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2.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(2): 120-125, 2020 Feb 12.
Artigo em Chinês | MEDLINE | ID: mdl-32062881

RESUMO

Objective: To study the prevalence of c-ros oncogene 1 fusion in lung adenocarcinoma and to evaluate its relationship with clinical characteristics. Methods: We retrospectively analyzed epidermal growth factor receptor (EGFR) mutation, anaplastic lymphoma kinase (ALK) and c-ros oncogene 1 (ROS1) fusion in 1 482 patients with adenocarcinoma from March 2014 to January 2017 in the first affiliated hospital of Zhejiang University. Furthermore, ROS1 fusion positive patients diagnosed between February 2017 and December 2017 were also included in ROS1 positive group. The data of age, sex, smoking history, TNM stage and chest computed tomography were collected by Electronic Medical Record (EMR). The clinical data were compared by the chi-squared test or Mann-Whitney test. Results: Of these 1 482 patients,54 cases were diagnosed with ROS1 rearrangement, including 19 males and 35 females, while 73 cases were diagnosed with ALK rearrangement, including 28 males and 45 females, and 679 cases diagnosed with EGFR mutation including 293 males and 386 females. And there were 676 patients without driven genes mutation. The mean age in ROS1 fusion group (54±12) was lower than EGFR mutation group (60±11, z=-3.982, P<0.001) and WT group (62±10, z=-4.944, P<0.001). Female proportion in ROS1 fusion group (64.8%, 35/54) was higher than WT group (28.4%, 192/676, χ(2)=30.94, P<0.001). Non-smoker percentages in ROS1 fusion group (72.2%, 39/54) was significantly higher than WT group (38.0%,257/676, χ(2)=24.27, P<0.001). ROS1 fusion group was similar to ALK fusion group in sex, age and smoking history, and there were no significant difference in TNM stage among these groups. On chest CT, adenocarcinomas with ROS1 fusion were found to be more peripheral in location (71.4%, 20/28) and solid in density (75%, 21/28), usually with lobulated margins (75.0%, 21/28) and spiculated in contour (57.1%,16/28). Conclusion: In our study lung adenocarcinoma with c-ROS oncogene 1 fusion was a rare subtype lung cancer and was usually detected in young, never smoking, and female patients.

3.
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
4.
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
5.
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
6.
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
7.
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
8.
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
9.
Zhonghua Yi Xue Za Zhi ; 99(46): 3617-3621, 2019 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-31826582

RESUMO

Objective: To summarize the clinical characteristics of pulmonary actinomycosis and analyze its diagnostic methods. Methods: The clinical symptoms, underlying diseases, imaging characteristics, preliminary diagnosis, diagnostic methods, treatment and prognosis of 30 patients with pulmonary actinomycetes admitted into the First Affiliated Hospital of Zhejiang University School of Medicine during the 10 years (January 2007 to November 2017) were retrospectively analyzed. Results: The 30 patients with pulmonary actinomycetes included were from 47 to 81 years old, with an average age of (59.5±7.8) years, with a course of disease from 5 days to 48 months, and a median course of disease of 1.5 months; 18 patients (60.0%) were complicated with underlying diseases, 10 patients (33.3%) had a history of smoking, 10 patients (33.3%) had a history of alcohol abuse. The main clinical manifestations were cough in 29 cases (96.7%), followed by sputum in 22 cases (73.3%), hemoptysis in 20 cases (66.7%), fever in 12 cases (40.0%), chest pain in 5 cases (16.7%) and shortness of breath in 3 cases (10.0%). Mass, nodules, consolidation, atelectasis can be seen by imaging, there can be a low-density lesion necrosis, formation of voids or vacuoles. Among the 25 patients (83.3%) who underwent bronchoscopy, 14 cases were abnormal, 5 cases showed endotracheal polypoid neoplasms, 9 cases showed endotracheal mucosal inflammatory changes, 2 cases of them showed bronchial foreign body, and 1 case showed broncholithiasis. All cases were diagnosed by pathology. Nine cases (30.0%) were confirmed by bronchoscopic biopsy. Two cases (6.7%) underwent CT-guided percutaneous lung biopsy, 18 cases (60.0%) underwent surgical resection of pathology, and 1 case (3.3%) was diagnosed by puncture of chest wall mass. Sufficient dose and course of penicillin were effective. Surgical excision of the lesion with antibiotics for 2-4 weeks was effective. Conclusion: The clinical manifestation of pulmonary actinomycosis is lack of specificity, obtaining positive pathological specimens is the key to the diagnosis of this disease, the first choice is bronchoscopy and percutaneous lung biopsy.


Assuntos
Actinomicose , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Broncoscopia , Humanos , Pulmão , Pessoa de Meia-Idade , Estudos Retrospectivos
10.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1432-1438, 2019 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-31838817

RESUMO

Objective: To understand the prevalence of carotid plaque (CP) in population at high-risk for cardiovascular disease (CVD) in Jiangsu province and identify related influencing factors. Methods: Based on the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project from 2015 to 2016, a total of 11 392 persons at high-risk for CVD were selected from six project areas in Jiangsu province for the questionnaire survey, physical measurement, laboratory test and bilateral ultrasound examination of carotid arteries. The prevalence of CP and influencing factors of abnormal carotid arteries, CP and plaque burden (CP≥2) were analyzed. Results: Among the persons surveyed, 4 821 (42.3%) were males. The age of the persons surveyed was (59.4±8.9) years. There were 5 971 abnormal carotid arteries cases (52.4%), including 1 782 carotid intima-media thickness thickening cases (15.6%), 3 811 CP cases (33.5%) and 378 carotid stenosis cases (3.3%). Older age (OR=2.253, 95%CI: 2.127-2.386), urban residence (OR=2.622, 95%CI: 2.375-2.895), hypertension (OR=1.439, 95%CI: 1.195-1.732), smoking (OR=1.441, 95%CI: 1.259- 1.650), pulse pressure difference (OR=1.270, 95%CI: 1.198-1.347), fasting plasma glucose (FPG) (OR=1.109, 95%CI: 1.059-1.161) and LDL-C/HDL-C (OR=1.225, 95%CI: 1.164-1.288) were possible risk factors of CP in population at high risk for CVD. Being women (OR=0.558, 95%CI: 0.494-0.630), high BMI (OR=0.948, 95%CI: 0.904-0.994), higher levels of education (OR=0.708, 95%CI: 0.531-0.945), and higher annual household income (OR=0.773, 95%CI: 0.669-0.894) were the possible protective factors. Conclusions: Over half of the population at high-risk for CVD in Jiangsu showed abnormal carotid arteries. High blood pressure, high blood glucose, high blood lipids and smoking were the main factors that could be changed.


Assuntos
Artérias Carótidas/patologia , Doenças das Artérias Carótidas/etnologia , Espessura Intima-Media Carotídea , Placa Aterosclerótica/epidemiologia , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/patologia , Doenças das Artérias Carótidas/patologia , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
11.
Zhonghua Yi Xue Za Zhi ; 99(42): 3323-3327, 2019 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-31715669

RESUMO

Objective: To explore the natural course of obstructive sleep apnea-hypopnea syndrome (OSAHS) and its associated factors in young and middle-aged patients with OSAHS. Methods: A total of 52 young and middle-aged OSAHS patients were recruited in this study from West China Hospital of Sichuan University. All patients were performed twice overnight polysomnography (PSG) examinations. At the baseline, patients underwent the first PSG and clinical evaluation from September 2009 to September 2017 and the patients received the second PSG from January 2017 to January 2019. During the follow-up period, these patients had no treatment. All patients were categorized into two groups including mild-to-moderate [5/h≤ apnea-hypopnea index (AHI)<30/h] group and severe (AHI ≥ 30/h) group according to the baseline AHI value. Differences in the clinical characteristics and PSG variables between baseline and follow-up were compared in two groups separately using t-tests or Mann-Whitney U test. The general linear correlation analysis was used to explore the factors related to the severity of OSAHS including AHI, the mean oxyhemoglobin saturation and the minimal oxyhemoglobin saturation during the follow-up period. Results: This study recruited 28 OSAHS patients in mild-to-moderate group [mean age, (39.7±10.2) y] and 24 patients in severe group [mean age, (41.0±7.1) y]. Compared to the baseline, there was a significant increase in AHI value [(45.0±25.3) vs (33.6±27.3)/h, P<0.001] in all OSAHS patients. Notably, the increase of AHI was more significant in the mild-to-moderate OSAHS group [(32.1±22.2) vs (13.6±8.7)/h, P<0.05] but not in severe OSAHS patients [(60.7±19.5) vs (58.0±21.5)/h, P>0.05]. A person correlation analysis revealed that the AHI value was positively related to the age (r=0.531, P=0.004) in mild-to-moderate OSAHS patients. Conclusion: The severity of OSAHS is increased with the age in young and middle-aged patients with mild-to-moderate OSAHS, but not in those with severe OSAHS.


Assuntos
Apneia Obstrutiva do Sono , China , Seguimentos , Humanos , Pessoa de Meia-Idade , Polissonografia
12.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1115-1118, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683397

RESUMO

Objective: To evaluate the effectiveness and benefit of the upper gastrointestinal cancer screening in Yangzhong city, Jiangsu province, from 2009 to 2015. Methods: From 2009 to 2015, 31 natural villages with high-incidence of upper gastrointestinal cancer were selected from Baqiao town, Youfang town and Xinglong sub-district in Yangzhong city. 13 776 residents aged 40 to 69 years old were recruited and screened for upper gastrointestinal cancer by using endoscopic examination and pathological diagnosis. Two economic evaluation methods, cost-effectiveness analysis and cost-benefit analysis, were performed to evaluate the current screening schemes. Results: The mean age of all respondents were (53.60±8.14) years old and the males accounted for 43.64% (6 012). A total of 502 cases of upper gastrointestinal tract lesions were detected, including 100 cases of cancer (62 cases of esophagus, gastric/cardiac early stage cancer, 38 cases of advanced stage cancer), 38 cases of severe esophageal hyperplasia/carcinoma in situ, and 15 cases of high-grade intraepithelial neoplasia in stomach/cardia, the detection rate was 0.73%, 0.28% and 0.11%, respectively; the early diagnosis rate was 75.16% (115/153). The cost of a precancerous lesion, a case diagnosed at the early stage and a positive case identified through the upper gastrointestinal cancer screening in Yangzhong City was 10 037.17, 30 460.64 and 22 895.25 RMB, respectively. The early detection cost index from 2009 to 2015 was 0.52, 0.56, 0.48, 0.48, 0.21, 0.30, and 0.26, respectively. The effectiveness-cost ratio from 2009 to 2015 was 3.41, 2.77, 2.66, 2.58, 4.99, 3.12, and 3.48, respectively. Conclusions: The project of early diagnosis and treatment of upper gastrointestinal tract cancer in Yangzhong city has achieved good results and benefits.


Assuntos
Cárdia/patologia , Detecção Precoce de Câncer/economia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/economia , Programas de Rastreamento/economia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/economia , Adulto , Idoso , China/epidemiologia , Análise Custo-Benefício , Neoplasias Esofágicas/etnologia , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Neoplasias Gástricas/etnologia
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1089-1094, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594151

RESUMO

Objective: To analyze the disease burden of stroke and its health loss attributable to passive smoking in people aged 60 years and over in Jiangsu province. Methods: Data were retrieved from the Chronic and Non-communicable Diseases and Risk Factors Surveillance in Jiangsu in 2013 and the death registry system in Jiangsu. Combined with the method in Global Burden of Disease Study 2016 (GBD2016), the indicators, such as population attributable fraction (PAF) and disability-adjusted life years (DALY) for stroke due to passive smoking were calculated. Results: In 2013, the mortality rate, age-standardized mortality rate, DALY and DALY rate of stroke in people aged 60 years and over in Jiangsu were 718.15/100 000, 439.28/100 000, 1 179 602 person years and 9 234.99/100 000, respectively. Year of life lost (YLL) accounted for 87.00% of the total DALY. The DALY and corresponding rate of stroke increased rapidly with age, and were higher in women (612 084 person years and 9 319.71/100 000, respectively) than those in men (567 518 person years and 9 145.33/100 000, respectively). The prevalence of passive smoking was 34.04% in people aged 60 years and over in Jiangsu. The PAF, attributable DALY, attributable DALY rate and its age- standardized rate of stroke due to passive smoking in people aged 60 years and over in Jiangsu were 3.88%, 45 769 person years, 358.12/100 000 and 920.64/100 000, respectively; and were also higher for men (4.35%, 24 687 person years, 397.82/100 000 and 515.30/100 000, respectively) than those for women (3.44%, 21 056 person years, 320.60/100 000, 405.34/100 000, respectively). Conclusions: The disease burden of stroke was heavy in the elderly in Jiangsu, and passive smoking might have great influence on the disease burden of stroke. Prevention and control of stroke and passive smoking exposure should be taken actively to improve health for the elderly.


Assuntos
Carga Global da Doença , Acidente Vascular Cerebral/epidemiologia , Poluição por Fumaça de Tabaco , Idoso , China/epidemiologia , Efeitos Psicossociais da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida , Acidente Vascular Cerebral/economia
14.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1139-1144, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594161

RESUMO

Objective: To investigate the prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province and provide evidence for the prevention and control of hypertension. Methods: A population-based cardiovascular disease screening project was conducted during 2015-2018 in Jiangsu, a total of 95 348 community-dwelling adults aged 35-75 years from 6 project areas were included in the study. The prevalence rate of hypertension and rates of awareness, treatment and control of hypertension in the adults with different characteristics were analyzed. Multilevel model was applied to identify the influencing factors. Results: Among 95 348 adults surveyed, 54 407 were hypertensive, the standardized prevalence rate was 48.1%. The prevalence rate was significantly higher in males than in females (62.1% vs. 54.0%, P<0.05). Among the hypertension patients, the rates of awareness, treatment and control of hypertension were 56.6%, 45.3% and 12.0% (standardized rates: 52.2%, 41.0% and 11.2%), respectively, and all the rates were positively associated with age (all P<0.05). Multilevel model analysis showed that those who were males, at older age, lived in rural area, suffered from diabetes, had frequent alcohol drinking and those who were overweight/obese had higher risk for hypertension (all P<0.05). Among people with hypertension, those who had younger age, lower education level, lower household income level and those who had frequent alcohol drinking had lower awareness, treatment and control rates of hypertension (all P<0.05). Conclusions: The prevalence rate of hypertension was high, but related awareness, treatment and control rates were low in adult residents in Jiangsu province. Comprehensive measures should be taken to improve awareness, treatment and control of hypertension in whole population, especially in young adults, and those with low education or income levels.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/epidemiologia , Adulto , Idoso , Conscientização , China/epidemiologia , Feminino , Humanos , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
15.
Zhonghua Zhong Liu Za Zhi ; 41(8): 604-609, 2019 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-31434452

RESUMO

Objective: To evaluate preoperative nutritional status and inflammatory status by Nutritional Risk Screening-2002 (NRS-2002) and hematologic inflammatory markers in patients with thoracic esophageal squamous cell carcinoma (ESCC), and to explore their effects on long-term survival prognosis. Methods: A total of 113 patients with thoracic ESCC treated by radical resection were grouped for further analysis according to preoperative NRS-2002 score, systemic inflammation score (SIS) and the combination of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (CNP) score. The progression free survival (PFS) and overall survival (OS) between groups were compared. Multivariate Cox regression analysis was used to determine the independent prognostic factors of patients with thoracic esophageal squamous cell carcinoma, and the interaction analysis of statistically significant factors was carried out. Results: The median PFS was 21 months for all the patients. The 1-year, 3-year and 5-year PFS rates were 69.0%, 25.7% and 23.1%, respectively. Correspondingly, the median OS was 36 months, and the 1-year, 3-year and 5-year OS rates were 95.6%, 46.2% and 29.2%, respectively. Cox univariate analysis showed that T stage, N stage, TNM stage, SIS, CNP score and NRS-2002 score were significantly associated with PFS and OS (all P<0.05), and sex was associated with PFS (P=0.032) in patients with thoracic ESCC. Furthermore, cox multivariate analysis showed that TNM stage (HR=1.570, P=0.039), NRS-2002 score (HR=2.706, P<0.001) and CNP score (HR=1.463, P=0.011) were independent prognosis factors of PFS in patients with thoracic ESCC. In cox model interaction analysis, there was a positive interaction between NRS-2002 score and CNP score (RR=2.789, P<0.001). Conclusion: Preoperative NRS-2002 score combined with CNP score are risk factors for prognosis of patients with thoracic ESCC, which can be used as prognostic indicators.


Assuntos
Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Neoplasias Torácicas/cirurgia , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Neutrófilos , Estado Nutricional , Contagem de Plaquetas , Cuidados Pré-Operatórios , Prognóstico , Medição de Risco
16.
Zhonghua Jie He He Hu Xi Za Zhi ; 42(7): 510-514, 2019 Jul 12.
Artigo em Chinês | MEDLINE | ID: mdl-31365967

RESUMO

Objective: To investigate the clinical and epidemiological characteristics of influenza A (H3N2) infected patients in Jinhua area, and therefore to improve the understanding of infection with H3N2 influenza virus. Methods: The pharynx swab specimens for pathogenic detection were collected from acute respiratory infection (ARI) cases in the fever clinic of the sentinel hospital in Jinhua area from 2014 to 2017. Descriptive statistics method was used to analyze the clinical features and pathogenics characteristics of the patients infected with H3N2 influenza virus. The t test or χ(2) test of independent samples were used for comparison between groups. Results: A total of 3 803 cases of acute respiratory infection (ARI) were reported in the sentinel hospital in Jinhua area from 2014 to 2017. Among them, 245 cases (6.4%) of H3N2 influenza were diagnosed, including 153 males (62.4%) and 92 females (37.6%), aged from 0.5 to 95 years, with an average age of (50.1+15.7) years. They were divided into 5 age groups, with 107 (43.7%) patients aged 60 years and older. The incidence of major diseases was 43.7%. There was no significant difference in the gender in different age groups (χ(2)=4.581, P=0.333). The seasonal peak of H3N2 influenza A virus infection was mainly in summer (In June-September), but was also seen in other months. In the 4 years from 2014 to 2017, there were a total of 4 peaks, which occurred in July-September, July-August, June-August, and June-August. The body temperature of most patients (73.1%) was between 38.0 and 38.9 ℃. The main positive signs of H3N2 influenza A virus infection were different degrees of pharyngeal hyperemia and tonsillar enlargement. Fever (>38 ℃), cough, dizziness, fatigue, sore throat, headache, chills, shortness of breath, runny nose, myalgia, expectoration, nasal congestion were the main symptoms of H3N2 cases. The proportion of abnormal X-ray/CT manifestations in H3N2 influenza A virus infection cases was lower than that of other influenza viruses. 89.8% of the patients were positive for H3N2 influenza A. The average lymphocyte count was (1.1±0.5) × 10(9)/L, total platelet count (157±39) × 10(9)/L in H3N2 influenza A infection group, which were lower than those in other influenza positive patients [(1.2±0.6)×10(9)/L and (165±42) × 10(9)/L], while the neutrophil count (3.6±0.8) × 10(9)/L was higher than that in other influenza positive patients (3.4±1.0) × 10(9)/L(all P<0.05). Conclusions: Patients with H3N2 influenza A in Jinhua mostly presented with throat congestion and tonsillar enlargement in varying degrees, fever (>38 ℃), cough and sputum production. The seasonal peak of influenza A was in summer (June-September). Elderly aged 60 years or older were the susceptible group.


Assuntos
Vírus da Influenza A Subtipo H3N2 , Influenza Humana/epidemiologia , Infecções Respiratórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Tosse/etiologia , Feminino , Febre/etiologia , Humanos , Lactente , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Influenza Humana/diagnóstico , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/diagnóstico , Estações do Ano , Adulto Jovem
17.
Zhonghua Nei Ke Za Zhi ; 58(8): 566-571, 2019 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-31365977

RESUMO

Objective: To evaluate the efficacy and safety of different antimicrobial regimens in patients with bloodstream infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods: The clinical date of patients with CRKP bloodstream infections were retrospectively analyzed at the First Affiliated Hospital of Zhejiang University Medical College between January 2017 and January 2018. All subjects were separated into three groups based on antibiotics regimens over 72 hours, including meropenem 2.0 g every 8 hours, tigecycline 200 mg as initial dose and 100 mg every 12 hours, and polymyxin B 1.25 mg/kg every 12 hours as salvage treatment of tigecycline. Results: A total of 86 patients were finally recruited, including 14, 52 and 20 patients in groups of meropenem, tigecycline and polymyxin B salvage, respectively. All of the strains were resistant to meropenem and susceptible to tigecycline and polymyxin B initially, while 2 of them became resistant to tigecycline during treatment. The 28-day mortality was significantly higher in meropenem group (13/14) than that in tigecycline group and polymyxin B salvage group (61.5%, 32/52) and (12/20), respectively (P<0.01), while as no significant difference was seen in the last two groups (χ(2)=0.014, P>0.05). The incidences of hepatic impairment [3.8%(2/52) vs. 1/20] and renal dysfunction (0 vs. 1/20) between tigecycline group and polymyxin B salvage group were both comparable (P>0.05). Conclusion: The meropenem-based therapy is not recommended for CRKP-related bloodstream infections. Tigecycline-based therapy is still disappointing despite salvage use of polymyxin B after 72 hours. Hepatic and nephretic toxicities caused by additional polymyxin B are acceptable.


Assuntos
Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/efeitos dos fármacos , Meropeném/uso terapêutico , Polimixinas/uso terapêutico , Tigeciclina/uso terapêutico , Antibacterianos/administração & dosagem , Bacteriemia/mortalidade , China/epidemiologia , Farmacorresistência Bacteriana Múltipla , Humanos , Infecções por Klebsiella/diagnóstico , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Resultado do Tratamento , Resistência beta-Lactâmica
18.
Zhonghua Yi Xue Za Zhi ; 99(24): 1864-1869, 2019 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-31269581

RESUMO

Objective: To examine the association between mixed sleep apnea (MA) and treatment-emergent central sleep apnea (TE-CSA). Methods: A total of 256 patients meeting the diagnostic criteria of moderate to severe obstructive sleep apnea (OSA) based on overnight polysomnography (PSG) and receiving continuous positive airway pressure (CPAP) therapy in West China Hospital, Sichuan University during the period from August 2013 to November 2018 were enrolled in the study. Based on the mixed apnea index (MAI) and apnea-hypopnea index (AHI) in the baseline PSG study during non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep, the subjects were categorized into three groups of A (MAI=0/h, n=110), B (NREM-MAI≥5/h and REM-MAI<5/h, n=72) and C (REM-MAI≥5/h and NREM-MAI< 5/h, n=74). Sleep and breathing related parameters before and after CPAP therapy among three groups and the difference of TE-CSA incidence were analyzed. Results: The AHI [(44.2(26.8,64.5)/h,66.6(56.0,81.7)/h, 79.8(63.6, 88.3)/h], REM-AHI [50.0(34.7, 64.7)/h, 60.1(49.1, 70.0)/h, 66.3(56.1, 74.6)/h] and NREM-AHI[43.5(25.9, 65.1)/h,67.6(53.7, 82.4)/h,81.3(64.2, 91.5)/h]) were higher in group B and C compared to group A (all P<0.05),while the mean and lowest oxygen saturation [(92.6%±3.5%),(90.8%±3.6%),(87.3%±5.1%) and (70.6%±14.1%), (61.0%±16.0%), (47.9%±17.0%)] were lower in group B and group C compared to group A (all P<0.05). The incidence of TE-CSA after initial CPAP was 7.8% in all patients, and the incidence was significantly higher in group B of 14.1% compared to group C of 4.1% and group A of 2.7% (all P<0.05). Conclusions: TE-CSA is correlated with baseline MA, and baseline MA in NREM sleep can predict the incidence of TE-CSA after initial CPAP.


Assuntos
Síndromes da Apneia do Sono , Apneia do Sono Tipo Central , China , Pressão Positiva Contínua nas Vias Aéreas , Humanos , Polissonografia
19.
Zhonghua Gan Zang Bing Za Zhi ; 27(7): 567-571, 2019 Jul 20.
Artigo em Chinês | MEDLINE | ID: mdl-31357788

RESUMO

Chronic excess alcohol intake triggers the formation of enterogenic endotoxemia. TLR4 ligand localization activates nuclear transcription factor NF-κB by inducing the up-regulation of NLRP3 inflammasome and the biologically inactive IL-1ß and IL-18 precursors to form initiation of pro-inflammatory signals. Under the influence of ethanol, the damaged hepatocyte release uric acid, and adenosine triphosphate and induces NLRP3 inflammasome assembly and functional activation in Kupffer cells to promote the release of inflammatory mediators, such as interleukin-1ß and interleukin-18, that cascade mediates inflammation and drive alcoholic liver disease from steatosis to inflammation and fibrosis. The NLRP3 inflammasome acts as a ligand-sensing element and plays an important role in mediating the immune and inflammatory response in the course of alcoholic liver disease. Thus, exploring the activation mechanism of NLRP3 inflammasome and its pathogenic role may provide a new idea in the clinical treatment of alcoholic liver disease.


Assuntos
Inflamassomos/metabolismo , Hepatopatias Alcoólicas/patologia , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Humanos , Interleucina-18/metabolismo , Interleucina-1beta/metabolismo , Macrófagos do Fígado
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 660-665, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238615

RESUMO

Objective: To investigate the association between fresh fruit consumption and status of glycemic control, among patients with type 2 diabetes mellitus (T2DM). Methods: Using the stratified cluster sampling method, a cross-sectional study was conducted among 19 473 diabetic patients who were under the Disease Management Program related to the National Basic Public Health Service in Changshu county, Huai'an and Qinghe districts of Huai'an city from December 2013 to January 2014, under the combination of fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) methods, the glycemic control status in T2DM patients was assessed. Multiple logistic regression method was used to explore the relationship between fresh fruit consumption and status of glycemic control among T2DM patients. Results: 62.4% of the T2DM patients reported their amount of fruits intake in the past year. Both the levels of FPG and HbA1c decreased in T2DM patients, when the frequency and amount of fresh fruit consumption were increasing. Compared with patients who did not take fresh fruits, the risk of poor glycemic control in patients with fresh fruit consumption of 1-4 times/week and ≥5 times/week decreased 20% (OR=0.80, 95%CI: 0.73-0.87) and 30% (OR=0.70, 95%CI: 0.62-0.80), respectively. Patients with fruit consumption of 50-99 g/day and ≥100 g/day had lower risk of poor glycemic control, with ORs (95%CI) as 0.71 (95%CI: 0.62-0.83) and 0.68 (95%CI: 0.59-0.78), respectively. Conclusions: The association of fresh fruit intake and glycemic control was statistically significant in patients with type 2 diabetes. With the increase of frequencies and amounts of fresh fruit consumption, the levels of FPG and HbA1c showed a decreasing trend. Our findings suggested that fresh fruit intake seemed helpful for glycemic control.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Frutas , Hemoglobina A Glicada/análise , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Humanos
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