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Objective:To evaluate the development and application of gastrointestinal endoscopy technology in Beijing-Tianjin-Hebei (BTH) region from 2016 to 2020, and the impact of the corona virus disease 2019 (COVID-19) epidemic on gastrointestinal endoscopy screening and lesion detection rate of medical institutions.Methods:Data of gastroscopy and colonoscopy cases from 26 cooperative institutions in BTH Region Gastrointestinal Endoscopy Medical Association from January 2016 to December 2020 were collected by questionnaire. The number of gastrointestinal endoscopy, the detection of main lesions (including upper gastrointestinal malignant tumors, early gastric cancer and colon cancer), and the number of endoscopic treatment were retrospectively analyzed by year.Results:From 2016 to 2019, the number of gastroscopy and colonoscopy showed a yearly increasing trend with an annual growth rate of over 10%. Compared with 2019, the number of gastroscopy and colonoscopy decreased by 10.86% and 8.29%, respectively, in 2020 due to the impact of the epidemic. The annual detection rates of upper gastrointestinal malignant tumors, early gastric cancer and colon cancer were on a rise, from 7.22%, 1.49% and 8.98% in 2016 to 9.87%, 2.71% and 12.04% in 2020, respectively. The number of gastroscopic mucosal resection, submucosal dissection and colonoscopic endoscopic submucosal dissection increased yearly, from 2 132, 300 and 217 cases in 2016 to 5 466, 872 and 560 cases in 2020, respectively.Conclusion:The Medical Association has promoted the expansion of endoscopic screening and the application of endoscopic treatment techniques, resulting in a continuous increase in the endoscopy detection rate and early cancer diagnosis rate in the BTH region. The sharp decrease of gastrointestinal endoscopy procedures and the increase in the lesion detection rate in 2020 reflect the impact of epidemic COVID-19 on detection of gastrointestinal cancers.
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Prostate cancer (PC) is one of the malignant tumors of the genitourinary system that occurs more often in elderly men. Screening, early diagnosis, and treatment of the PC high risk population are essential to improve the cure rate of PC. The development of the guideline for PC screening and early detection in line with epidemic characteristics of PC in China will greatly promote the homogeneity and quality of PC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. This guideline strictly followed the World Health Organization Handbook for Guideline Development and combined the most up-to-date evidence of PC screening, China's national conditions, and practical experience in cancer screening. A total of fifteen detailed evidence-based recommendations were provided with respect to the screening population, technology, procedure management, and quality control in the process of PC screening. This guideline aimed to standardize the practice of PC screening and improve the effectiveness and efficiency of PC prevention and control in China.
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Aged , Humans , Male , Beijing , China/epidemiology , Early Detection of Cancer , Mass Screening , Prostatic Neoplasms/epidemiologyABSTRACT
Objective: To analyze the mortality of upper gastrointestinal cancer in Cixian County, Hebei Province, China, over the past 33 years, and provide evidence for the prevention and treatment of such cancer. Methods: According to the cancer registration regulations, changes in the mortality of upper gastrointestinal cancer were collected, sorted and evaluated, and the trends in the mortality of upper gastrointestinal cancer were analyzed using the cancer registration data accumulated by the Cixian cancer Registration Office between January 1, 1983, and December 31, 2015. The percentage changes in crude mortality, standardized mortality in China, and the standardized worldwide mortality were calculated. The annual percent change of mortality was estimated using a linear regression model of the adjustment rate. Results: Over the 33-year period in Cixian County, the average crude mortality of upper gastrointestinal cancer was 119.31/100,000, including 149.21/100,000 for males and 88.40/100,000 for females. The standardized mortality rate in China was 160.85/100,000, including 227.00/100,000 males and 108.07/100,000 females. The worldwide standardized mortality rate was 162.39/100,000, including 228.52/100,000 males and 109.30/100,000 females. Conclusions: The mortality of upper gastrointestinal cancer displayed a decreasing trend, but it still had the highest mortality rate of malignant tumors in Cixian County. Age-specific mortalities were increasing along with the rise of age.
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Background: In India, laryngeal cancer contributes to approximately 3–6% of all cancers in men.Objective: The aim of this study was to study the clinicopathology of cancer larynx with respect to age, sex, site, complaints,histology, staging, and predisposing factors.Materials and Methods: The study population consisted of 100 patients who were suffering from cancer larynx. A completeclinical history was taken from the patients. After the clinical diagnosis of growth larynx, the patients were prepared for directlaryngoscopy under general or local anesthesia. The lesions were visualized, the extent of growth defined, and biopsy taken andthen sent for histopathological examination. The staging of cancer larynx was done according to tumor, node, and metastasisclassification.Results: There were 80 male (80%) and 20 female (20%) patients. Maximum patients were in the age group of 51–60 years(40%). 54% showed supraglottic cancer, 45% had glottic cancer, and only 1% had subglottic cancer. In cases of supraglotticcancer, the most common complaint was difficulty in swallowing seen in all 54 patients; in cases of glottis cancer, the mostcommon complaint was hoarseness of voice seen in 88.88%. There was only 1 patient of subglottic cancer who presentedwith difficulty in swallowing and difficulty in breathing. Out of 100 cases, there were 99 cases of squamous cell carcinomawhereas there was only 1 case of adenocarcinoma. Out of total 100 patients, overall most common stage was Stage 2 (34%),followed by Stage 3 (25%), Stage 4a (16%), Stage 1 (15%), and Stage 4b (10%). Smoking was found to be the most commonpredisposing factor (92%), followed by alcohol intake (78%) and tobacco chewing (50%).Conclusion: Early diagnosis and treatment of laryngeal cancer is important to reduce the morbidity and mortality of patients.
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Objective To analyze the effect of colorectal cancer screening in the general population in Guangzhou,and provide evidence for the for development of colorectal cancer screening policy and strategy.Methods The data of colorectal cancer screening in Guangzhou during 2015-2016 were collected.The participation,the positive rate of fecal occult blood test,the detection rate of colonoscopy and screening effect of colonoscopy were evaluated.Results A total of 220 834 residents aged 50-74 years received the screening,and the positive rate of the screening was 16.77％ (37 040 cases).Colonoscopy was performed for 7 821 cases (21.12％).Colorectal lesions were found in 4 126 cases (52.76％),of which 614 (7.85％) and 73 (0.93％) and 230 (2.94％) were identified as advanced adenoma,severe dysplasia lesions and colorectal cancers,respectively.The detection rates of all colorectal lesions were higher in men than in women (all P＜0.01).The diagnostic rate of early lesion was 87.24％,and 99 early cancer cases were found,accounting for 46.26％ of the total cases.The overall screening detection rate of colorectal cancer was 104.15/100 000,higher than the incidence rate (81.18/100 000) in colorectal cancer surveillance (P＜0.001),but age group ＜70 years had higher detection rate,age group ≥70 years had higher incidence rate.Conclusions The colorectal cancer screening strategy in Guangzhou is effective in the detection of the population at high risk,increase the detection rate of colorectal lesions,early diagnosis rate of precancerous lesions and diagnosis rate of early colorectal cancer.The benefit in those aged ≤69 years was more obvious than that in those aged 70-74 years.It is necessary to improve the compliancy of colorectal cancer screening in population at high risk.
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Objective To analyze the effect of colorectal cancer screening in the general population in Guangzhou,and provide evidence for the for development of colorectal cancer screening policy and strategy.Methods The data of colorectal cancer screening in Guangzhou during 2015-2016 were collected.The participation,the positive rate of fecal occult blood test,the detection rate of colonoscopy and screening effect of colonoscopy were evaluated.Results A total of 220 834 residents aged 50-74 years received the screening,and the positive rate of the screening was 16.77％ (37 040 cases).Colonoscopy was performed for 7 821 cases (21.12％).Colorectal lesions were found in 4 126 cases (52.76％),of which 614 (7.85％) and 73 (0.93％) and 230 (2.94％) were identified as advanced adenoma,severe dysplasia lesions and colorectal cancers,respectively.The detection rates of all colorectal lesions were higher in men than in women (all P＜0.01).The diagnostic rate of early lesion was 87.24％,and 99 early cancer cases were found,accounting for 46.26％ of the total cases.The overall screening detection rate of colorectal cancer was 104.15/100 000,higher than the incidence rate (81.18/100 000) in colorectal cancer surveillance (P＜0.001),but age group ＜70 years had higher detection rate,age group ≥70 years had higher incidence rate.Conclusions The colorectal cancer screening strategy in Guangzhou is effective in the detection of the population at high risk,increase the detection rate of colorectal lesions,early diagnosis rate of precancerous lesions and diagnosis rate of early colorectal cancer.The benefit in those aged ≤69 years was more obvious than that in those aged 70-74 years.It is necessary to improve the compliancy of colorectal cancer screening in population at high risk.
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Objective@#To compare the results of two rounds of colorectal cancer screening in Haining, explore the long-term mechanism and interval time of screening during the prevention and control of colorectal cancer, and establish practical basis for the rational prevention and control strategies.@*Methods@#Between 2007 to 2010 and 2013 to 2015, a total of 80, 000 cases who had completed two rounds of tumor screening were enrolled and analyzed. All cases comes from five towns in Haining.@*Results@#The first round of screening was performed in 80 603 cases and 12.92% (n=10 417) were identified as high-risk population. Colonoscopy were completed in 7 796 subjects and 22.05%(n=1 719) of them were found at least one neoplastic lesions (polyps, adenoma or carcinoma). The population detection rate of all neoplasia was 21.33 per thousand. The detection rate of advanced neoplasia was 4.58% per colonoscopy and 4.43‰ in the population. A total of 357 advanced neoplasia including 296 advanced adenomas and 61 colorectal cancers were found, 330 of whom were applied to early treatment (92.44%). A total of 89 403 subjects participated the second round of screening. The detection rate of high-risk population in the second round (20.81%) was significantly higher than that in the first round (P<0.05). A total of 12 917 subjects completed colonoscopy and 31.97% (n=4 129) of them were found as least one neoplastic lesion. The population detection rate of all neoplasia was 46.18 ‰. Both in the subjects completed colonoscopy and in the screened population, the detection rate of all neoplasia were significantly (P<0.01) higher than that of the first round. The detection rate of advanced neoplasia (n=851) in both the subjects completed colonoscopy (6.59‰)and the total screened population (9.52‰) in the second round were also significantly (P<0.01) higher than that of the first round. The difference of early detection rates for the first (92.44%) and the second (97.53%) round screening were not statistically significant(P>0.05).@*Conclusions@#The main technical indicators of the second round of colorectal cancer screening were significantly better than that of the first round, with significant screening effect. A screening interval of 5 years was suggested for the next round of colorectal cancer screening.
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Objective To understand the significance of upper eyelid swelling in early diagnosis and treat-ment of infectious mononucleosis(IM).Methods We early diagnosed these patients IMwith upper eyelid swelling, fever and lymph node enlargement under five days course of disease,and compared the coincidence rate with last diag-nosis,investigated the rate of upper eyelid swelling in non -early diagnosis cases with the course of disease above one week,and evaluated the effect of ganciclovir in treating IMin two groups.Results The coincidence rate was 97.14%in early and last diagnosis groups,and the rate of upper eyelid swelling was 60.2% in non -early diagnosis group. There were significant differences in disappear of upper eyelid swelling,fever and lymph node enlargement in the two groups.Conclusion Upper eyelid swelling has important significance in early diagnosis and treatment of IM.
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Objective:Colorectal cancer screening was performed on a general population with age ranging between 40 and 74 years old to evaluate the screening effects of questionnaire survey, fecal occult blood (FOB) test, and colonoscopy, as well as to provide some implications of colorectal cancer screening strategies. Methods: Two-step screening model of questionnaire survey combined with FOB test was applied for the screening. Colonoscopy was conducted in a high-risk population identified through preliminary screening as final diagnosis. Results:Based on the 2,117,304 cases screened, the screening compliance was 39.72%, and 126,118 cases (5.96%) were identified as high risk. Colonoscopies were performed on 25,837 cases, of which 8,095, 1,236, 134, 112, and 336 were identified as adenoma, advanced adenoma, severe dysplasia lesions, early cancer, and advanced cancer, respectively. The early stage di-agnostic rate was 81.52%. Conclusion:The colorectal cancer screening method performed in Tianjin can significantly concentrate on the high-risk population with colorectal cancer, increase the positivity rate of total colonoscopy, and economize medical resources.
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Objective To analyze the clinical manifestations,diagnosis,treatment and prognosis of patients with splenic abscess.Method The clinical data,including baseline clinical data,clinical features,past history,pathogen culture result,treatment and the prognosis were retrospectively analyzed in the patients with the discharge diagnosis splenic abscess from January 1991 to March 2012 in Peking Union Medical College Hospital.Results The media time from onset to Peking Union Medical College Hospital of the 19 patients were 29 days.Among them,9 patients were cured,8 were improved and 2 died.Risk factors,such as tumor burden,diabetes,and using immunosuppressive agents etc,can be found in most patients with splenic abscess.All the 19 patients had splenic image changes and non-specific clinical features.The most common three clinical symptoms were fever(18 cases),chills (12 cases) and shivering (11 cases).The most common three signs were abdominal tenderness (9 cases),left upper quadrant sensitive to percussion (7 cases) and splenomegaly (4 cases).The most common etiological culture results were gram negative bacilli (9 cases),gram positive coccus (8 cases),and fungi (4 cases).Conclusions Clinical features are non-specific in splenic abscess patients.Related exam such as ultrasound should be performed on patients with splenic abscess risk factors to avoid misdiagnosis.Empiric antibiotic administration should begin right after the diagnosis based on the image.Pathogen culture should be timely conducted after pus collection.Individual therapeutical protocol should be chosen according to patient's condition.
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In the 20th century, major progresses were made for treatment of hepatocellular carcinoma: standard resection, radiotherapy and chemotherapy were applied in the 1950s; liver transplantation emerged in the 1960s, and the positive clinical results for the treatment of hepatocellular carcinoma were proved in the 1990s; the survival rates were significantly increased due to local resection for small liver cancer in the 1970s and local tumor therapies benefited the patients more in the 1980s. But the purpose of these procedures was only to destroy the tumors. In the past half century, the survival rate of liver cancer patients in our hospital increased every ten years. It is predicted that in the 21st century, the purpose of improving the outcome of treatment for liver cancer will elaborate to manipulating procedures between tumor and the human body on the basis of destroying the tumors. There are various ways to improve the therapeutic results for hepatocellular carcinoma. For example, these efforts can be achieved by developing and using new therapeutic methods. In the early 21st century, further biological study is the key point to influence the clinical progress for hepatocellular carcinoma. Although to destroy the tumors is basic and important, the most important thing is how to regulate the relationship between residual tumors and the human body.
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Objective To study the early diagnosis and treatment of cervical vertebrae injury.Methods 86 cases with cervial vertebrae injury were retrospectively analyzed.8 cases were treated by head halter treaction,78 cases were treated by skull traction,15 cases treated in early-day operation,27 cases seclected-day operation.Results According to frankel grading.A degree was 36 cases,no betterment,one case died;B degree 18 cases,2 cases improved to C degree,3 cases improved to D degree,13 cases had no improverment;9 cases,all had one or two degree improvement.20 cases with the nerve root injury all had determinate improverment or were cured.Conclusion Quick and correct early diagnosis and treatment after cervical vertebrae injury are the key steps in decreasing the death rate and disability rate.
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Objective To investigate early diagnosis,treatment and prev ention of tibia fatigue fracture. Methods From August 1988 to July 1999, 66 case s of tibia fatigue fracture were treated with exposure to the irradiation of Zho u Lin Spectrum Treatment Device, plaster splintage, according to their different clinic characteristics and results of X-gram.Results The 66 cases were followe d up for an average of 6 months. The result was excellent in 50 cases, good in 1 6, with the excellent and good rates of 100%. Conclusions As a result of a chro nic course of accumulative injury, the tibia fatigue fracture develops from quan titative changes to qualitative changes. It is essential for medical workers to have a good knowledge of the classification and features of the condition. It is also important for the army to make scientific and reasonable training plans fo r the soldiers.
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OBJECTIVE: Suprasellar meningioma have in general been difficult lesions to treat because of their vicinity to the optic apparatus and major vessels, and high vascularity. This study was performed to analyze clinical outcome of patients with histopathologically identified suprasellar meningioma. METHOD: Between 1989 and 1998, 37 patients(30 women, 7 men: average 47.5years) with histopathologically identified meningiomas originating from the suprasellar region underwent surgical tumor removal in our institution. The medical records and clinical data of these patients are retrospectively analyzed. RESULT: The tumor size ranged from 2.1cm to 6.5cm(average 5.1cm) in diameter. The tumors have been approached basically through the pterional and bifrontal routes. Skull base technique was also applied in large or complicated cases. Total resection rates and overall outcome including visual function was better in patients with tumor of less then 3cm. A considerable increase of mortality, morbidity and failure of visual improvement were seen in case of the tumors size of 3cm or more. CONCLUSION: Early diagnosis and treatment were important factors in the successful management of these suprasellar meningioma. In large complicated cases encasing major vessels or invading cavernous sinus or anterior skull base, surgeons need to operate with extreme caution and piecemeal removal of the tumor without injuring optic apparatus and major vessels utilizing skull base technique.