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Objective: To analyze the base incidence, distribution characteristics, survival status and social security of occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") in Zibo City. Methods: The new pneumoconiosis patients in Zibo City from 1949 to 2021 were selected as the research subjects using a cross-sectional survey. Household survey or telephone follow-up were carried out, and the distribution characteristics, living conditions and social security situation were retrospectively analyzed. Results: A total of 8 910 patients with pneumoconiosis were investigated, and 96.0% of them were male. The stage Ⅰ pneumoconiosis patients accounted for 91.3%. From 1949 to 2021, the number of pneumoconiosis patients showed a stepwise upward trend with time. Most of the patients suffered from coal worker pneumoconiosis and silicosis, which accounted for 48.7% and 38.9%, respectively. The average age of onset was (52.7±11.4) years, and the average length of service exposed to dust was (21.1±9.4) years. The patients were concentrated in Zichuan District, Boshan District and Zhangdian District, that accounted for 87.8%. The industry distribution was mostly mining industry and manufacturing industry, accounting for 61.1% and 31.6% respectively. Among the 8 910 cases of pneumoconiosis, 543 cases were lost in follow-up. A total of 8 367 patients were followed-up, with a follow-up rate of 93.9%. The mortality rate of patients who completed follow-up was 50.5%, and the mortality rate decreased with the increase of the stage of pneumoconiosis (P<0.01). The rate of adoring social security in the 4 138 surviving patients was 98.4%. Conclusion: The situation of prevention and treatment of pneumoconiosis in Zibo City is challenging. It is necessary to strengthen the special control of dust hazards in mining and manufacturing industries in key areas such as Zichuan District, Boshan District and Zhangdian District.
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@#Abstract: Objective To analyze the survival status of HIV/AIDS patients aged above 50 years receiving antiviral therapy (ART) in Shanxi Province from 2011 to 2019, and to provide evidence for further improvement of antiviral therapy. Methods Basic information and follow-up information of HIV/AIDS patients aged above 50 years who first received HIV/AIDS antiviral therapy in Shanxi Province from 2011 to 2019 were collected. Excel database was established and SPSS23.0 software was used for analysis. Retrospective cohort study was conducted. Cox proportional risk regression model was used to analyze the factors influencing survival time. Results A total of 1 183 subjects were included, of which 172 died, including 84(48.84%) from other causes, 74(43.02%) AIDS-related death and 14 (8.14%) from accidents, suicides and undetermined deaths. Setting AIDS-related deaths as an outcome event, life table analysis showed that the cumulative survival rates at 1, 3, 5, 7 and 9 years after receiving ART were 96.61%, 93.59%, 90.35%, 87.57% and 83.44%, respectively. Multivariate Cox proportional risk model analysis showed that the risk of death in patients aged 60-<70 years group and over 70 age group was 2.53 times (95%CI: 1.51-4.23) and 3.59 times (95%CI: 1.74-7.40) for patients aged the 50-<60 group , respectively. The risk of death in patients with baseline CD4+T lymphocyte (CD4) counts of ≥200/mm3, 50-<200 /mm3 was 0.22 times (95%CI: 0.12-0.41) and 0.37 times (95%CI: 0.21-0.67) for patients with CD4+T lymphocyte counts of <50/mm3. The risk of death in patients with opportunistic infections at baseline was 1.99 times (95%CI: 1.16-3.39) for patients without baseline opportunistic infections. Conclusions The survival rate of HIV/AIDS patients aged above 50 who received antiviral therapy (ART) in Shanxi Province from 2011 to 2019 was relatively high. To further improve the quality of antiviral treatment in our province, the strategy of "early detection and early treatment" should be continued and improved in the future, and information collection of specific causes of non-AIDS-related deaths among this population should be further strengthened.
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OBJECTIVE@#To investigate the effect of epidural anesthesia on the long-term prognosis of patients after selective colorectal cancer resection surgery.@*METHODS@#This was a retrospective cohort study and approved by local institution review board. Patients who underwent selective colorectal cancer resection surgery from August 2011 to December 2012 in Peking University First Hospital were enrolled. The patients were divided into general anesthesia (GA) group and combined epidural-general anesthesia (EGA) group according to anesthesia type. Primary outcome was patient's long-term survival status. Secondary outcome included the overall incidence of in-hospital complications and length of postoperative in-hospital stay. Propensity score was used to match cases between the two groups based on the probability of receiving EGA. Survival was analyzed by Kaplan-Meier analysis and compared by Log-rank test between the two groups. Multivariate Cox regression analysis was used to investigate the relationship between epidural anesthesia and other variables with long-term survival status.@*RESULTS@#A total of 264 patients were entered into final analysis, including 166 cases in GA group and 98 cases in EGA group. Mean age of the patients was (63.3±12.1) years and mean survival time was 47.2 (95%CI 45.7-48.7) months. Before the propensity score match, the mortality in EGA group was 16.9% (28/166) and 9.2% (9/98) in GA group. But comparison between the two groups had no statistical significance (P=0.091). After the propensity score match, 87 paired cases were matched and analyzed. The risk of long-term mortality in EGA group was lower than that of GA group by Kaplan-Meier analysis (5.7% vs.16.1%, HR=0.344, 95%CI 0.124-0.955, P=0.041). Mean survival time of EGA group was longer than that of GA group (50.3 months vs. 42.9 months, P=0.032). Multivariate Cox regression ana-lysis showed that EGA, in comparison with GA, was related with lower risk of long-term mortality (HR=0.326, 95%CI 0.117-0.909, P=0.032). Age (HR=1.042, 95%CI 1.001-1.085, P=0.046) and preoperative lymph node metastasis (HR=2.924, 95%CI 1.162-7.356, P=0.023) were also related with increased risk of long-term mortality.@*CONCLUSION@#Present study found that perioperative use of epidural anesthesia and analgesia was associated with improvement of the patient's long-term survival. Well-designed studies are needed to verify this hypothesis.
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Aged , Humans , Middle Aged , Anesthesia, Epidural , Anesthesia, General , Colorectal Neoplasms/surgery , Propensity Score , Retrospective StudiesABSTRACT
Objective:To examine the long-term survival of elderly patients with differentiated thyroid cancer(DTC)after surgery, and to analyze its influencing factors.Methods:Clinical data of 80 elderly DTC patients from our department who had completed a 5-year post-surgery follow-up between January 2017 and June 2020 were analyzed.The survival characteristics and survival time of patients were analyzed.The difference in mortality was compared in patients with different general conditions.Influencing factors for long-term survival in elderly DTC patients 5 years after surgery were analyzed by using Cox regression.Results:Of 80 elderly DTC patients, the average survival time was 4.53±0.41 years, 18 cases died during the follow-up period, the mortality was 22.50%(18/80), and the survival rate was 77.50%(62/80). Cox regression analysis showed that histological type(follicular thyroid cancer), surgical method(unilateral gland resection), no cervical lymph node dissection and low therapeutic doses of iodine were influencing factors for the long-term survival of elderly DTC patients 5 years after surgery( OR=5.888, 5.795, 6.753 and 4.923, P=0.004, 0.004, 0.002 and 0.003). Conclusions:The 5-year long-term survival of elderly DTC patients may be affected by the histological type, surgical method, cervical lymph node dissection and therapeutic doses of iodine.Clinical management with an emphasis on these factors and with targeted risk mitigation intervention plans may offer a positive impact on the long-term survival for patients.
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Objective:To examine the survival status and explore factors related to death among human immunodeficiency virus （HIV） infected patients receiving antiretroviral therapy （ART） in Taizhou City during 2006‒2019. Methods:A retrospective cohort study was conducted to analyze the data on HIV-infected patients receiving ART in Taizhou during 2006‒2019. Kaplan-Meier （K-M） method was used to calculate the cumulative survival rate and cumulative treatment success rate. Cox regression model was used to determine survival status and factors associated with ART. Results:A total of 2 904 HIV-infected patients was included. The cumulative survival rate after 1， 3， 5， and 8 years of ART were 96.9%， 94.9%， 93.1% and 92.1%， respectively， and the cumulative treatment response rate were 91.3%， 85.3%， 81.8% and 73.8%， respectively. Compared with aged 18-30 years old， baseline CD4+T cell >350 count/μL， normal hemoglobin level， effective ART， no clinical symptom at baseline， and homosexual transmission， we found that aged 51-60 years old（HR=4.94，95%CI：1.66-14.69）， aged over 60 years old（HR=9.14，95%CI：3.14-26.63）， anemia at baseline（HR=2.24，95%CI：1.55-3.23）， baseline CD4+T cell <200 count/μL（HR=4.35，95%CI：2.14-8.86）， ART failure （HR=3.90，95%CI：2.73-5.58）， heterosexual transmission（HR=1.92，95%CI：1.15-3.20）， and signs of symptom at baseline（HR=1.68，95%CI：1.16-2.41） were risk factors of HIV-related death. Conclusion:The effect of ART in Taizhou City is confirmed with a high cumulative survival rate and treatment success. We should pay additional attention to senior HIV-infected patients with anemia at baseline and intensively monitor the effect of ART. Interventions such as “treat after discover” are supposed to be implemented more widely to further reduce HIV-related mortality.
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Objective:To understand the current living and health status of leprosy survivors in Fengxian District， Shanghai， and to provide scientific evidence for improving their quality of life. Methods:In January 2018-June 2020， professionally trained CDC staff performed a household investigation on 41 patients with leprosy （case group） and 82 non-leprosy persons （control group） every year. Living and health status， and routine laboratory examinations such as blood pressure， blood glucose， and blood lipids were monitored. Results:Majority of the patients with leprosy had low educational level （68.29% being primary school） and were mostly farmers （51.22%）.The patients had abnormal residual Ⅱ level 5 （12.20%） and mostly were tb-like （TT） （53.66%）. Moreover， some patients were not incapacitated （46.34%）， had no family financial difficulties （29.27%）， did not acquire the national subsistence allowance policy （58.54%）， and asked for "regular physical examination" （68.29%）.Compared to the 82 control persons， the patients with leprosy had significantly different body mass index （BMI） and blood pressure （P<0.05）. Conclusion:Living and health status of leprosy survivors in Fengxian District remains to be further improved. The China Disabled Persons’ Federation （CDF）， Red Cross， civil affairs， and health administration need to further strengthen the cooperation.
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OBJECTIVE: To understand the research status on living conditions of patients with occupational pneumoconiosis in China. METHODS: The Chinese academic journal database, Wanfang Chinese periodical database and VIP database were used to search the relevant domestic literatures on the survival status of patients of occupational pneumoconiosis. The NoteExpress literature management software, VOSviewer 1.6.10 software and CiteSpace 5.2 software were used to sort out and visually analyze the searched literatures. RESULTS: A total of 4 043 articles were obtained, including 2 745 journal papers, 1 165 degree papers and 133 conference papers. The publication was increasing rapidly in years. The journal papers were published in 766 journals, and the degree papers came from 257 graduate training units. Disease prevention and control institutions, occupational defense institutions, colleges and universities were the supporting units of first authors that published the largest number of periodical papers. Pneumoconiosis was a high-frequency keyword. The emerging key words in this field from 2015 to 2019 include: occupational health examination, nursing intervention, lung function, industrial injury insurance, occupational health monitoring and quality of life. CONCLUSION: The number of literatures published on the survival status of pneumoconiosis patients in China shows a trend of rapid growth. The prominent words in the current and future studies on the living conditions of pneumoconiosis patients in China are occupational health examination, nursing intervention, lung function, industrial injury insurance, occupational health monitoring and quality of life.
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Objective:To investigate the survival status of the surgical treatment of hilar cholangiocarcinoma patient and related factors that influence long-term survival rate of patients.Methods:79 hilar cholangiocarcinoma patients in our hospital from June 2008 to March 2011 were selected and retrospectively analyzed,survival status of patients after 1,3,5 years was observed and recorded,clinic data was given simple factor and COX regression analysis.Results:From 79 hilar cholangiocarcinoma patients,there were 41 cases given surgical resection,38 cases given operative drainage,postoperative survival rate of all patients after 1,3,5 years were 49.37％ 、22.78％ 、7.59％,postoperative survival rate of patients with surgical resection after 1,3,5 years were 70.73％、36.59％ 、14.63％,postoperative survival rate of patients with operative drainage after 1,3,5 years were 26.32％、7.89％、0.00％.The difference of 5-year survival rate of patients with different pathological pattern,TNM stages,differentiated degree,surgical approach,excision method,lymphatic metastasis or not,different incisal edge had statistic significance (P ＜0.05).Mucinous carcinoma,TNM stages 1 ～ IV,operative drainage,palliative surgery,lymphatic metastasis were independent risk factors that influence survival status of hilar cholangiocarcinoma patients (P ＜ 0.05).Conclusion:The prognosis of surgical treatment of hilar cholangiocarcinoma patient is poor,mucinous carcinoma,TNM stages Ⅲ ～ IV,operative drainage,palliative surgery,lymphatic metastasis are independent risk factors that influence survival status of hilar cholangiocarcinoma patients.
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Objective:To investigate the survival status of the surgical treatment of hilar cholangiocarcinoma patient and related factors that influence long-term survival rate of patients.Methods:79 hilar cholangiocarcinoma patients in our hospital from June 2008 to March 2011 were selected and retrospectively analyzed,survival status of patients after 1,3,5 years was observed and recorded,clinic data was given simple factor and COX regression analysis.Results:From 79 hilar cholangiocarcinoma patients,there were 41 cases given surgical resection,38 cases given operative drainage,postoperative survival rate of all patients after 1,3,5 years were 49.37％ 、22.78％ 、7.59％,postoperative survival rate of patients with surgical resection after 1,3,5 years were 70.73％、36.59％ 、14.63％,postoperative survival rate of patients with operative drainage after 1,3,5 years were 26.32％、7.89％、0.00％.The difference of 5-year survival rate of patients with different pathological pattern,TNM stages,differentiated degree,surgical approach,excision method,lymphatic metastasis or not,different incisal edge had statistic significance (P ＜0.05).Mucinous carcinoma,TNM stages 1 ～ IV,operative drainage,palliative surgery,lymphatic metastasis were independent risk factors that influence survival status of hilar cholangiocarcinoma patients (P ＜ 0.05).Conclusion:The prognosis of surgical treatment of hilar cholangiocarcinoma patient is poor,mucinous carcinoma,TNM stages Ⅲ ～ IV,operative drainage,palliative surgery,lymphatic metastasis are independent risk factors that influence survival status of hilar cholangiocarcinoma patients.
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O objetivo desse artigo é construir indicadores de gasto com consultas, exames e internações no setor de saúde suplementar, considerando os registros administrativos de uma operadora de autogestão do Estado de São Paulo, Brasil, para 2009. Os indicadores de gastos foram discriminados por grupo etário, sexo e status de sobrevivência. O dispêndio médio anual dos beneficiários que faleceram é cerca de 40 vezes superior ao daqueles que permaneceram ativos na carteira. A discriminação dos gastos por sexo mostrou diferenças segundo a situação de sobrevivência: mulheres sobreviventes têm gasto mais elevado, com inversão desta relação entre não sobreviventes. A maior parcela de dispêndios é destinada às internações e esta categoria também representa a maior diferença observada, no gasto condicionado ao uso, entre sobreviventes e não sobreviventes, segundo grupo etário. Entre beneficiários que faleceram, verifica-se tendência crescente das despesas condicionadas ao uso com a idade para homens, enquanto para mulheres a tendência é de queda a partir do grupo etário 60-69 anos.
The aim of this paper is to construct indicators of expenditures on medical consultations, examinations and admissions in private health care, based on the administrative records of a private self-management health plan in the State of São Paulo, Brazil, in 2009. The expenditure indicators were separated by age group, gender and survival status (beneficiaries who survived vs. those who died in 2009). The average annual expenditures for the beneficiaries who died were approximately 40 times higher than those of individuals who remained alive. Expenditures by gender showed differences according to survival status, with female survivors costing more than female non-survivors. The highest expenses were for hospital treatment and this category also showed the highest difference in costs observed between survivors and non-survivors, by age group. For beneficiaries who died, there was a trend toward increasing costs for men for hospital treatment whereas there was a fall in such costs for women, beginning with the 60-69 age group.
El objetivo de este artículo es construir indicadores de gasto con consultas, análisis e internaciones en el sector de salud suplementaria, considerando los registros administrativos de una operadora de autogestión del estado de São Paulo, Brasil, para el 2009. Los indicadores de gastos fueron discriminados por grupo de edad, sexo y status de supervivencia. El gasto promedio anual de los beneficiarios que fallecieron es cerca de 40 veces superior al de los que permanecieron activos en la cartera. La discriminación de los gastos por sexo mostró diferencias según la situación de supervivencia: mujeres sobrevivientes tienen gasto más elevado, con inversión de esta relación entre no sobrevivientes. La mayor parcela de gastos se destina a las hospitalizaciones y esta categoría también representa la mayor diferencia observada en el gasto condicionado al uso, entre sobrevivientes y no sobrevivientes, de acuerdo al grupo de edad. Entre los beneficiarios que fallecieron, se verifica una creciente tendencia de los gastos condicionados al uso con la edad para hombres, mientras que para las mujeres la tendencia es de reducción a partir del grupo de edad de 60-69 años.