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Objective: To analyze and compare the distribution of the high-risk population of upper gastrointestinal (UGI) cancer and the factors influencing the compliance rate of endoscopic screening in urban China and rural China. Methods: From 2015 to 2017, an epidemiological survey was conducted on residents aged 40-69 in two rural areas (Luoshan county of Henan province, Sheyang county of Jiangsu province) and two urban areas (Changsha city of Hunan province, Harbin city of Heilongjiang province). As a result, high-risk individuals were recommended for endoscopic screening. Chi-square χ(2) test was used to compare the high-risk rate of UGI cancer between urban and rural residents. In addition, the multivariate logistic regression model was used to analyze the factors influencing the compliance rate of endoscopic screening. Results: A total of 48, 310 residents aged 40-69 were enrolled in this study, including 22 870 (47.34%) residents from rural areas and 25 440 (52.66%) residents from urban areas. A total of 23 532 individuals were assessed with a high risk of UGI cancer, with an overall risk rate of 48.71%. A higher proportion of participants with high risk was observed in rural China (56.17%, 12 845/22 870) than in urban China (42.01%, 10 687/25 440). A total of 10 971 high-risk individuals with UGI cancer participated in endoscopic screening, with an overall compliance rate of 46.62% (10 971/23 532), 45.15% (5 799/12 845) in rural China, and 48.40% (5 172/10 687) in urban China. In rural population, the compliance rate of endoscopic screening was higher in those of females, aged 50-69 years, primary school education or above, high income, a family history of UGI cancer, history of gastric and duodenal ulcer, history of reflux esophagitis, and history of superficial gastritis, but lower in smokers (P<0.05). Among the urban population, the compliance rate of endoscopic screening was higher in those aged 40-49 years, uneducated, low income, family history of UGI cancer, history of reflux esophagitis, history of superficial gastritis, but lower in smokers (P<0.05). Conclusions: The proportion of participants with high risk of UGI cancer in rural areas is higher than that of urban areas. The compliance rates of endoscopic screening in urban and rural areas are low, and influencing factors of endoscopic screening exhibit some differences in rural China and urban China.
Subject(s)
Female , Humans , China/epidemiology , Early Detection of Cancer , Esophagitis, Peptic , Gastritis , Gastrointestinal Neoplasms/epidemiology , Rural Population , Urban PopulationABSTRACT
Objectives:The purpose of this study was to evaluate the prognostic value of the Thrombolysis In Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores for in-hospital mortality in Chinese ST-segment elevation myocardial infarction (STEMI) patients. Methods:Present data are obtained from the prospective, multicenter Chinese AMI (CAMI) registry, 107 hospitals from 31 provinces, municipalities or autonomous districts in China took part in this study. From January 2013 to September 2014, 17886 consecutive ST-segment elevation myocardial infarction patients admitted to these 107 hospitals were enrolled. For each patient, TIMI and GRACE risk scores were calculated using specific variables collected at admission. Their prognostic value on the primary endpoint (in-hospital mortality) was evaluated. Results:Mean age of this patient cohort was (61.9±12.4)years, 76.5% (n=13685) patients were males. The in-hospital mortality was 6.4%(n=1 153)and the median length of hospital stay was 10.0 days. The incidence of cardiac arrest at admission were 4.3% (n=764). Coronary reperfusion therapy including fibrinolytic therapy(n=1782), primary percutaneous coronary intervention (n=7763) and emergent coronary artery bypass grafting (n=10) were applied to 9555 (53.4%) patients and the median of time to reperfusion was 300.0 minutes. The predictive accuracy of TIMI and GRACE for in-hospital mortality was similar:TIMI risk score (AUC) [area under the curve:0.7956; 95% confidence interval (95%CI:0.7822~0.8090)] and GRACE risk score (AUC:0.8096; 95%CI:0.7963~0.8230). Conclusions:The TIMI and GRACE risk score demonstrate similar predictive accuracy for in-hospital mortality and there are some disadvantages in risk stratification by these two risk scores for Chinese STEMI patients.
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<p><b>OBJECTIVE</b>To establish a new inducing system for differentiation of human embryonic stem (ES) cells to dendritic cells (DC), and further explore how microRNA-223 (miR-223) regulates DC differentiation from ES cells.</p><p><b>METHODS</b>Human ES cells were cultured on plates coated by IV type collagen and differentiated into hematopoietic stem/progenitor cells, common myeloid progenitor cells and DC step by step via adding different hematopoietic growth factors. The differentiated cells were identified by morphology, flow cytometry and hematopoietic colony forming unit (CFU) assays. Human ES cells were transfected with lentiviral vectors to overexpress miR-223 or inhibit miR-223 expression, then initiated the differentiation to DC. The differentiated cells at the different miR-223 levels were compared by the numbers of hematopoietic CFU and the expressions of specific surface markers. Dual-luciferase reporter assay was performed to test whether miR-223 directly targets TGFBR3.</p><p><b>RESULTS</b>Human ES cells were successfully induced into DC as the percentage of CD83 was approximately 82%, and the expression of miR-223 was up-regulated during the whole process. Supplementing miR-223 level using synthetic miR-223 mimics improved the proportions of CD34CD45, CD34CD45and CD83in differentiated cells, which were significantly higher than those in synthetic miR-223 inhibitor group and negative control (P<0.05). The expressions of cell makers at each differentiated phase in miR-223 inhibitor group were significantly lower than those in negative control (P<0.05). The differentiated cells in miR-223 mimics group showed approximately 759 CFUs per 10cells, which was significantly higher than that in others (P<0.05). Compared with negative control, miR-223 substantially inhibited the luciferase activity of Tgfbr3 3'UTR construct (by 37%) (P<0.05). In addition, the luciferase activity of the mutant construct was significantly higher than that of the WT construct in the presence of miR-223 mimics (P<0.05). With DC mature, the protein level of TGFBR3 gradually decreased using miR-223 mimics, and increased in miR-223 inhibitor group due to the suppression of the endogenous miR-223.</p><p><b>CONCLUSION</b>MiR-223 promotes the differentiation of human ES cells to DC, probably through direet target to TGFBR3.</p>