Résumé
Objective To analyze the incidence and risk factors of de novo malignant tumors in renal transplant recipients. Methods Clinical data of 1 549 renal transplant recipients were retrospectively analyzed, including the basic status, pathological type and incidence rate of patients with de novo malignant tumors after renal transplantation. The survival situation of these patiensts was assessed. And the risk factors of de novo malignant tumors after renal transplantation were identified. Results The incidence rate of de novo malignant tumors in renal transplant recipients was 3.03%(47/1 549). The 47 recipients were (48±12) years old when undergoing renal transplantation, and they were (55±12) years old when diagnosed malignant tumors. The time interval between transplantation and diagnosis was 66 (36, 100) months. Among the de novo malignant tumors, colorectal cancer was the most common, with a cumulative incidence rate (CIR) of 0.58%. The survival time of 47 recipients with de novo malignant tumors after renal transplantation was 59 (2, 135) months, and the 5-year survival rate was 50%. The recipients with the age > 45 years old when undergoing renal transplantation was a risk factor for de novo malignant tumors after renal transplantation (P < 0.05). Conclusions The incidence rate of de novo malignant tumors is relatively high in renal transplant recipients. The recipients with the age > 45 years old when undergoing renal transplantation is a risk factor for de novo malignant tumors.
Résumé
OBJECTIVE: To analyze the tendency of incidence in coal workers' pneumoconiosis( CWP) in different time of dust exposure and different types of work in a mining enterprise in Huaibei City. METHODS: A total of 12 152 dust exposed workers who worked from 1970 to 2014 in a mining enterprise in Huaibei City were chosen as study subjects by judgment sampling method. They were divided into 2 cohorts were formed according to initial year of dust exposure( 1970-,1980-),and 4 group according to the type of work( tunneling,mining,combining and helping). Life table method was adopted to calculate cumulative life-incidence of CWP in each cohort. RESULTS: Among 12 152 workers,there were 594 of them diagnosed as CWP patients with a 4. 89% of incidence. During the same 34-year-observation period,the cumulative CWP incidence of 1970-cohort was higher than that of the 1980 s( 8. 03% vs 5. 45%,P < 0. 01). The cumulative CWP incidence of tunneling,mining,combining and helping workers were 69. 33%,40. 53%,36. 66% and 19. 70% by 2014,respectively. The cumulative incidence of CWP in tunneling group started to rise from the 14-year-observation window,mining's from 16-year-observation window,combining and helping workers from 18-year-observation window. Among the workers in 1970-cohort at the 34-year-observation window,the CWP cumulative incidence in mining group was the highest( 33. 83%,P < 0. 004),and combining's was the lowest( 2. 28%,P < 0. 004). Among the workers in 1970-cohort at the 44-year-observation window,the CWP cumulative incidence in tunneling group was the highest( 66. 66%,P < 0. 004),and helping's was the lowest( 27. 24%,P < 0. 004). Among the workers in 1980-cohort at the 34-year-observation window,the CWP cumulative incidence in tunneling group was the highest( 29. 87%,P < 0. 004). CONCLUSION: The cumulative incidence of CWP patients was slowed down with prolonged dust exposure starting time. There were differences among different types of workers with different starting time of dust exposure.
Résumé
Objective To analyze the results of screening for tuberculosis (TB) in health examination participants and study the spontaneous occurrence of TB in the subjects with strong positive reaction to tuberculin skin test (TST) in ten years. Method Totally 12 598 health examination participants without past TB history were selected, of whom 8 896 were college students, 2 496 migrant workers and 1 206 had close contacts with active TB patients. They were screened by TST with strong positive reaction. All of subjects with TST strong positive results received chest X-ray examination and sputum acid-fast bacteria detection. The subjects diagnosed to have TB were given regularly anti-tuberculosis drugs treatment and followed up for ten years. The 429 subjects without TB and no isoniazid preventive treatment were chosen to be followed up for ten years and spontaneous occurrence of TB in first three years and the fourth to tenth years respectively, as well as the recurrence of TB for the patients who received anti-tuberculosis regimen were recorded. Result Thirty-seven cases were diagnosed as TB by TST screening, and the total detection rate was 0.29% (37/12 598). Among them 11 were college students (0.12%, 11/8 896), 12 were migrant workers (0.48%, 12/2 496) and 14 were close contacts (1.16%, 14/1 206) respectively. The detection rates were different among the three groups (χ2=31.40, P=0.000). Among 897 strong positive subjects, the strong positive rate was 7.12%(897/12 598), 316 were college students (3.55%, 316/8 896), 388 migrants workers (15.54%, 388/2 496), and 193 close contacts (16.00%, 193/1 206) respectively. There was significant difference in strong positive rate among the three groups (χ2=583.04, P=0.000), and the strong positive rate of college students was lower compared with that of the migrant workers and the close contacts (χ2=483.51 and 344.11, P<0.01). In ten years, 54 subjects were diagnosed as TB in 429 subjects with strong positive reaction to TST, the spontaneous cumulative incidence rate was 12.58% (54/429). Among them, the cumulative morbidity rate was 9.21%(14/152) in college students, 9.58%(18/188) in migrant workers and 24.72%(22/89) in close contacts respectively. The spontaneous morbidity rate of close contacts was higher than that of college students and migrant workers(χ2=10.63 and 11.21, P<0.001); 75 were lost in 398 participants, the dropout rate was 18.84%(75/398). In first three years of follow-up, 31 were diagnosed TB in 429 participants, the cumulative incidence rate was 7.23% (31/429). Of them 9 were college students (5.92%, 9/152), 10 migrant workers (5.32%, 10/188) and 12 close contacts (13.48%, 12/89) respectively (χ2=6.60, P=0.037). In the fourth to tenth years of follow-up, 23 were diagnosed TB in 398 participants, the cumulative incidence rate was 5.78% (23/398), which was not significantly different compared with the cumulative incidence rate of the first three years (χ2=2.50, P=0.37). Tirty-seven patients received standard anti-tuberculosis drug therapy for one year, no one of them had recurrence at ten-year follow-up. Conclusion The migrant workers and close contacts are the high-risk populations for TB. All of them with strong positive response to TST results are susceptible to TB. So regular physical examination is recommended for them and health management should be strengthened.