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1.
Zhonghua Gan Zang Bing Za Zhi ; 32(5): 406-410, 2024 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-38858190

RESUMO

The World Health Organization (WHO) released the Global Health Sector Strategy 2016, which explicitly proposes a 90% reduction in the new hepatitis B virus (HBV) infection rate and a 65% reduction in HBV-related mortality by 2030. However, at present, there are still 296 million chronic hepatitis B virus-infected patients worldwide, and nearly 900,000 patients die every year from cirrhosis and liver cancer caused by HBV infection. Antiviral treatment for chronic hepatitis B virus infection can effectively inhibit HBV replication, reduce liver inflammation and necrosis, effectively block and reverse liver fibrosis, and even early cirrhosis, thereby lowering cirrhosis-related complications, liver cancer, and liver disease-related mortality. Although the domestic and foreign guidelines have gradually eased antiviral treatment indications for chronic hepatitis B, there are still a considerable number of chronic hepatitis B patients with nonconformity who cannot receive antiviral treatment because they do not meet the existing standards, resulting in the progression of more severe diseases. This study analyzed the prevalence of hepatitis B, the therapeutic effect of antiviral drugs, domestic and international guideline treatment standards, the assessment of key indicators changes in the guidelines, comprehensively considered the coverage rate and treatment standards for antiviral treatment, and explored the changes in disease burden and cost-effectiveness following increasing the coverage rate and reducing treatment thresholds in order to achieve the global strategic goal of eliminating hepatitis B as soon as possible as a public health threat.


Assuntos
Antivirais , Hepatite B Crônica , Humanos , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/economia , Antivirais/uso terapêutico , Antivirais/economia , Vírus da Hepatite B
2.
Clin Radiol ; 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38763807

RESUMO

PURPOSE: To create a reliable radiomic nomogram for the prediction of the International Society of Urological Pathology (ISUP) grading ≥ 3 prostate cancer (PCa) patients. METHODS: patients with verified PCa were obtained from three different hospitals. The patients were divided into training, internal validation, and two external validation groups. A radiomic signature (rad-score) extracted from T2WI, diffusion-weighted imaging, and apparent diffusion coefficient (ADC) maps were constructed in the training cohort. Eight clinical features were performed to develop a clinical model using univariate and multivariate logistic regression. The combined model incorporated the radiomic signature and clinical model. The model's performance was assessed by the receiver operating characteristic (ROC) curve. RESULTS: Rad-score, magnetic resonance imaging T-stage, and ADC value were significant predictors of ISUP ≥ 3 PCa. A nomogram of these three factors was shown to have greater diagnostic accuracy than using only the radiomic signature or clinical model alone. The area under the ROC curve was 0.85, 0.88, 0.81, 0.81 for the training, internal, and two external validation cohorts, respectively. In the stratified analysis based on the MR scanner model, the area under the ROC curve of predicting ISUP ≥ 3 PCa for GE, Siemens, and combined groups were 0.84, 0.83, and 0.84, respectively, in the combined training group and an internal validation group. CONCLUSIONS: The proposed nomogram has the potential to predict the differentiation degree of ISUP PCa patients.

3.
Vaccine ; 42(9): 2200-2211, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38350768

RESUMO

BACKGROUND: The Global COVID Vaccine Safety (GCoVS) Project, established in 2021 under the multinational Global Vaccine Data Network™ (GVDN®), facilitates comprehensive assessment of vaccine safety. This study aimed to evaluate the risk of adverse events of special interest (AESI) following COVID-19 vaccination from 10 sites across eight countries. METHODS: Using a common protocol, this observational cohort study compared observed with expected rates of 13 selected AESI across neurological, haematological, and cardiac outcomes. Expected rates were obtained by participating sites using pre-COVID-19 vaccination healthcare data stratified by age and sex. Observed rates were reported from the same healthcare datasets since COVID-19 vaccination program rollout. AESI occurring up to 42 days following vaccination with mRNA (BNT162b2 and mRNA-1273) and adenovirus-vector (ChAdOx1) vaccines were included in the primary analysis. Risks were assessed using observed versus expected (OE) ratios with 95 % confidence intervals. Prioritised potential safety signals were those with lower bound of the 95 % confidence interval (LBCI) greater than 1.5. RESULTS: Participants included 99,068,901 vaccinated individuals. In total, 183,559,462 doses of BNT162b2, 36,178,442 doses of mRNA-1273, and 23,093,399 doses of ChAdOx1 were administered across participating sites in the study period. Risk periods following homologous vaccination schedules contributed 23,168,335 person-years of follow-up. OE ratios with LBCI > 1.5 were observed for Guillain-Barré syndrome (2.49, 95 % CI: 2.15, 2.87) and cerebral venous sinus thrombosis (3.23, 95 % CI: 2.51, 4.09) following the first dose of ChAdOx1 vaccine. Acute disseminated encephalomyelitis showed an OE ratio of 3.78 (95 % CI: 1.52, 7.78) following the first dose of mRNA-1273 vaccine. The OE ratios for myocarditis and pericarditis following BNT162b2, mRNA-1273, and ChAdOx1 were significantly increased with LBCIs > 1.5. CONCLUSION: This multi-country analysis confirmed pre-established safety signals for myocarditis, pericarditis, Guillain-Barré syndrome, and cerebral venous sinus thrombosis. Other potential safety signals that require further investigation were identified.


Assuntos
COVID-19 , Síndrome de Guillain-Barré , Miocardite , Pericardite , Trombose dos Seios Intracranianos , Humanos , Vacina de mRNA-1273 contra 2019-nCoV , Vacina BNT162 , Estudos de Coortes , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Síndrome de Guillain-Barré/induzido quimicamente , Síndrome de Guillain-Barré/epidemiologia , Vacinas de mRNA , Vacinação/efeitos adversos , Masculino , Feminino
4.
Artigo em Chinês | MEDLINE | ID: mdl-37006142

RESUMO

Objective: To construct and verify a light-weighted convolutional neural network (CNN), and explore its application value for screening the early stage (subcategory 0/1 and stage Ⅰ of pneumoconiosis) of coal workers' pneumoconiosis (CWP) from digital chest radiography (DR) . Methods: A total of 1225 DR images of coal workers who were examined at an Occupational Disease Prevention and Control Institute in Anhui Province from October 2018 to March 2021 were retrospectively collected. All DR images were collectively diagnosed by 3 radiologists with diagnostic qualifications and gave diagnostic results. There were 692 DR images with small opacity profusion 0/- or 0/0 and 533 DR images with small opacity profusion 0/1 to stage Ⅲ of pneumoconiosis. The original chest radiographs were preprocessed differently to generate four datasets, namely 16-bit grayscale original image set (Origin16), 8-bit grayscale original image set (Origin 8), 16-bit grayscale histogram equalized image set (HE16) and 8-bit grayscale histogram equalized image set (HE8). The light-weighted CNN, ShuffleNet, was applied to train the generated prediction model on the four datasets separately. The performance of the four models for pneumoconiosis prediction was evaluated on a test set containing 130 DR images using measures such as the receiver operating characteristic (ROC) curve, accuracy, sensitivity, specificity, and Youden index. The Kappa consistency test was used to compare the agreement between the model predictions and the physician diagnosed pneumoconiosis results. Results: Origin16 model achieved the highest ROC area under the curve (AUC=0.958), accuracy (92.3%), specificity (92.9%), and Youden index (0.8452) for predicting pneumoconiosis, with a sensitivity of 91.7%. And the highest consistency between identification and physician diagnosis was observed for Origin16 model (Kappa value was 0.845, 95%CI: 0.753-0.937, P<0.001). HE16 model had the highest sensitivity (98.3%) . Conclusion: The light-weighted CNN ShuffleNet model can efficiently identify the early stages of CWP, and its application in the early screening of CWP can effectively improve physicians' work efficiency.


Assuntos
Antracose , Minas de Carvão , Pneumoconiose , Humanos , Estudos Retrospectivos , Antracose/diagnóstico por imagem , Pneumoconiose/diagnóstico por imagem , Redes Neurais de Computação , Carvão Mineral
5.
Zhonghua Yu Fang Yi Xue Za Zhi ; 57(12): 2064-2067, 2023 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-38186157

RESUMO

Seasonal influenza leads to a significant disease burden, and older people infected with influenza are susceptible to various complications. Influenza immunization can prevent infection effectively and significantly reduce the risk of complications and severe cases. Creating a supportive environment for vaccination is crucial in advancing the influenza vaccination rate among the elderly population. In China, the present environment for supporting influenza vaccinations among the elderly is primarily comprised of policies for free vaccination and expense reimbursement, which exhibit noteworthy regional variations across cities and regions. This study systematically analyses the supportive environment and regional disparities associated with influenza vaccination among the elderly in China. It aims to comprehend the opportunities for influenza prevention and control resulting from the current background of influenza vaccination and to identify potential health inequality challenges caused by regional differences. The findings should inform the introduction of relevant national policies and programs to protect the health and well-being of the elderly population.


Assuntos
Disparidades nos Níveis de Saúde , Influenza Humana , Humanos , Idoso , Influenza Humana/prevenção & controle , China , Cidades , Vacinação
6.
Zhonghua Fu Chan Ke Za Zhi ; 57(11): 836-842, 2022 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-36456480

RESUMO

Objective: To compare oxytocin combined with ergometrine with oxytocin alone in terms of primary prophylaxis for postpartum hemorrhage (PPH) at the time of cesarean section (CS). Methods: This was a multicenter double-blind randomized controlled interventional study comparing ergometrine combined with oxytocin and oxytocin alone administered at CS. From December 2018 to November 2019, a total of 298 parturients were enrolled in 16 hospitals nationwide. They were randomly divided into experimental group (ergometrine intra-myometrial injection following oxytocin intravenously; 148 cases) and control group (oxytocin intra-myometrial injection following oxytocin intravenously; 150 cases) according to 1∶1 random allocation. The following indexes were compared between the two groups: (1) main index: blood loss 2 hours (h) after delivery; (2) secondary indicators: postpartum blood loss at 6 h and 24 h, placental retention time, incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution; (3) safety indicators: nausea, vomiting, dizziness and other adverse reactions, and blood pressure at each time point of administration. Results: (1) The blood loss at 2 h after delivery in the experimental group [(402±18) ml] was less than that in the control group [(505±18) ml], and the difference was statistically significant (P<0.05). (2) The blood loss at 6 h and 24 h after delivery in the experimental group were less than those in the control group, and the differences were statistically significant (all P<0.05). There were no significant differences between the two groups in the incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution (all P>0.05). (3) Adverse reactions occurred in 2 cases (1.4%, 2/148) in the experimental group and 1 case (0.7%, 1/150) in the control group. There was no significant difference between the two groups (P>0.05). The systolic blood pressure within 2.0 h and diastolic blood pressure within 1.5 h of drug administration in the experimental group were higher than those in the control group, and the differences were statistically significant (P<0.05), but the blood pressure of the two groups were in the normal range. Conclusion: The use of ergometrine injection in CS could reduce the amount of PPH, which is safe and feasible.


Assuntos
Hemostáticos , Hemorragia Pós-Parto , Gravidez , Feminino , Humanos , Hemorragia Pós-Parto/prevenção & controle , Ergonovina/uso terapêutico , Ocitocina/uso terapêutico , Cesárea , Placenta
7.
Zhonghua Yi Xue Za Zhi ; 102(42): 3395-3400, 2022 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-36372770

RESUMO

Objective: To evaluate the quality of life and influencing factors of patients with herpes zoster (HZ) seen in hospitals. Methods: Based on Zoster Brief Pain Inventory (ZBPI) and Five-level EuroQol Five-dimensional Questionnaire (EQ-5D-5L), a cross-sectional survey was conducted to evaluate the pain severity and quality of life of 332 HZ cases seen in 22 hospitals of Lu'an City (Anhui Province), Zibo City (Shandong Province) and Tongchuan City (Shaanxi Province) from October to December 2021. The censored least absolute deviations (CLAD) model was used to analyze the related factors affecting the changes of patients' health utility values. Results: The 45.5% of 332 HZ cases were male. The median (Q1,Q3) age was 59 (50, 68) years. 59.64% of them assessed by ZBPI had moderate to severe pain in the past 24 hours (worst pain score≥5), and that of PHN cases was 84.8%(39/46). 77.7% (258/332), 77.4% (257/332) and 74.1% (246/332) of all patients reported that pain interfered with sleep, mood and general activities, respectively. Aging [ß40-49y (95%CI)=-0.11 (-0.15, -0.08); ß50-59y (95%CI)=-0.03 (-0.05, 0.00); ß60-69y (95%CI)=-0.09 (-0.12, -0.06); ß70-90y(95%CI)=-0.16 (-0.19, -0.12)], working status (unemployed) [ßfarmer (95%CI)=0.15 (0.13, 0.18); ßretirees(95%CI)=0.21 (0.18, 0.24); ßemployee (95%CI)=0.13 (0.10, 0.16) ], complications[ßPHN (95%CI)=-0.08 (-0.13, -0.04); ßother complications (95%CI)=-0.12 (-0.15, -0.08)], within 30 days after onset [ß(95%CI)=-0.01 (-0.03, 0.01)] and treatment [ßother complications (95%CI)=-0.09 (-0.11, -0.06)] were related factors for the decline of health utility value (all P values <0.05). Conclusions: More than half of the patients with HZ had moderate to severe pain in the past 24 hours, which had a serious negative impact on the physical and mental health of the patients. Elderly patients, acute patients and patients with complications had lower health utility values and worse health status. We suggest that eligible people be vaccinated with HZ vaccine as soon as possible.


Assuntos
Herpes Zoster , Qualidade de Vida , Humanos , Masculino , Idoso , Feminino , Radioisótopos de Ítrio , Estudos Transversais , Herpes Zoster/complicações , Herpes Zoster/prevenção & controle , Herpesvirus Humano 3 , Dor/etiologia , Fatores de Risco
8.
Zhonghua Nei Ke Za Zhi ; 61(8): 901-907, 2022 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-35922214

RESUMO

Objective: Charcot-Marie-Tooth disease (CMT) comprises a group of clinically and genetically heterogeneous inherited neuropathies with an estimated prevalence of 1 in 2500. This study aimed to analyze the clinical and mutational characteristics of Chinese CMT patients with MFN2, BSCL2 and LRSAM1 variants. Methods: In this study, genetic analysis was performed in 206 Chinese patients at Chinese PLA General Hospital from December 2012 to March 2020 with clinical diagnosis of CMT, and reported variants of MFN2, BSCL2 and LRSAM1 related to CMT2. Results: We reported ten MFN2 mutations in ten unrelated patients (7 male, 3 female), two of whom had positive family history. Three novel mutations were detected including c.475-2A>G (splicing); c.687dupA (p.E230Rfs*16) and c.558dupT (p.S186fs). We reported three BSCL2 mutations of four unrelated patients, including c.461C>G (p.S154W), c.461C>T(p.S154L), and novel variants of c.1309G>C (p.A437P) and c.845C>T (p.A282V). Furthermore, two novel variants of LRSAM1, including c.1930G>T (p.G644C) and c.1178T>A (p.L393Q) were detected in two unrelated patients. Conclusion: Mutational spectrum of MFN2-, BSCL2-and LRSAM1-related CMT disease is expanded with the identification of novel variants in Chinese patients.


Assuntos
Doença de Charcot-Marie-Tooth , Subunidades gama da Proteína de Ligação ao GTP , Povo Asiático/genética , Doença de Charcot-Marie-Tooth/epidemiologia , Doença de Charcot-Marie-Tooth/genética , China , Feminino , GTP Fosfo-Hidrolases/genética , Subunidades gama da Proteína de Ligação ao GTP/genética , Testes Genéticos , Humanos , Masculino , Proteínas Mitocondriais/genética , Mutação , Ubiquitina-Proteína Ligases/genética
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 43(6): 974-980, 2022 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-35725358

RESUMO

With characteristics of high infectivity, diverse transmission routes and high variation, norovirus is the main pathogen of sporadic cases and outbreaks of acute gastroenteritis, resulting in a serious disease burden. This paper summarizes the latest progress in epidemiological research of norovirus infection from aspects of disease burden caused by acute gastroenteritis, virus variation and predominant strains, prevention and control measures, and immunization and vaccine development.


Assuntos
Infecções por Caliciviridae , Gastroenterite , Norovirus , Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Estudos Epidemiológicos , Gastroenterite/epidemiologia , Gastroenterite/prevenção & controle , Humanos
10.
J Eur Acad Dermatol Venereol ; 36(4): 566-572, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34908189

RESUMO

BACKGROUND: Vulvovaginal candidiasis (VVC) is frequent in women of reproductive age, but very limited data are available on the epidemiology in cases of VVC in China. OBJECTIVES: The current study has been conducted to reveal the prevalence, species distribution of yeast causing VVC and molecular genetics of Candida albicans in China. METHODS: Vaginal swabs were collected from 543 VVC outpatients recruited in 12 hospitals in China between September 2017 and March 2018. They were preliminarily incubated on Sabouraud dextrose agar and then positive subjects of which were then transmitted to our institute for further identification. CHROMagar™ was used to isolate Candida species, and all isolates were finally identified by DNA sequencing. Multilocus sequence typing (MLST) was used to analyse phylogenetic relationships of the various C. albicans isolates. RESULTS: Eleven different yeast species were identified in 543 isolates, among which C. albicans (84.7%) was the most frequent, followed by C. glabrata (8.7%). We obtained 117 unique diploid sequence types from 451 clinical C. albicans isolates and 92 isolates (20.4%) belonged to a New Clade. All the strains appearing in the New Clade were from northern China and they were isolated from non-recurrent VVC. CONCLUSIONS: Our findings suggest that C. albicans are still the main cause of VVC in China and the majority of C. albicans isolates belongs to Clade 1 with DST 79 and DST 45 being two most common. Moreover, the New Clade revealed in our study seems to be specific to northern China.


Assuntos
Candidíase Vulvovaginal , Antifúngicos/uso terapêutico , Candida albicans/genética , Candidíase Vulvovaginal/tratamento farmacológico , Candidíase Vulvovaginal/epidemiologia , China/epidemiologia , Feminino , Humanos , Epidemiologia Molecular , Tipagem de Sequências Multilocus , Filogenia , Estudos Prospectivos
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(5): 948-954, 2021 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814494

RESUMO

Combined vaccines contain two or more antigens. Research suggested that combined vaccines could prevent multi diseases and reduce the frequency of vaccination. This article focus on combined vaccines for children used both at home and abroad, such as diphtheria-pertussis-tetanus vaccine (DTaP), measles-rubella-mumps vaccine (MMR), etc. and summarizes their immunogenicity, safety and social values, including benefits to families, vaccination workers and health services, to provide evidence for promoting the research, development and use of combined vaccines in China. We found that combined vaccines can not only ensure the immunogenicity and safety, but also give convenient and lower cost vaccination to families, and using combined vaccines can improve the work efficiency of vaccination workers, reduce the impact of the epidemic on immunization services and improve vaccination coverage and timeliness. At present, the promotion of combined vaccines in China is restricted by many technical bottlenecks, high prices, and low awareness among people. It is recommended that research on the safety, effectiveness and health economics of combined vaccines should be strengthened, and the value of combined vaccines should be scientifically evaluated; the public's awareness and trust in combined vaccines should be enhanced, as well as the development and application of multi-linked multivalent vaccines should be promoted. The government should improve regulations to assist the development and application of combined vaccines.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular , Valores Sociais , Criança , Humanos , Lactente , Vacina contra Sarampo-Caxumba-Rubéola , Vacina Antipólio de Vírus Inativado , Vacinação , Vacinas Combinadas
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(8): 1371-1375, 2021 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814556

RESUMO

Human challenge trial (HCT) is a test in which human volunteers are intentionally infected with pathogens in order to evaluate the efficacy of candidate preventive or therapeutic drugs. During the COVID-19 pandemic, the HCT of vaccines has aroused people's attention due to its significant advantages over clinical trial. This paper introduces the concept, development and application of HCT, the advantages and limitations of HCT for vaccine evaluation, and the consideration of future HCT of COVID-19 vaccine in China.


Assuntos
COVID-19 , Vacinas , Vacinas contra COVID-19 , Humanos , Pandemias , SARS-CoV-2
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(9): 1523-1526, 2021 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814578

RESUMO

Viral hepatitis has been causing big threat to public health globally. The number of annual deaths caused by hepatitis surpassed the deaths caused by AIDS, tuberculosis, and malaria. World Health Organization (WHO) issued the global health sector strategy on viral hepatitis 2016-2020 (GHSS) to control its epidemic. It established the Strategies and Technical Advisory Committee on HIV, viral hepatitis, and sexually transmitted infections (STAC). This paper summarizes the GHSS goals and the keynote of the 2020 STAC meeting, analyzes the challenges and opportunities faced by China in eliminating viral hepatitis, and provides the comments on the papers on this issue, which could guide further actions.


Assuntos
Hepatite Viral Humana , Malária , Comitês Consultivos , Saúde Global , Hepatite Viral Humana/epidemiologia , Hepatite Viral Humana/prevenção & controle , Humanos , Organização Mundial da Saúde
14.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(9): 1615-1620, 2021 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814592

RESUMO

Objective: To investigate the incidence and determinants of vaccine hesitancy towards national immunization program in China and understand the current status of parents' hesitancy to different vaccines used in national immunization program. Methods: A cross-sectional survey was conducted in Beijing, Sichuan and Gansu. The methods of proportional probability sampling and convenience sampling were used to select the eligible study subjects for questionnaire surveys. Results: A total of 3 592 parents were enrolled in the study, in whom 38.22% fully accepted all the vaccines, 59.35% agreed to let their children to receive all the vaccines but showed slight concern, and 2.42% had hesitancy to the vaccines. The vaccine with the most hesitancy was polio vaccine (0.89%), followed by diphtheria pertussis tetanus vaccine (0.70%) and hepatitis A vaccine (0.64%). The dominant reason for vaccine hesitancy was the risk-benefit perception of vaccination (31.03%), followed by the low awareness of the parents (21.84%) and the inconvenience caused by distance and time (21.84%). Conclusions: The incidence of vaccine hesitancy towards national immunization program was low in parents in China, but over 50% of the parents showed concern to the vaccines. It is essential to improve the service quality of national immunization program and strengthen the health education about the vaccination to reduce the incidence of vaccine hesitancy in parents.


Assuntos
Vacinas , Criança , China/epidemiologia , Estudos Transversais , Vacina contra Difteria, Tétano e Coqueluche , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Programas de Imunização , Pais , Vacinação
15.
Zhonghua Gan Zang Bing Za Zhi ; 29(8): 725-731, 2021 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-34517450

RESUMO

China has the highest disease burden of viral hepatitis. After understanding the epidemic characteristics of viral hepatitis in China and putting forward scientific prevention and control strategies, the Chinese government has been effectively practicing the policy of "prevention first with combination of prevention and control". Over the past 40 years, China has taken effective measures to promote vaccination, strengthen blood screening, standardize diagnosis and treatment services and strengthen supervision, and achieved remarkable success. The incidence of hepatitis A decreased from 52.6 per 100,000 in 1990 to 1.38 per 100,000 in 2019, the HBsAg prevalence among children under 5 years of age decreased from 9.67% in 1992 to 0.32% in 2014, and the cure rate of chronic hepatitis C patients has reached more than 95%. The incidence of hepatitis E is also on the decline. However, in 2019, the estimated diagnosis rate for hepatitis B patients is 25% and treatment rate is 17%; hepatitis C diagnosed rate is 30% and only 9% of the diagnosed were treated. This still falls far from the target of 90% diagnosis rate and 80% treatment rate by 2030. Relevant policies should be implemented as soon as possible, health promotion should be carried out, and screening and diagnosis and treatment services should be strengthened to promote timely treatment for more chronically infected people.


Assuntos
Hepatite B , Hepatite C , Hepatite Viral Humana , Criança , Pré-Escolar , China/epidemiologia , Antígenos de Superfície da Hepatite B , Vacinas contra Hepatite B , Hepatite Viral Humana/diagnóstico , Hepatite Viral Humana/epidemiologia , Hepatite Viral Humana/prevenção & controle , Humanos
18.
Zhonghua Yi Xue Za Zhi ; 100(41): 3218-3223, 2020 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-33167107

RESUMO

Objective: To investigate the correlation between tissue oxygen saturation during one lung ventilation and postoperative neuro cognitive dysfunction (PND) in elderly patients in thoracic surgery. Methods: One hundred and twenty-eight elderly patients who underwent selective lobectomy from August 2017 to September 2018 in the Forth Hospital of Hebei Medical University were enrolled. The patients were divided into PND group (n=34) and non-PND group (n=94) according to whether PND occurred 3 days after surgery. Tissue oxygenation was monitored at bilateral forebrain, brachioradialis muscle and quadriceps. Cognitive function was assessed by the Montreal Cognitive Assessment (MoCA) at baseline and the third day after the operation. Postoperative cognitive dysfunction was diagnosed if postoperative MoCA decreased at least 2 scores compared with preoperative baseline value. Outcomes included the incidence of PND, the incidence of tissue oxygen desaturation during one lung ventilation, postoperative complications within 30 days and length of postoperative in-hospital stay. Logistic regression was used to screen independent risk factors of PND. Results: The incidence of postoperative cognitive dysfunction was 26.6% (34/128). The two groups had no significant difference in the incidence of non-neurogenic complications (new occurred arrhythmia, pulmonary infection, pulmonary embolism, acute renal insufficiency, sepsis, deep vein thrombosis, all P>0.05). However, the length of postoperative in-hospital stay of PND group was 7.0 (6.0, 8.5) d, which was longer than that of non-PND group [6.0 (5.0, 8.0) d]. There was significant difference (U=2.394, P=0.017) . There was no correlation between the two groups within the minimum of SmtO(2) in upper limbs (OR=0.988, 95%CI: 0.954-1.024, P=0.519) and the range of desaturation (OR=1.010, 95%CI: 0.979-1.042, P=0.514) , as well as the minimum of SmtO(2) in legs (OR=0.996, 95%CI: 0.961-1.032, P=0.832) and the range of desaturation (OR=0.997, 95%CI: 0.971-1.025, P=0.851) . Multivariate logistic regression analysis showed that the high ASA grade (OR=2.617, 95%CI: 1.112-6.157, P=0.029) and the minimum of cerebral oxygen saturation during one lung ventilation (OR=0.931, 95%CI: 0.880-0.986, P=0.014) were independent risk factors of PND. There was no statistical correlation between muscle oxygen saturation and PND. Conclusion: Cerebral desaturation during one lung ventilation increased the risk of PND in elderly patients, while the muscle desaturation has no statistical correlation with PND.


Assuntos
Transtornos Cognitivos , Ventilação Monopulmonar , Idoso , Cognição , Humanos , Oxigênio , Complicações Cognitivas Pós-Operatórias , Complicações Pós-Operatórias/epidemiologia
19.
Zhonghua Zhong Liu Za Zhi ; 42(9): 713-717, 2020 Sep 23.
Artigo em Chinês | MEDLINE | ID: mdl-32988151

RESUMO

Lung cancer is currently the malignant tumor with the highest morbidity and mortality in the world, and the main type is non-small cell lung cancer. Immune checkpoint inhibitor is a landmark discovery in the history of cancer treatment, which rewrites the history of cancer treatment, and improves the medical treatment of advanced tumors by a big step forward. The article summarizes the research progress of therapeutic drugs against anti-programmed cell death protein and programmed cell death protein ligand antibodies in the clinical diagnosis and treatment of non-small cell lung cancer. The principle of drug action, the differences in the diagnosis and treatment of non-small cell lung cancer in different clinical stages, and future research directions are discussed to provide the usage guidelines of immune checkpoint inhibitors for clinical oncologists.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Inibidores de Checkpoint Imunológico , Neoplasias Pulmonares , Antígeno B7-H1/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Humanos , Inibidores de Checkpoint Imunológico/uso terapêutico , Imunoterapia , Neoplasias Pulmonares/tratamento farmacológico , Receptor de Morte Celular Programada 1/uso terapêutico
20.
Eur Rev Med Pharmacol Sci ; 24(12): 6589-6596, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32633347

RESUMO

OBJECTIVE: The purpose of this study was to uncover the role of VASN in regulating proliferative ability of prostate cancer (PCa) cells through the yes-associated protein/transcriptional coactivator with PDZ-binding motif (YAP/TAZ) axis, thus influencing the progression of PCa. PATIENTS AND METHODS: VASN, YAP, and TAZ levels in PCa tissues or in the serum were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The diagnostic value of VASN in PCa was assessed by introducing receiver operating characteristic (ROC) curves. Besides, the regulatory effects of VASN on viability, clonality, and expression levels of YAP/TAZ were evaluated by cell counting kit-8 (CCK-8), colony formation, and Western blot, respectively. Finally, rescue experiments were conducted to uncover the involvement of YAP in VASN-regulated proliferation of PCa. RESULTS: Results manifested that VASN, YA, and TAZ were upregulated in PCa patients, and VASN presented a certain diagnostic value. Knockdown of VASN in LNCaP and C4-2 cells suppressed viability and clonality, and downregulated protein levels of YAP and TAZ. Notably, overexpression of YAP abolished the attenuated viability and clonality in PCa cells with VASN knockdown. CONCLUSIONS: VASN promotes proliferative ability in PCa via regulating the YAP/TAZ axis, thus aggravating the progression of the disease.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/biossíntese , Proteínas de Transporte/biossíntese , Proliferação de Células/fisiologia , Proteínas de Membrana/biossíntese , Neoplasias da Próstata/metabolismo , Transativadores/biossíntese , Fatores de Transcrição/biossíntese , Linhagem Celular Tumoral , Humanos , Masculino , Neoplasias da Próstata/patologia , Proteínas com Motivo de Ligação a PDZ com Coativador Transcricional , Proteínas de Sinalização YAP
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