Interrupted time series analysis using the ARIMA model of the impact of COVID-19 on the incidence rate of notifiable communicable diseases in China.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic in China is ongoing. Some studies have shown that the incidence of respiratory and intestinal infectious diseases in 2020 decreased significantly compared with previous years. Interrupted time series (ITS) is a time series analysis method that evaluates the impact of intervention measures on outcomes and can control the original regression trend of outcomes before and after the intervention. This study aimed to analyse the impact of COVID-19 on the incidence rate of notifiable communicable diseases using ITS in China. METHODS: National data on the incidence rate of communicable diseases in 2009-2021 were obtained from the National Health Commission website. Interrupted time series analysis using autoregressive integrated moving average (ARIMA) models was used to analyse the changes in the incidence rate of infectious diseases before and after the COVID-19 epidemic. RESULTS: There was a significant short-term decline in the incidence rates of respiratory infectious diseases and enteric infectious diseases (step values of -29.828 and - 8.237, respectively), which remained at a low level for a long time after the decline. There was a short-term decline in the incidence rates of blood-borne and sexually transmitted infectious diseases (step = -3.638), which tended to recover to previous levels in the long term (ramp = 0.172). There was no significant change in the incidence rate of natural focus diseases or arboviral diseases before and after the epidemic. CONCLUSION: The COVID-19 epidemic had strong short-term and long-term effects on respiratory and intestinal infectious diseases and short-term control effects on blood-borne and sexually transmitted infectious diseases. Our methods for the prevention and control of COVID-19 can be used for the prevention and control of other notifiable communicable diseases, especially respiratory and intestinal infectious diseases.

Opinions and clinical practice of functional movement disorders: a nationwide survey of clinicians in China.

BACKGROUND: There is rare reports about opinions and clinical practice of functional movement disorders (FMD) in China. The present survey aimed to investigate the views of FMD in Chinese clinicians. METHODS: The Chinese version survey of FMD were conducted in nationwide practitioners by means of an online questionnaire. RESULTS: Four hundred and thirty-four Chinese clinicians completed a 21-item questionnaire probing diagnostic and management issues in FMD. More than 80% of respondents considered that atypical movement disorder, multiple somatizations, and emotional disturbance were essential or absolutely necessary for clinically definite diagnosis of FMD. About three quarters of respondents requested standard neurological investigations to rule out organic causes. Over half believed that prior diagnosis of an organic disorder (59.9%), lack of associated non-physiologic deficits (51.8%), and evidence of physical injury (50.0%) were 'very influential' or 'extremely influential' for a non-FMD diagnosis. The majority (77.4%) of the respondents may refer patients to a neuropsychiatrist or psychiatrist experienced in FMD, followed by psychologist or psychotherapist experienced in FMD (53.2%). However, lack of guidelines, physician knowledge, and training often limited clinicians' ability in managing patients with FMD. Early diagnosis of FMD, identification and management of concurrent psychiatric disorder, and acceptance of the diagnosis by the patient were considered most important for predicting a favorable prognosis. CONCLUSIONS: Opinions and clinical practice of Chinese practitioners not only varied among Chinese neurologists, but also differed from international peers. Combined efforts are needed to promote related research and establish practice guidelines in China in the future.

Time-varying effect of drunk driving regulations on road traffic mortality in Guangzhou, China: an interrupted time-series analysis.

BACKGROUND: China has introduced a series of stricter policies to criminalize drunk driving and increase penalties since May 2011. However, there is no previous study examining the time-varying impacts of drunk driving regulations on road traffic fatalities based on daily data. METHODS: We collected 6536 individual data of road traffic deaths (RTDs) in Guangzhou from 2008 to 2018. The quasi-Poisson regression models with an inclusion of the intervention variable and the interaction of intervention variable and a function of time were used to quantify the time-varying effects of these regulations. RESULTS: During the 11-year study period, the number of population and motor vehicles showed a steady upward trend. However, the population- and motor vehicles- standardized RTDs rose steadily before May 2011, the criminalizing drunk driving intervention was implemented and gradually declined after that. The new drunk driving intervention were associated with an average risk reduction of RTDs (ER = -9.01, 95% eCI: - 10.05% to - 7.62%) during the 7.7 years after May 2011. On average, 75.82 (95% eCI, 54.06 to 92.04) RTDs per 1 million population annually were prevented due to the drunk driving intervention. CONCLUSION: These findings would provide important implications for the development of integrated intervention measures in China and other countries attempting to reduce traffic fatalities by stricter regulations on drunk driving.

Trends and seasonality in cause-specific mortality among children under 15 years in Guangzhou, China, 2008-2018.

BACKGROUND: This study analyzed the trends and seasonality in mortality among children aged 0-14 years in Guangzhou, China during 2008-2018. Understanding the epidemiology of this public health problem can guide policy development for children mortality prevention. METHODS: A population-based epidemiological retrospective study was conducted. Seven thousand two hundred sixty-five individual data of children mortality were obtained from the Guangzhou Center for Disease Control and Prevention (CDC). The Poisson regression was used to quantify the annual average reduction rate and the difference in mortality rate between sex and age groups. Incidence ratio with 95% confidence interval (CI) was estimated to determine the temperaol variations in mortality by month, season, school term, day of the week and between holidays and other days. RESULTS: Between 2008 and 2018, the children mortality rate in Guangzhou decreased from 54.0 to 34.3 per 100,000 children, with an annual reduction rate of 4.6% (95% CI: 1.1%-8.1%), especially the under-5 mortality rate decreased by 8.3% (95% CI: 4.8%-11.6%) per year. Decline trends varied by causes of death, even with an upward trend for the mortality of asphyxia and neurological diseases. The risk of death among males children was 1.33 times (95% CI: 1.20-1.47) of that of females. The distribution of causes of death differed by age group. Maternal and perinatal, congenital and pneumonia were the top three causes of death in infants and cancer accounted for 17% of deaths in children aged 1-14 years. Moreover, the injury-related mortality showed significant temporal variations with higher risk during the weekend. And there was a summer peak for drowning and a winter peak for asphyxia. CONCLUSIONS: Guangzhou has made considerable progress in reducing mortality over the last decade. The findings of characteristics of children mortality would provide important information for the development and implementation of integrated interventions targeted specific age groups and causes of death.

Immunogenicity of adenovirus and DNA vaccines co-expressing P39 and lumazine synthase proteins of Brucella abortus in BALB/c mice.

Brucella poses a great threat to animal and human health. Vaccination is the most promising strategy in the effort to control Brucella abortus (B. abortus) infection, but the currently used live vaccines interfere with diagnostic tests and could potentially result in disease outbreak. Therefore, new subunit vaccines and combined immunization strategies are currently under investigation. In this study, immunogenicity and protection ability of a recombinant adenovirus and plasmid DNA vaccine co-expressing P39 and lumazine synthase proteins of B. abortus were evaluated based on the construction of the two molecular vaccines. Four immunization strategies (single adenovirus, single DNA, adenovirus/DNA, DNA/adenovirus) were investigated. The results showed that the immunization strategy of DNA priming followed by adenovirus boosting induced robust humoral and cellular immune responses, and it significantly reduced the numbers of B. abortus in a mouse model. These results suggest that it could be a potential antigen candidate for development of a new subunit vaccine against B. abortus infection.

The impact of ambient air pollution on suicide mortality: a case-crossover study in Guangzhou, China.

BACKGROUND: Preventing suicide is a global imperative. Although the effects of social and individual risk factors of suicide have been widely investigated, evidence of environmental effects of exposure to air pollution is scarce. We investigated the effects of ambient air pollution on suicide mortality in Guangzhou, China during 2003-2012. METHODS: A conditional logistic regression analysis with a time-stratified case-crossover design was performed to assess the effects of daily exposure to three standard air pollutants, including particulate matter less than 10 µm in aerodynamic diameter (PM10), sulphur dioxide (SO2) and nitrogen dioxide (NO2), on suicide mortality, after adjusting for the confounding effects of daily mean temperature, relative humidity, atmospheric pressure and sunshine duration. Further analyses were stratified by season, gender, age group, educational attainment and suicide type. RESULTS: Between 2003 and 2012, there were a total of 1 550 registered suicide deaths in Guangzhou. A significant increase in suicide risk were associated with interquartile-range increases in the concentration of air pollutant, with an odds ratio of 1.13 (95 % confidence interval (CI): 1.01, 1.27) and 1.15 (95 % CI: 1.03, 1.28) for PM10 and NO2 at lag 02, and 1.12 (95 % CI: 1.02, 1.23) for SO2 at lag 01, respectively. The suicide risks related to air pollution for males and people with high education level were higher than for females and those with low education level, respectively. Significant air pollution effects were found on violent suicide mortality and in cool season but not on non-violent suicide mortality or in warm season. CONCLUSIONS: Suicide risk was positively associated with ambient air pollution levels. This finding would provide important information for the health impact assessment of air pollution and for the development of effective strategies and interventions for the prevention of suicide.

Incidence trends and age distribution of colorectal cancer by subsite in Guangzhou, 2000-2011.

INTRODUCTION: Colorectal cancer (CRC) is the third most common cancer in China. The incidence of CRC has been increasing in recent years. The aim of this study was to explore the incidence trends and the age distribution of CRC by subsite in Guangzhou between 2000 and 2011. METHODS: A total of 22,432 incident cases of CRC between 2000 and 2011 from Guangzhou Cancer Registry were identified. Crude incidence and age-standardized rates (ASRs), using the Segi's world standard population, were calculated for CRC and CRC subsites. The incidence trend was analyzed and the annual percentage change (APC) in incidence was calculated by using JoinPoint software. RESULTS: The crude incidence increased significantly from 23.4/10(5) in 2000 to 37.4/10(5) in 2011 for males and from 20.9/10(5) to 30.5/10(5) for females. The ASRs of CRC incidence stabilized during the period of 2000-2011 for both males and females. The ages at the onset of CRC for both males and females during 2010-2011 were significantly higher compared with those during 2000-2002 (males: t = 1.95, P = 0.05; females: t = 6.03, P < 0.01). For males aged 50-64 years, the CRC incidence increased by 8.50% annually (P = 0.04) during 2000-2004 and by 1.68% annually (P = 0.03) during 2005-2011. For females aged 65 years and older, the CRC incidence increased by 5.77% annually (P = 0.03) during 2000-2004. There were no significant changes for the CRC incidences in males aged 49 and younger and 65 years and older and females aged 64 years and younger during 2000-2004, or for those in all females as well as males aged 49 years and younger and 65 years and older during 2005-2011. The percentage of colon cancer in all CRCs increased significantly for both males and females between the periods of 2000-2002 and 2010-2011. The ASRs of descending colon and sigmoid colon cancer incidences increased significantly for females during 2005-2011 (APC, 5.51% and 1.08%, respectively, both P < 0.05). CONCLUSIONS: The crude incidence of CRC increased significantly between 2000 and 2011 because of the aging, whereas the ASRs kept stable. The percentage of colon cancer in all CRCs increased significantly. Further surveillance, research, and intervention are needed to identify the causes of these changes and to reduce the incidence and mortality of CRC.

Estimation of cancer burden in Guangdong Province, China in 2009.

BACKGROUND: Surveying regional cancer incidence and mortality provides significant data that can assist in making health policy for local areas; however, the province- and region-based cancer burden in China is seldom reported. In this study, we estimated cancer incidence and mortality in Guangdong Province, China and presented basic information for making policies related to health resource allocation and disease control. METHODS: A log-linear model was used to calculate the sex-, age-, and registry-specific ratios of incidence to mortality (I/M) based on cancer registry data from Guangzhou, Zhongshan, and Sihui between 2004 and 2008. The cancer incidences in 2009 were then estimated according to representative I/M ratios and the mortality records from eight death surveillance sites in Guangdong Province. The cancer incidences in each city were estimated by the corresponding sex- and age-specific incidences from cancer registries or death surveillance sites in each area. Finally, the total and region-based cancer incidences and mortalities for the entire population of Guangdong Province were summarized. RESULTS: The estimated I/M ratios in Guangzhou (3.658), Zhongshan (2.153), and Sihui (1.527) were significantly different (P < 0.001), with an average I/M ratio of 2.446. Significant differences in the estimated I/M ratios were observed between distinct age groups and the three cancer registries. The estimated I/M ratio in females was significantly higher than that in males (2.864 vs. 2.027, P < 0.001). It was estimated that there were 163,376 new cancer cases (99,689 males and 63,687 females) in 2009; it was further estimated that 115,049 people (75,054 males and 39,995 females) died from cancer in Guangdong Province in 2009. The estimated crude and age-standardized rate of incidences (ASRI) in Guangdong Province were 231.34 and 246.87 per 100,000 males, respectively, and 156.98 and 163.57 per 100,000 females, respectively. The estimated crude and age-standardized rate of mortalities (ASRM) in Guangdong Province were 174.17 and 187.46 per 100,000 males, respectively, and 98.59 and 102.00 per 100,000 females, respectively. In comparison with the western area and the northern mountain area, higher ASRI and ASRM were recorded in the Pearl River Delta area and the eastern area in both males and females. CONCLUSIONS: Cancer imposes a heavy disease burden, and cancer patterns are unevenly distributed throughout Guangdong Province. More health resources should be allocated to cancer control, especially in the western and northern mountain areas.

The impact of relative humidity and atmospheric pressure on mortality in Guangzhou, China.

OBJECTIVE: Although many studies have examined the effects of ambient temperatures on mortality, little evidence is on health impacts of atmospheric pressure and relative humidity. This study aimed to assess the impacts of atmospheric pressure and relative humidity on mortality in Guangzhou, China. METHODS: This study included 213,737 registered deaths during 2003-2011 in Guangzhou, China. A quasi-Poisson regression with a distributed lag non-linear model was used to assess the effects of atmospheric pressure/relative humidity. RESULTS: We found significant effect of low atmospheric pressure/relative humidity on mortality. There was a 1.79% (95% confidence interval: 0.38%-3.22%) increase in non-accidental mortality and a 2.27% (0.07%-4.51%) increase in cardiovascular mortality comparing the 5th and 25th percentile of atmospheric pressure. A 3.97% (0.67%-7.39%) increase in cardiovascular mortality was also observed comparing the 5th and 25th percentile of relative humidity. Women were more vulnerable to decrease in atmospheric pressure and relative humidity than men. Age and education attainment were also potential effect modifiers. Furthermore, low atmospheric pressure and relative humidity increased temperature-related mortality. CONCLUSION: Both low atmospheric pressure and relative humidity are important risk factors of mortality. Our findings would be helpful to develop health risk assessment and climate policy interventions that would better protect vulnerable subgroups of the population.

Impact of heat wave in 2005 on mortality in Guangzhou, China.

OBJECTIVE: To assess the impact of the heat wave in 2005 on mortality among the residents in Guangzhou and to identify susceptible subpopulations in Guangzhou, China. METHODS: The data of daily number of deaths and meteorological measures from 2003 to 2006 in Guangzhou were used in this study. Heat wave was defined as ⋝7 consecutive days with daily maximum temperature above 35.0 °C and daily mean temperature above the 97th percentile during the study period. The excess deaths and rate ratio (RR) of mortality in the case period compared with the reference period in the same summer were calculated. RESULTS: During the study period, only one heat wave in 2005 was identified and the total number of excess deaths was 145 with an average of 12 deaths per day. The effect of the heat wave on non-accidental mortality (RR=1.23, 95% CI: 1.11-1.37) was found with statistically significant difference. Also, greater effects were observed for cardiovascular mortality (RR=1.34, 95% CI: 1.13-1.59) and respiratory mortality (RR=1.31, 95% CI: 1.02-1.69). Females, the elderly and people with lower socioeconomic status were at significantly higher risk of heat wave-associated mortality. CONCLUSION: The 2005 heat wave had a substantial impact on mortality among the residents in Guangzhou, particularly among some susceptible subpopulations. The findings from the present study may provide scientific evidences to develop relevant public health policies and prevention measures aimed at reduction of preventable mortality from heat waves.

Early outcomes, associated factors and predictive values of clinical outcomes of tandospirone in generalized anxiety disorder: a post-hoc analysis of a randomized, controlled, multicenter clinical trial.

OBJECTIVE: To examine the early outcomes, associated factors and predictive values of clinical outcomes of different tandospirone doses in patients with a generalized anxiety disorder (GAD). METHODS: This was a posthoc analysis of "a randomized, controlled multicenter clinical trial of the efficacy and safety of different doses of tandospirone on GAD". A total of 274 patients with GAD were included and randomized into the high-dose (tandospirone 60 mg/d) and low-dose (tandospirone 30 mg/d) groups for a 6-week treatment. The Hamilton Anxiety (HAMA), Clinical Global Impression-Severity (CGI-S), Short-Form-12 (SF-12) scales were used for assessment. The trial was registered at clinical trail.gov (NCT01614041). RESULTS: (1) In the first week of treatment, 35.8% of patients in the high-dose group fulfilled the early onset criteria, which was significantly higher than 19.0% found in the low-dose group (p = 0.002). In the second week of treatment, 22.6% of patients in the high-dose group achieved an early response, versus 12.4% in the low-dose group, indicating a significant difference (p = .026). (2) Factors associated with early onset at week 1 included baseline HAMA total score (OR = 0.916, 95%CI 0.882-0.952), age (OR = 0.974, 95%CI 0.950-0.998), drug dose (30 mg vs. 60 mg; OR = 0.298, 95%CI 0.156-0.568) and SF-12 physiological total score (OR = 1.030, 95%CI 1.010-1.050). (3) Early onset was significantly associated with response rate (OR = 18.34, 95%CI 12.10-27.81), remarkable response rate (OR = 27.56, 95%CI 11.65-65.17) and recovery rate (OR = 11.85, 95%CI 4.98-28.18). Group (high dose group vs. low dose group) (χ2 = 8.535, p = .003) and baseline HAMA total score (χ2 = 70.840, p < .001) were independent predictors of onset time. CONCLUSIONS: The early outcomes of high-dose tandospirone in the treatment of GAD are better than those of the low-dose group. Patients with younger age at onset, milder anxiety symptoms and better physiological functions administered high-dose tandospirone showed rapid onset, great early outcomes, high recovery rate and good prognosis. Drug onset time had a good predictive effect on treatment outcome.

Genetic and Neuroimaging Analysis of SIGMAR1 for Frontotemporal Dementia.

BACKGROUND: Recently, Sigma nonopioid intracellular receptor 1 (SIGMAR1) variants have been shown harboring C9orf72 pathogenic repeat expansions in some frontotemporal dementia (FTD) cases. However, no SIGMAR1 genotype analysis has been reported in a cohort absent of C9orf72 pathogenic repeat expansions to date. OBJECTIVE: The present study investigated the contribution of SIGMAR1 independent of C9orf72 gene status to FTD spectrum syndromes. METHODS: We directly sequencing the entire coding region and a minimum of 50 bp from each of the flanking introns of SIGMAR1 gene in 82 sporadic FTD patients (female: male = 42 : 40) and 417 controls. For the patient carrying SIGMAR1 variant, a follow-up 3T MR imaging was performed in the study. RESULTS: Gene sequencing of SIGMAR1 revealed a rare 3'UTR nucleotide variation rs192856872 in a male patient with semantic dementia independent of C9orf72 gene status. The MR imaging showed asymmetrical atrophy in the anterior temporal lobes and the degeneration extends caudally into the posterior temporal lobes as the disease progresses. ESEFinder analysis showed new SRSF1 and SRSF1-IgM-BRCA1 binding sites with significant scores, which is predicted to affect normal splicing. CONCLUSION: We found a novel SIGMAR1 variant independent of C9orf72 gene status associated with semantic dementia phenotype.

Short-term effects of individual exposure to PM2.5 on hospital admissions for myocardial infarction and stroke: a population-based case-crossover study in Guangzhou, China.

Some studies have investigated the effects of PM2.5 on cardiovascular diseases based on the population-average exposure data from several monitoring stations. No one has explored the short-term effect of PM2.5 on cardiovascular hospitalizations using individual-level exposure data. We assessed the short-term effects of individual exposure to PM2.5 on hospitalizations for myocardial infarction (MI) and stroke in Guangzhou, China, during 2014-2019. The population-based data on cardio-cerebrovascular events were provided by Guangzhou Center for Disease Control and Prevention. Average annual percent changes (AAPCs) were used to describe trends in the hospitalization rates of MI and stroke. The conditional logistic regression model with a time-stratified case-crossover design was applied to estimate the effects of satellite-retrieved PM2.5 with 1-km resolution as individual-level exposure. Furthermore, we performed stratified analyses by demographic characteristics and season. There were 28,346 cases of MI, 188,611, and 36,850 cases of ischemic stroke (IS) and hemorrhagic stroke (HS), respectively, with an annual average hospitalization rate of 37.2, 247, and 48.4 per 100,000 people. Over the six-year study period, significant increasing trends in the hospitalization rates were observed with AAPCs of 12.3% (95% confidence interval [CI]: 7.24%, 17.6%), 13.1% (95% CI: 9.54%, 16.7%), and 9.57% (95% CI: 6.27%, 13.0%) for MI, IS, and HS, respectively. A 10 µg/m3 increase in PM2.5 was associated with an increase of 1.15% (95% CI: 0.308%, 1.99%) in MI hospitalization and 1.29% (95% CI: 0.882%, 1.70%) in IS hospitalization. A PM2.5-associated reduction of 1.17% (95% CI: 0.298%, 2.03%) was found for HS hospitalization. The impact of PM2.5 was greater in males than in females for MI hospitalization, and greater effects were observed in the elderly (≥ 65 years) and in cold seasons for IS hospitalization. Our study added important evidence on the adverse effect of PM2.5 based on satellite-retrieved individual-level exposure data.

Prevalence and patterns of multimorbidity in chronic diseases in Guangzhou, China: a data mining study in the residents' health records system among 31 708 community-dwelling elderly people.

OBJECTIVES: Examination of the prevalence, influence factors and patterns of multimorbidity among the elderly people in Guangzhou, China. DESIGN: Cross-sectional study. PARTICIPANTS: 31 708 community-dwelling elderly people aged 65 and over. PRIMARY AND SECONDARY OUTCOME MEASURES: Prevalence, influence factors and patterns of multimorbidity in seven chronic conditions among the participants. A multistage, stratified random sampling was adopted for selection of health records in the residents' health records system of Guangzhou. Data mining by association rule mining analysis was used to explore the correlations and multimorbidity patterns between seven chronic diseases. RESULTS: The prevalence of morbidity was 55.0% (95% CI 40.1% to 60.1%) and the multimorbidity was 15.2% (95% CI 12.4% to 18.4%) among the participants. Elderly, women, higher education level, being single, living in urban areas and having medical insurance were more likely to have chronic diseases and multimorbidity. Data mining by association rule mining analysis reveals patterns of multimorbidity among the participants, including coexistence of hypertension and diabetes (support: 12.5%, confidence: 17.6%), hypertension and coronary heart disease (support: 4.4%, confidence: 5.7%), diabetes and coronary heart disease (support: 1.6%, confidence: 5.7%), diabetes, coronary heart disease and hypertension (support: 1.4%, confidence: 4.4%). CONCLUSIONS: A high prevalence of morbidity (especially on hypertension and diabetes) and a relatively low multimorbidity of chronic diseases exist in elderly people. Data mining of residents' health records will help for strengthening the management of residents' health records in community health service centres of Guangzhou, China.

Association between meteorological factors and elderly falls in injury surveillance from 2014 to 2018 in Guangzhou, China.

Introduction: With rapid increase in the aging population, falls injuries have become an important public health problem. However, limited data have been reported on the associations between meteorological factors and falls injuries in the elderly. This study assessed the epidemiology of falls injuries and explored this association in the elderly in Guangzhou, China. Methods: Data on elderly falls injury cases and meteorological variables from 2014 to 2018 in Guangzhou were collected from the Guangzhou Injury Monitoring System and Guangzhou Meteorological Bureau, respectively. The monthly average data on falls injuries and meteorological factors were applied to the data analysis. These correlations were conducted using Pearson correlation analysis. A multiple linear regression model was used to estimate the effects of meteorological factors on falls injuries in the elderly in Guangzhou, China. Results: Accounting for 49.41% of causes of elderly injury were falls in the Guangzhou Injury Monitoring System from 2014 to 2018, which occupied first place for five consecutive years. The monthly number of elderly falls injury cases was lowest in April and highest in December, and had a positive correlation with monthly mean wind speed (r = 0.187, P < 0.01) and a negative correlation with monthly atmospheric pressure (r = -0.142, P < 0.05). A multiple linear regression model was constructed (F = 10.176, P < 0.01), which explained 23.7% of the variances (R 2 = 0.237). Monthly mean wind speed (ß = 76.85, P < 0.01) and monthly mean atmospheric pressure (ß = -3.162, P < 0.01) were independent factors affecting monthly elderly falls injuries. Conclusions: Falls are the primary cause of injury among elderly people in Guangzhou, China. Meteorological factors are related to falls injuries in the elderly population. Decreasing activity during high wind and low atmospheric pressure weather may help reduce the number of elderly falls injury cases.

Loop-mediated isothermal amplification assay targeting the omp25 gene for rapid detection of Brucella spp.

A novel loop-mediated isothermal amplification (LAMP) assay was established to detect Brucella species DNA in milk and blood samples of animals and humans. This LAMP assay based on the sequence of highly repetitive omp25 gene was able to detect 9fg/µl Brucella spp. DNA with high sensitivity, which was 10 times higher than the nested PCR. The LAMP was evaluated for its specificity using 19 strains of six Brucella species and 28 related non-Brucella micro-organism strains as controls. The target 19 Brucella strains were all amplified, and no cross-reaction was found with all the non-Brucella micro-organism strains. Both nested PCR and LAMP assays were then used to detect Brucella spp. DNA in 78 milk samples and 113 blood samples from animals and 11 blood samples from humans, and the established LAMP assay yielded 99.0% concordance rate with the nested PCR. The LAMP assay should be a potential tool with high convenience, rapidity, sensitivity and specificity for the diagnosis of Brucellosis.

Cost-effectiveness analysis of different screening strategies for colorectal cancer in Guangzhou, southern China: a Markov simulation analysis based on natural community screening results.

OBJECTIVES: To evaluate the cost-effectiveness of four different primary screening strategies: high-risk factor questionnaire (HRFQ) alone, single immunochemical faecal occult blood test (iFOBT), double iFOBT and HRFQ+double iFOBT for colorectal cancer (CRC) screening compared with no screening using the Markov model. METHODS: Treeage Pro V.2011 software was used to simulate the Markov model. The incremental cost-effectiveness ratio, which was compared with the willingness-to-pay (WTP) threshold, was used to reflect the cost-effectiveness of the CRC screening method. One-way sensitivity analysis and probabilistic sensitivity analysis were used for parameter uncertainty. RESULTS: All strategies had greater effectiveness because they had more quality-adjusted life years (QALYs) than no screening. When the WTP was ¥435 762/QALY, all screening strategies were cost-effective compared with no screening. The double iFOBT strategy was the best-buy option compared with all other strategies because it had the most QALYs and the least cost. One-way sensitivity analysis showed that the sensitivity of low-risk adenoma, compliance with colonoscopy and primary screening cost were the main influencing factors comparing single iFOBT, double iFOBT and HRFQ+double iFOBT with no screening. However, within the scope of this study, there was no fundamental impact on cost-effectiveness. Probabilistic sensitivity analysis showed that when the WTP was ¥435 762/QALY, the probabilities of the cost-effectiveness acceptability curve with HRFQ alone, single iFOBT, double iFOBT and HRFQ+double iFOBT were 0.0%, 5.3%, 69.3% and 25.4%, respectively. CONCLUSIONS: All screening strategies for CRC were cost-effective compared with no screening strategy. Double iFOBT was the best-buy option compared with all other strategies. The significant influencing factors were the sensitivity of low-risk polyps, compliance with colonoscopy and cost of primary screening.

Computer-Assisted Speech Analysis in Mild Cognitive Impairment and Alzheimer's Disease: A Pilot Study from Shanghai, China.

BACKGROUND: Language dysfunction is a frequently reported symptom in Alzheimer's disease (AD). However, computer-assisted analysis of spontaneous speech in AD and mild cognitive impairment (MCI) is rarely used to date. OBJECTIVE: To characterize the language impairment in AD and amnestic MCI (aMCI) with computer-based automatic analysis via the "Automatic Speech Recognition (ASR) software for cognitive impairment V1.3". METHODS: A total of 64 subjects, including 20 AD patients, 20 aMCI patients, and 24 healthy controls were recruited. All subjects underwent neuropsychological tests, and spontaneous speech samples were recorded through the description of the "Cookie-Theft Picture" and then analyzed by the computerized software. Subsequently, we compared the speech parameters between the subjects and the controls. RESULTS: We identified seven spontaneous speech parameters (percentage of silence duration, average duration of phrasal segments, average duration of silence segments, number of speech segments, number of long pauses, ratio of hesitation/speech counts and ratio of short pause/speech counts) demonstrating significant differences between the three groups (p < 0.05). All seven speech parameters significantly correlated with cognitive performance, with average duration of silence segments demonstrating the best correlation to cognitive performance on stepwise multiple linear regression analysis. CONCLUSION: Computer-assisted automated analysis of speech/silence segments demonstrated the potential to reflect the intrinsic linguistic impairment associated with MCI and AD. It has a promising prospect in the early detection of AD and assessment of disease severity.

[Lead levels in children after 10-year use of unleaded gasoline in Guangzhou municipality].

OBJECTIVE: To investigate the blood lead levels (BLLs) in children after 10-year use of unleaded gasoline in Guangzhou and evaluate the effect of this measure. METHODS: Through stratified random sampling method, 4 kindergartens and 4 elementary schools were selected from each of three districts among 12 districts of Guangzhou. Totally 2373 children were recruited into this survey and 1-2 ml blood was sampled from each child through vein. The lead concentration in blood samples was determined with Inductively Coupled Plasma Mass Spectrometry (ICP-MS) after diluted with 0.1% Triton X-100 and 0.1% HNO(3) in the ratio of 1:20. RESULTS: Among 2373 children, the highest BLL was 330 microg/L, while the lowest was 10 microg/L. Geometric mean (GM) of BLL was 58.28 microg/L with 61.11 microg/L of male and 55.37 microg/L of female (t=8.671, P=0.000). Sixty (2.51%) children were identified as elevated BLLs (>or=100 microg/L), including 36 (2.90%) male and 24 (2.09%) female (chi2=1.594, P=0.207). Compared to the surveys conducted in China 10-year ago, the children with elevated BLLs decreased 96.28% and the GM of BLLs reduced 58.37%. BLLs in suburb children (60.33 microg/L) were higher than those in downtown (58.09 microg/L) or in countryside (56.72 microg/L). CONCLUSION: The BLLs in children and the ratio for children with elevated BLLs, had declined dramatically after 10-year implement of unleaded gasoline in Guangzhou.

Willingness to pay for colorectal cancer screening in Guangzhou.

AIM: To measure the willingness to pay for colorectal cancer screening in Guangzhou, and to identify those factors associated with it. METHODS: A face-to-face questionnaire survey for pre-screening population from free and non-free colonoscopy districts was used to collect information on demographic characteristics, health behaviours, the intention of the cancer screenings and willingness to pay for colorectal cancer screening. A total of 1243 participants who took part in the pre-screening for colorectal cancer in Guangzhou were collected in the study. Categorical data were compared using the χ2 test to analyse significant differences. Non-conditional logistic regression and multi-class logistic regression were also performed for multivariate analysis and to estimate the odds ratios. RESULTS: The percentage of participants willing to pay for colorectal cancer screening was 91.7%. "Unnecessary" was the dominant reason that participants gave for their unwillingness, accounting for 63.1%. Of those who were willing to pay, 29.2%, 20.7%, 14.8%, 13.0% and 22.4% of participants were willing to pay less than \100, \100-\199, \200-299, \300-\399 and more than \400, respectively. Non-logistic regression analysis showed that respondents who were male, had a high level of education, were from the family with more children/older to raise, and accepted colorectal cancer screening were willing to pay for this screening. Multi-class logistic regression analysis showed that respondents with higher annual household income per capita, from government and private enterprises, government agency/institution and peasants, and less family medical expenditure were willing to pay more. CONCLUSION: Willingness to pay for colorectal cancer screening in Guangzhou is high, but the amount of willing to pay is not much.