Analysis on the response measures and outcomes of four epidemics of infectious diseases in Shanghai based on a time axis / 上海预防医学

Objective To compare the response measures and outcomes of SARS-CoV(2003), H1N1 influenza(2009), H7N9 influenza(2013)and COVID-19(2020)in Shanghai and provide scientific evidence for the emergency response of public health emergencies. Methods We compared the response measures and outcomes of the four epidemics in Shanghai in the aspects of government response, prevention and control system, scientific and technological support, social mobilization and prevention effects, using critical incident analysis based on the time axis of the epidemics from literature review. Results In response to the four epidemics of infectious diseases occurred in 2003-2020, Shanghai has generally made some significant effort and flexible measures in the first month of the epidemics, including"closure of live poultry markets"and"three closed-loops and four 100% coverage"and other specific prevention and control measures, which have enhanced the prevention and control system. However, we identified that the construction of prevention and control system for public health emergencies remained inefficient, compared to rapid economic development. The majority of the construction measures were principally post-epidemic. In addition, there were many challenges, such as passive response, temporary response teams and measures, and difficulties in the flexible bottom-up response for residents, families and industries without standard operating procedure and guidelines. Conclusion It may be an effective measure for the prevention and control of infectious diseases to build joint prevention and control measures with mass participation and regular drills, in the perspectives of strategic, tactical and operational levels of epidemic prevention and control.

Spatial epidemiological characteristics of the mortality and probability of premature death caused by chronic obstructive pulmonary disease among residents in Pudong New Area of Shanghai in 2010-2020 / 公共卫生与预防医学

Objective To explore the spatial epidemiological characteristics of mortality and probability of premature death caused by chronic obstructive pulmonary disease (COPD) among residents in Pudong New Area of Shanghai from 2010 to 2020, and to provide reference for the formulation of chronic obstructive pulmonary disease prevention and control strategies according to local conditions. Methods The death data of chronic obstructive pulmonary disease were obtained from the local death surveillance system of Pudong New Area. Crude mortality, age-standardized mortality, and probability of premature death caused by COPD in each subdistricts and towns of Pudong New Area were calculated. The geographical information system (GIS) was used to plot the spatial distribution maps of chronic obstructive pulmonary disease death. The trend surface analysis and the spatial autocorrelation analysis were performed to analyze the spatial distribution of chronic obstructive pulmonary disease death. Results The crude mortality, age-standardized mortality and probability of premature death caused by COPD among residents in Pudong New Area between 2010 and 2020 were 58.40/100,000, 22.35/100,000, and 0.26%, respectively. The results of trend surface analysis showed that the crude mortality, age-standardized mortality and probability of premature death caused by COPD gradually increased from north to south. In the east-west direction, the crude mortality, age-standardized mortality, and probability of premature death showed an upward trend from west to east. The global autocorrelation analysis suggested that there existed a positive spatial autocorrelation for the crude mortality, age-standardized mortality, and probability of premature death. The local spatial autocorrelation analysis showed that the high-high clustering areas of COPD crude mortality, standardized mortality and premature mortality were all located in the rural areas of the southeast of Pudong New Area. Conclusion There are urban and rural differences in the mortality of chronic obstructive pulmonary disease among residents in Pudong New Area from 2010 to 2020. The residents living in rural southeast coast of Pudong New Area are more seriously affected by chronic obstructive pulmonary disease and should be paid more attention.

Incidence and survival rates of primary renal cell carcinoma in residents in Pudong New Area in Shanghai, 2002-2011 / 肿瘤

Objective: To investigate the incidence and survival rates of primary RCC (renal cell carcinoma) in residents in Pudong New Area in Shanghai. Methods: The residents in Pudong New Area in Shanghai were recruited in this study during the period 2002-2011. The standardized morbidity and mortality of primary RCC were calculated by world standard population. The survival of primary RCC patients according to gender, resident district, TNM staging and surgical operation was analyzed by Kaplan-Meier method and COX regression analysis. Results: Among 1 905 new cases of primary RCC occurring during 2002-2011, 1 234 were males and 671 were females. The age-standardized incidence rate in males (5.17/100 000 person-year) was higher than that in females (3.07/100 000 person-year). In 697 cases of RCC-related death, 453 were males and 244 were females. The age-standardized mortality in males (1.88/100 000 person-year) was higher than that in females (0.92/100 000 person-year). The one-, two-, three-, four-, and five-year survival rates of patients with primary RCC were 74.75%, 69.84%, 66.38%, 63.40% and 61.44%, respectively. There was a statistically significant difference in overall survival between central city vs other areas (P = 0.040), early stage vs advanced stage (P < 0.001), and having surgical operation vs not having surgical operation (P < 0.001). Advanced stage and not having surgical operation were independent risk factors in patients with primary RCC (P < 0.001). Conclusion: The incidence and mortality rates of primary RCC in males and in central city were significantly higher than those in females and in other areas in residents in Pudong New Area in Shanghai, 2002-2011, respectively. Early diagnosis of primary RCC and performance of surgery can significantly improve the prognosis of patients. Copyright © 2013 by TUMOR.

Cancer incidence and patient survival rates among the residents in the Pudong New Area of Shanghai between 2002 and 2006 / 癌症

With the growing threat of malignancy to health, it is necessary to analyze cancer incidence and patient survival rates among the residents in Pudong New Area of Shanghai to formulate better cancer prevention strategies. A total of 43,613 cancer patients diagnosed between 2002 and 2006 were recruited from the Pudong New Area Cancer Registry. The incidence, observed survival rate, and relative survival rate of patients grouped by sex, age, geographic area, and TNM stage were calculated using the Kaplan-Meier, life table, and Ederer II methods, respectively. Between 2002 and 2006, cancer incidence in Pudong New Area was 349.99 per 100,000 person-years, and the 10 most frequently diseased sites were the lung, stomach, colon and rectum, liver, breast, esophagus, pancreas, brain and central nervous system, thyroid, and bladder. For patients with cancers of the colon and rectum, breast, thyroid, brain and central nervous system, and bladder, the 5-year relative survival rate was greater than 40%, whereas patients with cancers of the liver and pancreas had a 5-year relative survival rate of less than 10%. The 1-year to 5-year survival rates for patients grouped by sex, age, geographic area, and TNM stage differed significantly (all P < 0.001). Our results indicate that cancer incidence and patient survival in Pudong New Area vary by tumor type, sex, age, geographic area, and TNM stage.

Incidence and survival condition of primary liver cancer among residents in Pudong district of Shanghai, from 2002 to 2011 / 中华流行病学杂志

Objective To analyze the incidence and survival rates of primary liver cancer (PLC) among residents in Pudong district of Shanghai.Methods Permanent residents of Pudong district,Shanghai were recruited in the study between 2002 and 2011,among whom 7981 PLC cases were diagnosed and 7233 death cases were certified.Both morbidity and mortality of PLC were calculated and standardized (ASR) by the world population of 1966,in order to analyze the survival condition of PLC patients on gender or address,to explore the prognosis of surgical excision treatment.Results Among the incident cases of PLC between 2002 and 2011,5754 cases were males,with an average age of 60.27; while 2227 cases were females,with an average age of 68.26.The crude incidence rate for both sexes was 30.73 per 100 000 person-year,and was 44.30 per 100 000 person-year for males,higher than that in females,17.16 per 100 000 person-year.The difference showed statistical significance (u=3.46,P＜0.01).The ASR for incidence rates were 25.72 per 100 000 person-year in males and 8.22 per 100 000 person-year in females,respectively,with difference statistically significant (u=3.00,P＜0.01).There were 7233 PLC death cases in total,including 5151 males and 2082 females,with the crude mortality rate as 27.85 per 100 000 person-year.Rate for males was 39.65 per 100 000 person-year,significantly different from 16.04 per 100 000 person-year in females,statistically (u=3.16,P＜0.01).The ASRs for mortality were 22.77 per 100 000 person-year in males and 7.39 per 100 000 person-year in females,with statistically significant difference (u=2.80,P＜0.01).Both incidence and mortality rates increased apparently for males aged over 35 and females aged over 45.The 1-to 5-year survival rates of PLC were 19.88％,14.91％,12.19％,10.29％ and 8.56％,respectively.There were statistically significant differences among urban,town and rural areas in the over-all survival rates(x2=8.711,P=0.013) ;The differences in 1-to 5-year survival rates between surgical and non-surgical groups showed statistically significant differences (u=10.8,6.93,4.75,3.3 and 2.61,respectively,P＜0.01).Conclusion The incidence and mortality rates in males were significantly higher than in females and the over-all survival in rural area was significantly lower than in other areas of Pudong district,suggesting that surgical treatment could improve the prognosis of PLC.