Efficacy and safety of total neoadjuvant therapy versus neoadjuvant chemoradiotherapy in the treatment of locally advanced rectal cancer: a meta-analysis / 中华胃肠外科杂志

Objective: To systematically evaluate the efficacy and safety of total neoadjuvant therapy (TNT) in the comprehensive treatment of locally advanced rectal cancer. Methods: Literatures were screened from PubMed, Embase, Web of Science, Cochrane Library, CBM, Wanfang Data, VIP and CNKI from the inception date to May 2021 to collect the randomized controlled clinical trials (RCTs) of TNT followed by total mesorectal excision (TME) versus neoadjuvant chemotherapy (nCRT) followed by TME in the treatment of locally advanced rectal cancer. The data of overall survival, disease-free survival, R0 radical resection rate, pathological complete response (pCR) rate, T downstaging rate, the incidence of adverse events ≥ grade III, including neutropenia, nausea and vomiting, diarrhea, radiation dermatitis and nervous system toxicity, and the morbidity of complications within postoperative 30 days of the two groups were extracted from the included literatures. Review Manager 5.3 software was utilized for statistical meta-analysis. Results: Nine RCTs were finally enrolled including 2430 patients. Meta-analysis results showed that compared with nCRT group, patients in TNT group had longer overall survival (HR=0.80, 95%CI: 0.65-0.97, P=0.03) and higher pCR rate (RR=1.73, 95%CI: 1.44-2.08, P<0.01) with significant differences. Besides, there were no significant differences between two groups in disease-free survival (HR=0.86, 95%CI:0.71-1.05, P=0.14), R0 radical resection rate (RR=1.02, 95%CI: 0.99-1.06, P=0.17) and T downstaging rate (RR=1.04, 95%CI: 0.89-1.22, P=0.58) between two groups. In terms of treatment safety, the incidence of adverse events ≥ grade III (RR=1.09, 95%CI: 0.70-1.70, P=0.70) and morbidity of complications within postoperative 30 days (RR=1.07, 95%CI: 0.97-1.18, P=0.19) did not significantly differ between two groups. Conclusions: In the treatment of locally advanced rectal cancer, TNT may bring more survival benefits than nCRT and does not increase the incidence of adverse events and postoperative complications. Therefore, TNT could be used as a recommended treatment for patients with locally advanced rectal cancer.

Incidence and associated factors for single and recurrent falls among the elderly in an urban community of Beijing / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the incidence of falls and recurrent falls, and explore associated factors for single and recurrent falls among urban community-dwelling elderly in Beijing.</p><p><b>METHODS</b>A cross-sectional study was conducted in 472 elderly in the Longtan community of Dongcheng district, Beijing in 2009. Data regarding the incidence of fall and recurrent falls in the previous year, as well as associated factors were collected from the elderly through face-to-face interviews.</p><p><b>RESULTS</b>The incidence of falls and recurrent falls was 17.8% and 6.1%, respectively, and it increased with age (χ2for trend=21.06, 19.20, P=0.001, 0.002). Binary logistic stepwise regression analysis showed that age (OR=2.20), living alone (OR=4.67) and gait disturbance (OR=1.27) were risk factors, while housing with elevators (OR=0.35), appropriate width/height of stair steps (OR=0.78), sufficient lighting for stairway (OR=0.45) and regular exercise (OR=0.12) could lower the risk for single fall; factors such as low monthly family income (OR=1.39), poor vision (OR=1.83), low physical ability (OR=4.47), abnormal static balance (OR=2.48), and fear of falls(OR=2.23) were risk factors, while appropriate width/height of stair steps (OR=0.49) and easiness of access to daily supplies (OR=0.41) were protective factors for recurrent falls.</p><p><b>CONCLUSION</b>The incidence of falls in community-dwelling elderly people in Beijing is common, and falls and their related injuries have been associated with both intrinsic and extrinsic factors.</p>

A prospective study on recurrent falls and related factors in elderly from the urban communities in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the incidence and risk factors for recurrent falls in community-dwelling elderly in Beijing.</p><p><b>METHODS</b>A cross-sectional study was conducted in 472 elderly in the Longtan community of Dongcheng district,Beijing in 2009. Data on recurrent falls within the past 12 months were collected through face-to-face interview, with both single factor analysis and logistic regression analysis used to explore the related factors on recurrent falls in the elderly.</p><p><b>RESULTS</b>The incidence of recurrent falls among 472 older adults was 6.1% (29) within the past 12 months. Results from logistic regression analysis showed that factors as higher family monthly income(OR = 1.39, 95% CI:0.67-2.16), afraid of being fallen(OR = 2.23, 95% CI:1.47-3.85)and abnormal static balance(OR = 2.48, 95% CI:1.84-4.05)were risk factors, while bench height in the surrounding environment(OR = 0.49, 95% CI:0.21-1.12)and easiness of access to daily supplies (OR = 0.41, 95%CI:0.14-1.16)were protective factors for recurrent falls.</p><p><b>CONCLUSION</b>The incidence of recurrent falls among the elderly from the communities in Beijing was high. Since falls could be caused by various factors, intervention should be targeting on risk factors in a multi-dimensional way.</p>

Study on severity, status of awareness and therapy regarding urinary incontinence in elderly people from rural areas in Jixian county,Tianjin / 中华流行病学杂志

Objective To understand the prevalence of urinary incontinence(UI)and its severity in rural elderly people,as well as to investigate the awareness on UI in the elderly and health-care service seeking behavior.Methods A cross-sectional study was carried out in two townships of Jixian county,Tianjin.A total of 743 people aged 60 years and over were selected under cluster sampling method.All the information was collected with a standardized structured questionnaire by face-to-face interview.Prevalence,severity,the awareness on UI in the elderly and their utilization of health-care service for its diagnosis and treatment were analyzed.Results Prevalence of UI was 33.38% among people aged 60 years and over in two townships of Jixian,higher in females than in males(43.15% vs.22.75%,χ~2=34.70,P＜0.0001).The prevalence rates of UI in 60-age group,65-age group,70-age group,75-age group,80-age group,85-95 age group were 28.64%,32.12%,34.08%,35.45%,47.76%,30.00%,respectively,and increased with age (for trend χ~2=219,P=0.029).Stress urinary incontinence(SUI)and urge urinary incontinence(UUI)were mild,while mixed urinary incontinence(MUI)were mainly moderate.The differences of severity of SUI,UUI,MUI between men and women did not show statistical significance(all P＞0.05).In 743 elderly people,more than half of the respondents had never heard of UI(50.20%,373/743)and only 170(22.88%)elderly people considered UI as a disease.630(84.79%)and 665(89.50%)elderly people in our research group did not know that such condition was curable and preventable.In 248 elderly people with UI,only 12(4.84%)of them ever seeking community health-care services in the health-care centers or hospitals.For the ones who did visit the centers,the purpose was only to seek for drug treatment.Conclusion Prevalence of UI appeared to be high among the elderly people in rural areas of Jixian county.Most of the elderly people were lack of knowledge about UI that hindered them from seeking for diagnosis and treatment in the clinics,plus the treatment program for UI was not standardized.Knowledge on UI and health care seeking behavior should be popularized and strengthened among elderly people living in the rural areas.

Prevalence and related factors of falls among the elderly in an urban community of Beijing / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To understand the prevalence, consequences and risk factors of falls among urban community-dwelling elderly in Beijing.</p><p><b>METHODS</b>A cross-sectional study was conducted in Longtan Community, Beijing. A total of 1512 individuals aged 60 years or over were selected by stratified cluster sampling. Data regarding the frequency of falls in the previous year, as well as circumstances, consequence and related factors of falls were collected from the elderly through face-to-face interviews with questionnaires in their home.</p><p><b>RESULTS</b>The prevalence of falls was 18.0% on the average among 1512 participants, higher in women (20.1%) than in men (14.9%) (P = 0.006), and increased with age (chi2(for trend) = 10.37, P = 0.001). The total rate of falls-induced injuries among the fallers was 37.7%. Falls usually resulted in soft-tissues bruises (58.7%), fear of repeated episodes of falls (58.8%), loss of independence and confidence in movement (35.7%) and even in hip fracture. In addition to the burden of medical care, falls also generated a big economic burden. Occurrence of falls was significantly associated with both intrinsic and extrinsic factors. The related factors of falls in the elderly included age > or = 60-70 years, femininity, less physical activities, fear of future falls, living alone, severely impaired vision, health problem-impacted activities of daily living, chronic diseases (diabetes, hypertension, postural hypotension, stroke sequela, cataract, arthritis, dementia and depression), medications (psychoactive, anti-diabetic), gait imbalance, high bed and faintly-lighted stairway.</p><p><b>CONCLUSION</b>The prevalence of falls among urban community-dwelling elderly in Beijing is closely associated with significant associated with intrinsic and extrinsic factors. Efforts to prevent falls in the elderly should be made at community level.</p>

Study of large medical equipment allocation in Xuzhou / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To investigate the allocation and management of large medical equipment (LME) in Xuzhou, Jiangsu Province, China, in order to make the best use of LME to meet the medical needs of local people.</p><p><b>METHODS</b>The research collected data from all hospitals that have LME in Xuzhou using questionnaire; 38 (97.4%) hospitals returned the questionnaire.</p><p><b>RESULTS</b>In Xuzhou, there are a total of 71 pieces of LME, each serving 126 600 people in an area of 163 km(2). Sixty-two percent of them are allocated in urban areas, with Gini coefficient at 0.52, indicating imbalance and biased allocation of LME.</p><p><b>CONCLUSION</b>The allocation of LME in Xuzhou is out of control and unfairly allocated.</p>