, and 372 residents were surveyed randomly about their satisfaction towards these centers. State-owned CHCs gained the least benefits and received most patient visits. Residents' opinions about health professionals working in these centers showed marked distrust due to their insufficient work experience and low education level; however, affordability, availability and access to services and drugs among CHCs generated comparatively high satisfaction. Therefore, enhancing CHCs' service delivery is a necessity to improve the quality of community doctors and nurses, increase enrolment and training programs, and augmenting hospitals' support to CHCs. © 2009 Elsevier Ltd. All rights reserved.

PubMed | Shenzhen Nanshan Center for Chronic Disease Control and Huazhong University of Science and Technology
Type: Journal Article | Journal: Health policy and planning | Year: 2016

Irrational use of medicines is a serious problem in China and has been the primary target of Chinas national essential medicines programme (NEMP). The aim of this study was to evaluate the effect of the NEMP on rational use of medicines in China.A nationwide sample of 376700 prescriptions written by primary care providers from 2007 to 2011 was obtained following a multistage sampling process. Six prescribing indicators were measured: average number of drugs prescribed per prescription, average expenditure per prescription, percentage of prescriptions with antibiotics, with injections, with two or more antibiotics and with corticosteroids. The pre-post with control study design and the difference-in-difference (DID) methodology were employed to evaluate the effect of NEMP.Prescriptions from primary care institutions with the NEMP implementation were better than those without NEMP implementation. Adjusting for the institutions sizes, ownership, economic geographic regions and the year of NEMP implementation, the DID estimator was statistically significant in all prescribing indicators except for the percentage of prescriptions with injection. The number of drugs per prescription decreased by 0.2 per prescription [95% confidence interval (CI): -0.3, -0.1] after the NEMP was implemented; the percentages of prescriptions with antibiotics, with corticosteroids and with two or more antibiotics decreased by 7% (95% CI: -10, -4), 1% (95% CI: -2, 0) and 2% (95% CI: -3, 0), respectively; and the average expenditure per prescription decreased by eight Renminbi Yuan (95% CI: -14, -2). The effect of NEMP on reducing irrational prescribing was greater in public institutions than in private institutions (P<0.05).Chinas NEMP is effective in promoting rational use of medicines, and the effect is greater in public institutions than in private institutions. However, the irrational use is still high, pointing to the need for further reforms to tackle the underlying causes, such as clinical guidelines and patient education.

PubMed | National Institute of Allergy and Infectious Diseases and Shenzhen Nanshan Center for Chronic Disease Control
Type: Journal Article | Journal: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease | Year: 2016

Recent advances have made molecular diagnosis of tuberculosis (TB) and drug susceptibility testing (DST) possible, but the high costs involved present a huge challenge. The refinement and improvement of affordable methods therefore remain a priority. Conventional indirect DST is inexpensive and reliable, but time-consuming. A direct DST method for the direct testing of sputum samples without culture has been developed to reduce the time required for DST, but there have been conflicting results.Direct and indirect DST against isoniazid and rifampicin were performed on 208 sputum smear-positive specimens, 186 from newly diagnosed patients and 22 from previously treated patients; respectively 169 and 180 of the direct and indirect DST results were reportable. In comparison with indirect DST, direct DST resulted in a saving of on average 10.5 days. The time to direct DST results was inversely correlated with the number of acid-fast bacilli in the sputum samples.Direct DST is highly sensitive, reliable, cost-effective and time-saving in comparison with indirect DST.

PubMed | Shenzhen Nanshan Center for Chronic Disease Control, University of Wollongong, Kunming Medical University and Zhejiang University
Type: | Journal: Clinical nutrition (Edinburgh, Scotland) | Year: 2016

Hyperhomocysteinemia (HHcy) is known to increase the risk of many diseases. Factors influencing HHcy in healthy and hypertensive subjects remain under-researched.A large population-based study was conducted in 60 communities from Shenzhen, China. Responses to standardized questions on lifestyle factors and blood samples were collected from all participants after a 12-h overnight fast. Multiple linear and multivariate logistic regressions were used to explore risk factors for HHcy. Results were then compared to those from a systematic review of English-language articles listed in Pubmed, EBSCOhost, Web of Science, Embase and Cochrane libraries that investigated HHcy risk factors in healthy and hypertensive subjects.A total of 1586 healthy (Male/Female=642/944) and 5935 hypertensive subjects (Male/Female=2928/3007) participated in our population-based study. In logistic regression analyses, age, BMI and creatinine (Cr) were risk factors, while being female, fruit intake and physical activity were protective factors for HHcy in healthy subjects. In hypertensive subjects, seven [age, smoking, salt intake, systolic blood pressure (SBP), uric acid, triglycerides (TG), and Cr] and four [female, fruit intake, total cholesterol (TC), and glucose] factors were associated with higher and lower HHcy respectively. The review of 71 studies revealed that potential risk factors for Hcy included nutritional, physiologic, lifestyle habits, ethnicity, genetics, interactions between gene-environment, gene-gene, gene-nutritional, environment-environment, nutritional-nutritional.Our study indicates the potential importance of increasing folic acid and vitamin B supplementation, daily fruit and vegetable intake, regular exercise and refraining from tobacco smoking and alcohol consumption as preventive strategies for Hcy.

Liu S.-Y.,Guangdong Medical College | Liu S.-Y.,Shenzhen Nanshan Center for Chronic Disease Control | Zeng F.-F.,Sun Yat Sen University | Chen Z.-W.,Shenzhen Nanshan Center for Chronic Disease Control | And 4 more authors.
CNS Neuroscience and Therapeutics | Year: 2013

Aim: Conclusions on the association between polymorphisms in the vascular endothelial growth factor (VEGF) gene promoter and risk of Alzheimer's disease (AD) are ambiguous, and sufficient evaluation of the association is lacking. Therefore, we performed a meta-analysis of observational studies to explore the association between polymorphisms in the VEGF gene promoter and AD risk. Methods: Bibliographical searches were performed in the MEDLINE, EMBASE, and China National Knowledge Infrastructure (CNKI) databases without any language limitations. Three investigators independently assessed abstracts for relevant studies and independently reviewed all eligible studies. A meta-analysis was conducted using a fixed- or random-effects model. Odds ratios (ORs) and their 95% confidence intervals (CIs) were used to assess the strength of association. All statistical analyses were performed using Stata 11.0 software. Results: The meta-analysis of 2787 AD cases and 2841 controls from eight published case-control studies on the -2578C/A polymorphism and 1422 AD cases and 1063 controls from four studies on the -1154G/A polymorphism did not show any significant associations. However, in a subgroup analysis stratified by the presence of APOE j{cyrillic, ukrainian}4, associations were observed with APOE ε4 (-) for -2578C/A (A vs. C: OR = 1.22, 95% CI = 1.04-1.43, P = 0.014; A/A vs. C/C: OR = 1.59, 95% CI = 1.11-2.27, P = 0.011 and A/A vs. A/C + C/C: OR = 1.46, 95% CI = 1.08-1.99, P = 0.015) and -1154G/A (A vs. G: OR = 0.74, 95% CI = 0.62-0.89, P = 0.001; A/A vs. G/G: OR = 0.57, 95% CI = 0.37-0.87, P = 0.009; A/G vs. G/G: OR = 0.69, 95% CI = 0.53-0.89, P = 0.004 and A/A + A/G vs. G/G: OR = 0.66, 95% CI = 0.52-0.85, P = 0.001). Conclusion: This meta-analysis showed the risk role of the -2578 polymorphism and the protective role of the -1154 polymorphism when the APOE j{cyrillic, ukrainian}4 status was negative, suggesting that the two polymorphisms in the VEGF promoter may have opposing effects on AD risk in an APOE j{cyrillic, ukrainian}4-independent manner. © 2013 John Wiley & Sons Ltd.

Wang C.-Y.,Sun Yat Sen University | Wang C.-Y.,Shenzhen Nanshan Center for Chronic Disease Control | Chen Z.-W.,Shenzhen Nanshan Center for Chronic Disease Control | Zhang T.,Shenzhen Nanshan Center for Chronic Disease Control | And 6 more authors.
European Journal of Internal Medicine | Year: 2014

Background Accumulating data suggest that hyperhomocysteinemia is associated with the risk of ischemic stroke (IS) and coronary heart disease (CHD) in the general population, but the relationship remains unclear in hypertensive patients. We examined the association of total homocysteine (tHcy) with IS and CHD in hypertensive patients. Methods A total of 5935 Chinese hypertensive patients were recruited in a community-based cross-sectional study from 60 communities in Shenzhen, China. Plasma tHcy was quantitatively measured using the enzyme cycle method. Conventional risk factors for IS and CHD were obtained through questionnaire interviews and physical examinations. We included cerebral infarction, embolism and small-vessel disease as IS; and myocardial infarction, angina pectoris, coronary revascularization, and cardiac arrest as CHD. IS and CHD were retrospectively adjudicated by specialists via interviews, hospital records or relevant tests. Results Significantly higher values of tHcy were observed in IS patients than in non-IS controls among both men and women. Greater tHcy level was dose dependently associated with an increased risk of IS presence in women, men and them combined (p-trend: 0.002, 3.8 × 10 - 4 and 0.001). The odds ratios (95% CI) of IS for tHcy ≥ 30 (vs. < 15) μmol/L were 2.84 (1.73-4.34) in men, 4.41 (1.62-9.15) in women, and 2.86 (1.72-4.75) in their combination after adjusting for other main risk factors of IS. We did not find any significant association between tHcy and presence of CHD after the adjustment for covariates. Conclusions Plasma homocysteine level is positively associated with the presence of IS, but not CHD, in Chinese hypertensive patients. © 2014 European Federation of Internal Medicine.

Zhang T.,Shenzhen Nanshan Center for Chronic Disease Control | Li L.,Shenzhen Nanshan Center for Chronic Disease Control | Shang Q.,State University of New York at Buffalo | Lv C.F.,Shenzhen Nanshan Center for Chronic Disease Control | And 3 more authors.
Biochemical and Biophysical Research Communications | Year: 2015

Type 2 diabetes mellitus (T2DM) is a major public health problem in China. Diagnostic markers are urgently needed to identify individuals at risk of developing T2DM and thus encouraging healthier life styles. Circulating miRNAs are valuable sources for non-invasive biomarkers of various diseases. The aim of this study was to examine whether reduced miR-126 expression could predict the onset of T2DM in susceptible individuals. Two groups of study subjects were involved, one group was diagnosed T2DM in 2013 and the other group was healthy control. To this end, our results showed that miR-126 expression were already decreased before the manifestation of T2DM. Univariable logistic regression confirmed that the plasma miR-126 level was inversely associated with the onset of DM (P=0.0158[U+02C2]0.05), suggesting reduced miR-126 is a predictor for the onset of T2DM. According to the logistic regression model and ROC curve, a cut-off points of miR-126 plasma level as 35 is recommended for clinical study to predict whether an individual is more likely to develop T2DM. If miR-126 expression is lower than 35, the individual is more likely to T2DM in the next 2 years. In conclusion, our results support the notion that the circulating miR-126 can be developed into a non-invasive and rapid diagnostic tool for the prediction of susceptible individuals to developing T2DM. © 2015 Elsevier Inc.

Liu S.-Y.,Guangdong Medical College | Liu S.-Y.,Shenzhen Nanshan Center for Chronic Disease Control | Wang W.,The First Hospital of Harbin | Cai Z.-Y.,Guangdong Medical College | And 5 more authors.
CNS Neuroscience and Therapeutics | Year: 2013

Aim: Alzheimer's disease (AD) is a multifactor disease that has been reported to have a close association with endoplasmic reticulum (ER) stress response. In the response, the regulator factor human X-box-binding protein 1 (XBP1) has been shown to facilitate the refolding and degradation of misfolded proteins, prevent neurotoxicity of amyloid-beta (Aβ) and tau, and play an important role in the survival of neurons. The aim in the study was to analyze the potential association between the -116C/G polymorphism of XBP1 and the risk of AD. Methods: The association between -116C/G polymorphism of XBP1 promoter and possible risk of AD was assessed among 276 patients with AD and 254 matched healthy individuals in a case-control study. Results: Overall, there was a significantly statistical difference in genotype (P = 0.0354) and allele frequencies (P = 0.0150, OR = 1.3642, 95% CI = 1.0618-1.7528) between the AD subjects and control subjects, showing that the -116C/G polymorphism of XBP1 might lead to increased susceptibility for AD in a Chinese Han population. In addition, the -116CG and -116GG genotypes were significantly associated with increased AD risk in female (P = 0.0217) and in subjects with APOE j{cyrillic, ukrainian}4 (-) (P = 0.0070) in stratified analyses, and the -116CC genotype was significantly associated with fast cognitive deterioration in the AD patients (P = 0.0270). Conclusion: The study supports a role for the -116C/G polymorphism of XBP1 gene in the pathogenesis of AD, and further studies with a larger sample size and detailed data should be performed in other populations. © 2013 Blackwell Publishing Ltd.

Tian W.,Harbin Medical University | Zhao Y.,Harbin Medical University | Liu S.,Shenzhen Nanshan Center for Chronic Disease Control | Li X.,Harbin Medical University
European Journal of Cancer Prevention | Year: 2010

Although nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, show chemopreventive effects on several types of cancer, their role in the development of gastric cancer remains controversial. The objective of this study is to assess the quantitative association between NSAIDs and gastric cancer by meta-analysis using both crude data and adjusted data. A search of Medline, Embase, Web of science, and citations from relevant articles was conducted for eligible articles published up to March 2009. A meta-analysis was developed. Pooled risk ratio and odds ratio with 95% confidence intervals were calculated, based on both crude and adjusted data from the selected studies and using random or fixed effects models based on heterogeneity analysis. Overall, 21 individual epidemiological studies (13 case-control studies with 29 560 participants and 8 cohort studies with 2 199 227 participants) were examined. The summary crude and adjusted risk ratios were 0.89 (0.83-0.97) and 0.81 (0.73-0.89) when the case-control and cohort studies were pooled, respectively. Significant protective effects of NSAIDs against gastric cancer appeared in all subgroups (study design, type of drug, site of cancer, and sample source), but only the site of cancer and sample source can substantially influence the estimate of effect. The chemopreventive effect of NSAIDs in gastric cancer was stronger based on the adjusted data than that based on crude data. Therefore, we conclude that NSAID use is associated with a decrease in the development of gastric cancer. The associations were more obvious after we adjusted for several risk factors that are known to contribute to the development of gastric cancer. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Wang C.,Shenzhen Nanshan Center for Chronic Disease Control
Zhonghua nei ke za zhi | Year: 2015

OBJECTIVE: To analyze the association between homocysteine (Hcy) and stroke in hypertensive patients.METHODS: This was a prospective cohort study conducted in 60 communities in Nanshan District, Shenzhen. Totally 5 488 patients with hypertension were included at baseline survey and followed for an average of 2.7 years. At the end of follow-up, 327 (5.96%) subjects were missing with unknown reasons. Hcy was detected by enzymatic cycling method. Head CT, MRI, cerebral angiography and transcranial Doppler ultrasound were performed in the patients. Stroke was defined based on the International Classification of Diseases (ICD10 coding I60-I64).RESULTS: After an average of 2.7-year follow-up, 197 developed new stroke. The incidence rate was 3.82%. Subjects whose Hcy levels were within the highest quartile (Q4) had higher risk to develop stroke compared with those whose Hey levels were within the lowest quartile (Q1). The HR (95% CI) were 7.4 (3.2-13.2) in total with 7.5(3.0-19.5) in men and 7.7 (2.7-22.1) in women after adjustment of age, sex, education, smoking, alcohol drinking, and BMI, physical activity, diabetes, depression, family history of stroke or coronary heart disease, years of hypertension, antihypertensive drugs, folic acid, systolic blood pressure, TC, glucose and TG. For every 5 µmol/L increase in Hcy, the HR (95% CI) of stroke increased 1.15-fold (1.09-1.21) in total subjects with 1.15 (1.08-1.21) in men and 1.19 (1.04-1.35) in women, respectively. No significant interactions on stroke could be found between Hcy and the above stratified factors.CONCLUSION: Elevated Hcy levels were associated with stroke in hypertensive patients.

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