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The low-burden Diet Quality Questionnaire (DQQ) is a standardized tool to collect indicators of dietary adequacy as well as indicators of the protection of health against noncommunicable diseases (NCDs) within the framework of the global diet quality project. Stroke is the leading cause of the cardiovascular disease burden in China, with poor diet being one of the major risk factors. In this study, we aimed to understand the association of several indicators of diet quality derived from the DQQ with stroke among Chinese adults and, further, to examine the gender differences using the 2011 wave of the China Health and Nutrition Survey. Multivariable logistic regression was used to examine the associations of the NCD-Protect score, NCD-Risk score, and global dietary recommendations score (GDR) score with stroke. There were 192 stroke cases (121 in men and 71 in women) of 12,051 adults. The continuous NCD-Risk score was positively associated with stroke in women (odds ratio (OR) = 1.52, 95% confidence interval (CI): 1.13-2.06). When compared with women with an NCD-Risk score of 0 points, those with an NCD-Risk score ≥2 points had a higher risk of stroke (OR = 2.71, 95% CI: 1.35-5.43). In addition, compared with women with a GDR score ≤0, those with a GDR score ≥2 points had lower odds of stroke (OR = 0.42, 95% CI: 0.22-0.77). Poor diet quality, as reflected by the NCD-Risk score, was associated with an increased risk of stroke in Chinese women, but not in men. Our findings provided evidence that an optimal diet quality could be conducive to preventing stroke for Chinese women and suggested a diverse diet characterized by the limited consumption of unhealthy foods, such as red meat, processed meat, sweets, soft drinks (sodas), and packaged ultra-processed salty snacks.

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Professor Cheng Zhifan (1922-2018), was a famous contemporary Chinese medical historian and medical history educator, who successively served as the deputy editor in chief, editor in chief and honorary editor in chief for the Chinese Journal of Medical History. He developed the Chinese Journal of Medical History into an important academic journal in the field of Chinese medical history. He had his 46 papers published in the Chinese Journal of Medical History. The papers published in his youth and middle age focused on the study of western medical history. In his later years, he shifted the focus of his research into the education of medical history and the comparative study of Chinese and Western medicine. He devoted his life to teaching and research of medical history, paid close attention to the Chinese Journal of Medical History and made an important contribution to the development of medical history.

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PURPOSE: The purpose of the study was to propose a health indicator system responsive to current Chinese adolescent health needs and identify data gaps in current information systems. METHODS: We identified 186 keywords for adolescent health gathered from three sources: contributors to the burden of disease captured in the Global Burden of Diseases 2015, together with independent literature and expert desk reviews; major health-related policies released by the State Council of China; and global strategies issued by UN agencies over the past five years. All keywords were synthesized into indicators and ranked with core indicators identified through panel discussions and literature review. A further systematic review was conducted to identify data sources for each indicator. RESULTS: We identified 100 indicators which we categorized into five dimensions: health outcomes including adolescent mortality and morbidity; health knowledge, skills and risk behaviors including smoking, physical activity; demographic and socioeconomic status including education or employment; responsiveness of the health service system including the provision of health education at school; and the physical and social environments including safe drinking water, secondhand smoke exposure, injuries, and bullying. In total, 72 indicators had nationally representative data, including 22 out of 24 core indicators (91.7%), 27 out of 33 potential core indicators (81.8%), and 23 out of 43 general indicators (53.5%). A large proportion of these indicators rely solely on data from school or household surveys. CONCLUSIONS: The proposed health indicator system has the potential to rapidly identify shifting priorities for adolescent health in China but will require greater investment in primary data collection in neglected areas.

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PURPOSE: We aimed to analyze the recent trends of mortality and rankings of causes of death in Chinese children and adolescents from 1953 to 2016. METHODS: Data on mortality and causes of death in Chinese children and adolescents aged 5-19 years were extracted from the China Health Statistics Yearbook and the Global Burden of Disease Study from 1953 to 2016. Mortality variations were analyzed by year, age, sex, province, and causes of death. RESULTS: The mortality of Chinese children and adolescents aged 5-19 years declined steadily from 1953 (366.03/100,000) to 2016 (27.21), with the largest reduction in adolescents aged 15-19 years and the smallest reduction in those aged 10-14 years. Large subnational disparities for all-cause mortality existed in national 31 provinces with higher mortality in western regions compared with eastern regions, but with narrowing disparities between 1981 and 2010. Injuries dominated the causes of death compared with noncommunicable diseases and communicable, maternal and neonatal, and nutritional diseases from 1990 (58.13/100,000 vs. 32.10 and 14.31) to 2016 (22.65 vs. 13.00 and 2.93). In 2016, the leading three causes of death were road injuries (8.30/100,000), drowning (7.25), and leukemia (2.60). Drowning was the leading cause of death for 5- to 14-year-olds, but road injuries have been the leading cause for 15- to 19-year-olds of both sexes since 2010. CONCLUSIONS: Although mortality in Chinese adolescents now stands at just 7% of rates in the 1950s, there is a need to address continuing inequalities across sex, economic status, and region.

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The aim of this study was to investigate the long-term trends of human immunodeficiency virus (HIV) mortality in China and its associations with age, period and birth cohort. We used HIV mortality data obtained from the Global Burden of Disease Study (GBD) 2016 and analysed the data with an age-period-cohort framework. Age effects indicate different risks of different outcomes at specific periods in life; period effects reflect population- wide exposure at a circumscribed point in time; and cohort effects generally reflect differences in risk across birth cohorts.Our results showed that the overall annual percentage change (net drift) of HIV mortality was 11.3% (95% CI: 11.0% to 11.6%) for males and 7.2% (95% CI: 7.0% to 7.5%) for females, and the annual percentage changes in each age group (local drift) were greater than 5% (p < 0.01 for all) in both sexes. In the same birth cohort, the risk of death from HIV increased with age in both sexes after controlling for period effects, and the risk for each five-year period was 1.98 for males and 1.57 for females compared to their previous life stage. Compared to the period of 2002-2006, the relative risk (RR) of HIV mortality in 2012-2016 increased by 56.1% in males and 3.7% in females, and compared to the 1955-1959 birth cohort, the cohort RRs increased markedly, by 82.9 times in males and 34.8 times in females. Considering the rapidly increasing risk of HIV mortality, Chinese policymakers should take immediate measures to target the key age group of 15-44 years in both sexes.

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Objective@#To identify the characteristics of social network and the association between ego-centric network and HIV status among young MSM Chinese students.@*Methods@#The cross-sectional study was conducted in Chongqing, Tianjin, Harbin and Xi an city from April to December 2017 and from March to May 2018. A mixed recruitment method of snowball sampling and RDS approach was used to recruit participants who reported information on social network and received HIV test. The Multiple Regression Analysis method was used to for the analysis of association between ego-centric social network and HIV status of men who have sex with men (MSM) among young students.@*Results@#The sample included 547 participants who nominated 1 088 social partners in total with average age of 13 to 60 years old. The MSM with different sexual orientation from their social members (aOR=0.38), embedded in a large network (aOR=0.63), with a high individual betweenness centrality (aOR=0.27) were at lower risk of HIV-positive status; while MSM who differed greatly in education level with their social members(aOR=1.60), existed in sexual networks(aOR=1.41), existed in the “risky networks” (aOR=1.88) , with high network density (aOR=1.91) and a high individual degree (aOR=4.10) had higher risk of HIV-positive status(P<0.05).@*Conclusion@#MSM with great difference in education level from social members, existed in sexual networks, with a large network density and a high degree were exposed to higher risk of HIV-positive status.

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Objective@#The proposal of this study is to determine the feasibility of using online social software to guide popular opinion leaders(POLs) among young students MSM (men who have sex with men, MSM) carrying out comprehensive AIDS prevention in young students MSM.@*Methods@#From November to December 2019 in Tianjin, 22 POLs who had previously experienced AIDS prevention education and training foucus on life skills were recruited. Though snowball sampling method, 100 POLs partners (friends, sexual partners, classmates, etc) were invited into the study. From January to March 2020, regular posters will be sent through the WeChat platform to guide POL to intervene their partners/sexual partners. The questionnaire surveys were conducted before and after the intervention.@*Results@#After the intervention, both the proportion of young students MSM had sex and with multiple sex partners decreased(χ2=12.12, 5.94, P<0.05). The comprehensive ability of AIDS prevention has improved significantly, the "National Eight Items" correct rate has risen from 90.0% to 99.0%(χ2=5.82, 7.56, P<0.05), and the "Youth Eight Items" correct rate has increased from 86.0% to 98.0%(P<0.01). Knowledge score increased from(11.08±1.89) to (11.84±1.27); Attitude score increased from (54.29±4.01) to (56.06±3.75), the behavior score increased from (52.12±4.78) to (55.08±4.25), skill score increased from (51.96±4.75) to (54.67±5.04), The comprehensive prevention ability score (percent) increased from (87.30±6.95) to (91.86±5.42)(t=-4.21, -3.51, -5.32, -5.16, -6.45, P<0.01).@*Conclusion@#Using Wechat platform to guide POL carrying out comprehensive AIDS prevention is effective for improving the comprehensive AIDS prevention ability of young students MSM.

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Objective@#To understand HIV status and depressive symptoms among men who have sex with men (MSM) in the HIV-infected young people/social network.@*Methods@#Intervention network of local CDC was used to recruit HIV-infected young people/students in the city. A mixed recruitment method of snowball sampling and respondent driven sampling method. A MSM young people/students with HIV infection. A total of 201 valid questionnaires were collected.@*Results@#Among them, 132(65.7%) were students, 121(60.2%) were HIV-positive, 108(53.7%) had depressive symptoms. The awareness rate was 92.0%(185). Binary-Logistic regression analysis showed that HIV infection(aOR=4.06,95%CI=2.13-7.72), living alone (aOR=2.93, 95%CI=1.31-6.52) and having sex before the age of 18 (aOR=4.13, 95%CI=1.32-12.96) were significantly associated with depression, moreover, HIV knowledge was a protective factor that help to resist depression in young MSM(aOR=0.30, 95%CI=0.13-0.69)(P<0.01).@*Conclusion@#Depressive symptoms are prevalent among HIV-infected MSM young people. It s cost-effective to promote a multiple biomedical package of increasing HIV/AIDS awareness, reducing HIV infection and transmission to protect young people/students from depression.

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Objective@#To understand the characteristics of sexual partners and the influence of having multiple sexual partners on substance use among young male students man who have sex with men (MSM) in China, and to provide scientific basis for the prevention and control of HIV/AIDS among young MSM students.@*Methods@#A mixed recruitment method of snowball sampling and respondent driven sampling was used to recruit young MSM students in Beijing and Tianjin, and a questionnaire survey was conducted among 220 participants from November to December 2019. Chi-square test and generalized linear model multi-factor Logistic regression were used to analyze the influencing factors of substance use before sexual behavior.@*Results@#The average age of them was (22.39±2.57) years old, 84.5% of them were students, the average age of first sexual behavior was (18.83±2.45) years old, 44.1% of them had two or more sexual partners (including fixed sexual partners, temporary sexual partners and commercial sexual partners), 22.7% had more than one male fixed partner. After adjusting for age and education, having multiple sexual partners was risk factor for drinking alcohol before sex (aOR=2.97) or substance abuse (aOR=2.39). Having male temporary sexual partner was an risk factor in substance use before sexual behavior(OR=4.10).@*Conclusion@#The characteristics of sexual partners among young MSM students are complex, and the proportion of multiple sexual partners is high. Having fixed single sexual partner can reduce the risk of substance use before sexual behavior. AIDS prevention education for young MSM students should be further strengthened.

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Objective@#To develop the Evaluation Sacle for the Comprehensive Ability of HIV/AIDS prevention among Chinese Young Students(hereinafter referred to as the Evaluation Scale).@*Methods@#The Evaluation Scale was preliminarily developed according to standardized preparation procedures of the scales. Firstly, the item pool of the Evaluation Scale was established via literature review and group discussions, and based on the Fourteen Core knowledge of young students HIV/AIDS prevention and control formulated by the Chinese Center for Disease Control and Prevention. Secondly, the Evaluation Scale was preliminarily formed via using the Delphi method to select items.@*Results@#The Evaluation Scale with 85 items was finally formed including four vertical dimensions of knowledge, attitude, behavior and skills and four horizontal dimensions of hazard, prevention, detection and treatment, laws and regulations via literature research, group discussion and two rounds of Delphi method.@*Conclusion@#The Evaluation Scale developed in this paper is scientific and reasonable for constructing is assumed to be a scientific and reasonable proxy tool for the evaluation of the comprehensive ability of young students to prevent AIDS. It can be used for AIDS prevention education or effect assessment before and after intervention.

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OBJECTIVES: HIV/AIDS has become the leading cause of death by infectious disease in China since 2009. However, the trend of gender disparities in HIV/AIDS has not been reported in China since 1990. Our study aimed to explore the secular trend of HIV/AIDS mortality in China from 1990 to 2016 and to identify its gender disparities over the past 27 years. METHOD: The mortality data of HIV/AIDS were obtained from the Global Burden of Disease Study 2016 (GBD 2016). Logistic regression was used to estimate the prevalence odds ratio (POR) of gender for HIV/AIDS mortality in different surveys. RESULTS: The standardized mortality of HIV/AIDS in China rose dramatically from 0.33 per 100,000 people in 1990 to 2.50 per 100,000 people in 2016. The rate of HIV/AIDS mortality increased more quickly in men than in women, and the sex gap of mortality of HIV/AIDS widened. By 2016, the HIV/AIDS mortality in men was 3 times that in women and was 5.74 times that in women within the 75- to 79-year-old age group. CONCLUSIONS: The mortality of HIV/AIDS in China is increasing, with a widening gender disparity. It is critical for policymakers to develop policies to eliminate these disparities and to ensure that everyone can live a long life in full health.

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Objective@#To evaluate the immediate effectiveness of intervention on HIV prevention and leadership of POL among young male students who have sex with men in a city, and to provide reference for health education of AIDS.@*Methods@#A life-skills based participatory approach was adopted to intervene the AIDS prevention and leadership of 54 POL in young male students who have sex with men in a city. A unified questionnaire was adopted before and after the intervention to investigate and evaluate the effects.@*Results@#After intervention, the scores of AIDS prevention information increased from (36.30±7.30) points to (42.09±3.43) points (P<0.01). In terms of motivation, the scores of experience and attitude of condom-using were increased from (5.43±1.19) points to (5.83±1.24) points (P<0.05). As for the behavioral skills, the scores of condom-use skills increased from (4.30±1.04) points to (4.85±0.53) points (P<0.01), the scores of condom self-efficacy increased from (55.85±12.40) points to (61.48±8.01) points (P<0.01), the scores of autonomic HIV testing ability increased from (4.11±1.09) points to (4.65±0.52) points (P<0.01), the ability to avoid alcohol consumption before sexual behavior increased from (3.74±1.19) points to (4.13±0.91) points(P<0.05), and the ability to correctly seek medical advice after illness increased from (9.33±1.32) points to (9.69±0.77) points(P<0.05). In the part of the leadership, the scores of peer status increased from (26.96±5.55) points to (29.81±6.68) points (P<0.01), the scores of active communication ability increased from (21.35±5.76) points to (24.43±4.17) points (P<0.01), and the scores of psychosocial ability increased from (77.96±13.42) points to (80.89±12.42) points (P<0.05).@*Conclusion@#Life-skill-based intervention, which is guided by Information-Motivation-Behavioral skills model, is effective in improving AIDS prevention and leadership.

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Objective@#Explore the feasibility of POL intervention based on life skills in young students at high-risk of AIDS, and to provide reference for POL intervention.@*Methods@#Nine potential POLs were recruited from young students at high risk of AIDS in Xi’an, and received life-skill-based interventions from May to October in 2017. A unified approach was adopted before the intervention. The effect of intervention was evaluated at 1 month and 3 months after the intervention.@*Results@#The difference in POLs peer status and psychosocial ability scores was not significant after the intervention. The scores of persistence efficacy dimension of condom use efficacy before, 1-month and 3-month after the intervention were (10.56±1.88)(11.11±2.21)(12.89±2.09)(F=6.84, P<0.05) respectively. No significant changes were found in AIDS-related knowledge and behavior before and after the intervention. POL has increased from 108 students before intervention to 216 publicity coverage after three months intervention, however, the difference was not statistically significant. Feasibility analysis of the POL intervention showed that 8 of the POLs considered to be "very useful".@*Conclusion@#Life skill-based POL intervention for young students at high-risk of AIDS has a wide coverage and reasonable acceptance, as well as condom use adherence. The long-term effectiveness still needs to be verified.

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Objective@#To understand HIV knowledge and high-risk sexual behaviors among men who have sex with men (MSM) in the HIV-infected students’ social network, and to provide a scentific reference of making targeted and effective measures.@*Methods@#A mixed recruitment method of snowball sampling and respondent driven sampling was used to recruit HIV-infected students with the help of local CDC in Harbin, Tianjin, Xi’an and Chongqing, with demographic information, sexual behaviors and HIV knowledge collected via questionnaire survey.@*Results@#A total of 549 valid questionnaires were analyzed. Among them, the awareness rate of "Guo Ba Tiao" was 90.7% and the awareness rate of "Qing Ba Tiao" was 89.4%, the consistent condom use rate was 59.4%. Among those who were aware of HIV, 40.8% exhibit the mismatch between HIV knowledge and condom use behavior, which was significantly associated with number and types of sex partners. Those who had 1-3 regular male sex partners (1 partner: aOR=2.48, 95%CI=1.61-3.82; 2-3 partners: aOR=2.45，95%CI=1.44-4.15),or 1-3 causal male sex partners (1 partner: a-OR=1.74, 95%CI=1.10-2.77; 2-3 partners: aOR=2.15, 95%CI=1.34-3.46) were more likely for this mismatch. Those who had more than one commercial male sex partner(aOR=3.35, 95%CI=1.15-9.80), or more than one regular female sex partner (aOR=2.49, 95%CI=1.17-5.28), or more than one casual female sex partner(OR=2.80, 95%CI=1.01-7.71), the risk for this mismatch was also high.@*Conclusion@#The mismatch between HIV knowledge and condom use behavior among MSM students from the social network of young students living with HIV/AIDS is severe. It is necessary to carry out tailored HIV intervention to reduce the transmission of HIV among those people.