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杨功焕课题组
[ 作者:基础医学研究所(院)    来源自:本站原创    点击数:18801    更新时间:2014-3-14    文章编辑:wangluo ]

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杨功焕教授课题组

  中心负责人介绍:杨功焕,研究员,教授,博士生导师,公共卫生和慢性病流行病学专家。1982年毕业于华西医大,1987年赴哈佛大学公卫学院学习,先后在中国预防医学科学院、中国医学科学院、世界银行、世界卫生组织和中国疾病预防控制中心工作。现为中国协和医科大学基础医学研究院特聘教授和全球控烟研究所中国分中心主任。主要研究方向为疾病模式和疾病负担研究,重点为烟草流行与控制、自杀模式研究和水污染和人群肿瘤等。发表上百篇中英文论文,主编30多本中英文书籍,获6个国家级科技成果奖。

 

发表文章:
1. Yang GH, Wang Y, Zeng YX, et al. Rapid health transition in China, 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 2013: 381: 1987-2015.
2. Yang GH. Marketing ‘less harmful, low-tar’ cigarettes is a key strategy of the industry to counter tobacco control in China. Tobacco control. 2013: 0: 1-6.
3. Wan Xia, Yang GH, Stillman F, et al. Development of policy performance indicators to assess the implementation of protection from exposure to secondhand smoke in China. Tobacco control. [June 11, 2013] doi:10.1136/tobaccocontrol-2012-050890
4. Wan Xia, Yang GH, Novotny TE. Acceptability and adoption of handheld computer data collection for public health research in China. BMC Med Inform Decis Mak. 2013, 13(1):68

5. 杨功焕、庄大方、任红艳等. 淮河流域水环境与消化道肿瘤死亡图集. 北京:地图出版社. 2013.
6. 杨功焕、王传法、胡大一等. 执业医师与控烟. 北京:人民卫生出版社. 2013.

 

 

 

 

 

1990—2010年中国人群健康模式快速转变:全球疾病负担研究2010之启示

Gonghuan Yang, Yu Wang, Yixin Zeng, George F Gao, Xiaofeng Liang, Maigeng Zhou, Xia Wan, Shicheng Yu, Yuhong Jiang, Mohsen Naghavi,Theo Vos, Haidong Wang, Alan D Lopez, Christopher J L Murray

背 景 在过去几十年中,中国经历了快速的人口统计学及流行病学模式转变,包括生育率和儿童死亡率的快速下降以及出生时预期寿命延长。以上模式的转变均要求卫生系统进行改革。为了帮助应对卫生系统的改革,本文全面地评估了中国的疾病负担,描述了其从1990年至2010年的变化,以及中国的疾病负担与其他国家的差别。

方 法 本研究采用了全球疾病负担、伤害及危险因素研究2010(GBD 2010)中包括中国在内的20国集团(G20)中19个成员国1990年和2010年的结果,评估死亡率、死亡原因、因过早死亡所致的寿命损失年(YLL)、伤残所致的寿命损失年(YLD)、伤残调整寿命年(DALY)和健康预期寿命(HALE)等指标的水平及其变化趋势。描述了与中国相关的231种疾病及伤害以及67个危险因素或危险因素集群的结果。采用年龄别标准化率及95%
不确定性区间(UI)评估了中国相对于G20其他成员国的水平(显著高于、低于或近似于G20的均值)。

结 果 2010年,中国的主要死亡原因是卒中(170万例死亡,95%UI 150万~180万)、缺血性心脏病(94.87万例死亡,95%UI 77.45万~102.46万)和慢性阻塞性肺疾病(COPD)(93.40万例死亡,95%UI 84.66万~103.23万)。2010年,中国的年龄标准化YLL低于G20中所有的新兴经济体,仅略高于美国;年龄标准化YLD率在G20中最低;HALE居G20第10位(95%UI 第8~10位),预期寿命居第12位(95%UI 第11~13位)。1990—2010年,中国人群的新生儿死亡、传染病及儿童伤害导致的YLL大幅降低;近半数YLD由精神和行为障碍、药物滥用和骨骼肌肉疾病所致。YLD占DALY的百分比由1990年的28.1%(95%UI 24.2% ~32.5%)上升至2010年的39.4%(95%UI 34.9%~43.8%);2010年,DALY排名居前的疾病主要是心血管疾病(卒中和缺血性心脏病)、癌症(肺癌和肝癌),腰痛和抑郁症。饮食危险因素、高血压和吸烟是主要的健康危险因素,在中国DALY中占据较大比例。2010年年龄标准化DALY中,大气污染居第4位(95%UI第3~5位,在G20中居第2位),室内空气污染居第5位(95%UI 第4~6位,在G20中居第3位)。

结 论 由快速的城镇化、经济收入增加和快速的老龄化导致的慢性非传染性疾病快速增
加,以及由此引起的慢性伤残的增加,对中国的卫生系统带来巨大挑战。减少人群不健康饮食、高血压、吸烟、高胆固醇、高空腹血糖的暴露,以及控制大气及室内空气污染,是中国公共政策中的优先重点。因此,针对这些问题,需要政府统一响应,改善初级医疗服务,同时,也需要多部门联合行动来控制主要危险因素。疾病负担分析提供了一个有益的框架,有利于制定有效、合理的政策,以应对中国健康模式的转变。

基 金 比尔及梅琳达·盖茨基金会。

 

Research Center for Chronic Diseases and Behavior Risk Factors

Introduction: Dr. Gonghuan Yang, professor of epidemiology on chronic disease and public health. Now she is a distinguished professor in institute of Basic Medical Sciences of PUMC and chief of Institute for Global Tobacco Control, China Branch Center. The main research areas include disease pattern and burden of disease, especially focused on tobacco prevalence and control, suicide pattern, water pollution and cancers. Dr. Yang has published more than 100 academic papers and edited more than 30 books. She also won National science and technology achievement award for 6 times.

 

 

Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010

Gonghuan Yang*, Yu Wang*, Yixin Zeng, George F Gao, Xiaofeng Liang, Maigeng Zhou, Xia Wan, Shicheng Yu, Yuhong Jiang, Mohsen Naghavi, Theo Vos, Haidong Wang, Alan D Lopez, Christopher J L Murray

Background China has undergone rapid demographic and epidemiological changes in the past few decades, including striking declines in fertility and child mortality and increases in life expectancy at birth. Popular discontent with the health system has led to major reforms. To help inform these reforms, we did a comprehensive assessment of disease burden in China, how it changed between 1990 and 2010, and how China’s health burden
compares with other nations.

Methods We used results of the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) for 1990 and 2010 for China and 18 other countries in the G20 to assess rates and trends in mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE). We present results for 231 diseases and injuries and for 67 risk factors or clusters of risk factors relevant to China. We assessed relative performance of China against G20 countries (signifi cantly better, worse, or indistinguishable from the G20 mean) with age-standardised rates and 95% uncertainty intervals.

Findings The leading causes of death in China in 2010 were stroke (1·7 million deaths, 95% UI 1·5–1·8 million), ischaemic heart disease (948 700 deaths, 774 500–1 024 600), and chronic obstructive pulmonary disease (934 000 deaths, 846 600–1 032 300). Age-standardised YLLs in China were lower in 2010 than all emerging economies in the G20, and only slightly higher than noted in the USA. China had the lowest age-standardised YLD rate in the G20 in 2010. China also ranked tenth (95% UI eighth to tenth) for HALE and 12th (11th to 13th) for life expectancy. YLLs from neonatal causes, infectious diseases, and injuries in children declined substantially between 1990 and 2010. Mental and behavioural disorders, substance use disorders, and musculoskeletal disorders were responsible for almost half of all YLDs. The fraction of DALYs from YLDs rose from 28·1% (95% UI 24·2–32·5) in 1990 to 39·4% (34·9–43·8) in 2010. Leading causes of DALYs in 2010 were cardiovascular diseases (stroke and ischaemic heart disease), cancers (lung and liver cancer), low back pain, and depression. Dietary risk factors, high blood pressure, and tobacco exposure are the risk factors that constituted the largest number of attributable DALYs in China. Ambient air pollution ranked fourth (third to fifth; the second highest in the G20) and household air pollution ranked fifth (fourth to sixth; the third highest in the G20) in terms of the age-standardised DALY rate in 2010.

Interpretation The rapid rise of non-communicable diseases driven by urbanisation, rising incomes, and ageing poses major challenges for China’s health system, as does a shift to chronic disability. Reduction of population exposures from poor diet, high blood pressure, tobacco use, cholesterol, and fasting blood glucose are public policy priorities for China, as are the control of ambient and household air pollution. These changes will require an integrated government response to improve primary care and undertake required multisectoral action to tackle key risks. Analyses of disease burden provide a useful framework to guide policy responses to the changing disease spectrum in China.

Funding Bill & Melinda Gates Foundation.


Director: Prof.Gonghuan Yang
Faculty member: Dr. Xia Wan;MS. AiPing Chen,
MD student: XiaoChang Zhang;GongBo Chen



 

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