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Objective To investigate the tendency of viral hepatitis in Changning District, Shanghai, and to provide scientific evidence for decision-making of prevention and control. Methods Cases of viral hepatitis in Changning District from 2009-2019 were collected , and the epidemiological characteristics of viral hepatitis were analyzed by descriptive epidemiological method. Joinpoint regression analysis were used to estimate the annual percent change and average annual percent change, and to perform the trend test. Results Among the 2009-2019 in Changning District, a total of 3 397 cases of viral hepatitis were reported , the annual average incidence rate was 49.32/100 000. Results from Joinpoint trend analysis indicated that the incidence of viral hepatitis in Changning District was mainly due to hepatitis A and hepatitis B. Conclusions Although the annual incidence rate of viral hepatitis in Changning District is far below the incidence rate of viral hepatitis in China, but it still shows an increasing trend. This shows that the situation of prevention and control of viral hepatitis in Changning is still serious, and hepatitis B remains the key point of prevention of viral hepatitis in Shanghai.
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Objective To investigate the prevalence and risk factors of injury among both primary and middle school students in Changning District， Shanghai， and to provide evidence for injury prevention. Methods In 2018， data of basic characteristics and injury-related factors were obtained through field questionnaire survey among the selected primary and middle schools （2 of each）. Results The study finally included 1 821 students， with injury incidence rate of 30.1%. Among them， the injury incidence rate for the primary schools was 32.0%， and 28.8% for the middle schools. The top three injury types were falls， sharps injuries， and blunt injuries. Age， gender， myopia， and injury-related knowledge/behaviors were significantly related to injury incidence. Conclusion Falls should still be the priority of injury prevention for primary/middle school students in Changning District. The effect of reducing injuries can be achieved by improving health education about injury-related knowledge/behaviors.
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Objective To investigate the current situation and annual trend of injuries among primary and middle school students in Changning District, Shanghai, and to provide scientific evidence for decision-making of prevention and control. Methods The monitoring data of various types of injuries was collected from the “cause of class absence” system during the 2010-2017 school years. The Joinpoint regression analysis was used to estimate the annual percent change and average annual percent change, and to perform the trend test. Results During the 2010-2017 school years in Changning District, a total of 2,286 cases of injuries occurred among primary and middle school students, with an injury rate of about 0.70%. The top three prevalent injury types were falls, traffic accidents, and burn-related injury. The results of Joinpoint trend analysis indicated that the incidence of total injuries in Changning District was generally decreasing, which was mainly due to the effective control of injuries caused by falls, traffic accidents, and burns, and to the decreasing injury incidence among primary school students. Conclusion The overall situation of injuries among primary and middle school students in Changning District has improved significantly, but falls and traffic accidents are still important health threats. More attentions should be paid to certain groups, such as vocational and special education students.
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Objective To analyze the secular trends of pancreatic cancer incidence and mortality in Changning district of Shanghai from 1974 to 2013. Methods We calculated the age-standardized rates of incidence and mortality and the average annual percent changes for pancreatic cancer using Segi's world standard population and the data from Shanghai Cancer Registry. Age-period-cohort model was constructed to further assess the effect of age, diagnosis period and birth cohort on the secular trends of pancreatic cancer incidence and mortality. Results During 1974-2013, the age-standardized incidence and mortality rates were 6.49/105 and 6.01/105 in male, 4.83/105 and 4.57/105 in female, respectively. The age-standardized incidence was increased by 0.8% per year in male during past 40 years, while there was no change in mortality. The age-standardized incidence and mortality rates were increased by 1.6% and 1.3% per year in female. After adjusting the effects of diagnosis period and birth cohort, the incidence and mortality rates of pancreatic cancer increased by about 11% every 5 years older in both male and female. Diagnosis period and birth cohort had no statistical impact on the incidence and mortality of pancreatic cancer. Conclusion The age-standardized incidence of pancreatic cancer shows significantly rising trends during 1974-2013 in both male and female in Changning district of Shanghai, as well as the age-standardized mortality in female. The incidence and mortality rates also increase with age.
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Objective To discuss the effect of laparoscopic cholecystectomy open cholecystectomy on liver function,inflammatory factors and immunoglobulin in patients with chronic cholecystitis and cholecystolithiasis.Methods One hundred and five cases of chronic cholecystitis and cholecystolithiasis patients in the First Hospital of Danjiangkou City were selected form May 2015 to May 2017 by taking a retrospective analysis,and divided into experimental group (treated with laparoscopic cholecystectomy,n =52) and control group (treated with traditional open cholecystectomy,n =53) according to the different ways of treatment,recorded and compared the indicators of the operation process,alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBIL),gamma glutamyl transpeptidase (GGT),tumor necrosis factor-u (TNF-α),interleukin-6 (IL-6),interleukin-8 (IL-8),C reactive protein(CRP),IgA,IgG,IgM.The measurement data were expressed by ((x) ± s),and the t test was used comparison between groups,and the x2 test was used comparison between enumeration data,the comparison of the incidence of postoperative complications between the two groups was used the rank sum test,repeated measurement data using repeated measurement variance analysis.Results The operation time,intraoperative blood loss,postoperative anal exhaust time,first defecation time after operation,hospitalization time and hospitalization costs of experimental group were (73.71 ± 11.62) minutes,(60.73 ±6.88) ml,(24.38 ± 3.72) hours,(37.21 ±2.79) hours,(5.68 ±1.78) days,(6600 ±1 600) yuan respectively,the control group were (118.48 ±25.52) minutes,(121.24 ± 13.29) ml,(32.77 ±4.46) hours,(56.85 ±5.81) hours,(9.29 ±2.89) days,(4 900 ± 1 100) yuan respectively,which were statistically significant(the values of t were 3.584,4.183,3.397,3.245,3.489,2.938 respectively,all P ＜ 0.05).The liver function indexes ALT,AST,TBIL and GGT of the two groups were increased significantly after operation,which were statistical difference between the two groups (all P ＜0.05).The inflammatory indexes,TNF-α,IL-6,IL-8,CRP of the two groups were significantly increased,and the 1,3,5 days TNF-α,IL-6,IL-8,CRP after operation of the experimental group were significantly lower than the control group,which were statistical difference (all P ＜ 0.05).Compared with preoperative,the immunoglobulin indexes (IgA,IgG,IgM) of the experimental group after operation were no statistical difference (all P ＞ 0.05).The immunoglobulin indexes IgA,IgG,lgM in the control group were significantly lower than preoperative all P ＜ 0.05,the 1,3,5 days IgA,IgG,IgM of the control group after operation were significantly lower than the experimental group (all P ＜ 0.05).The incidence of operative complications of experimental group 5.77％ (3/52) was significantly lower than the control group 15.09％ (8/53),which was statistical difference (Z =5.118,P =0.000).Conclusion The therapeutic effect of Laparoscopic cholecystectomy on chronic cholecystitis and cholecystolithiasis is reliable,small trauma and short hospitalization time,although patients with postoperative liver function increase significantly but can be quickly restored,the level of inflammatory factors in the patients is significantly improved,and there is little effect on the immune function,and the incidence of postoperative complications is low,so it is worth popularizing in clinical practice.
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Objective To investigate the distribution about TCM constitution types and quality of life of the elderly patients with high incidence of tumor in Changning district of Shanghai, and analyze the correlation of them, in order to provide reference for follow-up management and rehabilitation of the patients.Methods The data about lung cancer, gastric cancer, and colorectal cancer was collected from Changning District of Shanghai from Jan. 2013 to Oct. 2015. The classification of TCM constitution was for the TCM constitution identified, and the Karnofsky Performance Status (KPS) was used for the assessment of life quality. Data was analyzed by SPSS 23.0. Results This study had collected 673 patients with tumor, and the average age was 75.82 ± 6.73. The colorectal cancer accounted 56.6%, the lung cancer 26.9%, and the gastric cancer 16.5%. The 88.3% of the patients were Qi-deficiency, and 41.4% belonged to compound constitution. The 53.3% of the patients had 80 scores on the first follow-up KPS value and 54.6% of them had the same scores on the last follow-up KPS value. There was a significant difference in KPS scores between the two follow-ups (rs=0.112, P=0.002). There was a negative correlation between the Yang-deficiency constitution and the Blood-stasis constitution of gastric patients with its first KPS value. Conclusions The TCM constitution types of the elderly patients with high incidence of tumor was Qi-deficiency type, which its KPS value of the two follow-ups were all high. There was a certain correlation between TCM constitution and KPS. Therefore, during the follow-up management of tumor patients, according to the types of TCM constitution, the Chinese medicine rehabilitation program could be set in order to improve their quality of life.
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Objective To evaluate the effect of health literacy and exercise-focused interventions on glycemic control in patients with type 2 diabetes (T2DM) in China.Methods In this cluster randomized controlled trial,a total of 799 T2DM patients with most recent hemoglobin Alc (HbAlc) ≥ 7.5％ (or fasting plasma glucose level ≥ 10 mmol/L) were recruited from 8 communities in Minhang and Changning districts of Shanghai,and randomized into a health literacy intervention group,an exercise intervention group,a comprehensive intervention group and a control group.After baseline survey and examination,a one-year intervention and 3 times (at 3rd,6th,and 12th month) follow-up surveys were conducted.Results The follow-up rates for all the subjects were 99.4％,98.4％ and 95.2％,respectively,at 3rd,6th and 12th month.Patients in intervention groups were more likely to achieve a goal HbAlc level (HbA1c ＜ 7.0％) than those in control group,with the highest glycemic control rate (25.3％) observed in comprehensive intervention group at 3rd month and then in exercise intervention group (25.3％ and 34.6％) respectively,at 6th month and 12th month.The average levels of HbAlc in three intervention groups were lower at each follow-up time point than those at baseline survey.However,the decreases in HbA1c were obvious only at 6th month (P＜0.001),with ls-mean (95％CI) of-0.48％ (-0.71％,-0.25％),-0.33％ (-0.55％,-0.11％) and-0.70％ (-0.92％,-0.48％),respectively,in comprehensive,health literacy and exercise intervention groups,but it increased slightly by 0.03％ (-0.19％,0.25％) in control group.Compared with control group,the interventions were significantly associated with the decrease of HbA1c level,with the most improvement observed in comprehensive group (3 =-0.47,95％ CI:-0.73,-0.20) at 3rd month,and in exercise intervention group at 6th month (3=-0.73,95％CI:-0.98,-0.47) and at 12th month (β=-0.75,95％CI:-1.05,-0.45) of follow-up.Stratified analyses showed that patients with lower health literacy level could benefit from any intervention,while those with higher numeracy skill benefited more from exercise intervention.Conclusion Both health literacy and exercise-focused interventions may decrease HbA1c level in patients with T2DM,which would be helpful in reducing the risks of complications and deaths in diabetes patients.
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Objective To evaluate the effect of health literacy and exercise-focused interventions on glycemic control in patients with type 2 diabetes (T2DM) in China.Methods In this cluster randomized controlled trial,a total of 799 T2DM patients with most recent hemoglobin Alc (HbAlc) ≥ 7.5％ (or fasting plasma glucose level ≥ 10 mmol/L) were recruited from 8 communities in Minhang and Changning districts of Shanghai,and randomized into a health literacy intervention group,an exercise intervention group,a comprehensive intervention group and a control group.After baseline survey and examination,a one-year intervention and 3 times (at 3rd,6th,and 12th month) follow-up surveys were conducted.Results The follow-up rates for all the subjects were 99.4％,98.4％ and 95.2％,respectively,at 3rd,6th and 12th month.Patients in intervention groups were more likely to achieve a goal HbAlc level (HbA1c ＜ 7.0％) than those in control group,with the highest glycemic control rate (25.3％) observed in comprehensive intervention group at 3rd month and then in exercise intervention group (25.3％ and 34.6％) respectively,at 6th month and 12th month.The average levels of HbAlc in three intervention groups were lower at each follow-up time point than those at baseline survey.However,the decreases in HbA1c were obvious only at 6th month (P＜0.001),with ls-mean (95％CI) of-0.48％ (-0.71％,-0.25％),-0.33％ (-0.55％,-0.11％) and-0.70％ (-0.92％,-0.48％),respectively,in comprehensive,health literacy and exercise intervention groups,but it increased slightly by 0.03％ (-0.19％,0.25％) in control group.Compared with control group,the interventions were significantly associated with the decrease of HbA1c level,with the most improvement observed in comprehensive group (3 =-0.47,95％ CI:-0.73,-0.20) at 3rd month,and in exercise intervention group at 6th month (3=-0.73,95％CI:-0.98,-0.47) and at 12th month (β=-0.75,95％CI:-1.05,-0.45) of follow-up.Stratified analyses showed that patients with lower health literacy level could benefit from any intervention,while those with higher numeracy skill benefited more from exercise intervention.Conclusion Both health literacy and exercise-focused interventions may decrease HbA1c level in patients with T2DM,which would be helpful in reducing the risks of complications and deaths in diabetes patients.
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Objective To investigate the levels of literacy and numeracy in type 2 diabetes patients with poor glycemic status in communities of Shanghai,China,and to evaluate their associations with blood glucose level.Methods A total of 800 type 2 diabetes patients with recent HbA1c≥7.5％ or fasting plasma glucose level ≥10 mmol/L were recruited from 8 communities in Minhang district and Changning district of Shanghai,China,and were interviewed using a structured questionnaire during February 2015 and March 2016.Literacy and numeracy levels of all patients were evaluated using the validated Health Literacy Management Scale (HeLMS) and the 5-item version Diabetes Numeracy Test (DNT-5),respectively.Results The patients included in this study were observed to have higher levels of health literacy,with a median score of HeLMS being 116 [interquartile range (IQR),108-120] and a median correct rate of DNT-5 of 80％ (IQR,60％-100％).Age,educational level and occupation were significantly related with health literacy levels and numeracy.Sex and income were closely related with health literacy levels.HeLMS score was not significantly associated with HbA1c level (P =0.383),while the lower correct rate of DNT-5 was linked with a higher level of HbA1c.The median HbA1c level was 8.3％ (IQR 7.7％-9.4％) in the patients with the lowest tertile of DNT-5 correct rate,significantly higher than 8.2％ (IQR:7.5％-9.2％) in the medium and 8.0％ (IQR:7.5 ％-8.8 ％) in the highest tertile group (P =0.009).Conclusions Diabetes patients with poor glycemic status in communities of Shanghai have high levels of health literacy,which was significantly related with age,sex,educational level,occupation and income.Ability in numeracy may be a more important influence factor than health literacy for glycemic status of diabetes patients.
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Objective To understand the factors related with child restraint system (CRS) use,and provide evidence for the development of appropriate intervention measures to promote the use of CRS for the protection of child passengers' safety.Methods Self-administrated questionnaire survey was conducted among 0-6 years old children' s parents who owned private cars selected through stratified cluster random sampling in Shanghai and Shenzhen to collect date about CRS use and related factors.Group discussion was conducted among some of the parents randomly selected to further understand the reasons for using or not using CRS.Results Of 7 528 parents surveyed,39.23 ％ (2 820/7 189) reported to have CRS and 17.14％(1 232/7 189) reported consistent use of CRS.Multivariate analysis indicated that young age of children,high level of education of parents,good family economic status,awareness of importance of children's safety were the positive factors for CRS use.The frequency and distance of children' car taking and the seatbelt use of drivers significantly influenced the CRS use.The main reasons for not purchasing CRS included limited car space (53.33％,2 329/4 367),low frequency of children car taking (48.55％,2 120/4 367),difficulty in installation (42.25％,1 845/4 367),high cost (38.58％,1 685/4 367),and unreliable quality (31.03％,1 355/4 367).The main reasons for not using CRS included children' s refusal (67.36％,293/435),short travel distance (53.79％,234/435),difficulty in installation or use (53.10％,231/435),limited car space (32.41％,141/435),and unnecessary (25.75％,112/435).Conclusions Parents have gaps and misunderstandings in using CRSs to protect child passengers safety.There are demands of technical guiding service in use of CRS.Integrated intervention measures should be implemented targeting at the identified barriers and needs in CRS use to promote child passenger safety,which include strengthening the propaganda and education,promoting the legislation and law enforcement,strengthening market supervision,establishing CRS related services site,exploring the rental market,etc.
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Objective To study the epidemic characteristics of falls among older female adults.Methods Stratified random sampling was applied in this study.Totally 969 elderly female adults aged 60 years and over from communities of Changning district were recruited and self-designed questionnaire was used in survey.Results Among 969 interviewees,238 (24.6％) had an injury in the past years,and 4.7％ had more than one fall.Among those who fell in the past year,84.5％ had suffered from different kinds of fall-related injury with injury incidence of 20.7 ％,and 32.4 ％ suffered from fracture with the fracture rate of 7.9％.There was a significant difference in fall incidence between different age groups,and the incidence increased with aging (x2 =30.26,P＜0.01).After a fall,71.6％ cases needed certain medical service,and 11.8％ were hospitalized for treatment.Among those suffered from fall-related injury,the activities of 29.3％ patients were decreased,and 3.0％ lost the ability to live independently.Most falls (31.2％) occurred at home.Among those,61.8％ of patients considered the reason of their falls was the interaction between intrinsic hazards and environmental hazards.Conclusions High incidence and severe consequence of fall appear among elderly female adults.More attention should be paid to this population.
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[Objective]To analyze the characteristics of outpatient prescription drug withdrawal,reduce out-patient drug withdrawal to ensure the safety of patients with medication.[Method]Make statistics on outpatients from January to September of 2007,1292 prescription drug withdrawals,drug withdrawal rate accordingly,drug dosage forms,drug types,the cause of drug withdrawal classification.[Result]There're many pediatric drug withdrawal,injection drug withdrawal,retreat antibiotic drugs,drug withdrawal and the main reason is unreasonable adverse drug reaction.[Conclusion] Analyzing the characteristics of drug withdrawal to strengthen rational drug use can reduce the greatest degree of adverse drug reaction,reducing out-patient drug withdrawal to ensure the drug safe,effective,rational and economic.
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The inhibitory effect of hydroxyapatite ultrofine powder (HAUFP) on tumor and the effect on the immunity function of body were investigated. The levels of IL-2 in the spleen cells and serum TNF levels in the tumor-bearing mice at the 7th day and 14th after peritoneal injection of HAUFP were detected by using the methods of colorimetric analysis of MTT and crystal purple decoration, respectively. The disappearance of the ascites of the mice was observed. The results showed that the levels of IL-2 and TNF in the tumor-bearing mice were higher obviously in the drug-treated group than in the control group (P<0.01), the ascites growth was inhibited. It was suggested that HAUFP could increase the levels of IL-2 and TNF of the tumor-bearing mice and improve the immune function of body.
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The inhibitory effect of hydroxyapatite ultrofine powder (HAUFP) on tumor and the effect on the immunity function of body were investigated. The levels of IL-2 in the spleen cells and serum TNF levels in the tumor-bearing mice at the 7th day and 14th after peritoneal injection of HAUFP were detected by using the methods of colorimetric analysis of MTT and crystal purple decoration, respectively. The disappearance of the ascites of the mice was observed. The results showed that the levels of IL-2 and TNF in the tumor-bearing mice were higher obviously in the drug-treated group than in the control group (P<0.01), the ascites growth was inhibited. It was suggested that HAUFP could increase the levels of IL-2 and TNF of the tumor-bearing mice and improve the immune function of body.
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Objective To study the effect of Fas gene transfection on bladder cancer cells. Methods Fas cDNA were transduced into bladder cancer cells EJ by DOTAP liposomal transfection regeant. Northern blot,in situ hybrization and flow cytometric evaluation were used to confirm the Fas mRNA and protein expression. The apoptosis and proliferation of EJ cells pre and posttransfection induced by cisplatin were analysed by flow cytometry、DNA ladder and MTT methods. Results Transfection of Fas gene can significantly upregulate the expression of Fas in human bladder cancer EJ cells. Apoptosis and decrease of proliferation were easily induced by cisplatin in the transfected EJ cells. Conclusions Fas system might involve in the development and progression of urogenital malignant tumors. Transfection of Fas gene by lipofectin can significantly upregulate the Fas expression in target cell. The synergistic cytotoxic effect obtainted in EJ cells suggested that combined use of Fas gene transfection and cisplatin may help in the treatment of cisplatin resistant bladder cancer.