ABSTRACT
Objective:To evaluate the efficacy of high-risk HPV (HR-HPV) genotyping with vaginal self-sampling in primary screening and combining cytology or viral load for HR-HPV positive as secondary screening strategies.Methods:The data referring to HR-HPV genotyping of self-collected sample with mass array matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF-MS), HR-HPV viral load of physician-collected sample with hybrid capture Ⅱ (HC-Ⅱ), liquid-based cytology and histology of 8 556 women were from Shenzhen cervical cancer screening trial Ⅱ (SHENCCAST-Ⅱ) conducted between April 2009 and April 2010. The data were reanalyzed to determine the sensitivity and specificity to cervical intraepithelial neoplasia (CIN) of grade 2 or worse (CIN Ⅱ +), CIN of grade 3 or worse (CIN Ⅲ +) when HR-HPV genotyping combining with colposcopy as primary screening strategy based on varied HR-HPV subtype (strategy 1, including 5 sub-strategies: 1a: HPV 16/18 positive; 1b: HPV 16/18/58 positive; 1c: HPV 16/18/58/31/33 positive; 1d: HPV 16/18/58/31/33/52 positive; 1e: any HR-HPV positive). The data were also compared to determine the efficacy of cytology (strategy 2, including 5 sub-strategies: 2a, 2b, 2c, 2d, 2e) or HR-HPV viral load (strategy 3, including 4 sub-strategies: 3a, 3b, 3c, 3d) of physician-collected sample as a triage with HR-HPV genotyping for self-sampling HR-HPV positives. Results:(1) The HR-HPV positive rate was 13.77% (1 178/8 556) in the self-collected samples of 8 556 pregnant women. Of them,the prevalences of HPV 16/18, HPV 16/18/58, HPV 16/18/58/31/33 and HPV 16/18/58/31/33/52 were 3.16% (270/8 556), 5.14% (440/8 556), 6.66% (570/8 556) and 9.81% (839/8 556), respectively. The HR-HPV viral load ≥10 relative light units/control (RLU/CO) was 8.87%(759/ 8 556), while cytological results ≥atypical squamous cell of undetermined signification (ASCUS) were 12.05% (1 031/8 556). (2) The strategy 1e had the highest sensitivities for CIN Ⅱ +, CIN Ⅲ + which were 92.70% and 94.33%,respectively,among 14 sub-strategies,while the lowest specificity and positive predictive value (PPV). Meanwhile,the required colposcopy referral rates were much higher than other 13 sub-strategies (13.77%). The other 4 sub-strategies of strategy 1 (1a, 1b, 1c, 1d), strategy 1a had the highest specificities for CIN Ⅱ + and CIN Ⅲ + (97.92%, 97.69%, respectively), while 1d had the highest sensitivities for CIN Ⅱ + and CIN Ⅲ + (88.41%, 92.20%, respectively). (3) Both strategies of referring self-sampling HPV 16/18 positives for immediate colposcopy followed by triage physician-collected sample cytology (≥ASCUS) or viral load (≥10 RLU/CO) for non-HPV 16/18 positives had significantly higher sensitivity and specificity for CIN Ⅱ, CIN Ⅲ +, as well as lower referral rates (strategy 2a and 3a). Additionally, based on these two secondary screening strategies, cumulatively using the other four HR-HPV (HPV 58, 31, 33 and 52) positives as triage for immediate colposcopy showed an enhanced sensitivity. Conclusions:Primary HR-HPV cervical cancer screening strategy based on self-sampling with triage of cytology (≥ASCUS) or viral load (≥10 RUL/CO) provides a good balance among sensitivity, specificity for CIN Ⅱ + and CIN Ⅲ + and the number of tests required, referral rates. The efficacy of HR-HPV genotyping combining cytology or viral load secondary screening strategies will have a spiral escalation when HPV 58, 31, 33, 52 are included.
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Objective To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China,to explore the influence of population economic factors on them.Methods A total of 3 367 farmers,including fishermen or hunters,aged ≥ 18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015.Basic information (age,gender),data on anthropometric (body height,weight and waist size),blood biochemical and socioeconomic (occupation,income,education level and living area) were included.According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005,five cardio-metabolic risk factors appeared as central obesity,increased triglycerides,decreased HDL-C,increased blood pressure and increased plasma glucose.Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.Results In 3 367 framers of 15 provinces (autonomous region and municipality),the prevalence rates of central obesity,increased blood pressure,increased plasma glucose,increased triglycerides and decreased HDL-C were 51.8％,59.0％,17.0％,25.5％ and 38.7％ respectively.Multivariate logistic regression analysis showed that the risks for central obesity (OR=3.69,95％CI:3.17-4.28) and decreased HDL-C (OR=3.28,95％CI:2.81-3.82) were higher in women than in men,and the risks for increased blood pressure (OR=0.73,95％ CI:0.63-0.84),increased blood glucose (OR=0.80,95％ CI:0.67-0.97) were lower in women than in men.Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend P＜0.05).Framers in western China had obviously lower risk for central obesity compared with farmers in central China.No significant correlation was found between farmers' income level,education level or the prevalence of metabolic risk factors.Conclusion In 15 provinces of China,the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5％ of the farmers,and the co-prevalence of cardio-metabolic risk factor was found in 60％ of farmers.The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender.It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.
ABSTRACT
Objective To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China,to explore the influence of population economic factors on them.Methods A total of 3 367 farmers,including fishermen or hunters,aged ≥ 18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015.Basic information (age,gender),data on anthropometric (body height,weight and waist size),blood biochemical and socioeconomic (occupation,income,education level and living area) were included.According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005,five cardio-metabolic risk factors appeared as central obesity,increased triglycerides,decreased HDL-C,increased blood pressure and increased plasma glucose.Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.Results In 3 367 framers of 15 provinces (autonomous region and municipality),the prevalence rates of central obesity,increased blood pressure,increased plasma glucose,increased triglycerides and decreased HDL-C were 51.8％,59.0％,17.0％,25.5％ and 38.7％ respectively.Multivariate logistic regression analysis showed that the risks for central obesity (OR=3.69,95％CI:3.17-4.28) and decreased HDL-C (OR=3.28,95％CI:2.81-3.82) were higher in women than in men,and the risks for increased blood pressure (OR=0.73,95％ CI:0.63-0.84),increased blood glucose (OR=0.80,95％ CI:0.67-0.97) were lower in women than in men.Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend P＜0.05).Framers in western China had obviously lower risk for central obesity compared with farmers in central China.No significant correlation was found between farmers' income level,education level or the prevalence of metabolic risk factors.Conclusion In 15 provinces of China,the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5％ of the farmers,and the co-prevalence of cardio-metabolic risk factor was found in 60％ of farmers.The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender.It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.
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<p><b>OBJECTIVE</b>To establish the femtosecond laser experimental platform in vitro for numerical controlled cavity preparation, and to evaluate the roughness quantitatively and observe the microscopic morphology of the cutting surface.</p><p><b>METHODS</b>Enamel and dentin planes were prepared on human third molars. A universal motion controller was used to control the samples to do rectangle wave motion perpendicular to the incident direction of the laser at focus. The surface roughness was observed with confocal laser scanning microscope.</p><p><b>RESULTS</b>Precise ablation of the dental hard tissues can be achieved with the established femtosecond laser numerical control platform. For enamel, the surface roughness of the cavity inside laser scanning line was 7.173 µm at the bottom and 2.675 µm on the wall of the cavity. The surface roughness of the cavity between laser scanning lines was 13.667 µm at the bottom and 33.927 µm on the wall. For dentin, the surface roughness of the cavity bottom was 51.182 µm and 25.629 µm for the wall. Scanning electron microscope images showed no micro-cracks or carbonization on enamel, while carbonization, cracks and a small amount of crystalline particles were observed on dentin.</p><p><b>CONCLUSIONS</b>Precise tooth preparation can be achieved with femtosecond laser numerical control flatform. The surface roughness of cavity wall was less than that of the bottom and can meet the clinical needs. Suitable femtosecond laser output power should be set for different cutting objects, otherwise it may result in tissue damages.</p>