Optimal therapeutic strategies for pineal region lesions.

Background: The removal of pineal region lesions are challenging, and therapeutic strategies for their removal remain controversial. The current study was conducted to identify the characteristics and the optimal therapeutic strategies for pineal region lesions. Methods: This retrospective study reviewed the treatments of 101 patients with pineal region lesions, and different characteristics and therapeutic strategies were observed. Results: There were no statistical differences in the total resection ratio, complications, and prognosis outcomes between the hydrocephalus group and non-hydrocephalus group, except patients in the hydrocephalus group were younger and pediatric patients had an increased level of intracranial infections. Treatments of lesions and hydrocephalus secondary to pineal region lesions were two integral parts to therapeutic strategies. For the management of lesions, germinoma or non-germinoma were diagnosed preoperatively, and resection or diagnostic radiation were chosen to deal with pineal region lesions. Endoscopic-assisted surgery provided a higher total resection rate. For the management of hydrocephalus, endoscopic third ventriculostomy (ETV) had the better therapeutic effect. Additionally, cerebrospinal fluid (CSF) diversion before radiotherapy or resection did not improve prognosis outcome, but it was necessary for patients with severe hydrocephalus. Logistical regression analysis indicated that age, lesion size, reoperation ratio, and intracranial complications were predictors of prognosis outcome. Conclusion: More attention should be paid to intracranial infections in pediatric patients with hydrocephalus secondary to pineal region lesions, and CSF diversion before radiotherapy or resection did not promote prognosis outcome, but it was necessary for patients with severe hydrocephalus. Age, lesion size, reoperation ratio, and intracranial complications may be the predictors of prognosis outcome. Most importantly, the surgical algorithm for pineal region lesions which was based on preoperatively diagnosis (non-germinoma and germinoma) is useful, especially for developing countries.

The dengue preface to endemic in mainland China: the historical largest outbreak by Aedes albopictus in Guangzhou, 2014.

BACKGROUND: Dengue was regarded as a mild epidemic in mainland China transmitted by Aedes albopictus. However, the 2014 record-breaking outbreak in Guangzhou could change the situation. In order to provide an early warning of epidemic trends and provide evidence for prevention and control strategies, we seek to characterize the 2014 outbreak through application of detailed cases and entomological data, as well as phylogenetic analysis of viral envelope (E) gene. METHODS: We used case survey data identified through the Notifiable Infectious Disease Report System, entomological surveillance and population serosurvey, along with laboratory testing for IgM/IgG, NS1, and isolation of viral samples followed by E gene sequencing and phylogenetic analysis to examine the epidemiological and molecular characteristics of the outbreak. RESULTS: The 2014 dengue outbreak in Guangzhou accounted for nearly 80% of total reported cases that year in mainland China; a total of 37,376 cases including 37,340 indigenous cases with incidence rate 2908.3 per million and 36 imported cases were reported in Guangzhou, with 14,055 hospitalized and 5 deaths. The epidemic lasted for 193 days from June 11 to December 21, with the highest incidence observed in domestic workers, the unemployed and retirees. The inapparent infection rate was 18.00% (135/750). In total, 96 dengue virus 1 (DENV-1) and 11 dengue virus 2 (DENV-2) strains were isolated. Phylogenetic analysis indicated that the DENV-1 strains were divided into genotype I and V, similar to the strains isolated in Guangzhou and Dongguan in 2013. The DENV-2 strains isolated were similar to those imported from Thailand on May 11 in 2014 and that imported from Indonesia in 2012. CONCLUSIONS: The 2014 dengue epidemic was confirmed to be the first co-circulation of DENV-1 and DENV-2 in Guangzhou. The DENV-1 strain was endemic, while the DENV-2 strain was imported, being efficiently transmitted by the Aedes albopictus vector species at levels as high as Aedes aegypti.

Colorectal cancer: using blood samples and tumor tissue to detect K-ras mutations.

We performed a meta-analysis to assess whether blood can be substituted for tumor tissue in K-ras mutation testing. PubMed, EMBASE, MEDLINE, and BIOSIS databases were searched. Twenty-three studies including 1261 patients were included. The pooled overall sensitivity, specificity, and concordance rate were 0.69 (95% CI: 0.59-0.78), 0.96 (95% CI: 0.93-0.97), and 0.86 (95% CI: 0.82-0.89), respectively. Subgroup analysis indicated that plasma (sensitivity: 0.74; mutation rate: 0.34) exhibited superior sensitivity compared with serum (sensitivity: 0.45; mutation rate: 0.24). We conclude that blood is a suitable substitute for tumor tissue in K-ras mutation testing. K-ras mutation positivity in blood can be used to identify patients who should not receive EGFR monoclonal antibody therapy, but the absence of blood positivity does not necessarily imply negativity.

[Meta-analysis on the incidence rates of child sexual abuse in China].

OBJECTIVE: To offer basic data related to the prevention of child sexual abuse, we conducted a Meta-analysis on the national incidence rate on child sexual abuse in the country. METHODS: Publications between 2000 and 2013 were extracted from PubMed, Springer Link, Elsevier-SDOL, Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science & Technology journal database (VIP), Wanfang Databases, China master's Theses Full-text Database and China Conference Papers Full-text Database. Observational studies which containing the incidence rate of child sexual abuse were included. We used the Loney criteria to evaluate the quality of searched publications. The Meta incidence rate was estimated using the Stata software. Subgroup analysis were undertaken on gender issues. Sensitivity analysis were performed to evaluate the impact of types or qualities to the research objects. RESULTS: Fifteen papers were included in this Meta-analysis, with a sample size of 16 682. The combined incidence rate of child sexual abuse was 18.20% (95%CI:13.74%-22.66%). For injured persons, girls had a higher incidence rate on child sexual abuse (11.22%) than boys (8.25%) in terms of contact sexual abuse, but no significant difference on gender was found in the prevalence rates of global and un-contact sexual abuse. Data from sensitivity analysis revealed that the quality or types of the objects slightly affected the incidence rate of traffic injuries. CONCLUSION: of this study indicated that child sexual abuse was common and serious in China, suggesting that prevention and control programs on childhood abuse should be emphasized and promoted.

[Study on the mobile phone dependence syndrome and its distribution among 2213 college students in Guangzhou].

OBJECTIVE: To investigate the occurrence, distribution and risk factors of mobile phone dependence syndrome(MPDS)among college students in Guangzhou. METHODS: A unified questionnaire was adopted, with 2311 college students from 6 universities in Guangzhou investigated by cluster sampling. Distribution and risk factors of MPDS among different groups were analyzed by logistic regression. RESULTS: A total number of 2213 effective questionnaires was retrieved, including 1149 males and 1064 females. The average age was(21.33 ± 1.72). The incidence rate of MPDS among studied college students in Guangzhou was 23.3% (515/2213). Regarding the distribution of personal characteristics, significant differences were found in the following aspects:grades, majors in college, being the only child of the family, monthly cost of living, personal characters and the academic performance at school (P<0.05). Regarding the distribution of characteristics among parents, significant differences were found in the following areas:educational levels of the mother, rearing patterns of both parents, status of feeling on mother's caring(P<0.05)etc. The main risk factors for MPDS were as follows:students major in literature and law, with high monthly living cost, father's autocratic and democratic patterns of rearing, mother's autocratic and doting rearing pattern as well as personal feeling on mother's attitude of unconcern. The incidence of MPDS among those persons with uncertain characters was less than those who were extroverts. CONCLUSION: MPDS among college students seemed to be severe in Guangzhou. No difference was found in the incidence rates of MPDS between genders. Should take interventions according to its risk factors.

[Consciousness and abilities on health emergency and the roles of emergency response among public at the communities].

OBJECTIVE: To evaluate the consciousness of health emergency and the abilities on self- and mutual medical aids among the public at the community level, as well as the community responses on health-related emergencies and other factors. METHODS: Random equidistant sampling method was used to extract 617 households before choosing a family member sampled by Kish Grid method. All the members were investigated face to face on a questionnaire-"Health emergency and related ability regarding self and mutual medical aids of the residents". Data were entered into computer database by using software Epi Data 3.1 and were analyzed by SPSS 21.0. RESULTS: Among the 617 households under survey, 47.84% of the public had general awareness on health-related emergencies. Regarding the following items as:prevention and isolation strategies of infectious disease, on safely procedures of earthquake and fires, on prevention of food poisoning, on prevention and first aid of emerging infectious diseases etc., the rates of awareness were 65.04%, 62.92%, 43.62% and 18.79% respectively. Proportions of households which had the first aid supplies were:first aid medicine box as 56.08%; fire extinguisher as 43.60%; spare water and food as 39.40%; having facilities as ropes, whistles and smoke masks for escape were all less than 15%. Rates of awareness on the following items as: correct use of gas switch as 81.52%, knowing the location of the circuit with gear and the fire hydrant as 74.39% and 35.98% , respectively. The correct disposal rates of the residents on the following items were:electric shock and falls (89.63%), patients of infectious diseases (83.31%), gas poisoning (82.98%), suspected symptoms on infectious diseases(82.66%), explosion and burns (66.78%), scald (62.72%)and sprain (57.05%). Scores on the related abilities were as follows: emergency(7.65, out of 10 points), escape(3.55, out of 5 points), self- and mutual medical aids (10.71, out of 16 points). Proportions of having learned and applied of first aid techniques among residents on the following items were:artificial breathing, chest compressions and cardiopulmonary resuscitation were all less than 10%. Level of knowing the first aid techniques was correlated with age and culture of the residents (P < 0.05). CONCLUSION: Both consciousness on health emergency and the abilities on self- and mutual medical aids were low among the community public, suggesting that both the government and pubic should pay more attention to the role of the abilities on self- and mutual medical aids.

[Status quo and influencing factors of disabilities caused by injury in Guangdong province].

OBJECTIVE: To analyze the epidemiology status and risk factors of disabilities caused by injury in Guangdong province. METHODS: Stratified multi-stage cluster sampling was used to identify 1530 subjects with disabilities (among them, 415 disabilities caused by injury), in the villages or districts in the four regions of Guangzhou, Qingyuan, Zhaoqing and Huizhou in 2010. Subjects were interviewed by trained staff with self-made questionnaires about the status of the disabled, then 415 disabled caused by injury were interviewed about the process of the injury causing disability. The variables in this survey included gender, regions, rural (urban) residences, occupation, age and injury style. The difference of injury were analyzed through χ(2) test, and the influencing factors were explored through classification tree model. RESULTS: The top five causes of disability were road traffic injury, fall, work-related injury, medical accident, scald or burn, accounting for 32.53% (135/415), 21.45% (89/415), 12.77% (53/415), 8.43% (35/415) and 5.06% (21/415), respectively. The proportion of male was higher than female in all disabilities caused by injury (295 male, 117 female, 3 unknown). Female had higher proportion 8.55% (10/117) than male 3.05% (9/295) with the cause of scald or burn (χ(2) = 6.302, P = 0.012), the proportion of rural residents 38.89%(84/216)was also higher than urban residents 25.63% (51/199) in disabilities caused by traffic accident (χ(2) = 43.850, P < 0.001); and the proportion of rural residents 25.46%(55/216)was also higher than urban residents 8.55% (34/199) in disabilities caused by the fall (χ(2) = 8.257, P = 0.004). Different age groups and regions had different types of injury causing disability, 53.08% (69/130) traffic accident and 51.92% (27/52) work-injury mainly caused disability in 25 - 44 age group, 85.71% (30/35) medical accident and 76.20% (16/21) scald or burn mainly caused disability in 0 - 14 age group, the injury caused by the fall was 62.50% (5/8) in 65- age group. The proportions of fall in Qingyuan 29.09% (16/55) and Huizhou 28.23% (37/131) were significantly higher than that in Guangzhou 13.38% (21/157) and Zhaoqing 21.13% (15/71) (χ(2) = 11.904, P = 0.008). The proportions of work-injury in Guangzhou 19.11% (30/157) and Zhaoqing 19.72% (14/71) were significantly higher than that in Qingyuan 0.00% (0/55) and Huizhou 6.09% (8/131) (χ(2) = 22.309, P < 0.001). The proportions of disabled by scald or burn in Guangzhou 10.83% (17/157) and Qingyuan 0.00% (0/55) were significantly higher than that in Zhaoqing 1.41% (1/71) and Huizhou 2.27% (3/131) (χ(2) = 17.826, P < 0.001). Classification tree model revealed that the age group, occupation and urban-rural were major factors influencing intended harm, the highest proportion of the intended harm was in 25 - 44 age group (59.21%, 151/255). CONCLUSION: The road traffic injury, fall, work-related injury, medical accident and scald or burn were main causes of disability in Guangdong province. Gender, age, and urban-rural factors were associated with disabilities caused by injury.

[Analysis on the incidence and risk factors of campus violence among college students in Guangzhou].

OBJECTIVE: To explore the incidence and risk factors of campus violence in Guangzhou. METHODS: 2200 college students in three universities in Guangzhou were selected by cluster sampling method and were interviewed with self-designed questionnaire about the incidence and risk factors of campus violence in 2010. The final analysis sample was 2103. Chi-square test was used to analyze the gender, grade and major distribution of campus violence. Logistic regression method was used to analyze the influencing factors of campus violence in bully and victim. RESULTS: The incidence of campus violence in Guangzhou was 69.9% (1471/2103). In boys and girls the incidence of campus violence was 75.6% (830/1098) and 63.8% (641/1005) (χ(2) = 34.82, P < 0.05). The incidence of bully and victim of campus violence was 63.6%(1338/2103) and 55.3% (1163/2103). The incidence of bully and victim in boys was 70.9%(778/1098) and 60.0%(659/1098), and in girls was 55.7% (560/1005) and 50.1% (504/1005) (χ(2)(bully) = 51.93, χ(2)(victim) = 20.68, P < 0.01). The incidence of psychological violence was the highest (68.0%, 1430/2103), followed by sexual violence (34.2%, 719/2103), the incidence of physical violence was the lowest (16.5%, 348/2103). Results of logistic regression showed that boys (OR = 1.60), arts (OR = 1.82), with siblings (OR = 1.31), the living expenses was not enough (basic enough OR = 1.35, not enough OR = 1.54), playing the computer games (OR = 1.70), playing tricks such as sliding plate (OR = 2.03), loving violence program (general OR = 1.30, very like OR = 1.44), mother with gamble behavior (OR = 4.29), father's indulgent education style (OR = 1.60), been bullied by others before high school (OR = 1.61), dissatisfaction to the environment and rules of campus (nothing special feeling OR = 1.67, some dissatisfaction OR = 1.89), been treated badly by primary school teacher (one kind OR = 1.35, two kinds and above OR = 1.90)were the risk factors of bully. Boys (OR = 1.23), minority (OR = 1.71), with siblings (OR = 1.39), bad behavior and habit (OR = 1.32), the bad family economic conditions (general OR = 1.51, difficult OR = 1.88), mother with gamble behavior (OR = 2.33), father's indulgent education style (OR = 1.37), occasional physical punishment by mother (OR = 1.35), been bullied by others before high school (sometimes OR = 1.61, often OR = 1.85), high pressure during the study (a little high OR = 1.37, very high OR = 1.40), dissatisfaction to the environment and rules of campus (some dissatisfaction OR = 1.56, completely dissatisfaction OR = 2.04), been treated badly by primary school teacher (one kind OR = 1.70, two kinds and above OR = 2.04)were the risk factors of being victim. CONCLUSION: The campus violence in Guangzhou is serious, especially the psychological violence and sexual violence. And the risk factors of campus violence in bully and victim are multifold.

[The relationship between secular trend of road traffic injuries and gross domestic product per capita in China].

OBJECTIVE: To explore the relationship between secular trend of road traffic injuries (RTI) and gross domestic product (GDP) per capita in China. METHODS: Statistical description was used in the data about cases, injuries, deaths, mileage mortality and 10 million population mortality from 1970 to 2009. Cluster analysis was used to classify the 31 provinces, municipalities and autonomous regions in China. Ecological study was used to explore the relationship between RTI and GDP per capita. RESULTS: There were three stages of RTI in China. It grew rapidly in 1970 - 2002 (from 1.16 to 8.52 per 10 million population), kept steady in 2003 - 2004 (from 8.08 to 8.24 per 10 million population), and decreased obviously in 2005 - 2009 (from 7.55 to 5.08 per 10 million population). The ecological study showed that the population mortality of RTI rose along with the GDP per capita's growth. When the GDP per capita reached to 14 053 yuan (equivalent to 1716 US dollar, in 2005), the mortality began to decrease obviously, the average annual decreasing rate was 10.16%(8.14% - 10.52%)in the following five years. According to the GDP per capita during the period of 1999 - 2009, the 31 provinces, municipalities and autonomous regions in China were divided into three categories of region. The curves of population mortality of RTI and GDP per capita in different category possessed the same ecological trend. That was the population mortality early rose and then fell along with the GDP per capita's growth. All of they started to decrease obviously in 2005. The GDP per capita among three categories of region was different (45 281 yuan, 22 243 yuan and 10 475 yuan respectively) in the same period. CONCLUSION: In the early stage of economic development, the mortality of RTI increased along with the economic development. When the economic development reached a certain level, the mortality decreased along with the GDP per capita's growth.

[Survey on the development regarding institution and professional contingence of injury prevention and strategy in China].

OBJECTIVE: To explore the development on infrastructure and professional contingence related to injury prevention and control, in China. METHODS: 38 Centers for Disease Control and Prevention (CDC) were investigated by using a self designed questionnaire and data was analyzed descriptively. RESULTS: At present, all the CDCs at provincial and city level had not set up a specific department related to injury prevention and control, except for Shanghai and Guangxi CDCs. The proportions of full-time and part-time staff in all of the investigated CDCs were 37.30% and 62.70% respectively. From 2005 to 2008, the proportions of CDC which had made funds more than 500 000 Yuan available on injury prevention and control were: 27.78% in the eastern areas, 28.58% in central and 7.69% in the western areas of China. There were 76.92% of the CDCs in the western areas of China that the invested funding was less than 100 000 Yuan in the past years. Most of the routine work that had been carried out in those CDCs were surveillance and public education programs including collection of data and special surveys related to injuries on children, adolescents and the elderly population. 44.44%, and 28.57% of the CDCs in the eastern and central parts of the country wished to establish a Department of injury prevention and control, while 76.92% of the CDCs in the western part expressed their strong request for professional training on injury. CONCLUSION: China remained underdeveloped in the development of institutional and professional team working on injuries which called for, setting up related programs to suit the local needs. In accordance with the working condition, the progress that had been made and the objective demand on institutional and professional contingence of the problems in different areas, both short and medium terms on the issue, need to be put forward to develop both institutional and professional programs on injuries in the eastern, central, and western areas of China.

[Analysis on the mental disorders in the elderly after falling and its influencing factors].

OBJECTIVE: To explore the prevalence and its influencing factors on mental disorders in older people after falling in a community from Guangzhou city. METHODS: 184 people over 60 years of age had ever fallen within the past year in a community, were investigated by structured interview survey on their mental disorders in Guangzhou, with the impact of event scale (IES) and fear fall scale (FFS). Another 56 people over the age of 60 had never fallen at the same time were selected as controls. Data was analyzed by classification tree and logistic regression analysis. RESULTS: IES score showed that there were 8.2% older people suffering from PTSD after falling (average score 16.07 ± 9.52). People who were at older age, with either bad eyesight or hearing, having had injury or decreased activity had higher scores. Results from classification tree analysis showed that decreased activity and helped by others after falling were risk factors of PTSD while not having decreased activity was protective factor. FFS score showed that 58.2% of the older people suffering from FFS after falling (average score 22.29 ± 10.25), people who were at older age, having had bad eyesight or hearing, not living with spouse or children etc. had higher scores while Classification Tree Analysis showed that factors as decreased activity or older than 80 years of age were at risk of FFS. People who did not have decreased activity or their IES score was nine or lower were protective factors. Data from the logistic regression analysis showed that raised by others after falling (OR = 6.20, 95%CI: 1.32 - 29.12) were risk factors of PTSD while older age (OR = 4.62, 95%CI: 1.80 - 11.83; OR = 4.06, 95%CI: 1.39 - 11.87), injury (OR = 6.26, 95%CI: 2.60 - 15.09), higher IES score (OR = 8.75, 95%CI: 3.53 - 21.70;OR = 11.98, 95%CI: 3.88 - 37.02) and decreased activity (OR = 5.26, 95%CI: 2.29 - 12.06) were risk factors of FFS. CONCLUSION: There had been a high incidence of mental disorders after falling among the elderly. Older age and decreased activity were the risk factors in this study.

[Epidemiological study on disability caused by injury in the Chinese population].

OBJECTIVE: To describe and analyze the prevalence and epidemiological features of people with disability caused by injury in the Chinese population, and to provide scientific basis for developing the prevention and control programs on injuries. METHODS: Statistics and intervention measures were used to analyze the data from the Second China National Sample Survey on injury-caused Disability. Cluster analysis was used to analyze the differences in regions. RESULTS: The overall prevalence of disability caused by injury was 99.68/10 000 which occupied 15.59% of all the disability, with multiple disability excluded. Physical disability and hearing disability accounted for 65.59% and 23.35% of all the injury-caused disability respectively, while those ranked Grade IV and III making up the majority (55.14% and 25.83%) of the disability, respectively. There were significant differences in the distribution of injury-caused disability among different age groups (χ(2) = 23 106.14, P < 0.001) and gender (χ(2) = 2161.74, P < 0.001). Ageing and being males having a higher risk on injury-caused disability. Five clusters were identified by cluster analysis, in which injury-caused disability were severe in the fifth (Sichuan province) and the fourth clusters (Hunan, Chongqing, Guizhou, Ningxia province). CONCLUSION: Problems discovered by injury-caused disability in the Chinese population should not be ignored. Both physical and hearing disabilities appeared to be the two main types of disability while age, gender and region were related to injury-caused disability. Targeted strategies should be developed to decrease the injury-caused disability in China.

[Study on the secular trend of road traffic injuries and its influencing factors in China].

OBJECTIVE: To analyze and summarize the secular trend and influencing factors of road traffic injuries(RTI) in China, so as to provide evidence for the management of traffic safety. METHODS: Indexes as fatalities per 10,000 vehicles, fatalities per 100,000 population, fatalities per 10,000 kilometers, motorization(number of vehicles per 1000 population) and mortal coefficient were used. Clustering analysis and ranking correlation were used to analyze the relative factors. RESULTS: The number of casualties of RTI had doubled every decade before the year of 2000. One hundred thousand people were killed in RTI every year since 2000. Facts as: Gross National Product(GNP) of China exceeded 1000 USD in 2002, number of motor vehicles reached 1.3 million in 2005, had both influenced the rates of road traffic fatality, mileage fatality and mortal coefficient which causing them to drop since 2002. In China, RTI happened in the underdeveloped districts in the western part of the country including Tibet, Ningxia, Xinjiang, Qinghai, and in some coastal areas as Zhejiang and Guangdong provinces. Men seemed to be more at risk than women in RTI, and accounted for three-quarters of the victims. Majority of fatalities happened in 21-50 year olds and the fatalities among those over 65 year olds had risen every year. The vulnerable populations in road-user category were pedestrians, passengers, motorcyclists and bicyclists. Under most situations, drivers were responsible for RTI and over half of them were professionals. Bad behaviors were the major causes of RTI, including exceeding the speed limit, handle misfeasance, breaking traffic rules and regulation, having taken alcohol or driving with fatigue etc. Exceeding the speed limit was the most risky factor which causing 75% of the RTI and the traffic deaths increased between 2002 to 2004. A positive correlation was discovered between population fatality rate and the factors as the number of vehicles, volume of road haulage, volume of passengers and the degree of highway etc. with correlation coefficients as r1 = 0.986, r2 = 0.986, r3 = 0.987, r4 = 0.985, P = 0.001, respectively. CONCLUSION: Since 1951, the population fatality rate of RTI had been going up continuously until it began to fall in 2003.