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Objective@#To evaluate the efficacy of lung cancer screening in urban areas of Henan province by low-dose computed tomography (LDCT) from 2013 to 2017.@*Methods@#A cluster sampling method was used to select the residents of 40-74 years old in Henan province to investigate the risk factors and conduct lung cancer risk assessment. Subjects with high risk of lung cancer received LDCT for screening.@*Results@#A total of 179 002 residents completed the lung cancer risk assessment, and 35 672 subjects were identified as high risk of lung cancer, with a high risk rate of 19.93%. A total of 13 383 subjects with high risk received LDCT, and the screening rate was 37.52%. There were 786 cases diagnosed as positive nodules, and the detection rate was 5.87%. Among them, 755 cases of solid/partial solid nodule were ≥5 mm, 23 cases of non-solid nodules were ≥8 mm, 8 cases were intratracheal nodules, and 115 cases were diagnosed as suspicious lung cancer. The detection rate in males was 6.74%, which was higher than 5.02% in females. The detection rate was positively related with age (P<0.05).@*Conclusions@#The application of LDCT is a useful screening method which can elevate the early detection rate of positive nodules and other related diseases in lungs. In the future, males and older populations should be paid more attention to improve screening efficacy.
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Objective@#To describe the status of non-steroidal anti-inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. @*Methods@#This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High-risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)" . From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health-related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ2 test and Cochran-Armitage trend analysis method. @*Results@#Of 35 910 subjects, the mean age was (54.6±7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend <0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend <0.05 for all). @*Conclusion@#The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.
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Objective@#To investigate the helping role of Kangfuxin liquid on early enteral nutrition in craniocerebral injury patients with mechanical ventilation, and the indirect effect on mechanical ventilation.@*Methods@#60 craniocerebral injury patients with mechanical ventilation and early enteral nutrition were selected, and they were randomly divided into treatment group and control group according to the digital table, 30 cases in each group.All patients were given conventional treatment and nutritional support, the patients in the treatment group were given Kangfuxin liquid.Before and 7 days after treatment, the levels of albumin(ALB), pre albumin(PA) and totalprotein(TP) were tested.The incidence of abdominal distension, reflux and aspiration in 7 days were recorded.The time of mechanical ventilation and the stay time in ICU were recorded.The mortality rate in 28 days was recorded.@*Results@#7 days after treatment, the levels of ALB[(33.47±4.82)g/L vs.(30.47±4.64)g/L], PA[(206.21±41.87)mg/L vs.(185.62±38.94)mg/L]and TP[(57.82±5.96)g/L vs.(54.47±6.17)g/L]in the treatment group were higher than those in the control group(t=2.456, 2.338, 2.139, all P<0.05). The incidence rates of abdominal distension(20.00% vs.53.33%), reflux(16.67% vs.43.33%), time of mechanical ventilation[(11.76±2.02)d vs.(13.02±1.96)d]and the stay time in ICU[(13.74±2.31)d vs.(15.43±2.14)d]in the treatment group were lower than those in the control group(χ2=7.177, 5.07, t=2.452, 2.940, all P<0.05). There was no statistically significant difference in 28-day mortality rate (P>0.05).@*Conclusion@#Kangfuxin liquid has helping role on early enteral nutrition in craniocerebral injury patients with mechanical ventilation.And it is helpful to shorten the time of mechanical ventilation.
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Objective@#To evaluate the performance of high risk human papillomavirus (HR-HPV) DNA test for triage ASC-US in Chinese population.@*Methods@#The study population was from Jiyuan city in Henan Province where a cervical cancer screening cohort (4 026 women) was set up from April to July in 2017. Women with ASC-US and complete recall information of colposcope were selected as the study objects. Self-designed questionnaire was used to survey the general information and medical history of cervical cancer, thencervical cytological speciments were collected for cytodiagnosis and HPV DNA test, followed by colposcopy, lesion biopsy and histology diagnose. The diagnosis of histology was used as the gold standard. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) as well as corresponding 95% confidential interval (CI) were calculated.@*Results@#The average age of the included 393 women with ASC-US were (50.81±9.22) years old. The positivity of high risk human papillomavirus (HR-HPV), HPV16 and HPV18 were 35.6%, 10.69% and 2.80%, respectively. The sensitivity, specificity, PPV and NPV for HR-HPV to detect CIN2+ were 84.38% (68.25%-93.14%), 68.70% (63.74%-73.26%), 19.29% (13.61%-26.61%) and 98.02% (95.46%-99.15%). When compared with HR-HPV, HPV16/18 had a lower sensitivity (59.38% (42.26%-74.48%)) and a higher specificity(91.14% (87.75%-93.65%)), the PPV and NPV were 59.38% (25.32%-50.98%) and 91.14% (93.61%-97.77%).@*Conclusion@#It was more effective for HR-HPV to triage ASC-US than HPV16/18. In order to improve the effect of HPV16/18, it should include more HR-HPV types which were more prevalent in Chinese population.
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Objective@#To evaluate effect of screening of esophageal cancer though comparing difference of survival level between screening and non-screening patients in Linzhou city.@*Methods@#The records pathologically diagnosed as serious hyperplasia/carcinoma and esophageal cancer were drawn from database of first round screening in Linzhou city from 2005-2013 and were assigned to the screening group. The records of new esophageal cancer cases which diagnosed within 2 years before, screening from the same village aged from 40 to 69, were drawn from database of cancer registry in Linzhou city and were assigned to the non-screening group. Five or 10 year survival rate with 95%CI of patients with different malignant degree diseases in the screening group and the patients with esophageal cancer in the non-screening group was calculated respectively. The survival curves between the screening and non-screening group were compared by Log rank method.@*Results@#All 26 908 persons were examined in first round screening in Linzhou city from 2005 to 2013. There were 374 persons with serious hyperplasia/carcinoma in situ, 157 persons with esophageal cancer (141 intramucosal carcinomas/submucosal cancers, 16 invasive cancers). The 5 year survival rate of serious hyperplasia/carcinoma, intramucosal carcinoma/submucosal cancer and invasive cancer were 95.0% (95%CI: 91.7%-97.0%) , 72.0% (95%CI: 62.7%-79.3%) and 41.7% (95%CI: 17.4%-64.6%) separately. The 5 year survival rate of esophageal cancer in screening and non-screening group were 68.7% (95%CI:59.9%-75.9%) and 40.8% (95%CI: 36.4%-45.2%). The 10 year survival rate of esophageal cancer in screening and non-screening group were 58.0% (95% CI: 44.6%-69.3%) and 34.3% (95% CI:29.1%-39.5%). The 5 or 10 year survival rate of esophageal cancer in the screening group were higher than that in the non-screening group in whatever sex or age. The survival distribution of the screening group was better than non-screening group (χ2=38.88, P<0.001).@*Conclusion@#More precancerous lesions and early esophageal cancer can be detected and patients' survival level was improved through organized esophageal cancer screening, which provided support to evaluate value of organized screening.
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Objective@#To investigate the effect of fried food intake on the pathogenesis of gastric cancer and precancerous lesions.@*Methods@#From 2005 to 2013, the residents aged 40-69 years from 11 counties/cities where cancer screening of upper gastrointestinal cancer were conducted in rural areas of Henan province as the subjects (82 367 cases). The information such as demography and lifestyle was collected. The residents were screened with endoscopic examination. The biopsy sampleswere diagnosed pathologically, according to pathological diagnosis criteria, the subjects with high risk were divided into the groups with different pathological degrees. The multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and gastric cancer and precancerous lesions.@*Results@#The study coverd 46 425 males and 35 942 females, with a age of (53.46±8.07)years. The study collected 6 707 cases of normal stomach, 2 325 cases of low grade intraepithelial neoplasia, 226 cases of high grade intraepithelial neoplasia and 331 cases of gastric cancer. Multivariate logistic regression analysis showed that, compared with those whoeat fried food less than one time per week, fried foods intake (<2 times/week: OR=1.89, 95%CI: 1.57-2.28; ≥ 2 times/week: OR=1.91, 95%CI: 1.66-2.20) were a risk factor for gastric cancer and precancerous lesions after adjustment for age, sex, marital status, educational level, body mass index (BMI), smoking and drinking status.@*Conclusion@#The intake of fried food is a risk factor for gastric cancer and precancerous lesions. Therefore, reducing the intake of fried food can prevent the occurrence of gastric carcinoma and precancerous lesions.
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Objective To estimate the incidence and mortality of kidney cancer in China in 2014,based on the cancer registration data.Data was collected through the National Central Cancer Registry (NCCR).Methods All together,449 cancer registries submitted required data on incidence and deaths of kidney cancer occurred in 2014,to the NCCR.After evaluation on the quality of data,339 registries were accepted for analysis and stratified by areas (urban/rural) and age groups.Combined with data from the National population in 2014,the nationwide incidence and mortality of kidney cancer were estimated.Data from the 2000 National census was used,and with Segi's population used for the rates of age-standardized incidence/mortality.Results The qualified 339 cancer registries covered a total population of 288 243 347,with 144 061 915 in urban and 144 181 432 in rural areas.The percentage of morphologically verified cases and cases with only available death certificates were 72.70％ and 1.27％,respectively.The mortality to incidence ratio was 0.37.The estimates of new cases were around 68 300 in whole China,in 2014,with a crude incidence rate as 4.99/100 000 (95％CI:4.95/100 000-5.03/100 000).The age-standardized incidence rates of kidney cancer,estimated by China standard population (ASR China) and world standard population (ASR world)were 3.43/100 000 (95％CI:3.40/100 000-3.46/100 000) and 3.40/100 000 (95％CI:3.37/100 000-3.43/100 000),respectively.The cumulative incidence rate of kidney cancer was 0.40％ in China.The crude and ASR China incidence rates for males appeared as 6.09/100 000 (6.03/100 000-6.15/100 000)and 4.32/100 000 (4.28/100 000-4.36/100 000),respectively,whereas those were 3.84/100 000 (3.79/100 000-3.89/100 000) and 2.54/100 000 (2.50/100 000-2.58/100 000) for females.The crude and ASR China incidence rates in urban areas appeared as 6.60/100 000 (95％CI:6.54/100 000-6.66/100 000) and 4.25/100 000 (95％ CI:4.21/100 000-4.29/100 000),respectively,whereas those were 3.05/100 000 (95％CI:3.01/100 000-3.09/100 000) and 2.29/100 000 (95％CI:2.25/100 000-2.33/100 000) in rural areas.The estimates of kidney cancer deaths were around 25 600 in the country,in 2014,with a crude mortality rate of 1.87/100 000 (95％CI:1.85/100 000-1.89/100 000).The ASR China and ASR world mortality rates appeared as 1.16/100 000 (95 ％ CI:1.14/100 000-1.18/100 000)and 1.16/100 000(95％CI:1.14/100 000-1.18/100 000),respectively,with a cumulative mortality rate (0-74 years old) of 0.12％.The crude and ASR China mortality rates were 2.31/100 000 (95％CI:2.27/100 000-2.35/100 000) and 1.52/100 000 (95％ CI:1.50/100 000-1.54/100 000) for males,respectively,whereas those were 1.41/100 000 (95％CI:1.38/100 000-1.44/100 000) and 0.81/100 000(95％CI:0.79/100 000-0.83/100 000) for females.The crude andASR China mortality rates were 2.49/100 000 (95％CI:2.45/100 000-2.53/100 000) and 1.42/100 000 (95％CI:1.40/100 000-1.44/100 000)in urban areas,respectively,whereas those were 1.12/100 000 (95％CI:1.09/100 000-1.15/100 000)and 0.78/100 000 (95％ CI:0.76/100 000-0.80/100 000) in the rural areas.Conclusions Both the incidence and mortality of kidney cancer seemed low,in China.However,the incidence of kidney cancer had greatly increased.Our findings suggested that prevention and control strategies for kidney cancer should be focused on males in the urban areas.
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Objective To estimate the incidence and mortality of kidney cancer in China in 2014,based on the cancer registration data.Data was collected through the National Central Cancer Registry (NCCR).Methods All together,449 cancer registries submitted required data on incidence and deaths of kidney cancer occurred in 2014,to the NCCR.After evaluation on the quality of data,339 registries were accepted for analysis and stratified by areas (urban/rural) and age groups.Combined with data from the National population in 2014,the nationwide incidence and mortality of kidney cancer were estimated.Data from the 2000 National census was used,and with Segi's population used for the rates of age-standardized incidence/mortality.Results The qualified 339 cancer registries covered a total population of 288 243 347,with 144 061 915 in urban and 144 181 432 in rural areas.The percentage of morphologically verified cases and cases with only available death certificates were 72.70％ and 1.27％,respectively.The mortality to incidence ratio was 0.37.The estimates of new cases were around 68 300 in whole China,in 2014,with a crude incidence rate as 4.99/100 000 (95％CI:4.95/100 000-5.03/100 000).The age-standardized incidence rates of kidney cancer,estimated by China standard population (ASR China) and world standard population (ASR world)were 3.43/100 000 (95％CI:3.40/100 000-3.46/100 000) and 3.40/100 000 (95％CI:3.37/100 000-3.43/100 000),respectively.The cumulative incidence rate of kidney cancer was 0.40％ in China.The crude and ASR China incidence rates for males appeared as 6.09/100 000 (6.03/100 000-6.15/100 000)and 4.32/100 000 (4.28/100 000-4.36/100 000),respectively,whereas those were 3.84/100 000 (3.79/100 000-3.89/100 000) and 2.54/100 000 (2.50/100 000-2.58/100 000) for females.The crude and ASR China incidence rates in urban areas appeared as 6.60/100 000 (95％CI:6.54/100 000-6.66/100 000) and 4.25/100 000 (95％ CI:4.21/100 000-4.29/100 000),respectively,whereas those were 3.05/100 000 (95％CI:3.01/100 000-3.09/100 000) and 2.29/100 000 (95％CI:2.25/100 000-2.33/100 000) in rural areas.The estimates of kidney cancer deaths were around 25 600 in the country,in 2014,with a crude mortality rate of 1.87/100 000 (95％CI:1.85/100 000-1.89/100 000).The ASR China and ASR world mortality rates appeared as 1.16/100 000 (95 ％ CI:1.14/100 000-1.18/100 000)and 1.16/100 000(95％CI:1.14/100 000-1.18/100 000),respectively,with a cumulative mortality rate (0-74 years old) of 0.12％.The crude and ASR China mortality rates were 2.31/100 000 (95％CI:2.27/100 000-2.35/100 000) and 1.52/100 000 (95％ CI:1.50/100 000-1.54/100 000) for males,respectively,whereas those were 1.41/100 000 (95％CI:1.38/100 000-1.44/100 000) and 0.81/100 000(95％CI:0.79/100 000-0.83/100 000) for females.The crude andASR China mortality rates were 2.49/100 000 (95％CI:2.45/100 000-2.53/100 000) and 1.42/100 000 (95％CI:1.40/100 000-1.44/100 000)in urban areas,respectively,whereas those were 1.12/100 000 (95％CI:1.09/100 000-1.15/100 000)and 0.78/100 000 (95％ CI:0.76/100 000-0.80/100 000) in the rural areas.Conclusions Both the incidence and mortality of kidney cancer seemed low,in China.However,the incidence of kidney cancer had greatly increased.Our findings suggested that prevention and control strategies for kidney cancer should be focused on males in the urban areas.
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Objective@#To investigate the incidence and survival of esophageal cancer with different histological types and to understand the incidence trend and burden of esophageal cancer in Linzhou during 2003-2012.@*Methods@#All incidence records of esophageal cancer and population reported were collected from Linzhou Cancer Registry during 2003-2012. Incidence rate was calculated using gender and histological types. Age standardized incidence rate was calculated according to world Segi's population and Chinese census data in 2000. Age standardized incidence rate by world population between 2003 and 2012 was analyzed with JoinPoint regression model and estimated annual percentage change (EAPC) was calculated. 5-year survival rate was calculated with Kaplan-Meier model.@*Results@#There were 8 229 esophageal cancer cases in Linzhou during 2003-2012. The average annual incidence rate was 80.08/100 000 (8 229/10 276 481). Among all esophageal cancer cases, 7 019 (85.3%) were diagnosed as esophageal squamous cell carcinoma (ESCC). In Linzhou, the age standardized incidence rate by Chinese standard population and by world standard population was 80.92/100 000 and 81.85/100 000 in 2003, 67.97/100 000 and 68.63/100 000 in 2012. JoinPoint regression model showed that EAPC was-12.9% (95%CI:-16.4%--9.1%) for other and unspecified histological type between 2003 and 2012. The EAPC was-5.5% (95%CI:-9.2%--1.6%) for esophageal cancer between 2007 and 2012,-5.4% (95%CI:-7.0%--3.9%) for esophageal cancer in female between 2006 and 2012,-4.9% (95%CI:-9.5%--0.1%) for ESCC between 2007 and 2012. The 5-year prevalence of esophageal cancer was 215.49 per 100 000 (2 337/1 084 493), and 5 489 died within 5 years after incidence. 5-year survival rate of esophageal cancer was 34.6% (95%CI: 33.5%-35.6%).@*Conclusion@#Esophageal cancer had a decreasing trend in Linzhou. The survival rate was increasing. But, esophageal cancer was still a major burden in Linzhou. The major histological type was ESCC. ESCC had a similar decreasing trend with esophageal cancer.
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Objective To investigate the effect of fried food intake on the pathogenesis of esophageal cancer and precancerous lesions.Methods From 2005 to 2013,all the residents aged 40-69 years from 11 counties (cities) where cancer screening of upper gastrointestinal cancer had been conducted in rural areas of Henan province,were recruited as the subjects of study.Information on demography and lifestyle was collected.The residents under study were screened with iodine staining endoscopic examination and biopsy samples were diagnosed pathologically,under standardized criteria.Subjects with high risk were divided into the groups based on their different pathological degrees.Multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and esophageal cancer and precancerous lesions.Results A total number of 8 792 cases with normal esophagus,3 680 with mild hyperplasia,972 with moderate hyperplasia,413 with severe hyperplasia carcinoma in situ,and 336 cases of esophageal cancer were recruited.Results from multivariate logistic regression analysis showed that,when compared with those who did not eat fried food,the intake of fried food (＜2 times/week:OR=1.60,95％C1:1.40-1.83;≥2 times/week:OR=2.58,95％ CI:1.98-3.37) appeared a risk factor for both esophageal cancer or precancerous lesions after adjustment for age,sex,marital status,educational level,body mass index,smoking and alcohol intake.Conclusion The intake of fried food appeared a risk factor for both esophageal cancer and precancerous lesions.
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Objective To investigate the effect of fried food intake on the pathogenesis of esophageal cancer and precancerous lesions.Methods From 2005 to 2013,all the residents aged 40-69 years from 11 counties (cities) where cancer screening of upper gastrointestinal cancer had been conducted in rural areas of Henan province,were recruited as the subjects of study.Information on demography and lifestyle was collected.The residents under study were screened with iodine staining endoscopic examination and biopsy samples were diagnosed pathologically,under standardized criteria.Subjects with high risk were divided into the groups based on their different pathological degrees.Multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and esophageal cancer and precancerous lesions.Results A total number of 8 792 cases with normal esophagus,3 680 with mild hyperplasia,972 with moderate hyperplasia,413 with severe hyperplasia carcinoma in situ,and 336 cases of esophageal cancer were recruited.Results from multivariate logistic regression analysis showed that,when compared with those who did not eat fried food,the intake of fried food (＜2 times/week:OR=1.60,95％C1:1.40-1.83;≥2 times/week:OR=2.58,95％ CI:1.98-3.37) appeared a risk factor for both esophageal cancer or precancerous lesions after adjustment for age,sex,marital status,educational level,body mass index,smoking and alcohol intake.Conclusion The intake of fried food appeared a risk factor for both esophageal cancer and precancerous lesions.
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Objective To investigate the effect of early using periplaneta americana extract on gastrointesti-nal function in critically patients with infection,and to evaluate its possible mechanism.Methods 66 patients with infection in Intensive Care Unit(ICU)were divided into control group and treatment group(33 cases in each group) according to the random number table.All patients in the two groups were given conventional cluster treatment,the patients in the treatment group additionally received periplaneta americana extract.At the beginning of treatment and 3,7 and 10 days after treatment,the indicators of bowel sounds,gastrointestinal function,APACHEⅡ and blood lactic acid level were respectively tested or recorded.Results At the beginning of treatment,there were no statistically sig-nificant differences between the two groups in terms of gastrointestinal function,bowel sounds,APACHE II score and blood lactic acid level(t =0.132,0.201,0.329,0.190,all P >0.05).3,7 days after treatment,the gastrointestinal function[(1.56 ±0.49)points vs.(1.32 ±0.45)points,(1.27 ±0.44)points vs.(1.02 ±0.42)points],bowel sounds[(1.58 ±0.76)times/min vs.(2.27 ±0.75)times/min,(2.15 ±0.91)times/min vs.(3.11 ±0.97)times/min],APACHE II score[(19.61 ±4.02)points vs.(17.50 ±4.37)points,(17.69 ±3.94)points vs.(15.24 ± 3.82)points]and blood lactic acid level[(2.94 ±0.88)mmol/L vs.(2.45 ±0.75)mmol/L,(2.51 ±0.59)mmol/L vs.(2.20 ±0.55)mmol/L],the terms in the treatment were better than those in the control group,the differences were statistically significant(t3 =2.072,t7 =2.361;t3 =3.712,t7 =4.146;t3 =2.041,t7 =2.565;t3 =2.434,t7 =2.208,all P <0.05).Conclusion Early using periplaneta americana extract has protective effect on gastrointestinal function in critically patients with infection,and improve the condition in a certain degree.
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<p><b>OBJECTIVE</b>To analyze the efficacy of endoscopic screening for gastric cancer in rural population in high risk areas of upper gastrointestinal cancer in Henan province.</p><p><b>METHODS</b>Subjects aged 40-69 years in the high risk areas were selected to participate in the endoscopic screening based on the cluster sampling, and screening-positive subjects were sampled for pathological examination. The data of screening were summarized and the detection rates of severe chronic atrophic gastritis, severe intestinal metaplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia, early and middle-late cancer were calculated, and the constituent ratio of early cancer cases was calculated. The detection rates and early diagnosis rates for the first round screening and follow-up screening were compared.</p><p><b>RESULTS</b>In the 5 years, a total of 88 263 subjects were endoscopically examined in the first round screening and 4 004 subjects were diagnosed with low grade intraepithelial neoplasia or above (the detection rate was 4.54%), in which 3 256 cases were with low grade intraepithelial neoplasia (the detection rate of 3.69%), 366 cases with high grade intraepithelial neoplasia (the rate of 0.41%), 199 cases with early cancer (the rate of 0.22%) and 183 cases with middle-late cancer (the rate of 0.21%). The number of cases of high grade intraepithelial neoplasia and early cancer was 565 and the early diagnosis rate was 75.53%. 1 894 subjects with severe chronic atrophic gastritis, severe intestinal metaplasia and low grade intraepithelial were followed up with a compliance of 66.32%. A total of 45 cases of early cancer were diagnosed, with a detection rate of 2.38% and early diagnosis rate of 100%. The detection rate and early diagnosis rate in the follow-up screening were both statistically significantly higher than that in the first round screening (P<0.01 for both).</p><p><b>CONCLUSION</b>The efficacy of endoscopic screening for gastric cancer is significant in high risk areas of upper gastrointestinal cancer, and improving the quality of follow-up screening will achieve a better performance of the screening.</p>
Subject(s)
Adult , Aged , Humans , Middle Aged , Carcinoma in Situ , Diagnosis , Pathology , China , Chronic Disease , Early Detection of Cancer , Gastritis, Atrophic , Diagnosis , Gastroscopy , Mass Screening , Rural Population , Stomach Neoplasms , Diagnosis , PathologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the association between obesity and the risk of lung cancer and evaluate a dose-response relationship between body mass index (BMI) and incidence risk of lung cancer in the Chinese population.</p><p><b>METHODS</b>A systematic literature search for BMI and incidence risk of lung cancer in the Chinese population, as well as through the reference lists of retrieved articles. The literature databases including Chinese National Knowledge Infrastructure, Wanfang, PubMed, Embase and Google Scholar. Time range was from the founding of each database to September 2014 and a total of 93 research papers were collected. Meta-analysis was conducted to calculate pooled odds ratio and corresponding 95% CI. Generalized least-squares regression methods were used to make a dose-response meta-analysis between BMI and incidence risk of lung cancer.</p><p><b>RESULTS</b>Seven studies were included in the meta-analysis, with a number of 2 351 lung cancer cases. Results showed that obesity was inversely associated with lung cancer incidence (OR = 0.68, 95% CI: 0.59-0.79) (heterogeneity test: I² = 0, P = 0.594). The association did not change with stratification by study design, sex, smoking status, BMI measurement method and study population. A linear dose-response association between BMI and risk of lung cancer was visually significant, and lung cancer risk would be reduced 21% for per 5 kg/m² BMI increase (OR = 0.79, 95% CI: 0.71-0.89) (heterogeneity test: q = 22.43, P = 0.002).</p><p><b>CONCLUSION</b>The results of this meta-analysis indicated that higher BMI was a protective factor against lung cancer, but smoking may play a stronger role as a confounding factor for the most important role with lung cancer incidence.</p>
Subject(s)
Humans , Asian People , Body Mass Index , China , Incidence , Lung Neoplasms , Obesity , Odds Ratio , Protective Factors , Risk , SmokingABSTRACT
<p><b>OBJECTIVE</b>To evaluate effect of screening of esophageal cancer at rural areas in Henan province.</p><p><b>METHODS</b>At rural areas with high incidence of upper gastrointestinal carcinoma in Henan province total of 88,263 persons with 40 to 69 years old were set to the target population of the screening by the 12 cities and countries and endoscope and pathology diagnosis were performed during 2009-2013. For patients with precancerous lesions, follow-up visits were conducted and defined as follows: once in three years for patients with mild dysplasia, once per year for moderate hyperplasia patients, the patients with severe intraepithelial neoplasia/carcinoma in situ should be treat, at least once per year for those one who didn't under treatment. The result data of screening were summarized and detection rates of esophagus hyperplasia, carcinoma in situ, early and middle-late cancer were calculated, as well as the early diagnosis rate. The result between first round and follow-up screening was compared.</p><p><b>RESULTS</b>Target population were examined in first round screening. There were 8,434 persons with above mild dysplasia and the detection rate was 9.56%, among them there were 7,224 (8.18%) cases with light-middle hyperplasia, 789 (0.89%) cases with serious dysplasia or cancer in situ, 239 (0.27%) cases with early cancer and 182 (0.21%) cases with middle-late cancer. The sum of serious dysplasia or cancer in situ and early cancer was 1 028 and the early detection rate was 84.96% (1,028/1,210). From 2012 to 2013, the follow-up screening for persons with light-middle hyperplasia which should be followed 4,230 cases, there were 2 853 people to take in screening and compliance was 67.45%. Total of 94 cases were diagnosed with cancer in situ or early cancer. The detection rate and the early detection rate were 3.29% and 100%, respectively. The rates of detection and early detection in phase of follow-up screening were statistically significantly higher than that in first round screening respectively (P<0.001).</p><p><b>CONCLUSION</b>At rural areas of high incidence upper gastrointestinal carcinoma in Henan province, the screening with endoscope had good effect and strengthening the follow-up screening could increase the effect.</p>
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Humans , Early Detection of Cancer , Esophageal Neoplasms , Incidence , Rural Population , Time-to-TreatmentABSTRACT
Objective To study the role of maintaining ventilator tubing at low position in prevention of ventilator-associated pneumonia (VAP).Methods From January 2010 through December 2011,110 cases with invasive mechanical ventilation in Intensive Care Unit (ICU) were randomly divided into observation group (n =55) and control group (n =55).The patients of control group were given conventional prevention method including the head elevated 30°-45°.The patients of observation group were given prevention method of keeping ventilator tubing at low position in addition to conventional prevention method so as to avoid the condensate in ventilator tubing into the airway.After mechanical ventilation support for 28 days,the incidence of VAP,duration of mechanical ventilation,length of ICU stay,incidence of condensate flowing back,clinical pulmonary infection score (CPIS) and mortality were respectively recorded.At the same time,risk of mistakenly extubation by nurses was recorded.Results The comparison between two groups showed the incidence of VAP (16.36％ vs.34.55％),duration of mechanical ventilation (5.86 ± 2.66) d vs.(11.24 ± 3.80) d,length of stay in the ICU (13.60 ± 4.83) d vs.(19.58 ±5.27) d,incidence of condensate backflow (3.64％ vs.49.09％),presenting significant differences between two groups (P ＜ 0.05).The CPIS of observation group was lower than that of the control group (P ＜0.05),and the mortality in observation group (21.82％) was lower than that in the control group (27.27％),but the difference was not significant (P ＞0.05).There was no statistically significant difference in risk of mistakenly extubation between two groups (P ＞ 0.05).Conclusion Maintaining the ventilator tubing at low position can reduce the incidence of VAP,improve the prognosis,and the risk of mistakenly extubation did not increase compared with the conventional methods
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<p><b>OBJECTIVE</b>To summarize the results of endoscopic screening of esophageal, gastric cardiac and gastric cancers in the high-risk population, and analyze the influencing factors such as age, gender and biopsy rate on their detection and early diagnosis rates.</p><p><b>METHODS</b>Nine high incidence cities and counties of esophageal cancer in Henan province were included in this study. People aged 40-69 years were set to the target population. Excluding contraindications for gastroscopy, in accordance with the national technical scheme of early cancer diagnosis and treatment, gastroscopic screening and biopsy pathology for human esophageal, cardiac and gastric cancers were carried out.</p><p><b>RESULTS</b>During the 3-year period, a total of 40 156 subjects were screened. Among them, 18 459 cases of various precancerous lesions (46.0%) were detected. The cancer detection rate was 2.3% (916 cases), including 763 cases of early cancers. The diagnosis rate of early cancers was 83.3%. Precancerous lesions were detected in 9297 cases (23.2%) for esophagus and 9162 cases (22.8%) for gastric cardia as well as stomach, respectively.</p><p><b>CONCLUSIONS</b>The results of this study demonstrate that endoscopic screening is feasible for early detection, diagnosis and treatment of esophageal, gastric cardia and gastric cancers among high risk population in high incidence area. Exploration analysis of relevant affecting factors may help to further improve the screening project for early diagnosis and treatment of those cancers.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Age Distribution , Biopsy , Cardia , China , Early Detection of Cancer , Esophageal Neoplasms , Diagnosis , Gastroscopy , Mass Screening , Precancerous Conditions , Diagnosis , Stomach Neoplasms , DiagnosisABSTRACT
Objective To investigate the effect of early airway bundle intervention on prevention ventilator-associated pneumonia(VAP) in ICU patients.Methods One hundred and twenty-eight patients with invasive mechanical ventilation in ICU were randomly divided into the control group (64 cases) and observation group(64 cases).Patients in the control group were given conventional airway intervention,and in the observation group were given airway bundle intervention within 4 h including dumping of condensed water in tubing of breathing machine in time,keeping pressure of artificial airbags from 20 to 30 cm H2 O,chest physical therapy 2 h/time,continuous aspiration of subglottic secretion,using moisture exchanger in breathing machine,and mouth rinse by chlorhexidlne 4 h/time.Incidence of VAP,duration of mechanical ventilation,duration of stay in the ICU and mortality within 28-day were recorded.Clinical Pulmonary Infection Score (CPIS) and APACHE Ⅱ at 0,3rd,5th,7th,14th day were recorded respectively.Results The incidence of VAP,duration of mechanical ventilationand duration of stay in the ICU in observation group were 18.75％,(6.26 ± 2.89) d,(11.88 ± 3.97) d respectively,lower than those in control group (35.94％,(10.54 ± 4.36) d,(16.55 ±5.22) d)),and the differences were significant (x2=4.758,t =6.546,t =6.546,P＜0.05 orP＜0.01).At 3rd,5th,7th,14th day after diagnosed VAP,CPIS of patients with confirmed VAP in observation group were 7.01 ±2.24,5.67 ±2.14,4.36 ± 1.44,2.75 ± 1.37 respectively,lower than those in control group(8.74 ± 2.33,7.51 ± 2.27,6.95 ± 2.98,6.53 ± 2.88,and the differences were significant (Finter group =27.22,P ＜ 0.001 ; Fbetween group =29.41,P ＜ 0.001 ; Finteraction =4.35.P ＜ 0.01).APACHE Ⅱ were 17.02 ± 7.06,15.01 ± 6.06,12.40 ± 4.17,8.40 ± 2.57 respectively,significant lower than those in control group ((22.48 ±7.31,19.67 ± 7.14,16.13 ± 5.33,13.10 ± 4.93),and the differences were significant (Finter group =47.43,P ＜ 0.001 ; Fbetween group =45.36,P ＜ 0.001 ; Finteraction =4.25,P ＜ 0.01).Conclusion Early using airway bundle interventions on ICU patients can reduce the incidence of VAP,improve the condition and prognosis.
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The cluster sampling method was used and a retrospective survey on mortality trends of cerebrovascular diseases from 1989 to 2008 was conducted among residents from Erqi District in Zhengzhou city and Xigong District in Luoyang city. The average mortality rate of cerebrovascular diseases in these two districts was 69. 5/100 000 in 1989 to 2008. The standardized mortality rate for men was 118. 67/100 000 in 1989 to 1993, and dropped to 44. 23/100 000 in 2004 to 2008. The standardized mortality rate for women was 68.21/100 000 in 1989 to 1993, and dropped to 30. 2/100 000 in 2004 to 2008. The declining trends of cerebrovascular disease mortality rates might be related to early diagnosis and early treatment of the disease, and the extensive health education and prevention programs.
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objective To study the changes of reticulocyte micronueleus(MN-RET)from peripherai blood and polychromatic erythrocyte mieronucleUS(MN-PCE)from bone marrow in mice following exposure to X-rays in order to provide an experimental basis for exploring possible hish-throughput radiation biodosimeter.Methods Male ICR mice were whole-body irradiated with 0,0.5,1,2,4 and 5 Gy at a dose rate of 0.488 Gy/min.MN-RET from peripheral blood wag scored with FCM and MN-PCE from bone marrow was scored with manual microscopy at 24,48 and 72 h post-irradiation.Results Both MN-RET and MN-PCE rates increaged with doses in the range of 0-5 Gy at 24,48 and 72 h after WBI.The dose-response relationship can be fit with linear equations(t=10.26-25.77,P<0.05).The correlation coeffcients between MN-RET from peripheral blood and MN-PCE from bone mallow were highly significant(r=0.986-0.996,P<0.05).Conclusions In view of its simplicity,accuracy and high throughput capacity,FCM scoring of peripheral blood MN-RET may be a candidate for radiation biodosimetry,More work should be carried out on human specimens to investigate this possibility.