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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.
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Objective The cumulative incidence function (CIF) is an important descriptive indicator for competing risk data in medical follow-up study.However,the upper and lower limits of the classic confidence interval (CI) of CIF may be exclusive the boundaries.In this paper,the CI estimators based on five different transformations and their performances are studied.Methods The CIs of CIF are constructed based on the linear (classical),log,log (-log),arcsine and logit transformation,respectively.Through the simulation study,the average deviations of the false coverage probabilities for all CIs are comprehensively investigated by the ANOVA technology.Results The simulation results show that the CIs based on linear and arcsine transformation have a large positive deviation.Log transformation is prone to fluctuations and has a minimum negative deviation,only log (-log) transformation is closest to the expected constant 0,and most robust and reliable.Conclusion Combined with the simulation results and example,CIs base on linear and log transformation are easy to have wide range and unstable performance,and can not overcome the bounds being negative or above 1;the arcsine and logit is slightly fluctuated,but their performances are relatively balanced;only performance of log(-log) is the most robust and reliable.
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Objective To analyze the epidemic features of anemia among students aged 6-11 years old in Minghang District,to provide basis for the control and prevention strategies of anemia among school students.Methods Surveillance on hemoglobin concentration was conducted among 42 872 students aged from 6 to 11 years old between 2012 and 2015.All data analyses were completed by SPSS 18.0 statistical software.Results The prevalence rate of anemia among school students 6-11 years old was 5.05％ (95％CI:4.84-5.26).The prevalence rate of anemia among girls was 5.28％,which was significantly higher than that 4.84％ among boys (x2 =4.24,P =0.037).Six-year-old boys and girls were most susceptible to anemia.Compared to students in Hope Schools,public school students are more vulnerable to anemia (boys:OR =2.37,95 ％ CI:2.03-2.76;girls:OR =2.08,95 ％ CI:1.74 -2.49).Overweight and obese students had a lower risk of anemia than average students (boys:OR =0.65,95 ％ CI:0.55-0.76;girls:OR =0.75,95 ％ CI:0.61-0.92).The three-year cumulative incidence of anemia was 12.80％ (95 ％CI:12.49-13.12).The cumulative incidence among girls was 14.52％,which was significantly higher than that of 11.28％ among boys (x2 =100.26,P＜0.001).Six-year-old boys have the highest three-year cumulative risk among all students,while 10-11-year-old girls have the highest three-year cumulative incidence.The risk of anemia in Hope School was found highest in all schools (boys:RR =1.93,95％CI:1.72-2.16;girls:RR =1.20,95 ％CI:1.04-1.39).Overweight and obesity were considered protective factors to anemia (boys:RR =0.75,95％CI:0.67-0.84;girls:RR =0.77,95％CI:0.68-0.88).The primary and recurrent detection rates of anemia were 14.58％ and 2.54％.The anemia among students was mainly detected during the first examination despite the differences in ages,schools and nutrition conditions (P ＜ 0.05).Conclusions The prevalence of anemia among primary school students in Minhang District is at a mild level.Control measures should be adopted,including monitoring of hemoglobin in all school children and adolescents,taking individual intervention measures based on results,promoting the health education for adolescent girls and parents of school children,and paying special attention to Hope School and students with recurrent and continuous anemia.
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Objective To analyze the epidemic features of anemia among students aged 6-11 years old in Minghang District,to provide basis for the control and prevention strategies of anemia among school students.Methods Surveillance on hemoglobin concentration was conducted among 42 872 students aged from 6 to 11 years old between 2012 and 2015.All data analyses were completed by SPSS 18.0 statistical software.Results The prevalence rate of anemia among school students 6-11 years old was 5.05％ (95％CI:4.84-5.26).The prevalence rate of anemia among girls was 5.28％,which was significantly higher than that 4.84％ among boys (x2 =4.24,P =0.037).Six-year-old boys and girls were most susceptible to anemia.Compared to students in Hope Schools,public school students are more vulnerable to anemia (boys:OR =2.37,95 ％ CI:2.03-2.76;girls:OR =2.08,95 ％ CI:1.74 -2.49).Overweight and obese students had a lower risk of anemia than average students (boys:OR =0.65,95 ％ CI:0.55-0.76;girls:OR =0.75,95 ％ CI:0.61-0.92).The three-year cumulative incidence of anemia was 12.80％ (95 ％CI:12.49-13.12).The cumulative incidence among girls was 14.52％,which was significantly higher than that of 11.28％ among boys (x2 =100.26,P＜0.001).Six-year-old boys have the highest three-year cumulative risk among all students,while 10-11-year-old girls have the highest three-year cumulative incidence.The risk of anemia in Hope School was found highest in all schools (boys:RR =1.93,95％CI:1.72-2.16;girls:RR =1.20,95 ％CI:1.04-1.39).Overweight and obesity were considered protective factors to anemia (boys:RR =0.75,95％CI:0.67-0.84;girls:RR =0.77,95％CI:0.68-0.88).The primary and recurrent detection rates of anemia were 14.58％ and 2.54％.The anemia among students was mainly detected during the first examination despite the differences in ages,schools and nutrition conditions (P ＜ 0.05).Conclusions The prevalence of anemia among primary school students in Minhang District is at a mild level.Control measures should be adopted,including monitoring of hemoglobin in all school children and adolescents,taking individual intervention measures based on results,promoting the health education for adolescent girls and parents of school children,and paying special attention to Hope School and students with recurrent and continuous anemia.
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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.
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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.
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Femelle , Humains , Dysplasie du col utérin , Chine , Études de cohortes , Incidence , Dépistage de masse , Études prospectives , Tumeurs du col de l'utérusRésumé
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.
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OBJECTIVE: To examine the relationship between social contextual factors and child and adolescent labor. METHODS: Population-based cohort study carried out with 2,512 families living in 23 subareas of a large urban city in Brazil from 2000 to 2002. A random one-stage cluster sampling was used to select families. Data were obtained through individual household interviews using questionnaires. The annual cumulative incidence of child and adolescent labor was estimated for each district. New child and adolescent labor cases were those who had their first job over the two-year follow-up. The annual cumulative incidence of child and adolescent labor was the response variable and predictors were contextual factors such as lack of social support, social deprivation, unstructured family, perceived violence, poor school quality, poor environment conditions, and poor public services. Pearson's correlation and multiple linear regression were used to assess the associations. RESULTS: There were selected 943 families corresponding to 1,326 non-working children and adolescents aged 8 to 17 years. Lack of social support, social deprivation, perceived violence were all positively and individually associated with the annual cumulative incidence of child and adolescent labor. In the multiple linear regression model, however, only lack of social support and perceived violence in the neighborhood were positively associated to child and adolescent labor. No effect was found for poor school quality, poor environment conditions, poor public services or unstructured family. CONCLUSIONS: Poverty reduction programs can reduce the contextual factors associated with child and adolescent labor. Violence reduction programs and strengthening social support at the community level may contribute to reduce CAL.
OBJETIVO: Analisar a relação entre as variáveis sociocontextuais e o trabalho de crianças e adolescentes. MÉTODOS: Estudo de coorte com 2.512 famílias residentes em 23 áreas urbanas de Salvador, BA, entre 2000 e 2002. A seleção das áreas e a identificação das famílias foram realizadas por amostragem por conglomerados. Entrevistas domiciliares foram realizadas com questionários individuais. A incidência cumulativa anual do trabalho de crianças e adolescentes foi estimada para cada área. Crianças e adolescentes que se tornaram trabalhadores ao longo dos dois anos de seguimento do estudo foram considerados casos novos. A incidência cumulativa anual do trabalho de crianças e adolescentes foi analisada como variável resposta e fatores contextuais foram as preditoras (ausência de apoio social, deprivação social e famílias não-estruturadas, percepção de violência, má qualidade das escolas e dos serviços públicos, e existência de problemas ambientais na vizinhança). Regressão linear múltipla foi utilizada para análise. RESULTADOS: Foram encontradas 943 famílias com 1.326 crianças e adolescentes não trabalhadores de 8 a 17 anos. Ausência de apoio social, deprivação social e percepção de violência na vizinhança associaram-se positivamente ao trabalho de crianças e adolescentes quando analisadas separadamente. Ausência de apoio social e percepção de violência foram positivamente associadas com o desfecho na regressão linear múltipla. Má qualidade da escola e dos serviços públicos urbanos e a existência de problemas ambientais e familiares não apresentaram associação. CONCLUSÕES: Programas que visem à redução da pobreza podem atuar positivamente nos fatores contextuais considerados. Programas de pacificação em áreas violentas, assim como o fortalecimento das redes sociais nas comunidades, podem contribuir para a diminuição do trabalho de crianças e adolescentes.
OBJETIVO: Analizar la relación entre las variables sociocontextuales y el trabajo de niños y adolescentes. MÉTODOS: Estudio de cohorte con 2.512 familias residentes en 23 áreas urbanas de Salvador, Noreste de Brasil, entre 2000 y 2002. La selección de las áreas y la identificación de las familias fueron realizadas por muestreo por conglomerados. Entrevistas domiciliares fueron realizadas con cuestionarios individuales. La incidencia acumulada anual del trabajo de niños y adolescentes fue estimada para cada área. Niños y adolescentes que se tornaron trabajadores a lo largo de dos años de seguimiento del estudio fueron considerados casos nuevos. La incidencia acumulada anual del trabajo de niños y adolescentes fue analizada como variable respuesta y factores contextuales fueron los predictivos (ausencia de apoyo social; privación social y familias no estructuradas, percepción de violencia, mala calidad de las escuelas, de los servicios públicos, y existencia de problemas ambientales en la vecindad). Regresión linear múltiple fue utilizada para análisis. RESULTADOS: Se encontraron 943 familias con 1.326 niños y adolescentes no trabajadores de 8 a 17 años. Ausencia de apoyo social, privación social y percepción de violencia en la vecindad se asociaron positivamente al trabajo de niños y adolescentes al analizarlos separadamente. Ausencia de apoyo social y percepción de violencia fueron positivamente asociados con el resultado en la regresión linear múltiple. Mala calidad de la escuela y de los servicios públicos urbanos y la existencia de problemas ambientales y familiares no presentaron asociación. CONCLUSIONES: Programas que busquen reducir la pobreza pueden actuar positivamente en los factores contextuales considerados. Programas de pacificación en áreas violentas, así como el fortalecimiento de las redes sociales en las comunidades, pueden contribuir para la disminución del trabajo de niños y adolescentes.
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Adolescent , Enfant , Humains , Emploi/statistiques et données numériques , Problèmes sociaux/statistiques et données numériques , Brésil , Analyse de regroupements , Études de cohortes , Modèles linéaires , Pauvreté , Facteurs de risque , Problèmes sociaux , Facteurs socioéconomiques , Population urbaine/statistiques et données numériquesRésumé
In order to investigate the cumulative incidence and risk factors for diabetic retinopathy among non-insulin dependent diabetes mellitus, 116 patients which given diagnosis of diabetes at age 30 years or older who had been followed-up for more than 10 years and were initially free from retinopathy were analysed retrospectively. Several risk factors for retinopathy were analysed at the initial examinations: sex, age at the onset, age at the initial examination, duration, fasting plasma glucose(FPG), two-hour postpradial plasma glucose(pp2), blood pressure, hypertension status, therapeutic regimen, total cholesterol, HDL-cholesterol, triglyceride, body mass index. After a mean follow-up time of 11.7 years. The cumulative incidence was 31.0%. By univariate analysis. Significant risk factors of retinopathy were age at the onset, age at the initial examination. FPG, PP2, therapeutic regimen. However, By using multivariate analysis. Independent risk factors were not found.