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Abstract This study aimed to perform a meta-analysis comparing the efficacy and safety of gefitinib in combination with chemotherapy versus gefitinib alone in patients with advanced Non-Small Cell Lung Cancer (NSCLC). We searched databases for clinical studies that reported the efficacy or safety of gefitinib plus chemotherapy in comparison with gefitinib alone. Raw data from included studies were extracted and pooled to calculate the Odds Ratio (OR) for Objective Response Rate (ORR) and Disease Control Rate (DCR), the Hazard Ratio (HR) for Progression-Free Survival (PFS) and Overall Survival (OS), and OR for complication ≥ Grade 3. A total of 10 studies containing 1,528 patients with NSCLC were identified and included in the analysis. Gefitinib plus chemotherapy showed significantly better efficacy in improving ORR (OR = 1.54; 95% CI [Confidence Interval], 1.13‒2.1; p = 0.006), DCR (OR = 1.62; 95% CI 1.14‒2.29; p = 0.007), PFS (HR=1.67; 95% CI 1.45‒1.94; p < 0.001) and OS (HR = 1.49; 95% CI 1.2‒1.87; p < 0.001) as compared with gefitinib alone. Consistent results were observed in the sub-population with positive EGFR mutation. The combination of gefitinib with chemotherapy had a significantly higher risk of complication (≥ Grade 3) with an OR of 3.29 (95% CI 2.57‒4.21; p < 0.001). The findings in the present study suggest that the combination of gefitinib with chemotherapy can provide better disease response and survival outcomes for patients with advanced NSCLC.
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【Objective】 To investigate the clinical characteristics, long-term follow-up rate, level and control rate of low-density lipoprotein cholesterol (LDL-C) in patients with atherosclerotic cardiovascular disease (ASCVD) aged ≥75 years who underwent percutaneous coronary intervention (PCI) during hospitalization. 【Methods】 We selected ASCVD patients aged ≥75 years with PCI from January 2016 to December 2020 in The First Affiliated Hospital of Xi’an Jiaotong University, collected the baseline data of the patients and the follow-up of 1 month, 3 months, 6 months and 12 months after discharge by HIS system, and analyzed their LDL-C and control rate at each follow-up. 【Results】 A total of 1 129 patients were enrolled in this study, aged 78 (ranging from 75 to 89) years. Among them 72.1% were male; myocardial infarction was the main type of ASCVD (71.5% ); hypertension was the most common risk factor, accounting for 85.2% (717/842), followed by diabetes, 58.6% (493/842); 74.6% met the ultra-high risk criteria of the 2020 Chinese Expert Consensus on Lipid Management in Ultra-High Risk ASCVD Patients, and the LDL-C control rate was only 8.1% . The four routine follow-up rates of 1 129 elderly ASCVD patients were 49.5%, 24.1%, 17.1%, and 24.6%, respectively. The detection rates of LDL-C during follow-up were 26.3%, 5.3%, 10.4%, and 13.8%, respectively. LDL-C control rates in ultra-high risk ASCVD were 59.4%, 45.1%, 37.1%, and 17.6%, respectively, while LDL-C control rates in non-ultra-high risk ASCVD patients were 67.3%, 55.6%, 47.4%, and 44.0%, respectively. 【Conclusion】 The elderly patients with ASCVD-PCI were mainly ultra-high risk patients. The routine follow-up rate and the LDL-C compliance rate during follow-up were low and showed a downward trend.
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Although the use of postmastectomy radiation therapy (PMRT) has been proven to bring survival benefit to breast cancer patients, the use of chest wall tissue equivalent filler (bolus) remains controversial. In recent years, a large number of studies have shown that the use of bolus in PMRT does not significantly improve the local control rate, while it can significantly increase the acute skin toxicity, and even leads to more frequent and longer treatment interruption. Existing retrospective studies have indicated that for breast cancer patients undergoing mastectomy and systemic therapy, if there is no skin invasion, it is recommended not to routinely use bolus during radiotherapy. However, higher-level clinical studies are needed for further confirmation.
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Objective:To study the efficacy, safety and prognostic factors affecting survival of proton radiation therapy for primary hepatocellular carcinoma (HCC).Methods:Forty-four patients with primary hepatocellular carcinoma treated at Zibo Wanjie Cancer Hospital in Shandong Province from June 15, 2005 to September 12, 2018 were enrolled and given proton radiation therapy with a single dose of 2-5 Gy and a total dose of 25-75 Gy. The overall and local control rates, factors influencing survival, and adverse effects were observed during a follow-up period of 12 to 120 months.Results:The overall survival rates of all patients were 79.5% at 1 year, 68.2% at 2 years, 50.0% at 3 years, and 45.5% at 5 years. The overall local control rate was 95.5%. Patients older than 50 years had a longer overall survival (Log Rank Chi-Square of 4.787, P = 0.029). Child-Pugh A classification had better overall survival compared with B classification (Log Rank Chi-Square 4.077, P = 0.043). The main adverse reactions were skin reactions and gastrointestinal reactions. Among the patients with adverse reactions, 23 patients had skin reactions and 9 patients had mild gastrointestinal reactions, and no serious adverse events were found. Conclusions:Proton radiation therapy has good efficacy and high safety in patients with HCC. Age and Child-Pugh classification are prognostic factors affecting survival after proton radiation therapy.
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Objective:To analyze the control status of ambulatory blood (BP) pressure and influencing factors among hypertensive patients in Shanghai Fengpu community.Methods:From April 2020 to February 2022, 318 hypertensive patients in Shanghai Fengpu community were enrolled in the study. The basic information and thropometric indicators of patients, course of hypertension, the medication, complications, life habits, and biochemical indicators as well as the ambulatory BP monitoring (ABPM) data were collected. Multivariate analysis was used to evaluate the risk factors for lack of 24-hour BP control.Results:Among 318 patients, 63 cases (19.8%) had an average 24-hour BP controlled; the control rate of daytime BP and nighttime BP was 23.3% (74 cases) and 15.7% (50 cases), respectively. The proportion of combined medication in the control group and non-control group was 46.0% (29/63) and 51.8% (132/255), respectively (χ 2=0.66, P=0.415). There were significant differences in gender, proportion of patients with hypertension>10 years, the office blood pressure control rate, the abnormal diastolic circadian rhythm, abdominal obesity, the level of fasting blood glucose, diabetes, physical activity levels, and smoking and drinking (all P<0.05) between the control group and non-control group. Multivariate analyses showed that male gender ( OR=2.00, 95 %CI:1.07-3.76) and abdominal obesity ( OR=2.04, 95 %CI:1.10-3.76) were risk factors for uncontrolled ambulatory BP. Conclusions:The control rate of ambulatory BP in patients with hypertension is relatively low in Shanghai Fengpu community. The ABPM should be enhanced and the management for hypertensive patients with abdominal obesity and lack of physical activity should be strengthened in the community.
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Objective To investigate the effect of mosquito control at public environment in residential areas with property management in Wuhan from 2016 to 2018, and to provide background information for making scientific mosquito control strategies in residential areas. Methods The control rate of mosquito route index was taken as the evaluation index. A retrospective analysis of the ocular monitoring results of mosquito breeding sites in the public external environment of property communities in Wuhan from 2016 to 2018 was conducted. Chi-square test was used to compare the route index control rate between different years. Results The residential areas with property management that were effectively incorporated into surveillance were 179 in 2016, 437 in 2017 and 548 in 2018, while the control rate of route index was 51.40%, 59.27% and 41.06%, respectively. The outcome of statistical analysis indicated that the control rate of mosquito route index monitored in 2018 at external environment of residential areas with property management was significantly lower than that in 2017 (χ2=26.342，P<0.001). However, there was no significant difference between the control rate of route index monitored in 2016 and that in later two years. Conclusion Mosquito control effect at public environment on property management areas in Wuhan declined during the consolidation phase of the establishment of national health city. Relevant departments should make effort to explore more reasonable and scientific management strategies and measures for mosquito control to provide more healthy and safe living environment for city residents in Wuhan.
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Objective@#To survey on the home blood pressure measurement and blood pressure control rate among patients with hypertension in Beijing Yuetan community.@*Methods@#A questionnaire survey was conducted among 504 hypertensive patients, who were visiting Beijing Yuetan Community Health Service Center and selected by convenience-sampling method during June 2018 to January 2019. The status of home blood pressure measurement, the awareness of hypertension, the blood pressure control rate and factors related to not regularly measuring were surveyed.@*Results@#Of the 504 patients, 93.7% (472/504) took regular medication, but only 61.5% (310/504) had regular blood pressure measurements; 92.5% (466/504) had sphygmomanometers at home with electronic type mainly; 89.9% (453/504) patients knew the method of blood pressure measurement, but only 11.5% (52/453) had their sphygmomanometer calibrated. Among those who measured blood pressure, 77.4% (240/310) measured per week. The main reason for not measuring blood pressure regularly was that there was no need to measure blood pressure without any discomfort, accounting for 50.0% (97/194). The office blood pressure control rate (with desktop mercury sphygmomanometer) was 62.3% (314/504); the blood pressure control rate both in the morning and at bed time was 61.3% (73/119), that in the morning was 68.1% (81/119) and at bed time was 75.6% (90/119). The control rates of systolic blood pressure and heart rate by home measurement at morning and bedtime were significantly higher than those by office measurement (χ2=5.02, 9.97, 15.51, 13.72; all P<0.05).@*Conclusions@#The home blood pressure monitoring rate and knowledge level of hypertension among patients with hypertension in Yuetan community are relatively low. There are some differences in blood pressure control rate between office measurement and home measurement. Comprehensive evaluation is needed in the management process, and the treatment plan should be adjusted according to the specific condition of patients.
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BACKGROUND: Searching for a substitute donor corneal is a hotspot for treating fungal corneal ulcer. OBJECTIVE: To Investigate the clinical effect of bio-engineering cornea and donor cornea on treating fungal corneal ulcer. METHODS: Forty-four cases (44 eyes) of fungal corneal in General Hospital of Northern Theater Command were enrolled, and were randomized into two groups, followed by underwent lamellar keratoplasty using acellular porcine corneal matrix (bio-engineering group, n=22) and human donor cornea (donor group, n=22). The patients were followed up for 12 months. The control rate of infection, visual acuity, graft transparency, epithelizatlon time and complications were observed In both groups. The study was approved by the Ethical Committee of General Hospital of Northern Theater Command, approval No. K(2018)05. RESULTS AND CONCLUSION: (1) The control rate of Infection showed no significant difference between two groups (91%, 91%, P > 0.05). (2) The visual acuity in both groups was improved with time. The visual acuity in the donor group was significantly better than that in the bio-engineering group at 12 months after surgery (P 0.05). (4) The epithelization time showed no significant difference [(6.6±2.0) days, (6.7±1.9) days, P > 0.05]. (5) There was no significant difference In the Incidence of delayed healing of corneal epithelium, rejection reaction of graft, neovascularization, or recurrence between two group (P > 0.05). The rate of graft dissolved In the bio-engineering group was significantly higher than that In the donor group (32%, 8%, P < 0.05). (6) In summary, bio-engineering cornea used for lamellar keratoplasty holds significant efficacy, high safety and good prognosis in the treatment of fungal cornea ulcer, which may as substitute when donor cornea is deficient.
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Objective@#To analysis of the effect of strengthening management of dyslipidemia in community based on family doctor contracting service.@*Methods@#In December 2014, 1267 cases patients with dyslipidemia aged over 18 years were selected from three community health service centers in Hangzhou, including 645 in intervention group (311 males and 334 females) and 622 in control group (307 males and 315 females). In the intervention group, the management of dyslipidemia in community was strengthened by graded follow-up and personalized diagnosis and treatment based on the contracted services of family doctors, while the control group adopted the general management of dyslipidemia in the community. After 12 months of intervention, the changes of lifestyle (smoking, drinking, body mass index, waist circumference), regularly taking lipid-regulating drugs, blood lipid, blood pressure, blood sugar levels and their control rates were compared by χ2 test or t test before and after intervention between the intervention group and the control group. Non-conditional logistic regression analysis was used to analyze the influencing factors of blood lipid attainment.@*Results@#Before intervention, there were no significant differences in gender, age, cardiovascular risk stratification, the levels of lipid and other metabolic indicators, lipid compliance rate between intervention group and control group (P> 0.05). After intervention, the intervention group improved in drinking, overweight,obesity, abdominal obesity, and the rate of regularly taking lipid-regulating drugs increased,compared with the control group, the difference was statistically significant (χ2=5.923,4.765,8.587,5.341, 5.654; all P<0.05). The levels of total cholesterol, triglyceride, low density lipoprotein cholesterol, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, glycosylated hemoglobinin the intervention group were lower than those in the control group, the differences were statistically significant (t=-4.987,-3.207, -6.280, -3.339, -2.466, -4.052, -5.012, -2.865, -2.450; all P<0.05), while the HDL-C level in the intervention group was higher than that in the control group (t=2.294; P<0.05). The control rate of blood lipids, the control rate of blood pressure, and the combined control rates of blood lipid, blood pressure and blood sugar in the intervention group were higher than those in the control group, the differences were all significant (χ2=31.262,4.818,17.245; all P<0.05). Unconditional logistic regression analysis showed that family doctor contracted services (OR=1.961, 95%CI: 1.485-2.589), gender (OR=0.662, 95%CI: 0.471-0.930), smoking (OR=0.498, 95%CI: 0.332-0.745), obesity (OR=0.570, 95%CI: 0.359-0.904), hypertension (OR=0.353, 95%CI: 0.259-0.480), diabetes mellitus (OR=0.340, 95%CI: 0.239-0.483) was the influencing factor of blood lipid reaching the target (all P<0.05).@*Conclusion@#Intensive management of dyslipidemia in community based on family doctor's contracting service is helpful to improve the management effect of dyslipidemia.
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Objective@#To understand the prevalence, awareness, treatment and control of hypertension in elderly residents in Hebei province.@*Methods@#Elderly residents aged ≥60 were selected though multistage clustering sampling during August to December, 2015. Design based methods were adopted to analyze the prevalence, awareness, treatment and control of hypertension in local residents of Hebei.@*Results@#A total of 2 501 elderly adults were included in the study. The overall prevalence rate of hypertension was 63.7% (58.3% in males, 69.0% in females), the awareness rate of hypertension was 42.4% (35.7% in males, 48.0% in females), the treatment rate was 38.2% (32.0% in males, 43.3% in females), and the control rate was 9.0% (8.1% in males, 9.7% in females). The results of multivariate analysis indicated that age, sex, degree of education, BMI and central obesity were the factors influencing the prevalence, awareness, treatment and control of hypertension in elderly population in Hebei.@*Conclusions@#The prevalence of hypertension was high, but the rates of awareness, treatment and control of hypertension were low in elderly residents in Hebei. The influences of overweight, obesity and central obesity on hypertension were significant in the elderly. It is necessary to standard the management of hypertension and reduce the risk factors for hypertension in elderly population to improve the control of hypertension.
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Objective@#To investigate the prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province and provide evidence for the prevention and control of hypertension.@*Methods@#A population-based cardiovascular disease screening project was conducted during 2015-2018 in Jiangsu, a total of 95 348 community-dwelling adults aged 35-75 years from 6 project areas were included in the study. The prevalence rate of hypertension and rates of awareness, treatment and control of hypertension in the adults with different characteristics were analyzed. Multilevel model was applied to identify the influencing factors.@*Results@#Among 95 348 adults surveyed, 54 407 were hypertensive, the standardized prevalence rate was 48.1%. The prevalence rate was significantly higher in males than in females (62.1% vs. 54.0%, P<0.05). Among the hypertension patients, the rates of awareness, treatment and control of hypertension were 56.6%, 45.3% and 12.0% (standardized rates: 52.2%, 41.0% and 11.2%), respectively, and all the rates were positively associated with age (all P<0.05). Multilevel model analysis showed that those who were males, at older age, lived in rural area, suffered from diabetes, had frequent alcohol drinking and those who were overweight/obese had higher risk for hypertension (all P<0.05). Among people with hypertension, those who had younger age, lower education level, lower household income level and those who had frequent alcohol drinking had lower awareness, treatment and control rates of hypertension (all P<0.05).@*Conclusions@#The prevalence rate of hypertension was high, but related awareness, treatment and control rates were low in adult residents in Jiangsu province. Comprehensive measures should be taken to improve awareness, treatment and control of hypertension in whole population, especially in young adults, and those with low education or income levels.
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Objective To learn the implementation and effects of standardized management of hypertension in Xiangshan. Methods A total of 1500 patients who were over 35 years and admitted to community hypertension management were enrolled in the research. The patients were given standardized management of hypertension, and acceptance questionnaire survey and physical examination. Multivariate logistic regression model was used to analyze the influencing factors of blood pressure control. Results Totally 597 patients were managed according to the standardized management requirements, and the standardized management rate was 39.80％ . All patients were received blood pressure ≥1 times /year, 84.00％ , 84.47％ , 78.27％ and 77.67％ of the patients were received dietary guidance, physical activity guidance, guidance and control tobacco smoking cessation / drinking / alcohol limit guidance respectively. The standardized blood pressure control rate was 42.20％ , which was higher than that of the non standardized management patients (31.01％), and the difference was statistically significant (P<0.05) . Logistic regression showed that high education background (ORjunior middle scho l=0.86, 95％ CI: 0.78-0.95;ORhighscho landabove= 0.76, 95％ CI: 0.68-0.85), excessive waist circumference (OR=0.93, 95％ CI: 0.89-0.97), obesity (OR=0.66, 95％ CI: 0.47-0.93) , receiving dietary guidance, (OR=0.73, 95％ CI: 0.56-0.95 ) , receiving physical activity guidance (OR=0.89, 95％CI: 0.81-0.98), acceptance of standardized management (OR=0.74, 95％CI: 0.62-0.88) were promote factors of blood pressure control. Elder (OR=1.29, 95％CI: 1.08-1.54), male (OR=1.12, 95％ CI: 1.02-1.23), living in rural areas (OR=1.09, 95％ CI: 1.03-1.15) and high income (OR=2.01, 95％ CI: 1.31-3.08) were barriers of blood pressure control. Conclusion Providing standardized management services for patients with hypertension can effectively control the blood pressure level.
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Objective: The burden of noncommunicable diseases (NCDs) is increasing in China, together with economic development and social changes. The prevalence of risk factors for NCDs, such as overweight/obesity, hypertension, diabetes, and dyslipidemia, is reported to be high even among poor residents of rural areas. We aimed to investigate the prevalence of hypertension among elderly adults in rural Northeast China and the proportion with controlled hypertension among those on antihypertensive medication (hypertension control rate). We also aimed to examine the association of hypertension control with health facilities that provide treatment.Methods: We conducted a community-based cross-sectional study in six rural villages of Northeast China from February to early March, 2012. We interviewed 1593 adults aged 50–69 years and measured their blood pressure. We examined the differences in mean blood pressure between participants who obtained antihypertensive medication from village clinics and those who obtained medication from other sources, using analysis of covariance adjusted for several covariates.Results: The prevalence of hypertension among participants was as high as 63.3%, but the hypertension control rate was only 8.4%. Most villagers (98.1%) were not registered in the chronic disease treatment scheme of the public rural health insurance. The mean systolic blood pressure, adjusted for the covariates, of participants who obtained antihypertensive medication from village clinics was significantly lower than that of participants who obtained medication from township hospitals (by 16.5 mmHg) or from private pharmacies (by 7.3 mmHg).Conclusion: The prevalence of hypertension was high and the hypertension control rate low among elderly villagers during the cold season. As treatment at village clinics, which villagers can access during the cold season seems to be more effective than self-medication or treatment at distant hospitals, improving the quality of treatment in village clinics is urgently needed.
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Objective To more effectively prevent hypertension and provide better health care for college and university teachers and staff by keeping abreast with the epidemiology of hypertension. Methods The data were extracted from the selected Chinese and English papers on epidemiology of hypertension, which was followed by a meta-analysis of the prevalence, awareness rate, cure rate, and control rate of hypertension in college and university teachers and staff of China. Results A total of 73 papers were included in this study. The total prevalence of hypertension was 23. 3% (95%CI=21. 1%-25. 6%), the prevalence of hypertension was 27. 2% (95%CI=24. 4%-30. 0%) in male hypertensive teachers and staff and was 18. 6% (95%CI=16. 6%-20. 6%) in female hypertensive teachers and staff. The prevalence of hypertension increased with the increasing age and tended to increase with the year of investigation in college and university teachers and staff of China, and was the lowest in East China followed by Central China and West China. The awareness rate, cure rate and control rate of hypertension were 68. 3% (95%CI=59 . 7%-76 . 8%) , 63 . 7% ( 95%CI=55 . 5%-71 . 9%) , and 37 . 7% ( 95%CI=28 . 0%-47 . 5%) respec-tively in college and university teachers and staff of China. Conclusion The prevalence of hypertension is different in college and university teachers and staff of China due to different sexes, ages and areas.
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Objective To more effectively prevent hypertension and provide better health care for college and university teachers and staff by keeping abreast with the epidemiology of hypertension. Methods The data were extracted from the selected Chinese and English papers on epidemiology of hypertension, which was followed by a meta-analysis of the prevalence, awareness rate, cure rate, and control rate of hypertension in college and university teachers and staff of China. Results A total of 73 papers were included in this study. The total prevalence of hypertension was 23. 3% (95%CI=21. 1%-25. 6%), the prevalence of hypertension was 27. 2% (95%CI=24. 4%-30. 0%) in male hypertensive teachers and staff and was 18. 6% (95%CI=16. 6%-20. 6%) in female hypertensive teachers and staff. The prevalence of hypertension increased with the increasing age and tended to increase with the year of investigation in college and university teachers and staff of China, and was the lowest in East China followed by Central China and West China. The awareness rate, cure rate and control rate of hypertension were 68. 3% (95%CI=59 . 7%-76 . 8%) , 63 . 7% ( 95%CI=55 . 5%-71 . 9%) , and 37 . 7% ( 95%CI=28 . 0%-47 . 5%) respec-tively in college and university teachers and staff of China. Conclusion The prevalence of hypertension is different in college and university teachers and staff of China due to different sexes, ages and areas.
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Objectives:To test the effect of continuous care on rural hypertension control , we developed a com-prehensive intervention strategy and implemented a community-based quasi-experiment in Southwestern rural China.Methods:The intervention took place in Qianjiang District , Chongqing Municipality from July 2012 to June 2014.4 towns were randomly selected and categorized into 2 groups based on a comprehensive consideration of population and social development level.All the rural hypertension patients in treatment group were intervened with the Multi-institu-tional Continuous Pathway which was consisted of three parts:the Continuous Primary-Care Pathway , the Continuous Clinical Pathway and the Continuous Management Pathway.The patients in the control group served as a blank com-parison using the usual care.Difference-in-differences Model was used to test the effect of blood pressure control in treatment group.Results:853 patients were sampled and investigated using the stratified randomly sampling strategy and 712 of them had been followed up by the end of this program.The potential bias of pilot and patient selection were eliminated through control before and after the intervention.The previous blood pressure trends showed no statis-tically significant difference between groups.The systolic blood pressure in treatment group declined by 10.156 mm-Hg ( P<0.001 ) compared to control group after intervention , and the blood pressure control rate had increased by 27.6% ( P<0.001 ).Other contributing factors besides intervention were family structure , education level and med-ical service availability.Conclusion:The continuous care pathway have a significant marginal positive effect on hyper -tension control besides the national compulsory primary care , and the control rate change of blood pressure is more sen-sitive compared to blood pressure change.The potential contributing factors show that other intervention strategies could be developed to improve the rural hypertension control by adding to the social capital of rural patient , reinforcing the health education and facilitating the village transportation.
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Objective To study the efficacy and safety of CO2 laser microsurgery for early glottis carcinoma.Methods The data of 96 cases of early glottic laryngeal carcinoma treated with CO2 laser microsurgery were retrospectively analyzed.Surgical specimens were conventionally embedded with paraffin and serially sectioned.Sections were stained by using hematoxylin-eosin for pathologic examination.The local control rate was observed after operation.Results Among the 96 specimens,88 surgical margins were negative and 8 were positive.10 patients (10.4 ％) recurrenced followed up for 3 years.The recurrence rates of Tis,T1a,T1b and T2 were 0 (0/10),4.1％ (2/48),25.0 ％ (4/16) and 18.1％ (4/22),respectively,with significant differences among groups (X2 =6.105,P ＜ 0.05).All of 8 cases with positive margin and 2 cases with negative margin were recurrened.The recurrent rate of patients with involvement of the anterior commissure was 30.0 ％ (6/20),which was higher than that of patients with no tumor invasion [5.3 ％ (4/76)] (X2 =9.624,P ＜ 0.01).Conclusions The safe edges can be obtained by CO2 laser microsurgery for early stage of glottis carcinoma,which have advantages in local control rate,vocal function of the larynx and curative effect.
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With the support of World Bank ( WB ) and UK Department for International Development ( DFID) , China Rural Health Project ( hereinafter referred asHealth XI Project) has successfully covered 40 coun-ties in 8 provinces. With the establishment of community diagnosis and health records as the entry point, hyperten-sion, diabetes and other major chronic diseases as the starting point, and focus on the needs of healthy people, high-risk groups and patients, the project mainly adopts health education and promotion, health management, disease management and other measures to explore the establishment of a new model of rural chronic disease management. By analyzing the monitoring data of chronic diseases in the project zones, this study found that the number of registered and managed patients with hypertension and diabetes increased significantly, from 397,113 and 136,326 in 2009 to 1,500,252 and 388,846 in 2013, respectively. The management rate also increased from 60. 8% and 32. 2% in 2009 to 92. 2% and 88. 8% in 2013, respectively. The results of the 5th National Health Service Survey show that, the control rates for self-reported hypertension and diabetes ((53. 8% and 50. 2%, respectively) in the project zones were significantly higher than the national average in rural areas ( 54 . 9% and 38 . 3%, respectively ) . This paper suggests that, with focus on training, health education, health promotion, health management and disease manage-ment as the core mainline, the chronic disease management model has effectively improved the chronic disease service capabilities in rural areas,. The comprehensive and integrated chronic disease interventions implemented by the pro-ject in the rural areas is practical, and it has value of popularization and application.
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Objective To compare the efficacy after conventional radiotherapy and late course accelerated fractionation radiotherapy for nasopharyngeal carcinoma (NPC).Methods A total of 200 NPC patients were enrolled and randomly assigned to conventional radiotherapy (CF) group with 99 cases or late course accelerated fractionation radiotherapy (LCAF) group with 101 cases,who received irradiation to 60Co γ or 6 MV X-rays.In the CF group,the total dose of nasopharynx was 70 Gy/35 fractions at 2 Gy daily.In the LCAF group,for the first two-thirds of the treatment,two daily fractions of 1.2 Gy were given to the primary lesion and the total dose was 48 Gy/40 fractions.For the last one third of the treatment,the dose per fraction was increased to 1.5 Gy and the total dose was 30 Gy/20 fractions.Results There were 25,16,25 in CF group and 16,13,18 patients in LCAF group who had recurrence of nasophaynx,cervical lymph nodes,and distant metastasis,respectively.The 5-year nasopharyngeal control and overall survival rates was 75.9％ and 87.6％ in CFgroup (x2 =4.066,P＜0.05),58.0％ and 74.1％(x2 =5.076,P ＜ 0.05) in LCAF group,respectively.Cervical lymph nodes local rates and distant metastasesfree rates at 5 years were 8 1.5％ and 90.0％ in CF group (P ＞ 0.05),74.1％ and 83.3％ (P ＞ 0.05) in LCAF group,respectively.Conclusions Compared with CF,LCAF can improve nasopharyngeal control and overall survival rates,but there are no significant difference in the recurrence rates of cervical lymph nodes and distant metastasis.
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Objective To evaluate the effect of blood pressure intervention program on stroke among high risk population aged 45-79 at the community level,in Beijing.Methods 7604 subjects were followed and given specific advice according to the situation of each individual,every month.Data regarding average blood pressure,number of hypertension control and the incidence of stroke among people in the community,were recorded and analyzed.Results Prior to the follow-up program,the hypertension prevalence was 64.1％ but both the systolic and diastolic blood pressure showed a reduction of 2.9 and 1.5 mm Hg,respectively after the intervention program was implemented,with t value as-20.987,-15.494,respectively,and P values were both 0.000.Decrease of BP at the first four follow-up experiences was more obvious.Decrease of systolic blood pressure appeared more in elderly (F value was 14.287,and P value was 0.000),in males (t value was-2.885,P value was 0.004),people living in suburban areas (t value was 5.314,P value was 0.000) and with poorer education (t value was-6.943,P value was 0.000).However,decrease of diastolic blood pressure was seen more in younger age population (F value was 22.864,P value was 0.000),in males (t value was-2.259,P value was 0.024) and those having received better education (t value was 2.428,P value was 0.015).Rate regarding hypertension control increased from 67.7％ to 87.9％ after the intervention program was implemented (x2 value was 324.595,P value was 0.000).Incidence of stroke was 2.7‰ and seen higher in suburban area (x2 value was 5.293,P value was 0.021).Conclusion Community intervention program on hypertension could both reduce the blood pressure and the incidence rate of stroke among high-risk population.The earlier the blood pressure intervention program started,the better the effect would be seen.Reduction of blood pressure in males seemed more obvious.In order to prevent or delay the occurrence of stroke,knowledge on hypertension prevention should be improved among populations at high risk.Individualized and comprehensive follow-up management programs should be strengthened among the community health care takers.