Dual active sites over Cu-ZnO-ZrO2 catalysts for carbon dioxide hydrogenation to methanol.

CO2 hydrogenation to methanol is a significant approach to tackle the problem of global warming and simultaneously meet the demand for the portable fuel. Cu-ZnO catalysts with various kinds of promoters have received wide attention. However, the role of promoter and the form of active sites in CO2 hydrogenation are still in debate. Here, various molar ratios of ZrO2 were added into the Cu-ZnO catalysts to tune the distributions of Cu0 and Cu+ species. A volcano-like trend between the ratio of Cu+/ (Cu+ + Cu0) and the amount of ZrO2 is presented, among which the CuZn10Zr (the molar ratio of ZrO2 is 10%) catalyst reaches the highest value. Correspondingly, the maximum value of space-time yield to methanol with 0.65 gMeOH/(gcat·hr) is obtained on CuZn10Zr at reaction conditions of 220°C and 3 MPa. Detailed characterizations demonstrate that dual active sites are proposed during CO2 hydrogenation over CuZn10Zr catalyst. The exposed Cu0 takes participate in the activation of H2, while on the Cu+ species, the intermediate of formate from the co-adsorption of CO2 and H2 prefers to be further hydrogenated to CH3OH than decomposing into the by-product of CO, yielding a high selectivity of methanol.

A new indolizinium alkaloid from marine-derived Streptomyces sp. HNA39.

A new indolizinium alkaloid, named as cyclizidine J (1), was identified from Gause's liquid fermentation of marine-derived Streptomyces sp. HNA39. Its structure was elucidated by extensive NMR spectroscopic methods, HRESIMS data, and ECD calculations. To our best knowledge, compound 1 was a unique cyclizidine-type alkaloid that contain a chlorine atom substituted at position C-8. Unfortunately, biological evaluation of 1 exhibited no active against PC-3 cancer cell line, BRD4, and ROCK2 protein kinase.

Effectiveness of a short message service intervention to motivate people with positive results in preliminary colorectal cancer screening to undergo colonoscopy: A randomized controlled trial.

BACKGROUND: Colonoscopy adherence among populations at high risk for colorectal cancer (CRC) is crucial for the early diagnosis and treatment of CRC, but the adherence rate has been found to be poor. A short message service (SMS) is effective in promoting cancer screening, but its effectiveness in promoting colonoscopy among populations at high risk for CRC has not been well studied. METHODS: In this randomized controlled trial conducted in Guangzhou, China, participants who had tested positive during preliminary CRC screening (a high-risk factor questionnaire and/or an immunochemical fecal occult blood test) but had not undergone colonoscopy were randomized into low-frequency (monthly) intervention, high-frequency (biweekly) intervention, and control groups. The 2 intervention groups received behavioral theory-based SMS for 6 months. Data were obtained from the CRC screening database. The outcome was undergoing a colonoscopy examination. RESULTS: For the 1362 participants, the rates of colonoscopy adherence were 5.2%, 6.0%, and 10.5% at month 3 and 7.1%, 9.6%, and 13.7% at month 6 in the control, low-frequency intervention, and high-frequency intervention groups, respectively. After adjustments for potential confounders, the high-frequency intervention group was approximately twice as likely as the control group to undergo colonoscopy (adjusted hazard ratio, 1.99; 95% confidence interval, 1.32-3.01), whereas the difference between the low-frequency intervention and control groups was not statistically significant. The cost of SMS to increase colonoscopy uptake by 1 in the high-frequency intervention group was US $2.7. CONCLUSIONS: Text messages sent biweekly for 6 months to patients with positive preliminary screening results could increase colonoscopy adherence. SMS could be a prioritized intervention for promoting colonoscopy in large community-based populations.

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.

Gender difference in association of NEDD4L gene variants among southern Han Chinese with essential hypertension - a population-based case-control study.

Genetic variation of NEDD4L has been associated with hypertension and related phenotypes with conflicting results, probably attributable to gender-, age- and ethnicity-related variations in its phenotypic expression. We evaluated the association of three representative polymorphisms in NEDD4L (rs2288774, rs3865418 and rs4149601) with essential hypertension (EH) in a community-based sample of men (n = 1029) and women (n = 869) belonging to Han Chinese, Southern China, to probe whether gender interacts with NEDD4L in contributing to the risk of EH. In this population sample, rs4149601 was excluded from further analysis due to deviation from Hardy-Weinberg equilibrium. For two other variants tested, the allele frequencies and genotype distributions did not differ between cases and controls (p > 0.05) when both genders were combined. However, sex-stratified analysis revealed that the distribution of the dominant model of rs2288774 (TC + CC versus TT) and the additive and dominant (CT + TT versus CC) models of rs3865418 differed significantly between cases and controls in men (p = 0.044, 0.041 and 0.016, respectively) but not in women. After adjusting for confounding factors, logistic regression analysis showed that rs2288774 and rs3865418 (in the dominant model) were still significantly associated with EH (rs2288774: OR = 0.73, 95% CI = 0.57-0.95, p = 0.017 and rs3865418: OR = 0.71, 95% CI = 0.55-0.92, p = 0.009) in men. There was a significant interaction between the NEDD4L genotype and gender (p for interaction: 0.046 for rs2288774 and 0.033 for rs3865418). Genetic variation in NEDD4L may have sex-dependent effects in the development of EH in Han Chinese. Previous studies that ignore gender-specific effects in their design and interpretation could have failed to identify a uniform conclusion.

Prevalence of noncommunicable diseases and their risk factors in Guangzhou, China.

INTRODUCTION: This article reports on the prevalence of noncommunicable diseases (NCDs) and their risk factors in the city of Guangzhou, China, and shows a trend toward epidemic proportions when municipal data are compared with provincial data. METHODS: We conducted the Guangzhou Community Health Survey in the 12 administrative districts of Guangzhou to learn about NCDs and their risk factors. A community-based, face-to-face survey with a stratified multistage cluster sampling was used. Information was gathered on 27,743 respondents, aged 0 to 108 years, with a male to female ratio of 1 to 1. All participants completed a questionnaire, and those aged 15 years or older had a physical examination. Survey results were compared with the provincial results of the 2002 Guangdong Nutrition and Health Survey (GNHS). RESULTS: The data were weighted to the respondent's probability of selection and to the age- and sex-specific population. Prevalence estimate of self-reported NCDs was 16.0%. Hypertension and diabetes were reported as the most important NCDs. Of those who responded, 6.8% reported having more than 2 chronic conditions. The adjusted prevalence of hypertension decreased by 13.3% since 2002. Awareness, treatment, and control of hypertension and diabetes were improved. The estimated prevalence of current smoking decreased, and the prevalence of former smoking increased from 2002. However, the prevalence of overweight and obesity, especially central obesity, increased. CONCLUSION: Results were encouraging with regard to hypertension and diabetes. However, the unfavorable trends, especially for overweight, central obesity, and passive smoking, call for additional action.

Regulating oxygen vacancies by Zn atom doping to anchor and disperse promoter Ba on MgO support to improve Ru-based catalysts activity for ammonia synthesis.

In heterogeneous catalysis, surface defects are widely regarded as an effective means to enhance the catalytic performance of catalysts. In this study, the oxygen vacancy-rich Mg(1-X)ZnXO solid solution support was successfully prepared by doping a small amount of Zn into MgO nanocrystals. Based on this support, Ru/Ba-Mg(1-X)ZnXO catalyst for ammonia synthesis was prepared. Characterization using TEM, EPR, XPS, and DFT calculations confirmed the successful substitution of Zn atoms for Mg atoms leading to the formation of more oxygen vacancies (OVs). N2-TPD, SEM and TEM analyses revealed that a small amount of Zn had minimal influence on the surface morphology and the size of Ru nanoparticles. The abundance of OVs in the support was identified as the primary factor enhancing the catalytic activity. XPS, H2-TPD and kinetics experiment studies further elucidated the mechanism by which OVs promote the reaction, with OVs serving as an anchor point for the promoter Ba on the MgO support and promoted the dispersion of Ba. This anchoring effect not only enhanced the electron density on Ru, favoring the dissociation of the N[triple bond, length as m-dash]N bond, but also mitigated hydrogen poisoning. As a result,the ammonia synthesis rate reached 1.73 mmol g-1 h-1. Furthermore, the CO2-TPD and H2-TPR analyses indicated that Zn doping effectively promotes the metal-support interaction (MSI) and surface alkalinity. The findings of this study offers valuable insights for the design of defective modified catalyst supports.

Effects of adjunctive Chinese patent medicine on outcome of viral encephalitis in children: A multicenter retrospective study in China.

BACKGROUND: Some patients with viral encephalitis in China seek treatment with Chinese patent medicine (CPM) to improve their symptoms, but few studies have focused on the impact of CPM on the prognosis of viral encephalitis (VE). The aim of this multicenter retrospective study was to assess the benefit of adjunctive CPM therapy on the outcome of children with VE in China. METHODS: This study retrospectively included 834 children with viral encephalitis who were hospitalized at five medical institutions from 2018 to 2021. Univariate and multivariate logistic regression was used to assess the effect of CPM on sequelae in patients with VE. 1:1 propensity score matching was used to exclude the effect of confounding factors. Forest plots were used to observe the effect of CPM on the prognosis of VE in different subgroups. RESULTS: There were fewer patients with sequelae in the group of patients using CPM regardless of whether they were matched or not. The results of multivariate logistic regression analysis showed that the use of CPM was an independent protective factor for the development of sequelae in VE patients (OR = 0.063, 95 % CI: 0.011-0.350, p = 0.002). Subgroup analyses showed that CPM was a protective factor for the development of sequelae regardless of the presence or absence of coma and comorbidities. In addition, we evaluated other outcome indicators and found shorter duration of illness, fever and headache in children with EV in the CPM group. CONCLUSION: Adjunctive CPM therapy may significantly reduce sequelae in children with VE, as well as effectively alleviate patients' clinical symptoms. However, more prospective studies and clinical trials are needed to further evaluate its efficacy and safety.

A functional variant of NEDD4L is associated with obesity and related phenotypes in a Han population of Southern China.

NEDD4L is a candidate gene for hypertension, both functionally and genetically. Recently, studies showed evidence for the association of NEDD4L with obesity, a key intermediate phenotype in hypertension. To further investigate the relationship between NEDD4L and body mass-related phenotypes, we genotyped three common variants (rs2288774, rs3865418 and rs4149601) in a population-based study of 892 unrelated Han Cantonese using the Sequenom MALDI-TOF-MS platform. Allele frequencies and genotype distribution were calculated in lean controls and overweight/obese cases and analyzed for association by the Chi-squared test and Logistic regression. Linear regression analysis was used to analyze the effect of individual genotypes on quantitative traits. Multivariate analyses demonstrated that the minor allele of rs4149601(A = 20.9%) was associated with a 2.60 kg, 2.78 cm and 0.97 kg/m2 decrease per allele copy in weight, waist and BMI, respectively. Carriers of this allele also had a significant lower risk of overweight/obesity (p < 0.0001, OR = 0.52, 95% CI: 0.37-0.74) as compared to non-carriers. However, no significant association between genotypes at rs2288774 and rs3865418 and covariate-adjusted overweight/obesity or any related phenotypes was observed. These results suggested that the functional variant of NEDD4L, rs4149601, may be associated with obesity and related phenotypes, and further genetic and functional studies are required to understand its role in the manifestation of obesity.

Diagnosis of generalized joint hypermobility with gait patterns using a deep neural network.

Generalized joint hypermobility (GJH) describes the situation that the range of joint motion exceeds the normal range. GJH is found to increase the risk of knee-related injury and osteoarthritis, challenging the athletic ability of the population. Gait signals are directly related to hip and knee athletic conditions, and have been shown to have significant changes with GJH by our previous research. But gait data are noisy, and vary with age, gender, weight, and ethnicity, which makes them hard to analyze with traditional statistical methods. In this study, we proposed an end-to-end deep learning model to recognize the patterns of the gait signals. The model consists of convolutional network blocks, residual network blocks, and attention blocks. Our dataset is composed of 452 samples of gait data obtained by a three-dimension motion capture system, with the six-degree-of-freedom kinematic data of hip, knee, and ankle joints during level walking, downhill, and uphill walking. The model achieves 95.77% accuracy and 98.68% specificity with a recall of 76.84% while is more efficient than traditional machine learning methods. The trained model can be run on economical friendly devices, and provide help for immediate and precise diagnosis of GJH. It is also meaningful to consider its application in large-scale GJH screening, which can contribute to sports medicine.

Identification of Distinct Clinical Phenotypes of Heterogeneous Mechanically Ventilated ICU Patients Using Cluster Analysis.

This retrospective study aimed to derive the clinical phenotypes of ventilated ICU patients to predict the outcomes on the first day of ventilation. Clinical phenotypes were derived from the eICU Collaborative Research Database (eICU) cohort via cluster analysis and were validated in the Medical Information Mart for Intensive Care (MIMIC-IV) cohort. Four clinical phenotypes were identified and compared in the eICU cohort (n = 15,256). Phenotype A (n = 3112) was associated with respiratory disease, had the lowest 28-day mortality (16%), and had a high extubation success rate (~80%). Phenotype B (n = 3335) was correlated with cardiovascular disease, had the second-highest 28-day mortality (28%), and had the lowest extubation success rate (69%). Phenotype C (n = 3868) was correlated with renal dysfunction, had the highest 28-day mortality (28%), and had the second-lowest extubation success rate (74%). Phenotype D (n = 4941) was associated with neurological and traumatic diseases, had the second-lowest 28-day mortality (22%), and had the highest extubation success rate (>80%). These findings were validated in the validation cohort (n = 10,813). Additionally, these phenotypes responded differently to ventilation strategies in terms of duration of treatment, but had no difference in mortality. The four clinical phenotypes unveiled the heterogeneity of ICU patients and helped to predict the 28-day mortality and the extubation success rate.

A cardiologist-like computer-aided interpretation framework to improve arrhythmia diagnosis from imbalanced training datasets.

Arrhythmias can pose a significant threat to cardiac health, potentially leading to serious consequences such as stroke, heart failure, cardiac arrest, shock, and sudden death. In computer-aided electrocardiogram interpretation systems, the inclusion of certain classes of arrhythmias, which we term "aggressive" or "bullying," can lead to the underdiagnosis of other "vulnerable" classes. To address this issue, a method for arrhythmia diagnosis is proposed in this study. This method combines morphological-characteristic-based waveform clustering with Bayesian theory, drawing inspiration from the diagnostic reasoning of experienced cardiologists. The proposed method achieved optimal performance in macro-recall and macro-precision through hyperparameter optimization, including spliced heartbeats and clusters. In addition, with increasing bullying by aggressive arrhythmias, our model obtained the highest average recall and the lowest average drop in recall on the nine vulnerable arrhythmias. Furthermore, the maximum cluster characteristics were found to be consistent with established arrhythmia diagnostic criteria, lending interpretability to the proposed method.

A Retrospective Study of Recurrent Bacterial Meningitis in Children: Etiology, Clinical Course, and Treatment.

Objectives: Recurrent bacterial meningitis (RBM) is a rare but life-threatening disease. This study aims to analyze the clinical features, potential causes, and therapeutic outcomes of RBM in children. Methods: This article retrospectively reviews the clinical characteristics, etiologies, and treatments in children with RBM hospitalized in Hebei children's hospital from 2012 to 2020. Results: A total of 10 children with RBM, five males and five females, were included in this study. The age of RBM in children spans from the neonatal stage to the childhood stage. The underlying illnesses were identified and classified as cerebrospinal fluid rhinorrhea (1 case), humoral immunodeficiency with Mondini dysplasia (1 case), common cavity deformity with cerebrospinal fluid ear leakage (1 case), Mondini malformations (2 cases), incomplete cochlear separation type I with a vestibular enlargement (2 cases), local inflammation of the sphenoid bone caused by cellulitis (1 case), congenital skull base defects (1 case), and congenital dermal sinus with intraspinal abscess (1 case). 6 patients chose targeted therapy for potential reasons. Conclusions: Congenital abnormalities or acquired injuries lead to intracranial communication with the outside world, which can quickly become a portal for bacterial invasion of the central nervous system, resulting in repeated infections.

The immunogenicity and safety of vaccination with purified Vero cell rabies vaccine (PVRV) in China under a 2-1-1 regimen.

BACKGROUND: In China, rabies vaccine is only permitted to use under the Essen 5-dose regimen for the rabies post-exposure prophylaxis (PEP). However, Purified chick embryo cell vaccine made in India (Rabipur) has been approved in use under 2-1-1 immune program in 2010. Our objective is to confirm the immunogenicity and safety of PVRV manufactured in China (SPEEDA) under 2-1-1 program, compared with Rabipur and with the Essen 5-dose regimen. METHODS: A total of 112 subjects were divided into three groups: 50 subjects in test group A, 32 subjects in control group B and 30 subjects in control group C. "Zagreb" 2-1-1 program was chosen for group A and B using SPEEDA and Rabipur, "Essen" 5-dose regimen was adopted for group C using SPEEDA, thus to observe the general and local reactions within 72 h post vaccination. Serum samples were also collected at D0, D7, D14 and D45 to determine the rabies serum neutralizing antibody by rapid fluorescent focus inhibition test (RFFIT). RESULTS: All groups showed similar immunogenicity. The neutralizing antibody titers at D14 and D45 of all subjects showed more than 0.5 IU/ml. No moderate and severe adverse effects were observed, though mild adverse reactions may occur. CONCLUSIONS: PVRV (SPEEDA), under 2-1-1 regimen, is equally safe and immunogenic as the PCECV (Rabipur) for post-exposure prophylaxis vaccination.

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.

Synthesis and anticancer evaluation of alpha-lipoic acid derivatives.

alpha-Lipoic acid derivatives were synthesized and evaluated for their in vitro anticancer activities against NCI-460, HO-8910, KB, BEL-7402, and PC-3 cell lines. The results, for most compounds exhibited dose-dependent inhibitory property and several compounds had good inhibitions at the dose of 100 microg/mL. Compound 17 m was further selected for in vivo evaluation against S180 xenograft in ICR mice, which had 24.7% tumor-weight inhibition through intragastric administration of 200mg/kg of body weight. Moreover, the LD(50) in mice for 17 m through ig exceeded 1000 mg/kg of body weight.

Altered spontaneous brain activity in patients with childhood absence epilepsy: associations with treatment effects.

The study aims to detect resting-state functional MRI (RS-fMRI) changes and their relationships with the clinical treatment effects of anti-epileptic drugs (AEDs) for patients with childhood absence epilepsy (CAE) using the fractional amplitude of low-frequency fluctuation (fALFF). RS-fMRI data from 30 CAE patients were collected and compared with findings from 30 healthy controls (HCs) with matched sex and age. Patients were treated with first-line AEDs for 46.2 months before undergoing a second RS-fMRI scan. fALFF data were processed using DPABI and SPM12 software. Compared with the HCs, CAE patients at baseline showed increased fALFF in anterior cingulate cortex, inferior parietal lobule, inferior frontal lobule, supplementary motor area and reduced fALFF in putamen and thalamus. At follow-up, the fALFF showed a clear rebound which indicated a normalization of spontaneous brain activities in these regions. In addition, the fALFF changes within thalamus showed significant positive correlation with the seizure frequency improvements. Our results suggest that specific cortical and subcortical regions are involved in seizure generation and the neurological impairments found in CAE children and might shed new light about the AEDs effects on CAE patients.

How spatial accessibility to colonoscopy affects diagnostic adherences and adverse intestinal outcomes among the patients with positive preliminary screening findings.

BACKGROUND: Colonoscopy is an important procedure for early colorectal cancer (CRC) detection, however, patients with positive preliminary screening results in China may not seek for colonoscopy to confirm the diagnosis. We evaluated the spatial accessibility of colonoscopy among the residents with positive preliminary screening results in Guangzhou, China, and investigated how colonoscopy accessibility was associated with the population adherence and adverse intestinal outcomes. METHODS: This study was based on the Guangzhou community-based CRC screening program. Spatial accessibility was measured using three metrics including travel time from home to nearest colonoscopy hospital, physician-to-population ratio (PPR) and accessibility indicator estimated with enhanced two-step floating catchment area method (E2SFCA). We used Cox regression and logistic regression to assess the association of colonoscopy accessibility with population adherence and adverse intestinal outcomes, respectively. RESULTS: A total of 34 606 people were identified with positive preliminary screening findings. Central areas were reported with higher E2SFCA scores, higher PPR and less travel time. The model adjusting for potential individual level confounders found that PPR > 50 (Hazard Ratio (HR) = 1.88, 95% Confidence Interval (CI): 1.79-1.97) and higher scores of E2SFCA (HR = 3.78, 95% CI: 2.07-6.92) were associated with increased adherence, although estimates were not significant in the model adjusting for both individual and district-level confounders. For adverse intestinal outcomes, the final multilevel logistic model suggested a lower risk of intestinal lesions among the residents in areas with PPR > 50 (Odds Ratio (OR) = 0.49, 95% CI: 0.24-0.99) and higher scores of E2SFCA (OR = 0.20, 95% CI: 0.05-0.82). CONCLUSION: Significant inequality of colonoscopy accessibility was observed across Guangzhou. The increased incidence of intestinal lesions was associated with spatial inequalities of medical resources. Policies against the spatial inequality in medical resources should be developed.

Mass screening for colorectal cancer in a population of two million older adults in Guangzhou, China.

Screening is an effective measure to prevent and control colorectal cancer (CRC). A mass CRC screening programme was conducted in Guangzhou from 2015 to 2017. Public media and reminders from a mobile short message service were used to invite residents aged between 50 and 74 years. A high-risk factor questionnaire (HRFQ) and biennial faecal immunochemical testing (FIT) were chosen as the primary screening methods, and individuals with a positive test result were referred to a defined hospital for an assessment colonoscopy. During the 3 years, 350,581 residents of the total eligible population of 2,283,214 attended the free first stage of screening. In all, 91.0% of the participants finished the HRFQs and FITs. The total uptake rate was 15.4%, which increased with age, female sex, and rural location. There was 15.9% positivity in the first stage of screening, including 8.5% positive HRFQs, 6.2% positive FITs and 1.2% positive HRFQs and FITs. In total, 10,600 individuals with positive HRFQs/FITs completed an assessment colonoscopy. The total uptake rate of colonoscopies was 18.9%, which decreased with age and female sex. Three hundred fifty-one CRCs and 980 advanced adenomas (AAs) were diagnosed with positive predictive values (PPV) of 3.3% and 9.2%, respectively. The PPVs of CRCs in the exclusively FIT-positive population were 4.9%, which was 10 times greater than in the exclusively HRFQ-positive population (0.5%). The PPVs of CRCs and AAs increased with age and male sex. The detection ratio of localized CRCs (including stage I and stage II) increased 68.1% due to screening. Although the compliance rate was low, the PPVs for CRCs and AAs were high. More effective mobilization of the programme's needs and subsidies for colonoscopies should be taken into account to increase compliance.

Breast cancer mortality in Chinese women: does migrant status play a role?

PURPOSE: It is unclear whether migration would affect the mortality risk of breast cancer. In this study, we compared breast cancer mortality among three Chinese populations: Guangzhou (GZ)-born women, Hong Kong (HK)-born women, and HK residents who were born outside HK (HK immigrant), with the aim to explore the impact of migrant status on breast cancer mortality. METHODS: We applied an age-period-cohort model to annual age-specific mortality rates of breast cancer among GZ-born, HK-born, and HK-immigrant women from 2003 to 2016, respectively. We also projected mortality rates from 2017 to 2030. RESULTS: Annual age-standardized mortality rate of breast cancer in women aged 35 years or older was 9.18, 9.17, and 9.83 per 100,000 population, for GZ-born, HK-born, and HK-immigrant women, respectively. A decreasing trend was found in the post-1950s cohorts of GZ-born women and in the post-1960s cohorts of two HK populations. Annual mortality rates of breast cancer in these populations were projected to decrease among the 35-64 years age group and increase among the 65 years and older age group in 2017-2030. CONCLUSIONS: We found higher age-specific mortality rates of breast cancer in HK-immigrant women compared with HK- and GZ-born women, suggesting that immigration status might have an impact on breast cancer mortality.