Comparison of healthcare expenditures and self-payment among patients with lung cancer in Wenling City before and after implementation of diagnosis-related groups (DRGs) / 预防医学

Objective@#To investigate the healthcare expenditures and self-payment among patients with lung cancer in Wenling City before and after implementation of diagnosis-related groups (DRGs), so as to provide the evidence for controlling medical costs and relieving burdens of patients with lung cancer. @*Methods@#The basic data and healthcare expenditures of lung cancer patients that were definitively diagnosed from 2015 to 2019 and covered by medical insurance were captured from the cancer registration database of Wenling Center for Disease Control and Prevention and the database of chronic and specific diseases in Wenling Bureau of Medical Insurance. The changes of outpatient expenditures, inpatient expenditures and self-payments were compared before (2015-2016) and after implementation of DRGs (2018-2019) among lung cancer patients.@*Results@#Totally 4 947 lung cancer patients covered by medical insurance were enrolled in this study, including 3 052 males (61.69%) and 1 895 females (38.31%), with a mean age of (64.88±11.64) years. The annual mean healthcare expenditure was 56 675.85 Yuan per capita during the period between 2015 and 2016, in which 14.48% were outpatient expenditures and 85.52% were inpatient expenditures, and the annual mean healthcare expenditure was 38 702.94 Yuan per capita during the period between 2018 and 2019 (a 31.71% reduction as compared to that in 2015 and 2016), in which 24.49% were outpatient expenditures and 75.51% were inpatient expenditures. The proportions of outpatient expenditures, inpatient expenditures and total self-payments consisted of 25.38%, 32.49% and 29.67% of total healthcare expenditures in 2018 and 2019, which were significantly lower than those (50.84%, 50.96% and 50.95%, respectively) in 2015 and 2016 (χ2=13.741, P<0.001; χ2=7.015, P=0.008; χ2=9.340, P=0.002).@*Conclusions@#The annual mean healthcare expenditures per capita and the proportion of self-payment reduce among lung cancer patients covered by medical insurance following implementation of DRGs.

miR-9 targets glycogen synthase kinase-3β-Wnt/β-catenin affects cartilage matrix degradation in osteo-arthritis / 中华风湿病学杂志

Objective:To investigate whether miR-9 plays a role in regulating glycogen synthase kinase-3β (GSK-3β) expression, affecting Wnt/β-catenin pathway activity and the patho-genesis of Osteo-arthritis (OA).Methods:The cartilage tissue of OA patients and normal cartilage tissue after traumatic amputation were collected, and the expressions of miR-9 and GSK-3β were compared. The double luciferase gene reporting test verified whether there was a targeted regulatory relationship between miR-9 and GSK-3β. OA rat model was established and compared with sham group, enzyme-linked immuno sorbent assay (ELISA) was used to detect hydroxyproline (Hyp) content in joint fluid.A kit was used to detect caspase-3 activity, and miR-9 and GSK-3β expression differences were detected in cartilage tissue. The OA model rats were divided into 3 groups: the sham group, the OA+ antagomiR-NC group, the OA + antagomiR-9 group. ELISA was used to detect Hyp content in joint fluid, kit was used to detect caspase-3 activity, and flow cytometry was used to detect cell cartilage tissue. Apoptosis, quantitative real-time polymerase chain reaction (qRT-PCR) and western blot were used to detect the expression of miR-9, GSK-3β, β-catenin and COL2A1. The comparison of mea-surement data between the two groups was conducted by t-test. The comparison of measurement data between multiple groups was conducted by one-way Analysis of Variance (ANOVA) analysis of variance, and then Bon-ferroni method was used for comparison between the two groups. P<0.05 was considered as statistically sign-ificant. Results:The miR-9 expression of cartilage tissue were (1.09±0.25) in the control group, and (2.86±0.25) in the OA group ( t=24.30, P<0.01). The GSK-3 β mRNA expression of cartilage tissue was (0.99±0.11) in the control group, and (0.53±0.10) in the OA group ( t=15.40, P<0.01). There was a targeted regulatory relationship between miR-9 and GSK-3β. The miR-9 expression of cartilage tissue was (1.00±0.21) in the sham group, and (2.61±0.36) in the OA group (t=9.462, P<0.01). The GSK-3 β mRNA expression of cartilage tissue was (1.00±0.18) in the sham group, and (0.52±0.09) in the OA group ( t=5.842, P <0.01). The Hyp content of joint fluid was (10±3) ng/ml in the sham group, and (50±8) ng/ml in the OA group ( t=11.015, P<0.01). The Caspase-3 activity of cartilage tissue was (1.00±0.19) in the sham group, and (2.43±0.36) in the OA group ( t=8.605, P<0.01). The miR-9 expression of cartilage tissue was (2.86±0.31) in the OA+antagomir NC group, and (1.67±0.19) in the OA + antagomir-9 group ( F=105.2, P<0.01). The GSK-3β mRNA expression of cartilage tissue was (0.41±0.09) in the OA antagomir NC group, and (0.81±0.09) in the OA + antagomir-9 group ( F=49.32, P<0.01). The Hyp content of joint fluid was (52.3±6.8) ng/ml in the OA + antagomir NC group, and (30.3±3.4) ng/ml in the OA + antagomir-9 group ( F=119.7, P<0.01). The caspase-3 activity of cartilage tissue was (2.22±0.23) in the OA + antagomir NC group, and (1.43±0.14) in the OA+ antagomir NC group ( F=72.55, P<0.01). Compared with OA + antagomir NC group, the expression of β-Catenin protein in the OA + miran-tagomir-9 group wasdecreased, the expression of GSK-3 β and COL2A1 protein wasincreased, and cell apo-ptosis wasdecreased. Conclusion:The increased expression of miR-9 plays a role in reducing the expression of GSK-3β, enhancing the activity of Wnt/β-catenin pathway, promoting the degradation, destruction of cartilage matrix and the pathogenesis of OA. Inhibition of miR-9 expression can reduce the protective effect of OA.

Analysis on the demand, access and related factors of cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017 / 中华预防医学杂志

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.

Analysis on the health literacy of the cancer prevention and treatment and its related factors among urban residents in China from 2015 to 2017 / 中华预防医学杂志

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.

Analysis on the consciousness of the early cancer treatment and its influencing factors among urban residents in China from 2015 to 2017 / 中华预防医学杂志

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.

Analysis on the consciousness of the early cancer diagnosis and its related factors among urban residents in China from 2015 to 2017 / 中华预防医学杂志

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.

Analysis on the consciousness of the cancer early detection and its influencing factors among urban residents in China from 2015 to 2017 / 中华预防医学杂志

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.

The reaserch about miR-17 targeting signal transducer and activator of transcription 3 to regulate the proliferation of rheumatoid arthritis synovial fibroblasts and the release of inflammatory factors from rheumatoid arthritis synovial fibroblasts in the pathogenesis of rheumatoid arthritis / 中华风湿病学杂志

Objective To investigate whether miR-17 plays a role in re-gulation of signal transducer and activator of transcription 3 (STAT3) expression,affecting the proliferation of rheumatoid arthritis synovial fibroblasts (RASFs) and the release of inflammatory factors from RASFs.Methods The synovial tissues of rheumatoid arthritis (RA) patients were collected.As a comparison,synovial tissues from osteoarthritis (OA) patients were collected as control,the expression of miR-17,STAT3 were detected.The results were analyzed by Mann-Whitney U test.To analyze the effects of interleukin (IL)-17A treatment on the expression of micro RNA-17 and STAT3,cell proliferation and secretion of IL-6 and IL-8 in RASFs cells.The effects of cell proliferation and secretion of IL-6 and IL-8 were analyzed by cell transfection of micro RNA-17 mimic and siRNA-STAT3.The results about RASFs cells were analyzed by t-testof two independent samples.Results Compared with OA patients,the expression of miR-17 in synovial tissues of RA patients decreased significantly (Mann-Whitney U=6,P＜0.01),while the expression of STAT3 increased obviously (Mann-Whitney U=32,P＜0.01).The expressions of IL-17A,IL-6 and IL-8 in synovial fluid of patients with OA were (53±12),(43±9) and (33±5),respectively,significantly lower than those of patients with RA [(170±30),(222±37) and (156±34),t=18.83,24.28,19.23,P＜0.01].IL-17A treatment significantly lowered the expression of miR-17 [(1.00 ±0.12) vs (0.37±0.04),t=8.63,P＜0.01],while up-regulated the expression of STAT3 [(1.00±0.14) vs (1.92 ±0.23),t =5.92,P＜0.01),promoted the proliferation of RASFs cells,and promoted the release of inflammatory factors IL-6 and IL-8.The results of the double luciferase reporter gene showed that there was a targeting regulation relationship between miR-17 and STAT3.Transfection of miR-17 mimic or siRNA-STAT3 could significantly reduce the expression of STAT3 and p-STAT3 in RASFs cells,along with the inhabitation of cell proliferation [miR-NC vs miR-17 mimic (26.9±2.8) vs (41.5±3.1),t=6.06,P＜0.01;siRNA-NC vs siRNA-STAT3 (23.5±2.4) vs (43.2±3.2),t=8.58,P＜0.01] and reduction of the secretion of inflammatory factors [miR-NC vs miR-17 mimic (110±13) vs (66±9),t=4.88,P＜0.01;siRNA-NC vs siRNA-STAT3 为(117±12) vs (70±6),t=6.10,P＜0.01] and IL-8 [miR-NC vs miR-17 mimic (127±10) vs (72±7),t=8.10,P＜0.01;siRNA-NC vs siRNA-STAT3 (123±11) vs (52±6),t=10.19,P＜0.01].Conclusion Decreased expression of miR-17 may play an important role in enhancing STAT3 expres-sion and promoting the pathogenesis of RA.Overexpression of miR-17 could inhibit STAT3 expression,atten-uate RASFs cell proliferation and inflammatory factor release.

Analysis on the age of onset of malignant tumors in cancer registration areas in Zhejiang Province from 2000 to 2015 / 中华预防医学杂志

Objective@#To study the age of onset of malignant tumors in cancer registration areas in Zhejiang province from 2000 to 2015.@*Methods@#Based on the incidence data of cancer from 14 national cancer registration areas in Zhejiang province between 2000 and 2015, the incidence rate, average/standardized average age of onset, and age-specific incidence proportion were calculated, and standardized by Segi′s world population. The population was divided into 7 age groups (0-29, 30-39, 40-49, 50-59, 60-69, 70-79, ≥80 years old). The average age of onset and age-specific incidence proportion were analyzed by using a linear regression. The change trend of the proportion; the average annual percent change (AAPC) of the incidence rate was calculated by using the Joinpoint log-linear regression model. The birth cohort was constructed by using the standardized incidence rate and the year of onset of cancer, and the distribution characteristics of the age groups were described.@*Results@#From calendar year 2000 to 2015, the average age of onset of malignant tumors in Zhejiang Province decreased from 59.7 to 57.6, with an average annual percent decrease of 0.09 year (P=0.033). After the merge of age groups, the standardized incidence proportion of 30-49 and ≥60 years old group standardization increased by an average annual change of 0.38% and decreased by an average annual change of 0.39%, respectively (both P values <0.001). The results of the log-linear regression model showed that the standardized incidence rate of the 30-39 and 40-49 years old age groups increased rapidly, with the AAPC (95%CI) about 5.2% (4.4%-6.0%) and 3.4% (2.5%-4.3%), respectively. The incidence rate of female increased rapidly, especially for 30-39 and 40-49 years old age groups with the AAPC about 6.2% (5.1%-7.2%) and 4.9% (4.0%-5.9%), respectively. The results of the birth cohort analysis showed that the population with different birth years in the same age groups saw an increasing trend with the increase of the birth year.@*Conclusion@#The age of onset of malignant tumors in the cancer registration areas in Zhejiang Province is getting younger. The incidence rate and number of people with malignant tumors in 30-49 years old age group is evident. These characteristics are more obvious in female than that in male.

A case-control study to identify risk factors associated with carbapenem resistant Enterobacteriaceae nosocomial infection / 国际检验医学杂志

Objective To investigate the characteristics of nosocomial infection of carbapenem resistant En-terobacteriaceae ,then to study the risk factors and prognosis of patients ,as to provide evidence for effective control of CRE hospital infection .Methods A retrospective epidemiology study was conducted of CRE infec-ted patients from January 2016 to June 2017 .This was a 1∶2 matched case-control study of patients with in-fection due to carbapenem resistant Enterobacteriaceae and randomly select 218 patients with non CRE infec-tion in the same hospital as control group ,then the risk factors of CRE infection were investigate .Results A-mong the 109 cases CRE infection patients ,the most common bacteria were Klebsiella pneumoniae ,Enter-obacter cloacae and Escherichia coli .The CRE strains were more sensitive to minocycline than other common antibiotics ,the resistance rate to other antibiotics was more than 40% .Univariate analysis showed that ICU staying time more than 7 d ,using beta lactamase inhibitors and carbapenem antibiotics ,combination therapy and mechanical ventilation were the potential risk factors of CRE nosocomial infection .The non conditional multivariate Logistic regression analysis showed that Check in ICU more than 7 d (OR＝ 4 .981 ,95% CI 2 .451-10 .122 ) ,the use of containing beta lactamase inhibitor antibiotics (OR＝ 3 .718 ,95% CI 2 .162-6 .394) ,use of carbapenem antibiotics (OR＝3 .232 ,95% CI 1 .879-5 .561) ,and mechanical ventilation (OR＝5 .26 ,95% CI 2 .576-10 .742) were independent risk factors of CRE nosocomial infection .The nosocomial in- fection CRE strain was with highly antibiotic resistance rate ,and the average hospitalization time and mortality were significantly higher than those of the control group .Conclusion The carbapenem resistant Enterobacte-riaceae infection had multiple independent risk factors ,strengthening of these independent risk factor control can effectively prevent the spread of CRE isolates infection .

The expression and clinical significance of miR-210, miR-155 and miR-34a in peripheral blood of patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To examine the expression of miR-210,miR-155 and miR-34a in the peripheral blood of patients with systemic lupus erythematosus (SLE) and to analyze their clinical significance.Methods One hundred and teenty-six SLE patients were divided into the stable group (n=35),mild active group (n=49),medium and severe active group (n =42) based on systemic lupus erythematosus disease activity index (SLEDAI) score.Meanwhile,40 subjects for healthy check-up were selected as controls.The clinical data of patients were collected.Complete blood count,liver and kidney function and immunological indexes were tested in patients and the lupus activity index was assessed.The expression level of miR-210,miR-155 and miR-34a were determined by real-time polymerase chain reaction.Furthermore,the correlation between their levels and clinical parameters such as erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),SLEDAI score,were analyzed.The expression levels of miR-210,miR-155 and miR-34a in each group were compared by one-way analysis of variance (ANOVA).Correlation analysis was performed by non parametric Spearman test.The difference was statistically significant if P＜0.05.The diagnostic value of SLE was evaluated by the subjects characteristic (ROC) curve.Results The levels of miR-210 and miR-155 were no significantly differencet between the stable group (0.017±0.012);(0.150±0.101) and the control group (0.015±0.010);(0.071±0.034),but they were increased in mild active group (0.502±0.166);(1.521±1.138),medium and severe active group(1.237±0.584),(13.589±9.827) (F=124.321,70.065,P＜0.05).The average expression level of miR-34a in the control group,the stable group,the mild active group and the moderate and severe active group were (0.005±0.003),(0.249±0.137),(2.981±1.762) and (9.625±5.873) respectively,and showed a trend of increase in turn (F=75.688,P＜0.05).The expression level of miR-210,miR-155 and miR-34a was not significantly different between the LN group and the non LN group (P＞0.05).The R values of miR-210,miR-155,miR-34a and each index were IgG (0.347;0.518;0.482);IgA (0.463;0.635;0.379);IgM (0.287;0.392;0.336),ESR(0.317;0.428;0.369),C3(0.243;0.429;0.381),C4(0.317;0.513;0.429),ANA titer (0.462;0.594;0.527),Anti-ds-DNA antibodies (0.391;0.586;0.483),SLEDAI scores (-0.412;-0.558;-0.493),and there were significant correlations (P＜0.05).In patients with SLE,there was no significant correlation between hormone therapy alone or hormone plus immunosuppressive therapy (P＞0.05).The sensitivity and specificity of miR-210,miR-155,miR-34a in combination for the diagnosis of SLE reached 75.7％ and 72.3％,respectively.Conclusion The levels of miR-210,miR-155 and miR-34a in combination may be used as bio-markers for the diagnosis of SLE.

Report of colorectal cancer incidence and mortality in China, 2013 / 中华肿瘤杂志

Objective@#To estimate the incidence and mortality of colorectal cancer (CRC) in China, providing basic information of treatment and prevention in CRC.@*Methods@#In 2016, National Central Cancer Registry (NCCR) collected registration data in 2013 from local cancer registries and assessed the data according to the auditing methods and evaluation criteria formulated by NCCR. 347 cancer registries submitted data of 2013 to NCCR. Qualified data from 255 registries was pooled, analyzed and stratified by area (urban/rural), gender, and age. CRC incidence and mortality were estimated using national population in 2013.@*Results@#In 2013, the estimate of new cases diagnosed with CRC in China was 347.9 thousands, with 9.45% of new cancer cases. The crude incidence of CRC was 25.57/100, 000 (28.64/100, 000 for male and 22.34/100, 000 for female, 30.92/100, 000 in urban areas and 19.35/100, 000 in rural areas), ranking fourth in all cancer. The age-standardized rates by China population and by world population were 17.45/100, 000 and 17.20/100, 000, respectively. Cumulative incidence of CRC in China was 2.05%. The estimated CRC deaths of China was 164, 900 in 2013, accounting for 7.39% of overall cancer deaths. The crude mortality rate for CRC was 12.11/100, 000 (13.49/100, 000 for male and 10.67/100, 000 for female, 14.41/100, 000 in urban and 9.45/100, 000 in rural), ranking fifth in all cancer. The age-standardized rates by China population and by World population for mortality were 7.87/100, 000 and 7.76/100, 000, respectively. Cumulative mortality rate of CRC in China was 0.82%. For both of incidence and mortality, males had much higher rates than females, while urban areas had much higher rates than rural areas. The incidence and mortality rates of CRC increased greatly with age, especially after 35 or 40 years old, and reached the peak in the age group of 80 or 85+ year old.@*Conclusion@#The disease burden of CRC was still serious in China. Primary prevention and early detection of CRC in China is crucial.

Cancer mortality in Zhejiang cancer registration areas from 2010 to 2014 / 中国肿瘤临床

Objective:To investigate cancer mortality in Zhejiang cancer registration areas from 2010 to 2014. Methods:Cancer regis-tration data were collected from 14 cancer registries of Zhejiang province. The number of cases, crude rates, proportions, age stan-dardized rates, cumulative rates, cut rates, age-specific rates, top 10 mortality ranks, and annual percentage change (APC) of cancer mortality were calculated. Results:A total of 108,514 cancer deaths in Zhejiang cancer registration areas from 2010 to 2014, including 70,578 males and 37,936 females, were recorded. The crude mortality rate was 186.06/105. The standardized mortality rates in Chi-nese (ASMRC) and world populations were 103.02/105 and 101.73/105, respectively. The cumulative mortality rate (0-74 years old) was 11.46%. The ratio of ASMRC in male and female was 1.95, and that in urban and rural areas was 0.93. Age-specific cancer mortality in-creased significantly after 40 years old and peaked at the 85+age group. The crude cancer mortality increased from 2010 (182.85/105) to 2014 (191.00/105) by 4.46%. After age standardization, the mortality rate standardized by Chinese population was reduced from 107.85/105 to 100.60/105. The APC of ASMRC was-1.96%(P=0.017). The top three mortality cancers were lung cancer, liver cancer and gastric cancer. The top 10 cancers accounted for 89.51%of all cancer deaths. The mortality rates in different age groups were inconsis-tent. Leukemia was the main cancer type among 0~14-year-old population. Liver cancer was the most common cancer type in 15~44-year-old population. Lung cancer was the main cancer in population above 45 years old. The ASMRCs of liver cancer, gastric cancer and esophageal cancer decreased, whereas those of pancreatic cancer, prostate cancer and ovarian cancer increased. Conclusion:Can-cer mortality in Zhejiang cancer registration areas increased, which revealed that the number of cancer deaths will continue to in-crease. However, the ASMRC decreased, which indicated that cancer prevention in Zhejiang province had achieved certain effects. Fur-ther measurements, such as health education, cancer screening, and early detection and treatment, should be improved to reduce the danger of cancer.

Clinical study of febuxostat intervention in treatment of hyperuricemia and vascular endothelial dysfunction in patients with hyperlipidemia / 中华内分泌外科杂志

Objective To evaluate the clinical efficiency of febuxostat on hyperuricemia and hyperlipidemia,provide evidences for the option of clinical treatment.Methods From Mar.2015 to Mar.2016,80 patients with hyperuricemia and hyperlipidemia were enrolled to this study,and they were randomly divided into observation group and control group by random number table,each group with 40 cases.The observation group received 40 mg of fenbuterol tablets once a day.The control group received 100 mg allopurinol tablets three times a day.The levels of serum uric acid,lipids,endothelium-soluble intercellular adhesion molecule-1 (sICAM-1) and endothelium (ET-1) were measured at the baseline,12 weeks after treatment and 24 weeks after treatment.Meanwhile,the liver and kidney function damage and adverse reactions were recorded.Results After treatment,the levels of uric acid,blood lipid,sICAM-1 and ET-1 were decreased in two groups,and there was significant difference between them (P＜0.05).The adverse effects of the two groups were transient.The incidence of liver or kidney damage,side effect of drug in observation group was lower than that in the control group,and there was no significant difference between the two groups (P＞0.05),except the incidence of rash.Conclusion Febuxostat intervention in treatment of patients with hyperuricemia and hyperlipidemia is safe and efficient.

Effect of Tongfu Qingxia Decoction on Barrier Function of Intestinal Tract in Acute Pancreatitis Patients / 中医杂志

Objective To study the effect of Tongfu Qingxia Decoction on the barrier function and inflammatory reaction regulation of intestinal mucosa in acute pancreatitis patients.Methods Patients selected were randomly divided into two groups.Routine treatment was conducted in control group,while Tongfu Qingxia Decoction was added in treatment group.Plasmic endotoxin,tumor necrosis factor-?(TNF-?)and interleukin-6(IL-6)were observed before and after treatment.Results After treatment,plasmic endotoxin,TNF-? and IL-6 decreased and interleukin-2 increased significantly in both groups(P