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BACKGROUND@#Xuanwei and Fuyuan are rural counties, located in the late Permian coal poly area of eastern Yunnan and western Guizhou, where lung cancer mortality rates are among the highest in the China, with similarity for both men and women, younger age at diagnosis and death, and higher in rural areas than in urban areas. In this paper, long-term follow-up of lung cancer cases in local peasants was conducted to observe their survival prognosis and its influencing factors.@*METHODS@#Data of patients diagnosed with lung cancer from January 2005 to June 2011, who had lived in Xuanwei and Fuyuan counties for many years, were collected from 20 hospitals at the local provincial, municipal and county levels. To estimate survival outcomes, individuals were followed up until the end of 2021. The 5-year, 10-year and 15-year survival rates were estimated using the Kaplan-Meier method. Survival differences were examined with Kaplan-Meier curves and Cox proportional hazards models.@*RESULTS@#A total of 3,017 cases were effectively followed up (2,537 peasants and 480 non-peasants). The median age at diagnosis was 57 years, and the median follow-up time was 122 months. During the follow-up period, 2,493 cases (82.6%) died. The distribution of cases by clinical stage was as follows: stage I (3.7%), stage II (6.7%), stage III (15.8%), stage IV (21.1%) and unknown stage (52.7%). Treatment at the provincial, municipal and county-level hospitals accounted for 32.5%, 22.2% and 45.3%, respectively, and surgical treatment was performed in 23.3% of cases. The median survival time was 15.4 months (95%CI: 13.9-16.1), and the 5-year, 10-year and 15-year overall survival rates were 19.5% (95%CI: 18.0%-21.1%), 7.7% (95%CI: 6.5%-8.8%) and 2.0% (95%CI: 0.8%-3.9%), respectively. Peasants with lung cancer had a lower median age at diagnosis, higher proportion residing in remote rural areas, and higher use of bituminous coal as a household fuel. They also have a lower proportion of early-stage cases, treatment at provincial or municipal hospitals, and surgical treatment, leading to poorer survival outcomes (HR=1.57). Even when considering factors such as gender, age, residential location, clinical stage at diagnosis, histological type, hospital level of service, and surgical intervention, peasants still exhibit a survival disadvantage. Multivariable Cox model analysis comparing peasants and non-peasants reveals that surgical intervention, tumor-node-metastasis (TNM) stage, and hospital level of service are common factors influencing survival prognosis, while the use of bituminous coal as a household fuel, hospital level of service and adenocarcinoma (compared to squamous cell carcinoma) are independent prognostic factors for lung cancer survival among peasants.@*CONCLUSIONS@#The lower lung cancer survival rate among peasants is associated with their lower socioeconomic status, lower proportion of early-stage diagnoses, lower proportion of surgical interventions, and treatment at provincial-level hospitals. Furthermore, the impact of other factors such as high-risk exposure to bituminous coal pollution on survival prognosis requires further investigation.
Subject(s)
Male , Humans , Female , Lung Neoplasms/epidemiology , China/epidemiology , Adenocarcinoma , Carcinoma, Squamous Cell , CoalABSTRACT
Objective To evaluate the molluscicidal effect of Rongbao in schistosomiasis endemic areas in Mianyang City. Methods Three Oncomelania hupensis snail habitats with the similar snail status were selected and sprayed with Rongbao,ni-closamide,and fresh water,respectively. Then the snail status in the three fields was surveyed before the spraying and 7,15,30 and 60 days after the spraying,and the molluscicidal effects of different molluscicides were compared. Results The reducing rates of densities of living snails in the field sprayed with Rongbao were 94.4%,95.9%,98.2%and 98.8%,7,15,30 and 60 days after the spraying,respectively. The reducing rates of the densities of living snails in the other field sprayed with niclosamide were 94.0%,94.0%,89.9%and 92.2%in above-mentioned days,respectively. In the 30 days and 60 days after the spraying,the reducing rates of densities of living snails in the field sprayed with Rongbao were significantly higher than those sprayed with ni-closamide(χ230 d=8.18,χ260 d=3.97,Both P<0.05). Conclusion The short-term molluscicidal effect of Rongbao is similar to that of niclosamide,but the long-term effect of Rongbao is better than that of niclosamide.
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Objective To investigate the volatile components of Hypericum perforatum L. from Shandong province. Method The volatile components were extracted by supercritical-CO2 fluid (SF-CO2) and the extracts were analyzed by GC and GC-MS. Results Forty-seven components were identified and Caryophyllene oxide, Spathulenol, Cyclododecane and Dodecanoic acid were found to be the major components of the essential oils. Conclusion The essential oil of Hypericum perforatum L. from Shandong China was significantly different from that grown in different areas of the world in major constituents. It is found that the chemical composition is influenced by various factors, such as geographical location, environmental conditions and agroclimatic requirements.