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1.
Article in Chinese | WPRIM | ID: wpr-887907

ABSTRACT

The advent of the digital era brings new challenges and opportunities for cervical cancer prevention and research.With the development of digital techniques in China,the construction of an information platform for cervical cancer prevention based on the current achievements has become an important trend.This paper expounds the importance,existing problems,and challenges of the data integration of population-based cervical cancer screening and the information platform construction,and puts forwards effective measures to promote its construction.The establishment of an information platform for cervical cancer prevention in the digital era has far-reaching significance for the global elimination of cervical cancer.


Subject(s)
China , Early Detection of Cancer , Female , Humans , Uterine Cervical Neoplasms/prevention & control
2.
Article in Chinese | WPRIM | ID: wpr-793052

ABSTRACT

As an important branch of artificial intelligence,the emerging medical artificial intelligence(MAI)is facing many ethical issues.MAI may offer the optimal diagnosis and treatment for patients but may also bring adverse effects on society and human beings.This article discusses the ethical problems caused by MAI and elucidates its development in a direction that meets ethical principles and requirements.

3.
Article in Chinese | WPRIM | ID: wpr-826329

ABSTRACT

Cervical cancer is the second most common malignant tumor in women worldwide.The burden of cervical cancer is particularly heavy in less developed countries as the malignancy brings huge pain to the patients and their family members and causes huge losses to social development and global health.However,cervical cancer is a preventable and curable disease.While screening and human papillomavirus vaccination in developed countries have remarkably lowered the incidence and mortality of cervical cancer,there is still a far way to go to achieve the prevention and treatment of this disease.The multidisciplinary prevention and control programs slightly differ in different countries due to diverse economic and health conditions.The general principle is to vaccinate the young females and to implement a comprehensive strategy including human papillomavirus vaccine vaccination,screening,early diagnosis,and early treatment in adults.


Subject(s)
Early Detection of Cancer , Female , Humans , Papillomavirus Infections , Papillomavirus Vaccines , Uterine Cervical Neoplasms , Vaccination
4.
Article in English | WPRIM | ID: wpr-54947

ABSTRACT

OBJECTIVE: To investigate the extent of the cross-reactivity of hybrid capture 2 (HC2) assay and evaluate the potential effect of cross-reactivity on the long-term risk for cervical cancer and precancers. METHODS: Based on the Shanxi Province Cervical Cancer Screening Study-I (SPOCCS-I) cohort from 2005 to 2014 in Shanxi, China, SPF₁₀-line probe assay (LiPA) was performed in all 598 HC2 positive and 300 random-selected HC2 negative cervical specimens. Ten-year cumulative incidence rate (CIR) of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) of these two tests was evaluated using Kaplan-Meier methods. Possible human papillomavirus (HPV) types to be cross-reacted by HC2 were also analyzed. RESULTS: The overall agreement between HC2 and SPF₁₀-LiPA for detecting carcinogenic HPV was 73.27%. The highest 10-year cumulative risk of CIN2+ was observed in both HC2 positive and LiPA-carcinogenic HPV positive women (25.70%; 95% confidence interval [CI]=23.55%–27.91%), followed by HC2 positive but LiPA-non-carcinogenic HPV positive women (9.97%; 95% CI=8.57%–11.50%), HC2 negative but LiPA-carcinogenic HPV positive (2.56%; 95% CI=2.44%–2.70%) and HC2 positive but LiPA-HPV negative (1.85%; 95% CI=1.78%–1.92%) women. The proportion of cross-reactivity of HC2 with untargeted carcinogenic types was 8.9%, most of which were attributable to HPV26, 73, 82, 69, 71, 53, 11, 43, and 54. CONCLUSION: The noticeable high risk of CIN2+ in women infected with cross-reacted non-carcinogenic HPV and low risk in those with miss-to-detective carcinogenic HPV supported an overall good clinical performance of HC2 for a general cervical cancer screening.


Subject(s)
Cervical Intraepithelial Neoplasia , China , Cohort Studies , Female , Humans , Incidence , Mass Screening , Prospective Studies , Uterine Cervical Neoplasms
5.
Article in English | WPRIM | ID: wpr-54938

ABSTRACT

OBJECTIVE: We performed a pooled analysis to examine cigarette smoking and household passive smoke exposure in relation to the risk of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia grade 2+ (CIN2+). METHODS: Data were pooled from 12 cross-sectional studies for cervical cancer screenings from 10 provinces of China in 1999–2007. A total of 16,422 women were analyzed, along with 2,392 high-risk-HPV (hr-HPV) positive women and 381 CIN2+ cases. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models controlling for sexual and non-sexual confounding factors. RESULTS: There was an excess risk between active smoking and hr-HPV infection and CIN2+. Adjusted OR for ever smokers vs. never smokers was 1.45 (95% CI=1.10–1.91), for hr-HPV infection and 1.89 (95% CI=1.03–3.44), for CIN2+. Passive smoking had a slightly increased risk on the hr-HPV infection with adjusted OR 1.11 (1.00–1.24), but no statistical association was observed between passive smoke exposure and CIN2+. Compared with the neither active nor passive smokers, both active and passive smokers had a 1.57-fold (95% CI=1.14–2.15) increased risk of HPV infection and a 1.99-fold (95% CI=1.02–3.88) risk of CIN2+. CONCLUSION: Our large multi-center cross-sectional study found active smoking could increase the risk of overall hr-HPV infection and CIN2+ adjusted by passive smoking and other factors. Passive smoking mildly increased the risk of HPV infection but not the CIN2+. An interaction existed between passive tobacco exposure and active smoking for hr-HPV infection and the CIN2+.


Subject(s)
Asian Continental Ancestry Group , Cervical Intraepithelial Neoplasia , China , Cross-Sectional Studies , Family Characteristics , Female , Humans , Logistic Models , Mass Screening , Odds Ratio , Papillomaviridae , Papillomavirus Infections , Smoke , Smoking , Tobacco , Tobacco Smoke Pollution , Uterine Cervical Neoplasms
6.
Chinese Medical Journal ; (24): 1761-1764, 2015.
Article in English | WPRIM | ID: wpr-231696

ABSTRACT

<p><b>BACKGROUND</b>The studies of the natural progression of Parkinson's disease (PD) in Chinese populations have been lacking. To address this issue and obtain a preliminary data, we conducted a PD progression assessment in 15 adults with de novo PD from a nutritional intervention trial (NIT) cohort in Lin County China.</p><p><b>METHODS</b>Using the Copiah County screening questionnaire and United Kingdom Parkinson's Disease Society Brain Bank diagnostic criteria, we surveyed the available NIT cohort members in 2000 and diagnosed 86 patients as PD. In 2010, we resurveyed all PD patients and confirmed definite PD diagnosis in 15 cases with the rest of them being dead (54); having probable (10) PD or vascular Parkinsonism (3); refusing to participate (2); or being away (2). In both surveys, we used Hoehn and Yahr (HY) scale and assessed the disease progression. Unified Parkinson's Disease Rating Scale (UPDRS) was added to the second survey.</p><p><b>RESULTS</b>In 2010, the average disease duration for 15 definite PD patients was 13.6 ± 7.3 years. Over a 10-year time span, 9 out of 15 patients remained at the same HY stage while the remaining 6 progressed. Rigidity (47% vs. 100%; P = 0.002) and postural instability (7% vs. 47%; P = 0.005) worsened significantly. The mean UPDRS motor scores in 2010 were 39.4 ± 23.7.</p><p><b>CONCLUSIONS</b>Overall worsening of motor function in PD seems to be the rule in this untreated cohort, and their rate of progression seemed to be slower than those reported in the western populations.</p>


Subject(s)
Aged , Aged, 80 and over , Disease Progression , Female , Humans , Male , Middle Aged , Parkinson Disease , Pathology , Severity of Illness Index
7.
Article in Chinese | WPRIM | ID: wpr-329862

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the trend of cervical cancer incidence and mortality rates during 1989-2008 in Chinese women, so as to inform the development of relevant policies and strategies in China.</p><p><b>METHODS</b>The incidence and mortality rates of cervical cancer during 1989-2008 in urban and rural areas were calculated based on the data from the National Cancer Registry Database. Age-standardized rates were calculated using the Chinese population of 1982 and World Segi's population of 1985. Joinpoint regression analysis was performed to obtain annual percentage changes (APC) so as to assess the trend of incidence and mortality rates over the period from 1989 to 2008.</p><p><b>RESULTS</b>The crude incidence rate of cervical cancer in Chinese women increased from 3.06/10(5) in 1989-1990 to 11.87/10(5) in 2007-2008 (from 4.96/10(5) to 11.98/10(5) in urban registration areas and from 2.39/10(5) to 11.77/10(5) in rural registration areas).The crude mortality rate slightly increased from 2.19/10(5) in 1989-1990 to 3.20/10(5) in 2007-2008 (from 3.21/10(5) to 2.56/10(5) in urban registration areas and from 1.82/10(5) to 3.75/10(5) in rural registration areas). Generally, the upward trends of crude incidence rates were shown over the year 1989-2008, with an APC of 14.4% after 1997 in urban areas and 22.5% after 1999 in rural areas.After age standardization of world population, the APC of incidence rates in recent decade in urban areas remained stable, and the one in rural areas slightly decreased.Although the overall crude and world age-standardized mortality rates had no significant changes during 1989-2008, the crude mortality rates increased by 8.1% annually after 1999.The upward trends were also shown for crude and world age-standardized mortality rates in urban areas after 2001 with an APC of 7.3%.The crude mortality rates in rural areas increased by 3.9% annually during 1989-2008, but no significant change was found after age standardization.</p><p><b>CONCLUSIONS</b>Over the last decade, the cervical cancer incidence and mortality rates ascended by year in China. It is particularly urgent to establish a comprehensive prevention and control system that combines cervical cancer screening and human papillomavirus vaccination, so as to reduce the burden of cervical cancer in Chinese women.</p>


Subject(s)
China , Epidemiology , Female , Humans , Incidence , Uterine Cervical Neoplasms , Epidemiology , Mortality
8.
Chinese Journal of Cancer ; (12): 339-345, 2014.
Article in English | WPRIM | ID: wpr-320519

ABSTRACT

The overall survival of patients with cervical cancer has improved due to detection at an early stage and availability of comprehensive treatments in China. As patients' lives prolonged, it is important to understand their health-related quality of life (QoL) during and after treatment. We used the EQ-5D questionnaire to assess QoL of 194 patients with cervical lesions at Sichuan University West China Second Hospital between May 2010 and January 2011. Patients were surveyed before primary treatment and at 1, 3, and 6 months after primary treatment. Results showed a consistent decline in EQ-5D scores in the spectrum of cervical lesions at each time point after treatment (all P < 0.05). For patients with precursor lesions, there was an increasing trend along the timeline of treatment (P < 0.01). For patients with early-stage cervical cancer, EQ-5D scores declined in the first month (P = 0.01) and gradually increased to higher levels at 6 months post-treatment than those before treatment (P < 0.01). EQ-5D scores followed a similar trend in patients with advanced cervical cancer (P = 0.04), though they did not statistically rebound after 6 months (0.84 ± 0.19 vs. 0.86 ± 0.11, P = 0.62). Regarding advanced cervical cancer, EQ-5D scores for women above 40 years of age appeared to recover more rapidly and reached higher levels than those for women below 40 years (P = 0.03). Caution and extra care are recommended in the early period of cervical cancer treatment given the slight deterioration in the QoL, and in particular, for younger cervical cancer patients. Our study implies that health care providers may need to improve the health-related QoL of cervical cancer patients.


Subject(s)
Age Factors , China , Female , Humans , Neoplasm Staging , Prospective Studies , Quality of Life , Surveys and Questionnaires , Uterine Cervical Dysplasia , Uterine Cervical Neoplasms
10.
Chinese Journal of Epidemiology ; (12): 399-403, 2013.
Article in Chinese | WPRIM | ID: wpr-318388

ABSTRACT

<p><b>OBJECTIVE</b>To estimate the cost-effectiveness of once-in-a-lifetime cervical cancer screening program and to predict the optimal modality for its operation on women living in rural and urban areas of China, based on Markov modeling and simulation.</p><p><b>METHODS</b>Three modalities including visual inspection with acetic acid plus Lugol's iodine (VIA/VILI), conventional Pap Smear (Pap Smear), and simple HPV DNA testing (careHPV) were hypothesized for the rural cohort, whereas other five modalities including Pap Smear, liquid-based cytology (LBC), simple HPV DNA testing (careHPV), Hybrid Capture 2 HPV DNA testing (HC2), and LBC plus HC2 (LBC + HC2) were tested for the urban cohort. A Markov model was constructed based on the factors as natural history, screening, diagnosis and treatment on cervical cancer using data related to the epidemics and the costs from rural and urban areas of the country. Long-term effectiveness and cost-effectiveness were predicted through simulation of the model.</p><p><b>RESULTS</b>Compared to the non-screening scenario, the amount of life years saved were 277.97 - 2727.53 and 134.02 - 1446.84 years per 100 000 women, respectively, for different cohorts in rural and urban areas. The cost-effectiveness ratios were 1520.99 - 2453.74 and 3847.35 - 44 570.35 RMB per life year saved, respectively, for different cohorts in rural and urban areas. The incremental cost-effective ratio for careHPV starting from 40 years old (careHPV@40) and careHPV from 30 years old (careHPV@30) dominated other strategies for the rural cohort, while careHPV@40, careHPV@30, HC2 from 30 years old (HC2@30), and LBC + HC2 from 30 years old (LBC + HC2@30) were dominant for the urban cohort.</p><p><b>CONCLUSION</b>All eight once-in-a-lifetime cervical cancer screening modalities were cost-effective based on our model. In particular, careHPV screening starting from 40 years old seemed to be the most cost-effective one for women living in both rural and urban areas.</p>


Subject(s)
Adult , Age Factors , Cost-Benefit Analysis , Early Detection of Cancer , Female , Humans , Mass Screening , Economics , Middle Aged , Outcome and Process Assessment, Health Care , Uterine Cervical Neoplasms , Diagnosis
11.
Chinese Journal of Oncology ; (12): 796-800, 2013.
Article in Chinese | WPRIM | ID: wpr-267453

ABSTRACT

<p><b>OBJECTIVE</b>To estimate the contribution of known identified risk factors to breast cancer incidence and mortality in China, and provide evidence to support the prevention and control of breast cancer for Chinese females.</p><p><b>METHODS</b>We calculated the proportion of breast cancer attributable to specific risk factors. Data on exposure prevalence were obtained from Meta-analyses and large-scale national surveys of representative samples of the Chinese population. Data on relative risks were obtained from Meta-analyses and large-scale prospective studies. Cancer mortality and incidence were taken from the Third National Death Survey and from cancer registries in China.</p><p><b>RESULTS</b>The first 5 risk factors of breast cancer in China were benign breast disease (RR = 2.62), family history of breast cancer (RR = 2.39), smoking (RR = 1.86), overweight (RR = 1.60) and age at menarche (RR = 1.54). The proportion of breast cancer deaths attributable to reproductive factors, lifestyle factors, benign breast disease, the use of external hormone and family history of breast cancer was 27.84%, 23.55%, 15.09%, 3.60% and 2.49%, respectively. The total population attributable fraction (PAF) was 55.95% for risk factors in our study. Overall, we estimated that 79 862 breast cancer cases and 22 456 deaths were attributed to the five risk factors in China in 2005.</p><p><b>CONCLUSIONS</b>The prevention and control of unhealthy lifestyle factors may significantly reduce the number and death of breast cancer in China.</p>


Subject(s)
Breast Diseases , Breast Neoplasms , Epidemiology , Genetics , China , Epidemiology , Female , Genetic Predisposition to Disease , Humans , Menarche , Meta-Analysis as Topic , Overweight , Risk Factors , Smoking
12.
Article in English | WPRIM | ID: wpr-25978

ABSTRACT

PURPOSE: This study aims to analyze the clinical-pathological characteristics of multifocal and multicentric breast cancer (MMBC) in Chinese women. METHODS: Sixty-seven cases with MMBC were randomly collected and reviewed at seven hospitals in representative districts of China during 1999 to 2008. RESULTS: The incidence of MMBC in breast cancer in China was 1.75%. Compared to those with unifocal breast cancer, women with MMBC were more likely to have larger tumor size, lymph node metastasis (59.70% vs. 45.62%) and stage III to IV (46.26% vs. 21.10%). The peak age at onset of MMBC was 40 to 49 years old and has been gradually increasing during 1999 to 2008. Most of the MMBC women were treated with surgery and adjuvant therapy. CONCLUSION: In China, the incidence of MMBC in breast cancer is significantly lower than that in Western countries. Compared to unifocal breast cancer, MMBC is biologically more aggressive. Most MMBC women underwent mastectomy, instead of breast conservation surgery.


Subject(s)
Asian Continental Ancestry Group , Breast , Breast Neoplasms , China , Cohort Studies , Female , Humans , Incidence , Lymph Nodes , Mastectomy , Neoplasm Metastasis , Pathology, Clinical , Retrospective Studies
13.
Chinese Journal of Cancer ; (12): 275-282, 2013.
Article in English | WPRIM | ID: wpr-295871

ABSTRACT

With improved overall survival of cervical cancer patients, the importance of the quality of life (QOL) is increasingly recognized. This study was conducted to compare the QOL of women with different stage cervical cancer before and after treatment to facilitate improved cervical cancer prevention and treatment. We used the generic Medical Outcomes Study Short Form-36 (MOS SF-36) to collect QOL information. Based on SF-36, we interviewed cervical cancer patients at West China Second Affiliated Hospital and Sichuan Cancer Hospital between May 2010 and January 2011. A total of 92 patients with precancerous lesions, 93 with early cancer, and 35 with advanced cancer responded to our survey. Average physical component summary (PCS) scores were significantly different between the three groups at every time point (P < 0.05). Average mental component summary (MCS) scores were significantly different between the three groups after treatment (P < 0.05). Average PCS and MCS scores increased gradually from the pretreatment to posttreatment period for patients with precancerous lesions. However, they reached the lowest at 1 month after treatment for patients with early and advanced cancers and rebounded between 1 and 6 months after treatment. Our results indicate that patients with precancerous lesions and early cervical cancer show better overall QOL than do those with advanced cervical cancer. Additionally, patients with early cancer recover more quickly than do those with advanced cancer in terms of both physical and mental functions. Thus, early detection and treatment initiatives may improve the QOL for patients with precancerous lesions and cervical cancer.


Subject(s)
Adult , Aged , Carcinoma in Situ , Pathology , Therapeutics , Cervical Intraepithelial Neoplasia , Pathology , Therapeutics , Chemoradiotherapy , China , Female , Follow-Up Studies , Humans , Hysterectomy , Methods , Lymph Node Excision , Middle Aged , Neoplasm Staging , Precancerous Conditions , Pathology , Therapeutics , Quality of Life , Surveys and Questionnaires , Uterine Cervical Neoplasms , Pathology , Therapeutics , Young Adult
14.
Chinese Journal of Epidemiology ; (12): 164-167, 2013.
Article in Chinese | WPRIM | ID: wpr-327651

ABSTRACT

Objective To analyze the incidence and mortality of oral and pharyngeal cancers from 32 cancer registration centers,2003 to 2007.Methods Data from 32 eligible cancer registries were included in this study.Both crude and age-standardized incidence and mortality of oral and pharyngeal cancers from 2003 to 2007 were calculated and stratified by area and gender.Age-stratified incidence and mortality,as well as the proportions of new and death cases of oral and pharyngeal cancer were also calculated at each site.Results Mouth,tongue and salivary gland were the most predilcction sitcs of oral and pharyngeal cancers.The crude incidence for both oral and pharyngeal cancers was 3.15/105 from 2003 to 2007.The age-standardized incidence rates using the Chinese population (1982) and the World Segi' s population were 1.75/105 and 2.26/105.The crude mortality of oral and pharyngeal cancer was 1.37/105 from 2003 to 2007; with age-standardized mortality rates,using the Chinese population (1982) and the World Segi' s population were 0.69/105 and 0.94/105.Both incidence and mortality were higher in males than in females,higher in urban than in rural areas,and ascended with age.Age-standardized incidence and mortality in Zhongshan city ranked first among all the cancer registration areas.Age-standardized incidences by gender and area increased slightly from 2003 to 2007,while age-standardized mortalities were stable.Conclusion Although the incidence and mortality of oral and pharyngeal cancer were low in China from 2003 to 2007,attention should also be paid since the exposure of relative risk factors did not seem to have reduced and the incidence increased slightly.

15.
Chinese Journal of Epidemiology ; (12): 191-194, 2013.
Article in Chinese | WPRIM | ID: wpr-327645

ABSTRACT

To compare the predictive values of 5% acetic acid stain and visual inspection, human papillomavirus (HPV) Self test, ThinPrep Pap and HPV direct test in screening for cervical cancer with biopsy as gold standard. Positive predictive values and negative predictive values were compared simultaneously by joint hypothesis tests and then either positive predictive values or negative predictive values of the any two screening tests were compared by marginal regression based on both GEE and weighted least square methods. Hochberg method was used for multiplicity adjustment. It was showed that HPV direct test had the highest negative predictive value and ThinPrep Pap the highest positive predictive value. 5% acetic acid stain and visual inspection had both the lowest positive predictive value and negative predictive value. Both HPV direct test and ThinPrep Pap were efficient, but the latter required compatible infrastructure and skilled caregivers to go with. Both 5% acetic acid stain and visual inspection were inexpensive, and their positive predictive value and negative predictive value were lower than HPV self-test. They also had similar positive predictive value with HPV direct test and similar negative predictive value with ThinPrep Pap. HPV self-test appeared to be efficient, suggesting that it had significant potential for screening program to be implemented in the rural areas of China since the test could be performed without speculum examination in low-resource regions.


Subject(s)
Adult , Female , Humans , Mass Screening , Methods , Papillomaviridae , Predictive Value of Tests , Uterine Cervical Neoplasms , Diagnosis , Pathology , Vaginal Smears , Methods
16.
Article in Chinese | WPRIM | ID: wpr-286014

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the clinical performance of careHPV16/18/45 DNA testing of cervical specimens as a triage testing for women with positive findings during the cervical cancer screening.</p><p><b>METHODS</b>Eligible women aged 25-65 years were enrolled from two high-risk communities in Yangcheng County,Shanxi Province.After providing written informed consent on a voluntary base,women underwent questionnaire-based interview,gynecological examination,and sample collection.Hybrid capture 2 technology(HC2),careHPV,Avantage HPV E6 test,and visual inspection with acetic acid(VIA)were conducted as the primary screening tests at the enrollment visit.Women with any positive finding were invited to receive a second VIA and colposcopy.careHPV16/18/45 was performed as a triage testing.Any visible lesion under colposcopy was directly biopsied.Women with pathology confirmed cervical intraepithelial neoplasia grade 2 and worse(CIN2+)were treated with standard procedures.</p><p><b>RESULTS</b>For the self-collected and doctor-collected samples,the application of careHPV16/18/45 as a triage testing decreased the colposcopy referral to 3.2% and 3.1%,respectively.Meanwhile,the sensitivity,specificity,and positive predictive value(PPV)for CIN2+were 50.0%,97.6%,and 26.7% for women with positive self-sampling careHPV results and 63.0%,97.9%,and 34.0% for women with positive doctor-sampling careHPV results.</p><p><b>CONCLUSION</b>careHPV16/18/45 is promising as a triage testing among women with positive screening findings in low-resource settings.</p>


Subject(s)
Adult , Aged , Colposcopy , DNA, Viral , Early Detection of Cancer , Methods , Female , Human papillomavirus 16 , Genetics , Human papillomavirus 18 , Genetics , Humans , Mass Screening , Methods , Middle Aged , Uterine Cervical Neoplasms , Diagnosis , Virology , Vaginal Smears
17.
Chinese Medical Journal ; (24): 819-822, 2013.
Article in English | WPRIM | ID: wpr-342491

ABSTRACT

<p><b>BACKGROUND</b>Standardized screening tools for Parkinson syndrome have not been developed for non-western populations. This study aimed to validate the Copiah County questionnaire (CCQ) as a screening instrument in a Chinese rural population.</p><p><b>METHODS</b>All participants of a previously reported prevalent study were interviewed using CCQ. The participants who answered yes to at least one item on CCQ were defined as positive. The Parkinson's disease (PD) diagnosis was established using United Kingdom Parkinson's disease Brain Bank Clinical diagnosis criteria (UKPDBBC) and served as a gold standard to determine the sensitivity, specificity, and positive and negative predictive values (PPV, NPV) for the questionnaire.</p><p><b>RESULTS</b>Among 16 130 participants, 2872 (17.8%) were screened positive for CCQ and 13 258 negative (82.2%). Among the 697 participants diagnosed as having Parkinson syndrome, 605 were positive for CCQ, and 92 were negative, leading to a sensitivity of 86.8%. Out of the 15 433 non-Parkinson syndrome participants, 13 166 were negative to CCQ, giving a specificity of 85.3%. Among the 2872 participants screened positive, 605 were diagnosed with Parkinson syndrome, and their PPV was 21.1%. For the 13 258 participants screened negative on CCQ, 92 were diagnosed with Parkinson syndrome and 13 166 did not have Parkinson syndrome, leading to a NPV of 99.3%.</p><p><b>CONCLUSIONS</b>CCQ appeared to have satisfactory statistical parameters to serve as a screening instrument for Parkinson syndrome in this rural Chinese population. Further studies may prove the utility of this short questionnaire in Parkinson syndrome screening among Chinese populations including those residing in rural areas.</p>


Subject(s)
Asian Continental Ancestry Group , Female , Humans , Male , Middle Aged , Parkinsonian Disorders , Diagnosis , Rural Health , Surveys and Questionnaires
18.
Chinese Journal of Hepatology ; (12): 202-206, 2013.
Article in Chinese | WPRIM | ID: wpr-246721

ABSTRACT

<p><b>OBJECTIVE</b>To explore the relation between serum vitamin D (25(OH)D) concentrations and liver cirrhosis.</p><p><b>METHODS</b>A nested case control study was designed based on the Nutrition Intervention Trial (NIT) cohort, from which non-degraded serum samples and complete baseline and follow-up data were available for 282 individuals diagnosed with liver cirrhosis and 564 healthy controls. The serum samples were tested by enzyme-linked immunosorbent assay to detect and quantify 25(OH)D, as well as hepatitis B virus surface antigen and core antibody and hepatitis C virus antibody. The study participants were divided into four groups according to quartile range of 25(OH)D concentration and logistic regression modeling was used to evaluate the relation with liver cirrhosis risk by estimating odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><b>RESULTS</b>The liver cirrhosis group had a significantly lower concentration of 25(OH)D than the control group (median and quartile range in nmol/L, cases: 15.3 and 13.8; controls: 20.2 and 16.6; t = 5.169, P = 0.002). When the first interval was set as the reference level, the ORs(95% CIs) of the second, third, and fourth intervals were: 0.495(0.333 - 0.736), 0.452(0.303 - 0.675), and 0.349(0.231- 0.527). After adjusting the analysis for the presence of pathogenic-related confounding factors, the ORs(95% CIs) of the second, third, and fourth intervals were: 0.499(0.328 - 0.759), 0.427(0.278 - 0.654), and 0.344(0.222-0.532). The 25(OH)D level was inversely correlated with risk of liver cirrhosis (Chi2 = 25.200, P < 0.001).</p><p><b>CONCLUSION</b>Risk of liver cirrhosis increases as 25(OH)D serum concentration decreases. Vitamin D might function as a protective factor against development of cirrhosis.</p>


Subject(s)
Adult , Aged , Case-Control Studies , Female , Humans , Liver Cirrhosis , Blood , Epidemiology , Logistic Models , Male , Middle Aged , Prospective Studies , Risk Factors , Vitamin D , Blood
19.
Article in Chinese | WPRIM | ID: wpr-313556

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the relationship between the prognosis of patients with oropharyngeal squamous cell carcinoma (OSCC) and human papillomavirus (HPV) infection in OSCC.</p><p><b>METHODS</b>Sixty-six patients with oropharyngeal carcinoma who met the enrollment criteria during the period from January 1999 to December 2009 were retrospectively reviewed. The presence or absence of HPV oncogenic types in OSCC specimen was determined by multiplex polymerase chain reaction (PCR). Overall survival (OS) and disease specific survival (DSS) for HPV-positive and HPV-negative patients were estimated by Kaplan-Meier analysis. Cox regression model was used for multivariate analysis.</p><p><b>RESULTS</b>HPV-DNA was detected in 11(16.7%) of all specimens. Among them, 7 were positive for HPV-16, 1 for HPV-16/11, 1 for HPV-35, 1 for HPV-58/52, and 1 for HPV-33/52/54. With the follow-up of 3-78 months (a median of 24.5 months), patients with HPV-positive tumors had significantly better overall survival (χ2=5.792, P=0.016) and disease specific survival (χ2=4.721, P=0.030), the 3-year OS and DSS were 90.0% vs 52.4% and 90.0% vs 56.4%, respectively. Multivariate analysis by Cox regression model showed that HPV infection and nodal status were both independent prognostic factors for patients with OSCC (P<0.05).</p><p><b>CONCLUSIONS</b>Patients with HPV-positive OSCC have significantly better prognosis than patients with HPV-negative tumors. HPV infection is an independent prognostic factor.</p>


Subject(s)
Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell , Diagnosis , Virology , Female , Human papillomavirus 16 , Humans , Male , Middle Aged , Oropharyngeal Neoplasms , Diagnosis , Virology , Papillomavirus Infections , Pathology , Prognosis , Retrospective Studies
20.
Chinese Journal of Oncology ; (12): 352-355, 2012.
Article in Chinese | WPRIM | ID: wpr-335281

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the expression and clinical values of HPV L1 capsid protein and p16INK4a protein in uterine cervical lesions.</p><p><b>METHODS</b>Fifty-four cervical intraepithelial neoplasias CIN1, 44 CIN2, 78 CIN3, and 48 squamous cell carcinoma were included in this study. All CIN and squamous carcinomas were stained with anti-HPV L1 capsid protein antibodies and anti-p16INK4a antibody. Forty-five CIN1 patients were followed up for 6 years.</p><p><b>RESULTS</b>Forty-five CIN1 patients were followed up for 6 years, among them 6 cases showed a progression (One case changed to CIN3, 5 cases to CIN2). L1 positivity was found in 50 cases which decreased with CIN increasing (χ(2) = 259.923, P < 0.001) while p16INK4a positivity was found in 177 cases which co-increased with CIN (χ(2) = 48.842, P < 0.001). L1(-)p16INK4a (-) or L1(+)p16INK4a(-) appeared mainly in CIN1 while L1(-)p16INK4a(+) appeared mainly in CIN2 lesions. No progression was found in the group of L1(-)p16INK4a(-) CIN1 patients. The risk of CIN1 progression in L1(-)p16INK4a(+) group was 66.7% while L1(+)p16INK4a(-) group was 9.5%, and L1(+)p16INK4a(+) group was 33.3%.</p><p><b>CONCLUSIONS</b>The expression of p16INK4a together with HPV L1 are different in various cervical lesions, and the combined detection of p16INK4a and HPV L1 can be helpful for estimating the biological potentiality of CIN lesions.</p>


Subject(s)
Adult , Aged , Capsid Proteins , Metabolism , Carcinoma, Squamous Cell , Metabolism , Pathology , Virology , Cervical Intraepithelial Neoplasia , Metabolism , Pathology , Virology , Cyclin-Dependent Kinase Inhibitor p16 , Metabolism , Disease Progression , Female , Follow-Up Studies , Humans , Middle Aged , Oncogene Proteins, Viral , Metabolism , Papillomavirus Infections , Uterine Cervical Neoplasms , Metabolism , Pathology , Virology , Young Adult
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