Analysis of death attributable to smoking and drinking and the influence on life expectancy among residents ≥ 30 years old in Chengdu / 现代预防医学

@#Objective To understand the prevalence of smoking and drinking among residents ≥ 30 years old in Chengdu, and to investigate the death attributable to smoking and drinking and its effect on life expectancy. Methods The data sources were data of the causes of death of residents in the 2018 Sichuan Health Statistical Yearbook, the health survey data of Chengdu residents in the natural population cohort in southwest China, and the data of smoking and drinking related diseases and their relative risk in the global disease burden of the World Health Organization. The counterfactual attribution method was used to calculate the number of attributable deaths and life expectancy loss caused by smoking and drinking. Results The life expectancy of 30-year-old residents in Chengdu was 53.91 years (51.52 years for males and 56.48 years for females). The total number of deaths attributed to smoking was 14 370, with chronic obstructive pulmonary disease (4 926), lung cancer (4 234), and esophageal cancer (1 578) ranking the top three. The total number of deaths attributed to drinking was 2 185, among which cerebrovascular disease, esophageal cancer, and liver cirrhosis were the three leading causes of death attributable to drinking. The loss of life expectancy caused by smoking was 2.03 years (3.47 years for males and 0.39 years for females), and the loss caused by drinking was 0.28 years (0.48 years for males and 0.04 years for females). Conclusion Smoking and drinking cause a great loss of life expectancy of Chengdu residents and impose a huge disease burden on the death from respiratory system, digestive system, cardiovascular and cerebrovascular diseases.

Vagus Nerve Stimulation for Pediatric and Adult Patients with Pharmaco-resistant Epilepsy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Over past two decades, vagus nerve stimulation (VNS) has been widely used and reported to alleviate seizure frequency worldwide, however, so far, only hundreds of patients with pharmaco-resistant epilepsy (PRE) have been treated with VNS in mainland China. The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.</p><p><b>METHODS</b>We retrospectively assessed the clinical outcome of 94 patients with PRE, who were treated with VNS at Beijing Fengtai Hospital and Beijing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients. The clinical data analysis was retrospectively examined.</p><p><b>RESULTS</b>Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve. At last follow-up, we found McHugh classifications of Class I in 33 patients (35.1%), Class II in 27 patients (28.7%), Class III in 20 patients (21.3%), Class IV in 3 patients (3.2%), and Class V in 11 patients (11.7%). Notably, 8 (8.5%) patients were seizure-free while ≥50% seizure frequency reduction occurred in as many as 60 patients (63.8%). Furthermore, with regard to the modified Engel classification, 12 patients (12.8%) were classified as Class I, 11 patients (11.7%) were classified as Class II, 37 patients (39.4%) were classified as Class III, 34 patients (36.2%) were classified as Class IV. We also found that the factors of gender or age are not associated with clinical outcome.</p><p><b>CONCLUSIONS</b>This comparative study confirmed that VNS is a safe, well-tolerated, and effective treatment for Chinese PRE patients. VNS reduced the seizure frequency regardless of age or gender of studied patients.</p>

A molecular classification system for anaplastic glioma / 中华外科杂志

<p><b>OBJECTIVE</b>To project a new molecular classification system for anaplastic gliomas based on the molecular biomarkers.</p><p><b>METHODS</b>There were 161 patients with histological diagnosis of primary anaplastic gliomas after operation and complete and reliable follow-up data were enrolled in the study from May 2009 to June 2011. A total of 100 male and 61 female patients with a median age of (43 ± 12) years (range: 17-68 years). After the pathology review by 2 experienced neuro-pathologists, 36 anaplastic oligodendroglioma (AO), 66 anaplastic oligoastrocytoma (AOA) and 59 anaplastic astrocytoma (AA) were confirmed. There were 116 patients underwent gross-total resection, 37 sub-total resection and 8 partial resection. Molecular biomarkers evaluated included 1p/19q, IDH1 gene and O6-methylguanine-DNA-methyltransferase (MGMT). Kaplan-Meier plots were compared by Log-rank method.</p><p><b>RESULTS</b>The survival analysis results showed that the 6-month, 12-month, 18-month and 24-month progression-free survival (PFS) and overall survival (OS) rates of AO was significantly longer than AOA(χ(2) = 12.812 and 6.557, P < 0.05) and AA (χ(2) = 19.125 and 10.206, P < 0.05), but no significant difference of prognosis was observed between AOA and AA (P > 0.05). According to the status of biomarkers, AOA was reclassified into two subgroups-AOA1 and AOA2. AOA1 with 1p/19q co-deletion, IDH1 mutation and/or negative MGMT expression showed similar prognosis with AO (P > 0.05). AOA2 without any biomarkers showed similar prognosis with AA (P > 0.05). Besides, the 6-month, 12-month, 18-month and 24-month PFS and OS rates of patients with AO and AOA1 was significantly longer than patients with AA and AOA2 (PFS:χ(2) = 25.180, P < 0.001; OS: χ(2) = 15.649, P < 0.001). Multivariate analysis showed that the moecular pathology subtypes classified was an independent prognostic factor (PFS: OR = 0.499, 95% CI:0.381-0.653, P < 0.001; OS:OR = 0.605, 95% CI:0.450-0.814, P = 0.001).</p><p><b>CONCLUSIONS</b>The molecular classification system for anaplastic gliomas will be helpful in estimating patients' prognosis and guiding reasonable therapy for patients with anaplastic gliomas.</p>

The dose-response relationship of chrysotile asbestos exposure and lung cancer in cohort study / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To clarify the dose-response relationship between asbestos dust exposure and lung cancer incidence in chrysotile asbestos miners by fixed cohort study and to investigate the incidence rates of lung cancer in exposure to different concentrations of asbestos dust.</p><p><b>METHODS</b>A retrospective cohort study was conducted in 1932 asbestos miners who registered from January 1, 1981 to December 31, 1988, had worked for at least 1 year, and had no obvious cardiopulmonary diseases; the cohort study began in July 2009 and covered a time span of 29 years (1981 - 2009). The personal information, occupational history, disease history, and health data of these miners were recorded, and the monitoring data on dust concentrations in the mine over the years were collected. The dose-response relationship between asbestos dust concentration and lung cancer incidence was established by the method of life table; a regression equation was fitted to predict the excess incidence rates of lung cancer under the conditions of different working years and dust concentrations.</p><p><b>RESULTS</b>A significant dose-response relationship was observed between cumulative exposure (Ce) and cumulative probability (Px) of lung cancer incidence, and the smokers hada higher Px than nonsmokers. When Ce was less than 2000 mg/m(3)·each year, Px reached 6.58/10000; when Ce was not less than 2000 mg/m(3)·and less than 3000 mg/m(3)·each year, Px reached 91.72/10000; when Ce was more than 5000 mg/m(3)·each year, Px was as high as 141.02/10000. The three models were fitted to obtain the optimal regression equation: Px = -0.0004Ce(2) + 0.0052Ce - 0.0011 (r(2) = 0.9387). In the workshop of asbestos mine in this study, the average dust concentration was 85 times higher than the limit in 2009, so the excess incidence rate of lung cancer was 112.598/10000 if the miners worked under this condition for 40 years, according to the equation.</p><p><b>CONCLUSION</b>There is a significant dose-response relationship between cumulative asbestos exposure and lung cancer incidence in chrysotile asbestos miners. The risk for lung cancer rises as asbestos exposure increases.</p>

Characteristics of combining loss of heterozygosity of 1p/19q in glioma / 中华外科杂志

<p><b>OBJECTIVES</b>To find possible factors correlated with combined loss of heterozygosity (LOH) of 1p and 19q.</p><p><b>METHODS</b>The status of 1p and 19q of 138 glioma specimen from January 2009 to December 2009 was evaluated by Fluorescence in situ hybridization (FISH) method, and the frequencies of combining LOH of 1p/19q were compared between different pathologies, brain sub-regions, genders and ages.</p><p><b>RESULTS</b>The frequencies of combined LOH of 1p and 19q of oligodendroglial (81.3%) and oligo astrocytic tumors (55.8%) were significantly higher than that of astrocytic tumor (22.2%) (P < 0.01), and the frequency of oligodendroglial tumor was significantly higher than that of oligo astrocytic tumor (P < 0.05). The frequency of combining LOH of 1p and 19q in frontal lobe (61.8%) was higher than that in temporal (31.8%) and insular lobes (34.6%) (P < 0.05).</p><p><b>CONCLUSION</b>Combining LOH of 1p and 19q has significant correlation with the pathologies and brain sub-regions.</p>

An eight-year study on maternal and child health service utility in Sichuan province / 中华流行病学杂志

Objective To evaluate the effect of intervention on factors influencing the health service utility regarding Maternal and Child Health (MCH)under the 'Qinba Health Project' in Sichuan province. Methods 15 towns in 5 programmed counties were selected, using the method of 'random layer sampling' to be the trial group. With similar MCH status and comparable to the trial group, another 9 towns in 3 non-programmed counties were chosen as the control group, using the same sampling method. Indicators on MCH service utility were compared with that in the control group, and the influencing factors of MCH service utility analyzed by logistic model. Results The main characteristics of the two groups were quite similar at the baseline study, with the average annual family incomes and MCH service per 1000 people. Annual input on MCH services from the government had an distinct increase. The average annual rates of increase regarding the indictors as clean delivery, hospitalized delivery, systematic care on maternal and children, maternal and infant mortality rates were: 1.95%, 9.34%, 4.82%, 3.04%, -2.67%, -13.84% (P<0.02) through χ2 trend tests. In the trial group, the changes seen in the 6 indicators were better in the control group than in the control group(P<0.05). Data from the logistic regression model showed that the major influencing factors on the use of hospitalized delivery service were: age of the pregnant woman, average annual income of the family, health insurance status, number of pre-delivery visits, whether on poverty alleviate program, and on knowledge of MCH. Conclusion The intervention project in this programmed area seemed effective and better than the non-programmed area, through an eight-year observation.

The expression of growth hormone release factor gene carried with PLGA microspheres in muscle tissue and its effect on mouse growth / 生物工程学报

Injectable sustained-release pcDNA3-GRF (1-32) microspheres were prepared by double emulsion-in liquid evaporation process,using biodegrable poly lactic-co-glycolic acid as carrier. The enrapment efficiency, mean particle size, drug content thus prepared were 69%, 2.20 microm, 8% and 70% respectively. The result of transfection in vivo showed that after 30 days, accumulative increased body weights on the group injected with pcDNA3-GRF (1-32) microspheres was significantly higher than those group injected with naked plasmid (12.87%), plasmid-empty microspheres (19.72%) and saline (58.58%) respectively. PCR and RT-PCR showed that the expression level of GRF gene on the group injected with pcDNA3-GRF (1-32) microspheres was the highest. GRF gene released by microspheres was still detected after 30 days. In conclusion, pcDNA3-GRF (1-32) microspheres have a controlled release effect and GRF gene could be successfully transfected into muscle cells of mouse by microspheres with higher efficacy and stronger biological function.

Quantitative assessment of risks for coronary heart diseases in urban residents in Sichuan / 中华预防医学杂志

<p><b>OBJECTIVE</b>To set a quantitative criteria for determining risk for coronary heart disease (CHD) so that potential risk of an individual dying from CHD can be identified and to lay a foundation for predicting individual risk of CHD.</p><p><b>METHODS</b>Data of case-control and cohort studies published during 1978 to 2002, as well as data of surveillance of behavior exposure in Sichuan province, were collected by retrieval of literatures. Pooled odds ratios (OR) and relative risks (RR) of all risk factors for CHD were estimated using various statistical models with software for meta-analysis, and attributable risk fractions of varied levels of risk factors could be converted.</p><p><b>RESULTS</b>A risk score conversion table (quantitative criteria for assessment) of main risk factors for CHD were developed for men and women aged 15 - 69 at an interval of five years, including smoking, passive smoking, hypertension, high blood cholesterol level, body mass index, lack of physical activity, alcohol drinking, past history of diabetes, and family history of CHD and hypertension. Individuals with all these risk factors had a risk score beyond 1.00, and risk score for those without them was equal to or below 1.00, which would increase with rise in one's risk level.</p><p><b>CONCLUSIONS</b>Estimation of risk of dying from CHD was based on risk score conversion table of risk factors for CHD, which could be used to predict individual potential risk of dying from CHD in the following 10 years. It lays a foundation for health education to persuade people to change their unhealthy lifestyles and behaviors, and could be used in community health services.</p>

Quantitative assessment of risks on cerebral vascular diseases in urban residents in Sichuan / 中华流行病学杂志

<p><b>OBJECTIVE</b>To set a quantitative criteria for determining the risks on cerebral vascular disease (CVD) so to identify that potential risk of an individual dying from CVD and to predict the individual risk of CVD.</p><p><b>METHODS</b>Data on case-control and cohort studies published during 1978 to 2003 was collected through retrieval of literatures, and data on surveillance of behavior exposure was provided by Chengdu Municipal Center for Disease Control and Prevention. Pooled odds ratio (OR) and relative risk (RR) of all risk factors for CVD were estimated using software for meta-analysis to enable the varied levels of risk factors be converted into risk fractions by statistical models.</p><p><b>RESULTS</b>A risk score conversion table (quantitative criteria for assessment) of main risk factors for CVD was developed for men and women aged 35 - 69 at an interval of five years, including smoking, passive smoking, hypertension, high blood cholesterol levels, body mass index, lack of physical activity, alcohol drinking, dietary fat consumption, milk intake, oral contraceptive use, past history of diabetes and CVD, family history of CVD etc. Individuals with all these risk factors had a risk score beyond 1.00, but was equal to or below 1.00 when without. The risk score would increase along with the rise of one's risk level.</p><p><b>CONCLUSION</b>Estimation of risk of dying from CVD was based on risk score conversion table of risk factors for CVD, which could be used to predict individual potential risk of dying from CVD in the following 10 years. Our data provides evidence that education to be strengthened to persuade people to change their unhealthy lifestyles and behaviors.</p>