[Cancer survival analysis in Tianjin, 2010 to 2016].

Objective: Survival analysis of cancers' incidence data in Tianjin from 2010 to 2016 was conducted to provide the basis for formulating and evaluating regional health policies on cancer prevention and treatment. Methods: Registration data in Tianjin were used between January 1, 2010 to December 31, 2016 and patients were followed-up till 31 December, 2021. Life-table method was used to calculate the observed survival rate and Edered Ⅱ was used to calculate the relative survival rate. The data were stratified by year, gender, age group and cancer sites. Difference in survival curves between group was analyzed by Kaplan-Meier method and Log rank test. Joinpoint regression model was used to analyze the trend change. Results: The 5-year relative survival rates of cancer were 41.92% to 53.65% from 2010 to 2016 for residents in Tianjin, with an increasing trend (t=4.81, P=0.005), and the average was 48.56%. The survival rate of females was higher than that of males (57.71%vs. 39.20%), and the survival rate of urban residents was higher than that of rural residents (49.38% vs. 47.24%). The 5-year relative survival rates were 63.14%, 78.39%, 58.25% and 32.67% in 0-14, 15-44, 45-64 and 65 and above age groups, respectively. The median relative survival times of all cancer were 2.34 to 6.00 years from 2010 to 2016 in Tianjin, with an increasing trend (t=3.86, P=0.012). The average of median relative survival times was 4.11 years. The median survival time of females was longer than that of males (11.99 years vs. 2.03 years), and the time of urban residents were longer than that of rural residents (4.60 years vs. 3.43 years). The median relative survival time were 12.07, 11.92 and 1.34 years in 15-44, 45-64 and 65 and above age groups, respectively. Conclusions: The cumulative survival rate of cancer increased significantly from 2010 to 2016 in Tianjin, indicating that the prevention and treatment effect of cancer is obvious. The focus should be on male, rural areas, higher age group, and targeted prevention and treatment measures should be taken to lung, esophagus, liver, gallbladder and pancreatic cancer.

[Study on increase of average life expectancy of residents in Tianjin from 1999 to 2018].

Objective: To assess the trend and the factors responsible for the increase of life expectancy of residents in Tianjin over the past two decades. Methods: Abridged Life Table and Arriaga's decomposition method was applied to quantify the influence of the age structure and the leading causes of death on the increase of life expectancy of residents in Tianjin from 1999 to 2018. Results: In the past 20 years, the life expectancy of residents in Tianjin increased by 4.97 years, the life expectancy of men and women increased by 4.11 years and 5.86 years, respectively. The decrease of mortality rate in 0-year-old group contributed 19.17% to the increase of the life expectancy, while the decrease of mortality rate in residents aged ≥55 years contributed more to the increase of life expectancy, with the cumulative contribution rate of 67.38%. The major contribution to the increase of life expectancy was the mortality reduction of cerebrovascular disease, respiratory disease, cardiovascular disease, perinatal diseases, congenital malformations and injury, with the contribution percentage of 27.27%, 21.37%, 15.76%, 12.22%, 6.44% and 4.86%, respectively. The increase of mortality of malignant tumor, injury and poisoning, diabetes and nervous system diseases and others had a negative effect on the increase of life expectancy of people aged ≥75 years. From 1999 to 2018, the life expectancy increased from 76.72 years to 81.46 years (t=9.11, P<0.001), the annual percent change (APC) was 0.58%. From 2011 to 2018, it was stable, ranging from 81.46 years to 81.69 years (t=0.89, P=0.387, APC=0.13%). Conclusion: From 1999 to 2018, the increase of life expectancy was attributed to the decrease of mortalities in infants and the elderly and the decrease of mortalities of cerebro-cardiovascular disease, respiratory disease, perinatal disease, congenital malformations and injury. However, these positive contributions were partly offset by the negative contribution of malignant tumor, injury, diabetes and nervous system disease in those aged ≥75 years. Comprehensive prevention and control of key diseases should be strengthened in key population in order to further improve the life expectancy of the population.

[Analysis on long-term trend of mortality and years of life lost of breast cancer in women in Tianjin, 1999-2017].

Objective: To analyze the trends of mortality and years of life lost (YLL) of breast cancer in women in Tianjin and provide references for the development of intervention strategies. Methods: The crude mortality rate, standard mortality rate, cumulative rate (0-74 years old) and truncated rate (35-64 years old) of breast cancer in women in Tianjin from 1999 to 2017 were calculated. The annual percentage change of the mortality rate and YLL rate were analyzed by Joinpoint regression. Results: From 1999 to 2017, a total of 8 356 deaths of breast cancer were reported in Tianjin, resulting in a YLL of 262 835.53 person-years. The average crude mortality rate was 9.15/100 000. The average age standardized rate(ASR) (World) was 6.14/100 000. The ratio of ASR (World) between urban and rural areas was 1.73∶1. The peak mortality ratio of age groups between urban area and rural area was 3.13∶1. From 1999 to 2017, both the crude mortality rate and ASR of breast cancer in Tianjin had rising trends. In 2017, the crude mortality rate and the ASR of breast cancer increased by 113.7% and 44.4% respectively compared with 1999. The increase of urban mortality mainly came from elderly group aged ≥75 years, and the mortality of young age groups in rural area showed an fast increases, which was most obvious in age group 45-59 years (average annual percentage change=3.6%, P<0.01). Conclusions: The mortality rate of breast cancer and disease burden in women in Tianjin are still in rapid increase. We should continue to implement the prevention and control strategies such as lifestyle intervention and screening of key groups. More attention need to be paid to the increase of breast cancer incidence in rural area.

[Analysis on the alterative trend of colorectal cancer mortality from 1999 to 2015 in Tianjin of China].

Objective: To investigate the mortality of colorectal cancer and its trend from 1999 to 2015 in Tianjin, China, and to explore the mortality features in different populations in order to provide data for prevention and control strategies of colorectal cancer. Methods: Colorectal cancer mortality data between 1999 and 2015 were collected from Tianjin population - based mortality surveillance system maintained by the Tianjin Centers for Disease Control and Prevention (CDC). Population data of permanent residents were collected from Tianjin Municipal Public Security Bureau. The number of new cases and deaths, incidence [including crude incidence, age-adjusted standardized incidence and 95% confidence interval (95% CI)], and mortality (including crude mortality, age-adjusted standardized mortality and 95% CI) of colorectal cancer were calculated. Standardized incidence and mortality of colorectal cancer were calculated using the Segi's world standard population, adjusted with age and gender. JoinPoint regression and Cochran-Armitage trend test were used to determine the statistical significance of differences in mortality trend. Results: A total of 31 376 new onset cases and 14 893 death cases of colorectal cancer were observed in Tianjin from 1999 to 2015. Colorectal cancer incidence increased from 1999 to 2015 with a standardized rate from 9.66/100 000 to 15.36/100 000 [annual percent change(APC)=3.48%, Z=23.21, P<0.001]. Colorectal cancer mortality increased from 1999 to 2015 with a standardized rate from 5.18/100 000 to 6.11/100 000 (APC=1.24%, Z=5.69, P<0.001). Both showed an increasing trend. The death proportion of colon cancer increased (39.67% in 1999 and 50.33% in 2015), while the death proportion of rectal caner decreased (60.33% in 1999 and 48.57% in 2015). The median age of colorectal cancer onset fluctuated steadily around 66 years old (APC=0.16, T=1.75, P=0.100); the median age of death increased from 69 to 73 years old (APC=0.43, T=8.81, P<0.001). From 1999 to 2015, the mortality of colorectal cancer showed a downward trend (all P<0.05) in the age groups of <35 and 35-44 years, while an upward trend (all P<0.05) in the age groups of 45-54 years, 55-64 years and ≥ 65 years. Colorectal cancer mortality in males increased with a standardized rate of 5.53/100 000 in 1999 to 7.33/100 000 in 2015(APC=2.29%, Z=7.86, P<0.001), while colorectal cancer mortality in females flatted with a standardized rate of 4.83/100 000 in 1999 to 4.89/100 000 in 2015 (APC=0.10%, Z=-0.30, P=0.752). Colorectal cancer mortality increased with a standardized rate of 6.75/100 000 in 1999 to 7.33/100 000 in 2015 (APC=0.54%, Z=1.98, P=0.048) in urban areas and of 3.18/100 000 in 1999 to 4.38/100 000 in 2015 (APC=2.47, Z=6.46, P<0.001) in rural areas, whose differences were significant. Standardized mortality rate in rural area was lower but the rising velocity was faster as compared to urban area. Conclusions: Crude mortality and standardized mortality of colorectal cancer increase from 1999 to 2015 in Tianjin population. The people of elder, male and urban area have higher mortality. The mortality in people of male and rural area presents a faster rising state. Further efforts to reduce colorectal cancer mortality in Tianjin are needed to prevention and control of colorectal cancer.

[Analysis on trend of leukemia mortality from 1999 to 2015 in Tianjin, China].

From 1999 to 2015, there were 6 186 cases of leukemia deaths in tianjin residents, the males accounted for 58.28% (3 605) and 52.31% (3 236) deaths lived in urban areas; the crude mortality rate of Leukemia increased from 3.47/100 000 to 4.28/100 000 [t=7.09, P<0.001, annual percent change (APC)=1.30%] and the standardized mortality rate decreased from 3.15/100 000 to 3.01/100 000 (t=-2.95, P=0.006, APC=-0.65%). Special attention should be focused on children, the elderly, males and rural residents.

[Analysis on cancer deaths and cause-eliminated-life-expectancy among residents of Tianjin, 2015].

Objective: To explore the causes of cancer deaths and cause-eliminated-life-expectancy among residents of Tianjin. Methods: Data from the death registry system of Tianjin residents in 2015 were collected and cancers were grouped according to the classification of Global Burden of Disease. Specific cancer crude death rate and cause eliminated life expectancy (CELE) were calculated. Results: In 2015, 17 641 Tianjin residents died of cancer, with the crude death rate as 171.79 per 100 thousand and the standardized rate according to the Chinese population in 2000 as 86.32 per 100 thousand. The cancer deaths among men was 10 165, with crude death rate of 197.39 per 100 thousand and standardized rate was 95.41 per 100 thousand. While among females the cancer deaths was 7 476, with crude death rate as 146.04 per 100 thousand and standardized rate as 76.65 per 100 thousand. The top five leading deaths on cancers among men were lung, liver, stomach, "colon, rectum and anal" , pancreas, while lung, breast, liver, "colon, rectum and anal" , stomach were in women. The life expectancy increased 3.53 and 2.88 years among men and women respectively after the exclusion of cancer deaths. When lung cancer death was excluded, the life expectancy increased 1.25 and 0.97 years respectively among men and women. Lung cancer was the main reason of life expectancy lost than cancer of other locations. Conclusion: Cancers, with lung cancer in particular, were the major diseases causing death and life expectancy lost in the Tianjin residents which called for urgent effective intervention programs to develop.

[Trend of premature mortality from chronic and non-communicable diseases in Tianjin, 1999-2015].

Objective: To explore the trends and distribution of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, cancer, chronic respiratory disease and diabetes in different sex and residential areas in Tianjin so as to provide basis for setting up prevention and control programs on premature mortality. Methods: Population data on premature mortality in 1999-2015 were from the 'Tianjin population based mortality surveillance system' maintained by Tianjin Centers for Disease Control and Prevention (CDC). Data related to permanent residents was from the Tianjin Municipal Public Security Bureau. Standardized premature mortality rates were calculated and adjusted for age and gender according to the '2000 world standard population'. Premature mortality probabilities were analyzed according to the methods recommended by WHO. Joinpoint regression and Cochran-Armitage trend methods were used to determine the significance of differences on the trends of mortality. Results: From 1999 to 2015, the premature mortality appeared consistent (P<0.001) declining in the above-said four diseases with the APC of probabilities as-2.92%, -1.13%, -9.51% and -3.39%, respectively. The probabilities of premature mortality were all declining consistently in both men and women and in both urban and rural areas in Tianjin. From 1999 to 2015, the probabilities of the four main NCDs were between 19.67% and 12.85% (APC=-2.49%, P<0.001), higher in women (from 17.02% to 9.17%, APC=-3.84%, P<0.001) than that in men (from 22.27% to 16.47%, APC=-1.59%, P<0.001), in urban (from 21.04% to 12.34%, APC=-3.26%, P<0.001) than that in rural areas (from 17.80% to 13.54%, APC=-1.54%, P<0.001). Conclusion: Our findings suggested that premature mortality in Tianjin was decreasing during 1999-2015 but attention should still be called for on males and people living in the rural areas to further reducing the premature mortality.

[Incidence trends of cervical cancer in Tianjin, 2007-2013].

OBJECTIVE: To investigate the change of incidence and age distribution of cervical cancer in Tianjin from 2007 to 2013. METHODS: The incidence data of cervical cancer and population data were collected from the cancer registry system of Tianjin Center for Disease Control and Prevention and Tianjin Municipal Public Security Bureau, respectively. The crude incidence, and age-standardized incidence of cervical cancer were calculated by using SPSS software. The Join Point Regression Program software was used to detect the trend of cervical cancer incidence. RESULTS: A total of 3 362 cervical cancer patients were diagnosed during 2007 to 2013. The average age of the patients was 48.11 years. The crude incidence was 9.85/100 000. The annual world standard age specific incidence was 6.65 /100 000. The incidence in urban area was higher than that in rural area, but the proportion of the cases in urban area showed a downward trend(trend χ(2)=21.92, P=0.001)and the proportion of the cases in rural area showed a upward trend(trend χ(2)=12.70, P=0.048). The difference was significant. The incidence was generally stable in urban area, the APC value was 2.7%(95%CI:-9.1%-16.2%), the difference was not significant(Z=0.564, P=0.597); The incidence rate in rural area showed an upward trend, APC value was 13.4%(95% CI: 3.5%-24.2%), the difference was significant(Z=3.549, P=0.016). The two incidence peaks were in age groups 40-44 years and 75-79 years. CONCLUSION: The overall incidence of cervical cancer in Tianjin was still stable during 2007-2013, and the disease mainly occurred in middle-aged and elderly population. More attention should be paid to the increased incidence of cervical cancer in rural area.

Transplantation of Schwann cells differentiated from adipose-derived stem cells modifies reactive gliosis after contusion brain injury in rats.

This study investigated whether transplantation of Schwann cells differentiated from adipose-derived stem cells (ADSC-SCs) of rats could promote functional improvement after contusion brain injury, with a focus on the effect on reactive gliosis. ADSCs were isolated and expanded from groin adipose tissue of Sprague-Dawley rats and then differentiated into Schwann cells. ADSCSCs were transplanted into the contused rat brain. Immunofluorescence and Western blotting were used to analyse reactive gliosis, and locomotor function of the rats was assessed. Hemiparalysed rats transplanted with ADSC-SCs showed significant locomotor function recovery compared with rats transplanted with undifferentiated ADSCs or control rats injected with medium alone. Transplanted ADSC-SCs significantly reduced glial scar formation and neurocan protein levels compared with transplanted undifferentiated ADSCs. In conclusion, transplantation of ADSC-SCs can effectively promote locomotor functional recovery and reduce reactive gliosis after contusion brain injury in rats.

Comparison of four-drug discriminations in training compartments with four identical levers versus four different responses manipulanda.

Rats were trained to discriminate between four dissimilar drugs (phenobarbital, nicotine, fentanyl, and methylphenidate) in compartments which contained either four identical levers or four dissimilar response manipulanda. During successive training sessions, the drug condition was cycled through the four training conditions. The objective was to compare speed of acquisition and asymptotic accuracy of discriminative control in the following types of compartments: (1) Undecorated compartments with four identical levers; (2) Compartments with four dissimilar response manipulanda (lever, wheel, nosepoke, panel); (3) Four-lever compartments with a unique sensory environment surrounding each lever; (4) Compartments with four dissimilar manipulanda, each surrounded by a unique sensory environment. The required four-drug discrimination were learned in all training compartments. Independent variables that produced statistically significant effects on speed of acquisition and/or asymptotic accuracy included drug, dosage, use/nonuse of four dissimilar response manipulanda, and presence/absence of environmental decorations around each manipulandum. Although the use of four different response manipulanda and/or the use of distinctive decorations surrounding each of the four manipulanda did increase speed of acquisition, these manipulations also resulted in biases towards/against particular individual environments or manipulanda during the acquisition phase of the experiment. Such biases can complicate the interpretation of results of conventional drug discrimination studies, especially if they persist into the asymptotic accuracy phase, which was not observed in the present study.