Impacts of gender and age on meibomian gland in aged people using artificial intelligence.

Purpose: To evaluate the effects of age and gender on meibomian gland (MG) parameters and the associations among MG parameters in aged people using a deep-learning based artificial intelligence (AI). Methods: A total of 119 subjects aged ≥60 were enrolled. Subjects completed an ocular surface disease index (OSDI) questionnaire, received ocular surface examinations including Meibography images captured by Keratograph 5M, diagnosis of meibomian gland dysfunction (MGD) and assessment of lid margin and meibum. Images were analyzed using an AI system to evaluate the MG area, density, number, height, width and tortuosity. Results: The mean age of the subjects was 71.61 ± 7.36 years. The prevalence of severe MGD and meibomian gland loss (MGL) increased with age, as well as the lid margin abnormities. Gender differences of MG morphological parameters were most significant in subjects less than 70 years old. The MG morphological parameters detected by AI system had strong relationship with the traditional manual evaluation of MGL and lid margin parameters. Lid margin abnormities were significantly correlated with MG height and MGL. OSDI was related to MGL, MG area, MG height, plugging and lipid extrusion test (LET). Male subjects, especially the ones who smoke or drink, had severe lid margin abnormities, and significantly decreased MG number, height, and area than the females. Conclusion: The AI system is a reliable and high-efficient method for evaluating MG morphology and function. MG morphological abnormities developed with age and were worse in the aging males, and smoking and drinking were risk factors.

Short-term effects of fine particulate matter constituents on mortality considering the mortality displacement in Zhejiang province, China.

BACKGROUND: Evidence linking mortality and short-term exposure to particulate matter (PM2.5) constituents was sparse. The mortality displacement was often unconsidered and may induce incorrect risk estimation. OBJECTIVES: To assess the short-term effects of PM2.5 constituents on all-cause mortality considering the mortality displacement. METHODS: Daily data on all-cause mortality and PM2.5 constituents, including sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), organic matters (OM), and black carbon (BC), were collected from 2009 to 2020. The mortality effect of PM2.5 and its constituents was estimated using a distributed lag non-linear model. Stratified analyses were performed by age, sex, and season. RESULTS: Per interquartile range increases in SO42-, NO3-, NH4+, OM, and BC were associated with the 1.42% (95%CI: 0.98, 1.87), 3.76% (3.34, 4.16), 2.26% (1.70, 2.83), 2.36% (2.02, 2.70), and 1.26% (0.91, 1.61) increases in all-cause mortality, respectively. Mortality displacements were observed for PM2.5, SO42-, NH4+, OM, and BC, with their overall effects lasting for 7-15 days. Stratified analyses revealed a higher risk for old adults (>65 years) and females, with stronger effects in the cold season. CONCLUSIONS: Short-term exposures to PM2.5 constituents were positively associated with increased risks of mortality. The mortality displacement should be considered in future epidemiological studies on PM constituents. DATA AVAILABILITY: Data will be made available on request.

Analysis of differential expression profile of miRNA in peripheral blood of patients with lung cancer.

PURPOSE: To identify potential molecular targets for lung cancer intervention and diagnosis, we analyzed the differential miRNA expression of peripheral blood between lung cancer patients and healthy controls. METHODS: Three pairs of cases' and controls' peripheral blood samples were evaluated for miRNA expression by microarray. 12 miRNAs were selected for RT-PCR validation and target genes prediction. In addition, 4 miRNAs were selected for future validation by RT-PCR in a large sample of 145 cases and 55 frequency-matched healthy controls. RESULTS: A total of 338 differentially expressed miRNAs were screened and identified by microarray. According to the fold changes, the top ten upregulated miRNAs were hsa-miR-124-3p, hsa-miR-379-5p, hsa-miR-3655, hsa-miR-450b-5p, hsa-miR-29a-5p, hsa-miR-200a-3p, hsa-miR-542-3p, hsa-miR-138-5p, hsa-miR-219a-2-3p, and hsa-miR-4701-3p, and the top ten downregulated miRNAs were hsa-miR-34c-5p, hsa-miR-135a-5p, hsa-miR-132-3p, hsa-miR-3178, hsa-miR-4449, hsa-miR-4999-3p, hsa-miR-1246, hsa-miR-4424, hsa-miR-1252-5p, and hsa-miR-24-2-5p. RT-PCR verification of the 12 miRNAs revealed that 5 of 8 upregulated miRNAs, 2 of 4 downregulated miRNAs showed a significant difference between the cases and controls (P < .05). A large number of target genes and their functional set showed overlapping among the 453 predicted target genes of the 12 miRNAs (P < .01). RT-PCR in the large sample confirmed the significant differential expression level of hsa-miR-29a-5p, hsa-miR-135a-5p, hsa-miR-542-3p, and hsa-miR-4491 between cases and controls (P < .05), and three of these microRNA, except hsa-miR-29a-5p, were significant after Bonferroni correction for adjustment of multiple comparisons. CONCLUSION: There was a significant difference in miRNAs expression in the peripheral blood between lung cancer patients and healthy controls, and 4 miRNAs were validated by a large-size sample.

Analysis of Mortality and Survival Rate of Liver Cancer in Zhejiang Province in China: A General Population-Based Study.

Background: Few accurate up-to-date studies provide liver cancer mortality and survival information in Zhejiang province. This research aimed to depict the mortality and survival of liver cancer in Zhejiang province in China during 2005-2010. Methods: The data were collected from the Zhejiang Chronic Disease Surveillance Information and Management System, and the mortality rates of liver cancer were calculated by gender, age, and areas. Chinese population census in 2000 and Segi's world population were used for age-standardized mortality rate. The observed and relative survival rates of liver cancer patients were analyzed. Results: The crude mortality rate of liver cancer was 32.11/105. The age-standardized mortality rate was 17.39/105 and 23.07/105 by Chinese population (ASIRC) and Segi's world population (ASIRW), respectively. The crude liver cancer mortality rate and age-standardized rate in urban areas were lower than those of rural areas. The overall 1-, 3-, and 5-year observed survival (OS) rates of liver cancer patients were 38.61%, 21.65%, and 16.83%, respectively. The 1-, 3-, and 5-year relative survival (RS) rates of liver cancer patients were 39.49%, 23.27%, and 19.09%, respectively. Survival rate decreased obviously within 1 to 5 years and then leveled off. It was shown that the male overall survival rate was higher than the female one and the difference was statistically significant (P<0.05). Conclusions: Both lower mortality and better survival rates were observed in urban areas, compared to rural areas. Relevant parties including government, public resource, and propaganda department should devote enough attention to rural areas.

The associations between cigarette smoking and health-related behaviors among Chinese school-aged adolescents.

BACKGROUND: Evidence on the interrelations between cigarette smoking and a cluster of lifestyle behaviors is scarce for the Chinese youth population. This study is conducted to identify the associations between cigarette smoking and multiple health-related behaviors in a Chinese sample of adolescents. METHODS: We used data from 2012 Zhejiang Youth Risk Behavior Survey, which is a school-based survey of 19,542 adolescents that assess risk behaviors using a self-reported questionnaire. The interrelations of cigarette smoking with lifestyle behaviors were investigated using logistic regression models. RESULTS: Cigarette smoking was significantly inversely associated with breakfast (AOR = 0.58), vegetables (AOR = 0.81), fruits (AOR = 0.81), milk consumption (AOR = 0.69) and attending physical education classes (AOR = 0.69), while positively associated with soft drinks (AOR = 2.05), fast food consumption (AOR = 1.21), muscle strengthening activity (AOR = 1.67), computer use (AOR = 1.93) and alcohol drinking (AOR = 5.40). CONCLUSIONS: The results suggested that cigarette smoking was associated with a cluster of health-related behaviors in adolescents, which should be considered in health promotion interventions to target multiple health behaviors.

Breakfast Consumption and Its Associations with Health-Related Behaviors among School-Aged Adolescents: A Cross-Sectional Study in Zhejiang Province, China.

Evidence indicates that breakfast consumption is associated with a cluster of health-related behaviors, yet studies in mainland China are scarce. This study is conducted to describe the frequency of breakfast consumption among Chinese adolescents and examine its associations with other dietary, physical activity, sedentary, sleep, cigarette-smoking, and alcohol-drinking behaviors. Breakfast consumption and other health-related behaviors data was collected via a self-administered questionnaire in a cross-sectional study in Zhejiang Province, China. A total of 19,542 school-aged adolescents were recruited in this survey. The associations between breakfast consumption and other health-related behaviors were examined using logistic regression models. A significantly higher prevalence of daily breakfast consumption was found among students who were younger (p for trend <0.001), from urban schools (p < 0.001), and academic high schools (p < 0.001). More frequent vegetable and milk consumption, greater physical activity, and longer sleep duration were positively associated with daily breakfast consumption, while soft drinks and fast food consumption, computer use, cigarette-smoking and alcohol-drinking behaviors were inversely associated. The prevalence of irregular breakfast consumption was relatively high among Chinese adolescents in Zhejiang Province. Daily breakfast consumption was associated with a constellation of health-related behaviors.

Electronic Cigarettes Use and Intention to Cigarette Smoking among Never-Smoking Adolescents and Young Adults: A Meta-Analysis.

Electronic cigarettes (e-cigarettes) use is becoming increasingly common, especially among adolescents and young adults, and there is little evidence on the impact of e-cigarettes use on never-smokers. With a meta-analysis method, we explore the association between e-cigarettes use and smoking intention that predicts future cigarette smoking. Studies were identified by searching three databases up to January 2016. The meta-analysis results were presented as pooled odds ratio (OR) with 95% confidence interval (CI) calculated by a fixed-effects model. A total of six studies (91,051 participants, including 1452 with ever e-cigarettes use) were included in this meta-analysis study. We found that never-smoking adolescents and young adults who used e-cigarettes have more than 2 times increased odds of intention to cigarette smoking (OR = 2.21, 95% CI: 1.86-2.61) compared to those who never used, with low evidence of between-study heterogeneity (p = 0.28, I² = 20.1%). Among never-smoking adolescents and young adults, e-cigarettes use was associated with increased smoking intention.

Cancer risk among patients with type 2 diabetes mellitus: a population-based prospective study in China.

Evidence indicates an increased cancer risk among type 2 diabetes mellitus (T2DM) patients, yet studies in mainland China are scarce. Based on Diabetes Surveillance System linking to Cancer Surveillance System of Zhejiang Province in China, we explored the cancer risk among T2DM patients. Totally, 327,268 T2DM patients were identified and followed from January 1, 2007 to December 31, 2013. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were reported. Overall cancer risk was found significantly increased with an SIR of 1.15 (95% CI 1.12-1.19) and 1.25 (95% CI 1.21-1.30) in males and females, respectively. Regarding specific cancer sites, risks of liver, colon, rectum, pancreas, and kidney were significantly increased with SIRs of 1.26 (95% CI 1.16-1.36), 1.47 (95% CI 1.29-1.67), 1.25 (95% CI 1.09-1.43), 2.81 (95% CI 2.50-3.16) and 1.61 (95% CI 1.28-2.03) in males, 1.53 (95% CI 1.35-1.73), 1.33 (95% CI 1.15-1.54), 1.29 (95% CI 1.10-1.51), 3.62 (95% CI 3.20-4.09) and 1.71 (95% CI 1.28-2.29) in females, respectively. A significant increased SIR was noted for prostate (1.80, 95% CI 1.58-2.06). Significant increased SIRs for lung (1.32, 95% CI 1.20-1.44) and stomach (1.16, 95% CI 1.03-1.30) were observed in females. We suggested an increased cancer risk among T2DM patients.

[Association between type 2 diabetes mellitus and risk of cancers: a cohort study].

OBJECTIVE: To understand the association between type 2 diabetes and the risk of cancers. METHODS: Data related to type 2 diabetes mellitus (T2DM) cases and cancer cases were collected from Zhejiang Chronic Disease Surveillance Information and Management System (CDSIMS) , between January 1, 2007 and December 31, 2013. Cumulative incidence and relative risk (RR) with 95% confidence interval (CI) were calculated. RESULTS: From 2007 to 2013, a total of 327 268 T2DM and 7 435 cancer cases were respectively reported and 778 439 person-years completed the followed-up program. Among the T2DM patients, incidence of cancers was 955.12 per 100 000, with standardized incidence as 458.05 per 100 000. Compared with people without T2DM, the risk of cancer incidence increased in T2DM patients (RR=1.68, 95%CI: 1.68-1.70). Risk appeared the highest in 20-39 year age group but decreased when the increase of age. In addition, the increased risk was still significant in T2DM patients aged ≥60 years (RR=1.21, 95%CI: 1.18-1.25). CONCLUSION: Results from the study suggested that T2DM was associated with the increased risk of cancers, statistically.

[Survival analysis of gastric cancer patients during 2005-2010 in Zhejiang Province, China].

OBJECTIVE: To conduct a survival analysis of gastric cancer patients according to the data of population-based cancer registry during 2005-2010 in Zhejiang Province in order to provide information for prognosis assessment and control of this disease. METHODS: The deadline of the last follow-up of 26, 536 patients was December 31st, 2012. Cumulative observed survival rate (OSR) and expected survival rate were calculated by life table and Hakulinen method. RESULTS: the 1-, 3-, and 5-year OSR were 58.51%, 39.07%, and 33.08%, and the 1-, 3-, and 5-year relative survival rates (RSR) were 60.24%, 42.90%, and 39.03%, respectively. The 1-, 3-, and 5-year relative survival rates of males vs. females were 60.49% vs. 59.65%, 42.88% vs. 42.96%, and 38.76% vs. 39.64%, respectively, statistically with non-significant differences (χ(2) = 0.13, P > 0.05) between them. The 5-year OSR and RSR of urban patients were 39.15% and 46.30%, and the 5-year OSR and RSR of rural patients were 30.81% and 36.32%, with statistically significant differences between them (P < 0.05). The 15-44 age group had a better relative survival rate. CONCLUSIONS: The survival rate of gastric cancer patients in Zhejiang Province is low. Work of cancer prevention and control should be strengthened. The wide variation in gastric cancer survival rates between urban and rural patients indicates that priority should be given to rural areas in allocating medical and public health resources.

[Analysis of survival rate of breast, cervical, and ovarian cancer patients during 2005-2010 in Zhejiang province, China].

OBJECTIVE: To provide reference information for prognosis and control of female cancers by analyzing survival rates of breast, cervical and ovarian cancer patients during 2005-2010 in Zhejiang province. METHODS: The morbidity and mortality data of 18 133 breast, cervical and ovarian cancer patients whose information were registered in health surveillance zone during 2005-2010 in Zhejiang were analyzed. The December 31(st), 2012 was set as the deadline of survival time. Observed survival rate (OS) and relative survival rate (RS) were calculated using SURV3.01 software and comparison between survival rates was conducted through Hakulinen's likely hood ratio test. RESULTS: The 5-year OS of breast cancer, cervical cancer, and ovarian cancer were 76.89%, 70.79%, 2.59%, respectively during 2005-2010 in Zhejiang province. The 5-year RS of the three cancers were 80.26%, 73.89%, 55.17%, respectively. The 5-year RS of breast cancer, cervical cancer, and ovarian cancer in urban area were 83.11%, 77.87%, and 57.22% and 78.00%, 72.21%, and 53.83% in rural areas, respectively. The overall RS of urban patients was higher than the rural's (χ(2) = 24.98, 11.55 and 6.62, respectively, all P values < 0.05). The 5-year RS of breast cancer, which was grouped by age, showed that the 15-44 years group was the highest (83.40%), while 65-77 years group was the lowest (74.67%). The 5-year RS of cervical cancer decreased with age, with a 41.73% decrease from 83.83% (15-44 years group) to 42.10% ( ≥ 75 years group). The 15-44 years group showed the highest 5-year RS of ovarian cancer (74.30%), while ≥ 75 years group was the lowest (41.80%). CONCLUSION: The prognosis of breast cancer and cervical cancer were relatively optimistic, while the ovarian cancer was not. The prognosis of female cancer patients in urban areas were better than in rural areas.

[Survival rate of colorectal cancer patients during 2005-2010 in Zhejiang province, China].

OBJECTIVE: To analyze the survival rate of colorectal cancer, using data from the population-based cancer registry during 2005-2010 in Zhejiang. METHODS: The last follow-up activities on 17 235 cases regarding the survival status was December 31, 2012. Both cumulative observed survival rate (OS) and relative survival rate (RS) were calculated with SURV 3.01 software drawn up by Hakulinen. RESULTS: The OS on 1, 3 and 5 year were 76.71%, 58.14%, 50.58% and the RS on 1, 3 and 5 year were 78.93% , 63.48% , 58.73% , respectively. The 1, 3 and 5 year relative survival rates on males vs. females were 79.36% vs. 78.35% , 63.63% vs. 63.29%, and 58.85% vs. 58.57%, respectively and the difference between them was not statistically significant (χ(2) = 1.08, P = 0.298). The 5 year OS and RS of the urban population were 55.06% and 64.09% and the 5 year OS and RS of the rural population were 47.59% and 55.16%, with statistically significant differences (χ(2) = 85.84, P < 0.001). The 55-64 age group appeared higher relative survival rate. There were significant differences in the survival rates among different age groups (χ(2) = 333.42, P < 0.001). The 5 year RS of colon vs. rectum were 61.47% vs. 56.45% . Colon patients showed better relative survival rate (χ(2) = 7.26, P < 0.05). CONCLUSION: The wide variations in colorectal cancer survival rates were seen between the urban and rural populations. Public health resources should be focused on rural areas. Patients younger than 55 years should be under specific attention to further understand the related factors which influencing the prognosis of the diseases.