Cost-effectiveness of the screen-and-treat strategies using HPV test linked to thermal ablation for cervical cancer prevention in China: a modeling study.

BACKGROUND: Self-sampling HPV test and thermal ablation are effective tools to increase screening coverage and treatment compliance for accelerating cervical cancer elimination. We assessed the cost-effectiveness of their combined strategies to inform accessible, affordable, and acceptable cervical cancer prevention strategies. METHODS: We developed a hybrid model to evaluate costs, health outcomes, and incremental cost-effectiveness ratios (ICER) of six screen-and-treat strategies combining HPV testing (self-sampling or physician-sampling), triage modalities (HPV genotyping, colposcopy or none) and thermal ablation, from a societal perspective. A designated initial cohort of 100,000 females born in 2015 was considered. Strategies with an ICER less than the Chinese gross domestic product (GDP) per capita ($10,350) were considered highly cost-effective. RESULTS: Compared with current strategies in China (physician-HPV with genotype or cytology triage), all screen-and-treat strategies are cost-effective and self-HPV without triage is optimal with the most incremental quality-adjusted life-years (QALYs) gained (220 to 440) in rural and urban China. Each screen-and-treat strategy based on self-collected samples is cost-saving compared with current strategies (-$818,430 to -$3540) whereas more costs are incurred using physician-collected samples compared with current physician-HPV with genotype triage (+$20,840 to +$182,840). For screen-and-treat strategies without triage, more costs (+$9404 to +$380,217) would be invested in the screening and treatment of precancerous lesions rather than the cancer treatment compared with the current screening strategies. Notably, however, more than 81.6% of HPV-positive women would be overtreated. If triaged with HPV 7 types or HPV16/18 genotypes, 79.1% or 67.2% (respectively) of HPV-positive women would be overtreated with fewer cancer cases avoided (19 cases or 69 cases). CONCLUSIONS: Screen-and-treat strategy using self-sampling HPV test linked to thermal ablation could be the most cost-effective for cervical cancer prevention in China. Additional triage with quality-assured performance could reduce overtreatment and remains highly cost-effective compared with current strategies.

Association between intimate partner violence and prenatal anxiety and depression in pregnant women: a cross-sectional survey during the COVID-19 epidemic in Shenzhen, China.

OBJECTIVES: Intimate partner violence (IPV) against women remains a major global public health problem with harmful consequences for individuals and society. People's lifestyles have been greatly affected by the COVID-19 pandemic. This study investigated the prevalence of and relationship between IPV and anxiety and depression in pregnant Chinese women during the pandemic. DESIGN: Cross-sectional study. SETTING: This investigation was conducted in Shenzhen City, Guangdong Province, China from 15 September to 15 December 2020. PARTICIPANTS: A total of 3434 pregnant women were screened with the Abuse Assessment Screen Questionnaire to evaluate IPV and General Anxiety Disorder and Patient Health Questionnaire to evaluate symptoms of anxiety and depression, respectively. Pregnant women with perinatal health records at Shenzhen District Maternity and Child Healthcare Hospitals who consented to participate were enrolled. Women with psychotic disorders such as schizophrenia, mania or substance dependence and pregnant women who refused to participate were excluded. Data were analysed with the χ2 test and by logistic regression analysis. RESULTS: The prevalence of IPV among pregnant women was 2.2%. Mental violence was the most common type of violence (2.2%), followed by physical (0.6%) and sexual (0.7%) violence. The prevalence of anxiety and depression symptoms was 9.8% and 6.9%, respectively. After adjusting for covariates, there was a statistically significant association between IPV and prenatal anxiety (OR=4.207, 95% CI: 2.469 to 7.166) and depression (OR=3.864, 95% CI: 2.095 to 7.125). CONCLUSIONS: IPV increased the risk of prenatal anxiety and depression in pregnant women in China during the COVID-19 pandemic. Efforts should be made by the government and civil society to promote long-lasting antenatal interventions to ensure the safety and protect the mental health of pregnant women.

Living with parents or with parents-in-law and postpartum depression: A preliminary investigation in China.

BACKGROUND: Few studies have investigated the association between puerperal women's living situation and postpartum depression. The aim of this study was to examine the association between living with parents or with parents-in-law and postpartum depression among Chinese puerperal women. METHODS: A total of 1126 participants who completed questionnaire were included in our analysis. Postpartum depression status was assessed using the Edinburgh Postnatal Depression Scale. Logistic regression models were used to estimate the association between living with puerperal women's parents or with parents-in-law and risk of postpartum depression after adjustment for potential confounders. RESULTS: The prevalence of postpartum depression among participants was 11.8%. Of the 1126 participants, 524 (46.5%) lived only with their husbands, 387 (34.4%) lived with their parents-in-law, and 215 (19.1%) lived with their parents. Compared with those living only with their husbands, puerperal women living with their parents-in-law had higher risk of postpartum depression after adjustment for potential confounders (OR=2.48; 95% CI: 1.20, 5.15). No association between living with puerperal women's parents and postpartum depression was found after adjustment for confounders (OR=1.05; 95%CI: 0.42, 2.65). LIMITATIONS: Although we adjusted for a wide range of potential confounders, we cannot rule out the possibility of residual confounding by other unmeasured factors, such as breastfeeding, intimate partner violence, and marital relationship. CONCLUSIONS: Our findings suggest that living with parents-in-law may be a risk factor for postpartum depression among Chinese puerperal women. Future preventive interventions should include strategies that target the puerperal women who lived with parents-in-law.

Human Papillomavirus (HPV) infection in women participating in cervical cancer screening from 2006 to 2010 in Shenzhen City, South China.

PURPOSE: Human papillomavirus (HPV) infection plays an important role in the development of cervical cancer, but the prevalence of HPV infection in women of Shenzhen city remains unclear. The present study was performed to describe the change of cervical HPV infection in females who participated in voluntary cervical cancer screening from 2006 to 2010 in Shenzhen city, China. METHODS: A total of 4, 413 women were recruited. HPV infections were genotyped by polymerase chain reaction (PCR) and reversed dot blot hybridization in Shenzhen Maternity and Child Health Hospital. RESULTS: The prevalence of HPV infection was 13.8%. The five most commonly found HPV types were HPV16 (3.47%), HPV58 (1.68%), HPV33 (1.38%), HPV43 (1.36%) and HPV18 (1.27%). The secular trends of major HPV type-specific were diverse. Among of them, the prevalence of HPV18 increased sharply while others increased slowly or even decreased in the period. The change of total HPV, single HPV and multiple HPV infection were similar during the five years. CONCLUSIONS: Our findings suggested that HPV infection is common with HPV16 and HPV 58 as the primary subtypes in women in Shenzhen city. The prevalence of HPV 18 infection is increasing faster than any others, which will lead it to be one of the main subtypes in this city in the future.

[Research progress on geographic distribution new records of medicinal plants in Guizhou].

To introduce the advance on the species, ecological environment, distribution areas, the number of the species and efficacy of geographic distribution new records of medicinal plants in Guizhou. This article provides a basis for the collection and conservation as well as reasonable development of the genetic resources of medicinal plants.

[The impact of blood content in skin tissue on skin spectra].

Based on the analysis of skin structure, and the production mechanism of fluorescence and reflectance spectra, six-layer optical models for skin of different blood content in both upper blood plexus and deep blood plexus were developed, and Monte Carlo simulation was made. The result shows that (1) Both fluorescence and reflectance spectra could reflect the change of blood content in skin tissue; (2) The impact of blood content in upper blood plexus on skin spectra intensity is large, while the impact of blood content in deep blood plexus on skin spectra intensity is small; (3) Fluorescence and reflectance spectra could be used to detect or analyze change of blood content in skin tissue, especially to test the treatment and tune of dermatosis with plexus or blood pathological changes in upper dermis.