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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 47-53, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914569

RESUMO

Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion: The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Alfabetização em Saúde/estatística & dados numéricos , Neoplasias/prevenção & controle , População Urbana , Adolescente , Adulto , China , Estudos Transversais , Feminino , Humanos , Masculino , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 54-61, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914570

RESUMO

Objective: To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years. Results: The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (P<0.05). Compare with residents with annual household income less than 20 000 CNY in 2014, cancer risk assessment/screening intervention population, and self-assessment with cancer risk, residents with annual household income between 20 000 CNY and 59 000 CNY in 2014, occupational population, community residents, cancer patients, self-reported cancer-free risk, and self-assessment with unclear judgement of cancer risk were less likely to participate in the regular physical examination (all P values <0.05). Conclusion: From 2015 to 2017, the Chinese urban residents had a acceptable consciousness of the cancer early detection. The marital status, annual household income, population group and self-assessment of cancer risk were related to the consciousness of the cancer early detection of people who had not participated in the regular physical examination in the past five years.


Assuntos
Detecção Precoce de Câncer/psicologia , Conhecimentos, Atitudes e Prática em Saúde , População Urbana , Adolescente , Adulto , China , Estudos Transversais , Humanos , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
3.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 62-68, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914571

RESUMO

Objective: To understand the consciousness of the cancer early diagnosis among urban residents and identify the related factors from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The general demographic characteristics, the consciousness of the cancer early diagnosis (whether people would have a willingness or encourage their relatives/friends to confirm the abnormal results once which were detected from the physical examination) and other information were collected by using the self-designed questionnaire. The non-conditional logistic regression model was used to identify the relateol factors related to the consciousness of the cancer early diagnosis. Results: As for residents with abnormal result from the physical examination, 89.29% (28 802) of residents would choose to seek medical treatment for further diagnosis. If their relatives/friends had abnormal results from the physical examination, 89.55% (28 886) of residents would encourage their relatives/friends to confirm the diagnosis in time. The non-conditional logistic regression model analysis showed that compared with the public institution staff/civil servants, annual household income less than 20 000 CNY, the western region and the cancer risk assessment/screening intervention population, the company staff, annual household income about 40 000 CNY and more, and the residents from the middle and eastern region had a stronger consciousness to seek further diagnosis; while the unemployed residents and community residents were less likely to seek further diagnosis (P<0.05). Conclusions: From 2015 to 2017, the Chinese urban residents had a good consciousness of the cancer early diagnosis. Occupation, annual household income, residential region and population group were related to the consciousness of the cancer early diagnosis.


Assuntos
Detecção Precoce de Câncer/psicologia , Conhecimentos, Atitudes e Prática em Saúde , População Urbana , Adolescente , Adulto , China , Estudos Transversais , Humanos , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 69-75, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914572

RESUMO

Objective: To understand the consciousness of the cancer early treatment and its demographic and socioeconomic factors. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The questionnaire collected personal information, the consciousness of the cancer early treatment and relevant factors. The Chi square test was used to compare the difference between the consciousness of the cancer early treatment and relevant factors among the four groups. The logistic regression model was used to analyze the influencing factors related to the consciousness of the cancer early treatment. Results: With the assumption of being diagnosed as precancer or cancer, 89.97% of community residents, 91.84% of cancer risk assessment/screening population, 93.00% of cancer patients and 91.52% of occupational population would accept active treatments (P<0.001). If the immediate family members were diagnosed as precancer or cancer, people who would encourage their family members to receive early treatment in the four groups accounted for 91.96%, 91.94%, 92.44% and 91.55%, respectively (P<0.001). The company employees, annual household income with 40 000 yuan and more and other three groups had a relatively better consciousness of the cancer early treatment (P<0.05). Male, widowed, unemployed and from the central and western regions had a relatively worse consciousness of the cancer early treatment (P<0.05). Conclusion: Residents in urban China participants had a good consciousness of the cancer early treatment. The marital status, occupation, annual household income and residential regions were major factors related to the consciousness of the cancer early treatment.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias/terapia , Tempo para o Tratamento/estatística & dados numéricos , População Urbana , Adolescente , Adulto , China , Estudos Transversais , Feminino , Humanos , Masculino , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
5.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 76-83, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914573

RESUMO

Objective: To understand the health literacy of the cancer prevention and treatment among urban residents of China, and explore the related factors. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The health literacy of the cancer prevention, early discovery, early diagnosis, early treatment and the demands of cancer prevention and treatment knowledge was analyzed. The level of health literacy among different groups were calculated and compared. The binary logistic regression model was used to analyze the influencing factors of the health literacy of the cancer prevention and treatment. Results: The level of health literacy of the cancer prevention and treatment was 56.97% among all study population; in each group it was 55.01% for community residents, 59.08% for cancer risk assessment/screening population, 61.99% for cancer patients and 57.31% for occupational population, respectively (P<0.001). The level of health literacy of the cancer prevention and treatment of residents aged 50 to 69 years old, other occupational groups, unmarried, the central and western region residents and the group with unclear self-assessment of cancer risk was significantly lower than that of residents younger than 40 years old, personnel of public institutions/civil servants, married, the eastern region residents and the group whose self-assessment without cancer risk (P<0.05) . The level of health literacy of cancer prevention and treatment of females, people who went to high school or over, cancer risk assessment/screening population, cancer patients and occupational population was significantly higher than that of males, people who had an education level of primary school or below and community residents (P<0.05) . Conclusion: The health literacy of the cancer prevention and treatment of urban residents in China was relatively high, but there was still room for improvement. Gender, age, educational level, occupation, region, marital status, self-assessment of cancer risk, and type of respondents were the key influencing factors of the health literacy of the cancer prevention and treatment. Male, 50-69 years old, lower educational level, central and western regions, unclear cancer risk self-assessment, and without specific environmental exposure to cancer prevention and treatment knowledge or related risk factors were the characteristics of the key intervention group of the health literacy of the cancer prevention and treatment.


Assuntos
Alfabetização em Saúde/estatística & dados numéricos , Neoplasias/prevenção & controle , População Urbana , Adolescente , Adulto , Idoso , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
6.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 84-91, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914574

RESUMO

Objective: To investigate the demand and access to the cancer prevention and treatment knowledge and related factors among urban residents in China from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of general demographic characteristics, the demand and access to cancer prevention and treatment knowledge, and the influencing factors of the attitude. The Chi-square test was used to analyze the difference of the demand of the cancer prevention knowledge among different groups and the corresponding factors of the cancer prevention and treatment knowledge were analyzed by using the logistic regression model. Results: The proportion of residents who need the cancer prevention and treatment knowledge was 79.5%. The demand rate of the inducement, symptom and diagnosis methods of cancer in the occupational population was highest, about 66.8%, 71.0% and 20.8%, respectively. The demand rate of treatment methods and cost in current cancer patients was the highest, about the 45.9% and 21.9%, respectively. The top three sources to acquire the cancer prevention and treatment knowledge were "broadcast or television" (69.5%), "books, newspapers, posters or brochures" (44.7%) and "family and friends" (33.8%). The multivariate analysis showed that compared with public institution personnel/civil servants, unmarried/cohabiting/divorced/widowed and others, annual household income less than 20 000 CNY, from the eastern region, people without cancer diagnosis and people with self-assessment of cancer risk, the demand rate of cancer prevention and treatment knowledge was higher in enterprise personnel/workers, married, annual household income between 60 000 CNY and 150 000 CNY, from the central region, people with cancer and people with unclear cancer risk (all P values <0.05). Conclusion: There was a high demand for the cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017. The main access to the knowledge is from the radio or television. The occupation, marital status, annual household income, residential region, health status and risk of disease were the main factors of the demand of the cancer prevention and treatment knowledge.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Neoplasias/prevenção & controle , População Urbana , Adolescente , Adulto , China , Estudos Transversais , Humanos , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1426-1431, 2019 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-31838816

RESUMO

Objective: To analyze the epidemiological characteristics of hepatitis E Virus antibody (anti-HEV) in people aged 1-29 years in China in 2014. Methods: Based on database of the national serologic survey of hepatitis B in people aged 1-29 years in China, in 2014, the sample size was estimated. The serum samples of the people surveyed were randomly selected to detect anti-HEV IgG by using enzyme- linked immunosorbent assay (ELISA). Statistical software SAS 9.1.3 was used to calculate the positive rate of anti-HEV and 95% confidence interval (CI) in different age, gender groups, urban and rural areas and geographic areas by using the Taylor series linear method with sampling weight. The difference was determined by comparing 95%CI. Results: A total of 14 106 serum samples were detected from people aged 1-29 years, including 6 996 males (49.60%), 7 013 urban residents (49.72%). The positive rate of anti-HEV was 8.12%(95%CI: 7.19-9.15) in people aged 1-29 years. There was no statistical difference between the men and women, between urban area and rural area. The positive rates of anti-HEV in western area(11.36%, 95%CI: 9.45-13.62) was higher than those in eastern and central areas. The positive rates of anti-HEV were 2.46%, 2.24%, 4.50%, 7.58%, 11.89% and 17.27% in people aged 1-, 5-, 10-, 15-, 20- and 25-29 years, respectively. As the age increased, the positive rate of anti-HEV gradually increased. In different ethnic groups, the positive rate of anti-HEV was higher in Tibetan (18.32%, 95%CI: 12.02-26.90), Zhuang (9.54%, 95%CI: 4.33-19.73) ethnic groups. Conclusion: The positive rate of anti-HEV declined slightly in China in 2014. It is still necessary to pay close attention to the HEV infection, morbidity of hepatitis E and risk factors in people aged 1-29 years.


Assuntos
Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/isolamento & purificação , Hepatite E/epidemiologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Anticorpos Antivirais/sangue , Criança , Pré-Escolar , China/epidemiologia , Ensaio de Imunoadsorção Enzimática , Estudos Epidemiológicos , Feminino , Hepatite E/sangue , Hepatite E/imunologia , Vírus da Hepatite E/imunologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Lactente , Masculino , Inquéritos e Questionários , Proteínas Virais/imunologia , Adulto Jovem
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(4): 382-387, 2019 Apr 06.
Artigo em Chinês | MEDLINE | ID: mdl-30982272

RESUMO

Objective: To analyze the changing epidemiological characteristics of hepatitis E cases in China, in order to promote in preventing and controlling hepatitis E. Methods: Data of hepatitis E and outbreaks reported through national notifiable diseases reporting system were analyzed from 2004 to 2017, but data of Hongkong, Macau and Taiwan were not included. Data of hepatitis E were divided into three phases as 2004-2007, 2008-2011 and 2012-2017, representing eight years before, four years before and years after the postmarketing of hepatitis E vaccine. Linear regression was used for analyzing the trend of hepatitis E, improved muster method was used for analyzing the seasonal intensity. Results: From 2004 to 2017, 329 519 hepatitis E cases were reported and the annual incidence were increasing from 1.27/100 000 to 2.10/100 000 (t=6.87, P<0.001). The concentrations of hepatitis E during 2004-2007, 2008-2011 and 2012-2017 were 17.43, 16.06, 11.17, respectively, with low seasonal intensity. Number of cases reported by Jiangsu, Guangdong and Zhejiang accounted for 31.54% of national cases. The incidence were lower in central (1.45/100 000) and western (1.11/100 000) region than that in eastern region (2.67/100 000), but were increasing continuously. There was an increasing trend of incidence with growing ages (t=7.85, P<0.001). The incidence was higher than 2/100 000 among cases aged ≥40, and was the highest (5.22/100 000) in the age group of 65-69 years old. Farmers, retired persons, houseworkers and unemployees accounted for 67.46% of total cases. A total of 7 outbreaks were reported, among which 3 were in nursing homes. Conclusion: The incidence of hepatitis E in central and western regions were increasing continuously and the surveillance should be strengthened. There was higher risk among middle-aged population, farmers and nursing homes, so strategy for immunization among those population was in great need.


Assuntos
Surtos de Doenças/prevenção & controle , Vírus da Hepatite E , Hepatite E/epidemiologia , Imunização/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Vacinas contra Hepatite Viral/administração & dosagem , Adolescente , Adulto , Idoso , China/epidemiologia , Feminino , Hepatite E/prevenção & controle , Hepatite E/terapia , Humanos , Programas de Imunização , Incidência , Masculino , Pessoa de Meia-Idade , Vigilância da População , Adulto Jovem
10.
Beijing Da Xue Xue Bao Yi Xue Ban ; 50(6): 1039-1043, 2018 Dec 18.
Artigo em Chinês | MEDLINE | ID: mdl-30562778

RESUMO

OBJECTIVE: To comprehend clinical features and patient's physician visit patterns at onset of immunoglobulin G4 related disease (IgG4RD). METHODS: In the study, 100 patients with IgG4RD who received treatments in the Department of Rheumatology and Immunology of Peking University People's Hospital from Apr. 1st, 2017 to Apr. 1st, 2018 were investigated, including gender, age, height, body weight, age of onset, physician visit history, primary history and how did the disease affected their life, etc. RESULTS: In this 100 IgG4RD cohort (57 males and 43 females), the male/female ratio was 1:0.75, the mean age of onset was (51.51±12.9) years, and the median duration was 49 months (ranging from 4 to 231 months). The onset age of males was significantly older than that of females (P<0.01). The manifestations showed that up to 69% patients had submaxillay glands lesion, 59% patients had lacrimal glands lesion, 28% patients had pancreas involvement and 28% patients had parotid glands involvement. The females had more lacrimal glands involvement (P<0.05). 62% patients were complicated with anaphylactic disease. The primary physician visit departments concentrated upon general surgery department (19/100), oral and maxillofacial surgery department (17/100), rheumatology and immunology department (16/100), ophthalmology department (15/100) and gastroenterology department (10/100). The departments where the confirmed diagnose was made concentrated upon rheumatology department (67/100),oral and maxillofacial surgery department (16/100) and gastroenterology department (7/100). The mean diagnosis duration after 2010 was (16.96±2.163) months, significantly shorter than that before 2010, which was (113.3±11.01) months. Before the definite diagnose was made, 43% patients underwent surgeries and 12% patients had more than one time surgeries. The patients whose first-visit department was a surgery department were more likely to undergo surgeries (P<0.01). 18% patients (18/100) stated that the disease had affected their work. CONCLUSION: In this cohort of the IgG4RD patients, female is common and has earlier onset age than male. The major manifestations of IgG4RD are salivary glands, lacrimal glands and pancreas involvement. The common chief complains are salivary glands and lacrimal glands enlargement. Accompanied by anaphylactic disease is a marked manifestation of this disease. Delayed diagnoses are not rare, though this situation has been improved since 2010, and more attention still should be paid to the disease.


Assuntos
Diagnóstico Tardio , Doença Relacionada a Imunoglobulina G4 , Adulto , Idade de Início , Idoso , China , Estudos Transversais , Feminino , Hospitais Públicos , Humanos , Imunoglobulina G/análise , Doença Relacionada a Imunoglobulina G4/complicações , Doença Relacionada a Imunoglobulina G4/diagnóstico , Doença Relacionada a Imunoglobulina G4/terapia , Aparelho Lacrimal/patologia , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Glândulas Salivares/patologia
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(10): 1351-1355, 2018 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-30453436

RESUMO

Objective: Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination, to promote the recommendation profile on Hepatitis E vaccination program, in China. Methods: Three phases of time span were divided as 2004-2007, 2008-2011 and 2012-2015, with age groups divided as <20, 20-29, 30-39 and ≥40. Incidence rates in both different phases and age groups were compared. Numbers of Hepatitis A and E vaccines released and used, were described. Results: Between 2004 and 2015, a declining trend in the reported incidence of hepatitis A (t=-12.15, P<0.001), but an increasing trend in hepatitis E (t=6.63, P<0.001) were noticed. The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015. The peaks of hepatitis E appeared persistent annually, in March. The incidence of hepatitis A declined in three regions, with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (χ(2)=32 630, P<0.01). The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000), but more in the eastern region (2.66/100 000) (χ(2)=6 009, P<0.01). Incidence of hepatitis A declined in all age groups and declined by 84.36% among the 0-19 group. However, the incidence of hepatitis E showed an increasing trend among the ≥20 group. Incidence rates appeared higher in the older age groups. The coverage of hepatitis A vaccine increased from 62.05% to 93.54%, but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69, χ(2)<0.05). Conclusion: The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004 to 2015, calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.


Assuntos
Vacinas contra Hepatite A/administração & dosagem , Hepatite A/epidemiologia , Hepatite E/epidemiologia , Imunização/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Idoso , China/epidemiologia , Pesquisas sobre Serviços de Saúde , Humanos , Programas de Imunização , Incidência , Pessoa de Meia-Idade , Vigilância da População , Adulto Jovem
12.
Zhonghua Xue Ye Xue Za Zhi ; 39(11): 912-916, 2018 Nov 14.
Artigo em Chinês | MEDLINE | ID: mdl-30486587

RESUMO

Objective: To investigate the relationship between the erythrocyte membrane protein gene mutations and the clinical severity of hereditary spherocytosis (HS). Methods: Targeted sequencings were performed on 25 HS patients, correlation between HS mutations and patients' clinical characteristics were evaluated. Results: A total of 25 HS patients were enrolled, including 13 males and 12 females with median age of 20 (4-55) years, including 9 compensatory hemolysis patients, 9 patients with mild anemia, 3 patients with moderate anemia and 4 patients with severe anemia. Of them, 18 patients (72%) harbored HS-related mutations, including ANK1 mutation in 6 cases, SLC4A1 mutation in 6 cases, SPTB mutation in 5 cases and 1 case with EPB41 mutation. Seven patients (28%) didn't carry common HS mutations. SPTB and SLC4A1 mutations mainly affected male patients. There was no significant difference between the age of diagnosis (P=0.130) and HGB level (P=0.585) in patients with HS mutation and those without mutation, however, the EMA binding fluorescence intensity (P=0.015), AGLT50 (P=0.032) and EOF minimal hemolytic concentration (P=0.027) were significantly different in these two groups of HS patients. Conclusion: To screen erythrocyte membrane protein coding gene mutations could favor the diagnosis of HS, and patients without mutations have mild clinical phenotype.


Assuntos
Esferocitose Hereditária , Adolescente , Adulto , Criança , Pré-Escolar , Membrana Eritrocítica , Feminino , Hemólise , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Adulto Jovem
13.
Zhonghua Yu Fang Yi Xue Za Zhi ; 52(10): 1034-1038, 2018 Oct 06.
Artigo em Chinês | MEDLINE | ID: mdl-30392323

RESUMO

Objective: To review the consistency of diagnosis and reporting of hepatitis B (HB) patient in non-surveillance hospitals in three provinces and analyze the influencing factors. Methods: In 2016, using typical survey methods, we carried out a hospital-based pilot study in three provinces: Fujian, Hainan and Gansu. In each province, we chose two hospitals with grade 3 and grade 2 respectively in each province, using the following criteria: (1) in 2015, the hospital reported a greater number of hepatitis B cases compared the hospital-based provincial mean; (2) the hospital had an advanced laboratory information system (LIS) with access to HBsAg test results; (3) the hospital had an electronic hospital information system (HIS) which linked to the LIS via the inpatient medical record number; (4) general hospital; (5) non-surveillance hospitals for hepatitis B. Using national notifiable infectious disease reporting system (NNDRS), we chose all HB patients who were reported by the investigated hospitals in 2015, and we linked NNDRS HBV case-reports with patient-data from hospital information systems (HIS) to review the diagnosis, and then to compare the consistency of reviewed diagnosis and NNDRS report diagnosis, which we made a descriptive analysis. We used multivariable logistic regression to examine factors associated with misclassification of case-reports to NNDRS. Results: We found the NNDRS report accuracy was 47.11% (669) among 1 420 eligible inpatient hepatitis B inpatients. Of the 352 reported acute HBV cases, 6.53% (23) were consistent with our medical record review, the accuracy rate for level 2 hospitals and level 3 hospitals was 9.42% (21) and 1.55% (2), respectively. Of the1 068 reported chronic HBV cases, 60.49% (646) were consistent with our medical record review, the accuracy rate for level 2 hospitals and level 3 hospitals was 57.92% (106) and 60.02% (540), respectively. Compared to primary diagnosis of HB patients, the OR(95%CI) for mis-report was 29.36 (19.21-44.76) in non-primary diagnosis of HB patients. Compared to Fujian Province, the mis-report risk was higher in Hainan province and Gansu Province, with the values of OR (95%CI) being 2.33 (1.58-3.44) and 20.38 (11.29-36.78), respectively; compared to level 3 hospitals, the OR (95%CI) for mis-report was 2.38 (1.66-3.42) for level 2 hospitals; compared to HB related wards, the OR (95%CI) for mis-report was 1.45 (1.04-2.01) in non-HB-related wards. Conclusion: In some non-surveillance areas of China, the consistency between hepatitis B diagnosed in hospital and reported in NNDRS was low. Factors affecting the accuracy of HB surveillance data in NNDRS were level 2 hospitals, non-liver disease departments and nonprimary diagnosis of HB.


Assuntos
Notificação de Doenças/estatística & dados numéricos , Hepatite B/diagnóstico , Hospitais/estatística & dados numéricos , Vigilância da População , China/epidemiologia , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B/isolamento & purificação , Humanos , Pacientes Internados , Projetos Piloto
14.
Eur Rev Med Pharmacol Sci ; 22(15): 4975-4986, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30070334

RESUMO

OBJECTIVE: To investigate the role of Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway in the cardioprotective mechanisms of exercise preconditioning (EP). MATERIALS AND METHODS: Eighty male Sprague-Dawley (SD) rats were randomized into the Group control, Group EE, Group EP+EE, Group EP+EE+AG, and Group EE+AG. By using 3 days of intermittent treadmill exercise, this study established the EP animal model. Rats were subjected to run to exhaustion on the treadmill at 30 m/min with 0% grade as an exhaustive exercise (EE) protocol. The myocardial injury induced by exhaustive exercise was produced 24 h after EP. JAK2 inhibitor (AG490, 3 mg/kg) was injected before EP. Serum cardiac troponin I (cTnI) levels and hematoxylin basic fuchsine picric acid (HBFP) staining were used to observe the degree of myocardial ischemia. TUNEL, Bcl2, and cleaved caspase-3 levels were used to evaluate the change of myocardial apoptosis. Moreover, the phosphorylations of JAK2 and STAT3 were analyzed as possible mechanisms that might explain the EP-induced cardioprotection. RESULTS: EP significantly attenuated the exhaustive exercise-induced myocardial ischemia injury, associated with lower serum cTnI levels, decreased myocardial infarct area, reduced myocardial apoptosis, increased Bcl2 level, decreased cleaved caspase-3 level, and the increased phosphorylations of JAK2 and STAT3. Treatment with AG490 abolished the cardioprotective effects and the enhanced phosphorylations of JAK2 and STAT3 induced by EP. CONCLUSIONS: EP plays its cardioprotective role via activating the JAK2/STAT3 signaling pathway, reducing the apoptosis of myocardial cells and alleviating myocardial ischemia injury.


Assuntos
Janus Quinase 2/metabolismo , Condicionamento Físico Animal , Fator de Transcrição STAT3/metabolismo , Animais , Apoptose , Caspase 3/metabolismo , Masculino , Isquemia Miocárdica/metabolismo , Isquemia Miocárdica/patologia , Miocárdio/metabolismo , Miocárdio/patologia , Fosforilação/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Ratos , Ratos Sprague-Dawley , Transdução de Sinais/efeitos dos fármacos , Troponina I/sangue , Tirfostinas/farmacologia
15.
Obes Rev ; 19(9): 1236-1247, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30035367

RESUMO

BACKGROUND: Obesity, a comorbid medical condition, is usually observed in patients with established coronary artery disease. Paradoxically, patients with a higher body mass index (BMI) usually have better clinical outcomes after coronary revascularization. METHODS: We searched five online databases through December 2017. We identified studies reporting the rate of all-cause mortality or cardiovascular-related outcomes among patients after coronary revascularization with percutaneous coronary intervention or coronary artery bypass graft based on various BMI categories. Network meta-analysis was performed using Bayesian methods. RESULTS: Sixty-five records involving 865,774 participants were included in our study. A U-shaped association was observed across BMI categories for all-cause mortality. Using normal weight as the reference, all-cause mortality was increased for (relative risk [RR]: 2.4; 95% credibility interval [CrI]: 2.1-2.7) patients with underweight, whereas it was lowered in patients with overweight, obese, and severely obese. This association remained significant in many subgroups. We also observed that the risk of major adverse cardiovascular events (MACE) was lowest among patients with overweight. Furthermore, patients with underweight were associated with greater risks of myocardial infarction (RR: 1.9; 95% CrI: 1.4-2.5), cardiovascular-related mortality (RR: 2.8; 95% CrI: 1.6-4.7), stroke (RR: 2.0; 95% CrI: 1.3-3.3) and heart failure (RR: 1.7; 95% CrI: 1.1-2.7) compared with normal weight patients; no significant association was observed among individuals with higher BMI. CONCLUSIONS: The 'obesity paradox' does exist in patients after coronary revascularization, especially for patients with post-percutaneous coronary intervention. All-cause mortality in patients with high BMI is significantly lower compared with patients with normal weight. Furthermore, patients with underweight experience higher rates of cardiovascular outcomes compared with patients with normal weight.


Assuntos
Índice de Massa Corporal , Ponte de Artéria Coronária , Doença da Artéria Coronariana/cirurgia , Obesidade/complicações , Intervenção Coronária Percutânea , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/mortalidade , Humanos , Meta-Análise em Rede , Obesidade/mortalidade , Obesidade/fisiopatologia , Resultado do Tratamento
16.
Ann Oncol ; 29(8): 1741-1747, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29905759

RESUMO

Background: CBCSG006 trial reported the superior efficacy of cisplatin plus gemcitabine (GP) regimen than paclitaxel plus gemcitabine (GT) regimen as first-line treatment of metastatic triple-negative breast cancer (mTNBC). This study focused on the updated survival data and the explorations of potential biomarkers for efficacy. Patients and methods: Germ-line mutations of homologous recombination (HR) panel, BRCA1/2 included, were evaluated in 55.9% (132/236) patients. PD-L1 expression was evaluated in 48.3% (114/236) patients. A nonparametric sliding-window subpopulation treatment effect pattern plot (STEPP) methodology was used to analyze the absolute survival benefits. All statistical tests were two-sided. Results: Median progression-free survival (PFS) was 7.73 [95% confidence interval (CI) 6.46-9.00] months for GP arm and 6.07 (95% CI 5.32-6.83) months for GT arm (P = 0.005). No significant difference in overall survival (OS) was observed. There was significant interaction between HR status and treatment for PFS and status of HR deficient significantly correlated with higher objective response rate (ORR) and longer PFS in GP arm than in GT arm (71.9% versus 38.7%, P = 0.008; 10.37 versus 4.30 months, P = 0.011). There was no significant interaction between germ-line BRCA1/2 (gBRCA1/2) status and treatment for PFS. Patients with gBRCA1/2 mutation had numerically higher ORR and prolonged PFS in GP arm than in GT arm (83.3% versus 37.5%, P = 0.086; 8.90 versus 3.20 months, P = 0.459). There was no significant interaction between PD-L1 status and treatment for PFS, and no significant differences in ORR, PFS or OS between two arms regardless of PD-L1 status. In STEPP analysis, patients with lower composite risks had more absolute benefits in PFS than those with higher composite risks. Conclusions: GP regimen has superior efficacy than GT regimen as first-line chemotherapy for mTNBC patients. Germ-line mutations of BRCA1/2 and HR panel are possible biomarkers for better performance of cisplatin-based regimens. A composite risk model was developed to guide patient selection for GP treatment in TNBC patients. Trial registration: ClinicalTrials.gov, NCT01287624.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/genética , Seleção de Pacientes , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Biomarcadores Tumorais/metabolismo , Mama/patologia , Cisplatino/farmacologia , Cisplatino/uso terapêutico , Desoxicitidina/análogos & derivados , Desoxicitidina/farmacologia , Desoxicitidina/uso terapêutico , Resistencia a Medicamentos Antineoplásicos/genética , Feminino , Seguimentos , Mutação em Linhagem Germinativa , Humanos , Estimativa de Kaplan-Meier , Modelos Biológicos , Paclitaxel/farmacologia , Paclitaxel/uso terapêutico , Intervalo Livre de Progressão , Estudos Prospectivos , Medição de Risco/métodos , Resultado do Tratamento , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/mortalidade
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(3): 289-294, 2018 Mar 10.
Artigo em Chinês | MEDLINE | ID: mdl-29609241

RESUMO

Objective: To understand the acceptance and personal demand for cancer screening service among the urban residents who had never been involved in any national level cancer screening programs in China and identify the key factors influencing the sustainability of cancer screening. Methods: A questionnaire survey was conducted among the local people aged 40-69 years selected through convenience sampling in 16 provinces of China to collect the general information about their demands for the screening service and others. Results: A total of 16 394 qualified questionnaires were completed. The average age of the people surveyed was (53.8±8.0) years, and men accounted for 44.6%. Without concerning the cost, 4 831 people (29.5%) had no demands for cancer screening services, the reasons are as follow: they would like to go to see doctors only when they were ill (61.8%); they had already received similar medical examinations (36.8%) and they would like to receive cancer screening directly without pre-health risk assessment (33.0%). Among the people surveyed, 10 795 (65.8%) had demands for cancer screening services, but they had choice on the screening settings, 43.7% wanted to receive the service in a general hospitals, while 36.5% would like to go to cancer-specialized hospitals. As for the level of medical institutes providing cancer screening service, 61.4% of the people surveyed would choose a higher level one, while 36.4% would choose an ordinary one. On screening procedures, 61.5% of the people surveyed would accept the mode of "clinical examination after questionnaire-assessment" . Conclusion: Most people surveyed had demands for cancer screening services and they would like to receive the screening services in higher level medical institutes. It is suggested to spread cancer screening know ledge, and strengthen the capability building of screening in grass root medical institutes to attract more people to receive cancer screening.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Neoplasias/diagnóstico , População Urbana , Adulto , Idoso , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/prevenção & controle , Inquéritos e Questionários
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(3): 295-301, 2018 Mar 10.
Artigo em Chinês | MEDLINE | ID: mdl-29609242

RESUMO

Objective: To understand the constituent and workload of service providers engaged in cancer screening in China and provide evidence for the assessment of the sustainability of national cancer screening project. Methods: Using either questionnaire or online approach, the survey was conducted in 16 provinces, where Cancer Screening Program in Urban China (CanSPUC) was conducted, from 2014 to 2015. The medical institutes surveyed included hospitals [71.1% were class Ⅲ(A) hospitals], centers for disease control and prevention (CDCs) and community centers where cancer screening was undertaken during 2013-2015. The questionnaire survey was conducted among the staffs responsible for the overall coordination, management and implementation of the screening project to collect the information about the allocation, workload and compensation of the service providers from different specialties. Results: A total of 4 626 staffs were surveyed in this study, their average age was (37.7±9.5) years, and males accounted for 31.0%. Human resources allocated differed with province. The number of senior staff ranged from 6 (Chongqing) to 43 (Beijing) among the 8 comparable provinces. Among the staffs surveyed, 2 192 were from hospitals, 431 were from CDCs and 1 990 were from community centers, and the staffs who complained heavy workload accounted for 19.9%, 24.6% and 34.1% respectively (P<0.001). Among 227 staffs for overall coordination, 376 management staffs and 3 908 staffs for implementation, those who complained heavy workload accounted for 23.6%, 22.3% and 28.2% respectively (P<0.001). A total of 3 244 staffs (73.8%) got compensations for heavy workload. The compensation types were manly labor fee linked with workload (67.5%) and labor fee regardless workload (26.6%). Conclusion: The province specific differences in human resources allocation indicated the differences in screening project's organizing pattern and capability. It is suggested to conduct routine cancer screening (using specialized staffs), reduce the workload of the first line and community staffs and increase the compensation for the service providers for the sustainability of cancer screening project in China.


Assuntos
Atitude do Pessoal de Saúde , Detecção Precoce de Câncer , Neoplasias/diagnóstico , Carga de Trabalho , China , Hospitais , Humanos , Masculino , Neoplasias/prevenção & controle , Inquéritos e Questionários , População Urbana
19.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(2): 142-149, 2018 Feb 10.
Artigo em Chinês | MEDLINE | ID: mdl-29495196

RESUMO

Objective: From the perspective of actual service suppliers regarding cancer screening, this study aimed to assess the long-term sustainability of cancer screening programs in China. Methods: Based on a Cancer Screening Program in Urban China (CanSPUC), our survey focused on all the hospitals, centers for disease control and prevention (CDC) and community service centers across 16 provinces in China which participated in the programs between 2013 and 2015. All the managers (institutional/department level) and professional staff involved in the program were interviewed using either paper-based questionnaire or online approach. Results: A total of 4 626 participants completed the interview. It showed that the main gains from providing screening service emphasized promotion in social value (63.6%), local reputation (35.9%), and professional skills (30.6%), whereas difficulties encountered included inadequate compensation (30.9%) and discordance among information systems (28.3%). When the service remuneration amounts to about 50 Chinese Yuan per screening item, those professional staff self-reported that they would like to work overtime. More than half (63.7%) of the staff expressed willingness to provide routine screening service, the main expectations were to promote their reputation to the local residents (48.7%) and to promote professional skills (43.1%). Those who were not willing to provide screening services were worried about the potential heavy workload (59.8%) or being interfered with their routine work (49.8%). Further detailed results regarding the different organization types and program roles were presented in the following detailed report. Conclusions: Findings of gains and difficulties showed that if cancer screening is expected to become a long-term running, incentive mechanism from the program, external promotion and advocacy as well as capacity building should be strengthened; furthermore, rewards to staff's screening services should be raised according to the local situations. Results regarding the "willingness to provide service" showed that management of the program should also be strengthened, including information system building and inter-agency and inter-department coordination at the government levels.


Assuntos
Atitude do Pessoal de Saúde , Detecção Precoce de Câncer , Neoplasias/diagnóstico , China , Recursos em Saúde , Humanos , Entrevistas como Assunto , Motivação , Neoplasias/prevenção & controle , Inquéritos e Questionários , Estados Unidos , População Urbana , Carga de Trabalho
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(2): 150-156, 2018 Feb 10.
Artigo em Chinês | MEDLINE | ID: mdl-29495197

RESUMO

Objective: Based on the investment for potential suppliers of cancer screening services, we assessed the reasons that affecting their participation motivation related to the long-term sustainability of cancer screening in China. Methods: Hospitals that had never been involved in any national level cancer screening project were selected by using the convenient sampling method within the 16 project cities of Cancer Screening Program in Urban China (CanSPUC) with 1 or 2 hospitals for each city. All the managers from the institutional/department level and professional staff working and providing screening services in these hospitals, were interviewed by paper-based questionnaire. SAS 9.4 was used for logical verification and data analysis. Results: A total of 31 hospitals (18 hospitals at the third level and, 13 hospitals at the second level) and 2 201 staff (508 hospital and clinic unit managers, 1 693 professional staff) completed the interview. All the hospitals guaranteed their potential capacity in service providing. 92.5% hospital managers showed strong willingness in providing cancer screening services, while 68.3% of them declared that the project fund-raising function was the responsibility of the government. For professional staff, their prospect gains from providing screening service would include development on professional skills (72.4%) and material rewards (46.8%). Their main worries would include extra work for CanSPUC might interfere their routine work (42.1%) plus inadequate compensation (41.8%). Medians of the prospect compensation for extra work ran between 20 to 90 Chinese Yuan per screening item respectively. For all the screening items, workers from the third-level hospitals expected their compensation to be twice as much of those working at the second level hospitals. Conclusion: Professional capacity building and feasible material incentive seemed to be the two key factors that influenced the sustainability and development of the programs.


Assuntos
Atitude do Pessoal de Saúde , Detecção Precoce de Câncer , Motivação , Neoplasias/diagnóstico , China , Cidades , Humanos , Inquéritos e Questionários
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