The China National Health Survey (CNHS) is the first nationwide multi-ethnic cross-sectional interview and health examination conducted from 2012 to 2017. The survey is designed to study reference intervals for physiological constants as well as determinants of noncommunicable diseases among different ethnic populations in different areas, so that the data can be used to enhance clinical diagnosis strategies and health promotion. CNHS used a stratified, multistage cluster sampling method to obtain a sample of 53 895 people aged 20-80 years in 10 ethnic groups from 11 provinces or autonomous regions all over China. Blood samples were collected from each participant for the establishment of the China Multi-Ethnic Biobank (CMEB). CNHS collected data on demographic and socioeconomic information, lifestyle factors, anthropometric measures, laboratory tests and clinical profiles. These data provide a comprehensive resource for further study on risk factors of noncommunicable disease among different ethnic groups. Information about the CNHS database, including publication list, introduction of the survey design and methods, and guidelines for submitting electronic forms of data application, is available at [http://www.bmicc.cn/web/share/home].

AimsTo investigate the prevalence, ethnic differences and associated risk factors for pterygium in Han and Manchu populations aged 40–79 years in Hebei province, China.DesignCross-sectional study, as a part of the China National Health Survey.SettingHebei province, China.ParticipantsA multistage cluster sampling method with urbanisation level-based stratification was used to select participants for this study. A total of 4591 individuals over 40 years were recruited for this study. Inclusive criteria: (1) residents who had been living in Hebei for more than 1 year; (2) Han individuals with both parents being Han, or Manchu individuals with both parents being Manchu; (3) underwent ophthalmic examinations and (4) information in the questionnaire was complete.Main outcome measuresMultiple logistic regression analysis was used to evaluate the association between pterygium prevalence and factors of interest.ResultsA total of 3790 individuals (2351 Hans and 1439 Manchus) met the study criteria, of which 248 were diagnosed with pterygium (6.5%). There was no significant difference between the prevalence rates in Hans (6.2%) and Manchus (7.2%) (p=0.232). Multivariate analysis revealed that the risk factors for grade 2 or higher pterygium were increasing age (p<0.001) and rural residence (OR 1.83; 95% CI 1.11 to 3.02; p=0.018), while the protective factors include gender (female) (OR 0.58; 95% CI 0.37 to 0.88; p=0.011), cigarette smoking (OR 0.53; 95% CI 0.34 to 0.83; p=0.005) and myopia (OR 0.50; 95% CI 0.33 to 0.77; p=0.002). Premature menopause (OR 2.66; 95% CI 1.05 to 6.72; p=0.038) increased the risk of grade 2 or higher pterygium in females, while higher high-density lipoprotein (HDL) (OR 1.94; 95% CI 1.08 to 3.47; p=0.027) was a risk factor of grade 2 or higher pterygium in males.ConclusionThe overall prevalence of pterygium in Han and Manchu population in Hebei, China was approximately 6.1%. There were no differences in the prevalence of pterygium between Hans and Manchus, and the race was not a risk factor. This is the first study to report on the positive association between premature menopause and pterygium in females and between higher HDL levels and pterygium in males.

Introduction: The prevalence of hyperuricemia is increasing world widely; the understanding of population attributable faction of modifiable risk factors is important for disease prevention. Given the sparse evidence on how modifiable risk factors influence hyperuricemia in mainland China, we aim to explore the effect of excess weight and alcohol consumption and the population attributable fractions of hyperuricemia based on a national survey in mainland China. Methods: Using data from China National Health Survey which included 31746 Han Chinese aged 20-80 from ten provinces, we estimated the prevalence and modifiable risk factors (overweight/obesity and alcohol consumption)of hyperuricemia. Hyperuricemia was defined as serum uric acid > 417 μmol/L in men and > 340 μmol/L in women. Restricted cubic spline models were used to demonstrate the linear and non-linear association between exposures and hyperuricemia. The adjusted population attributable risk (PAR) was calculated to understand the relative importance of each modifiable risk factor. Results: The prevalence of hyperuricemia was 25.1% in men and 15.9% in women. The population fraction of hyperuricemia cases that could be avoided by weight loss was 20.6% (19.2% to 22.0%) in men and 18.1% (17.1% to 19.0%) in women. The PAR of alcohol consumption was 12.8% (8.5% to 17.1%) in men. Participants from southwest China had the highest hyperuricemia prevalence (47.9% in men and 29.9% in women), but with lower PAR of modifiable risk factors, especially in men (16.7%). Subjects in North China had lower hyperuricemia prevalence but higher PAR of modifiable risk factors. 44.8% male hyperuricemia cases in Inner Mongolia (26.9% of hyperuricemia prevalence) and 37.7% cases in men from Heilongjiang (34.4% of hyperuricemia prevalence) were attributable to overweight/obesity and alcohol consumption. Conclusion: There are significant sex and geographic difference on population attributable risk of hyperuricemia due to modifiable risk factors. More tailored prevention strategies are needed to prevent hyperuricemia through weight loss and the reduction of alcohol consumption.

New human immunodeficiency virus type 1 (HIV-1) diagnoses are increasing rapidly in Hebei. The aim of this study presents the most extensive HIV-1 molecular epidemiology investigation in Hebei province in China thus far. We have carried out the most extensive systematic cross-sectional study based on newly diagnosed HIV-1 positive individuals in 2013, and characterized the molecular epidemiology of HIV-1 based on full length gag-partial pol gene sequences in the whole of Hebei. Nine HIV-1 genotypes based on full length gag-partial pol gene sequence were identified among 610 newly diagnosed naïve individuals. The four main genotypes were circulating recombinant form (CRF)01_AE (53.4%), CRF07_BC (23.4%), subtype B (15.9%), and unique recombinant forms URFs (4.9%). Within 1 year, three new genotypes (subtype A1, CRF55_01B, CRF65_cpx), unknown before in Hebei, were first found among men who have sex with men (MSM). All nine genotypes were identified in the sexually contracted HIV-1 population. Among 30 URFs, six recombinant patterns were revealed, including CRF01_AE/BC (40.0%), CRF01_AE/B (23.3%), B/C (16.7%), CRF01_AE/C (13.3%), CRF01_AE/B/A2 (3.3%) and CRF01_AE/BC/A2 (3.3%), plus two potential CRFs. This study elucidated the complicated characteristics of HIV-1 molecular epidemiology in a low HIV-1 prevalence northern province of China and revealed the high level of HIV-1 genetic diversity. All nine HIV-1 genotypes circulating in Hebei have spread out of their initial risk groups into the general population through sexual contact, especially through MSM. This highlights the urgency of HIV prevention and control in China.

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