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ObjectiveTo understand the incidence and change trend of thyroid cancer in Qingpu District， Shanghai from 2007 to 2016， and to provide a reference for formulating relevant prevention and treatment strategies. MethodsThe incidence data of thyroid cancer among residents in Qingpu District from 2007 to 2016 were collected using the Shanghai Malignant Tumor Registration System， and the crude incidence rate was calculated for different gender and age groups. The age-standardized incidence rate was calculated using the world standard population， and the annual percentage change （APC） was calculated using Joinpoint software to analyze the time trend of the incidence of thyroid cancer. ResultsThe incidence of thyroid cancer changed from 8.97/105 in 2007 to 52.02/105 in 2016， with an increase of 479.93% （APC=23.60， P<0.05）. The standardized incidence rate of thyroid cancer in men and women was 11.21/105 and 32.11/105， respectively， Male to female incidence ratio was 1∶3. Thyroid cancer in Qingpu District was mainly concentrated in the 25‒64 age group， accounting for 88.03% of the total incidence. ConclusionFrom 2007 to 2016， the incidence of thyroid cancer in Qingpu District， Shanghai has a significant upward trend. The age of high incidence tends to be younger and the incidence of women is significantly higher than that of men. Corresponding prevention and treatment measures should be formulated in consideration of the discovered incidence characteristics.
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Objective:To analyze the influenza vaccination status of chronic disease management patients in Qingpu district of Shanghai and the vaccination characteristics of different characteristic populations, so as to provide scientific basis for improving the influenza vaccination rate of chronic disease patients in the community.Methods:By comparing the data of Shanghai chronic disease management information system, immunization planning information system and medical association platform, 89 453 subjects who met the inclusion and exclusion criteria in Qingpu district were selected as the research objects. The vaccination coverage rate of the study subjects was calculated according to gender, age group, urban and rural distribution, occupation, chronic disease type and quantity, and the vaccination coverage rate of different subgroups was compared to analyze the influencing factors of vaccination coverage rate.Results:Most of the 89 453 patients with chronic diseases were 60 years old and above (71.93%). Patients with hypertension, diabetes, chronic obstructive pulmoriary disease (COPD) and three chronic diseases accounted for 87.12%, 28.67%, 8.71% and 1.83%, respectively. Influenza vaccination coverage in the 2016/2017 flu season was low, at 0.32%. Influenza vaccination coverage rate of women (0.37%) was higher than that of men (0.27%), which was 1.41 times respectively(95% CI: 1.16, 1.72) that of men patients. The coverage rate of influenza vaccination for the 70-79 year-old group was the highest (0.74%), which was 1.74 times respectively(95% CI: 1.39, 2.19) that of 60-69 year-old patients. The vaccination coverage rate of government departments and institutions was the highest (1.14%), which was 12.58 times respectively(95% CI: 4.52, 34.99) that of retirees. The vaccination rate of COPD patients (3.68%) was 2.50 times (95% CI: 1.66, 3.77) higher than that of patients without COPD.Conclusions:Influenza vaccination rate for chronic disease management patients in Qingpu district of Shanghai is low. Gender, occupation, age and types of chronic diseases are the influencing factors. Patients with chronic disease management should be included in the priority vaccination targets for influenza vaccines, and vaccination intervention for occupational chronic diseases such as non-retired agriculture and forestry patients, especially male patients, should be strengthened to improve influenza vaccination coverage rate.
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Objective:To study the predictive values of the general movements (GMs) assessment combined total bilirubin for motor development outcomes in infants with severe neonatal jaundice.Methods:From June of 2014 to June of 2019, infants with severe neonatal jaundice in Chenzhou First People′s Hospital were enrolled in the study. Inclusion criteria included , the serum total bilirubin was measured at the time of admission, corrected gestational age of 37 to 48 weeks. General assessment were carried out when the infant was stable. The patients were regularly followed-up until the age of 12months to evaluate the predictive values.Results:A total of 204 patients with severe neonatal jaundice were enrolled in the study, with mean serum total bilirubin value (485.4±109.6)μmol/L. They were divided into two groups according to the outcome of motor development. The total bilirubin value, the proportion of abnormal GMs and dangerous total bilirubin level in the abnormal group were significantly higher than those in the normal group (all P<0.05). 13 cases (6.4%) were normal in the torsion stage of GMs; 191 cases (93.6%) were abnormal, including 164 cases (85.9%) of poor repertoire (PR) and 27 cases (14.1%) of cramped-synchronized (CS). Abnormal GMs and total bilirubin were the risk factors of abnormal motor development ( OR=4.651, 1.017, P<0.05). The predictive values of abnormal GMs for abnormal motor development outcomes were as following: sensitivity 100%, specificity 8.4%, negative predictive value (NPV) 100%. The predictive values of CS for cerebral palsy were as following: sensitivity 63.2%, specificity 97.8%, NPV 96.0%. Receiver operating characteristic (ROC) curve showed that the area under the curve predicted by GMs and total bilirubin was 0.765 and 0.757, respectively. The area under the curve of motor dysplasia predicted by combining the two was 0.854. Conclusions:The evaluation of general movement assessment combined total bilirubin has certain clinical predictive value for the outcomes of motor development in infants with severe neonatal jaundice.
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Objective To study the predictive values of the general movements (GMs) assessment in writhing stage for motor development outcomes in infants with severe neonatal jaundice.Method From December of 2012 to December of 2017,infants with severe neonatal jaundice (serum bilirubin reaching the corresponding level of exchange transfusion according to the reference nomogram) in our hospital were enrolled in the study.Inclusion criteria included corrected gestational age of 37 to 48 weeks,serum bilirubin level below phototherapy intervention value after treatment and general and detailed assessment were carried out in writhing stage when the infant was stable.The patients were regularly followed-up until one-year-old to evaluate the predictive values.Result A total of 241 patients with severe neonatal jaundice were enrolled in the study,including 153 males (63.5％) and 88 females (36.5％),with gestational age between 35 and 42 weeks.The mean gestational age was (37.9± 1.8) weeks,the average birth weight was (3 057±480) g,and the mean serum bilirubin value was (458.9± 119.1) μmol/L.The general evaluation of the GMs was normal in 15 cases (6.2％),and abnormal in 226 cases (93.8％) with 217 cases (90.0％) were poor repertoire (PR) and 9 cases (3.7％) were cramped-synchronized (CS).The predictive values of abnormal GMs for abnormal motor development outcomes were as following:sensitivity 100％,specificity 7.6％,negative predictive value(NPV) 100％.The predictive values of CS for cerebral palsy were as following:sensitivity 22.2％,specificity 97.8％,NPV 94.0％.Detailed evaluation of 241 subjects showed that 13 items had statistically significant differences in the prediction of cerebral palsy (P＜0.05),and 18 items in the prediction of abnormal motor development (P＜0.05).Conclusion The CS pattern and detailed assessment of GMs in the writhing stage may be correlated with the outcomes of motor development in infants with severe neonatal jaundice until one-year-old.
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To explore the correlation between nucleated red blood cell (NRBC) count and perinatal asphyxia in neonates.Full-term newborns born from May 2011 to November 2012 were recruited and divided into perinatal asphyxia (n =40) and normal (n =30) groups.Apgar score was recorded immediately at delivery.The umbilical arterial blood was also collected into anticoagulant-treated tube and NRBC was counted by Japan OlympusCX41 biological microscope.NRBC count for perinatal asphyxia group [(10.70 ± 2.61)/100 WBC] was significant higher than that for normal group [(2.67 ± 0.35)/100 WBC].A statistically significant negative correlation existed between NRBC and umbilical arterial blood pH,Apgar score at 1 min,BE value (r =-0.802,P ＜ 0.05 ; r =-0.639,P ＜ 0.05 ; r =-0.566,P ＜ 0.05).Associated with perinatal asphyxia in neonates,NRBC may be used as a simple index for assessing the severity of neonatal perinatal asphyxia.