Short-term effect evaluation of self-management group projects for chronic disease patients in Suzhou / 公共卫生与预防医学

Objective To evaluate the short-term effect of self-management group project for chronic disease patients in Suzhou. Methods Eight to ten streets / towns were randomly selected from 10 cities and districts under the jurisdiction of Suzhou. Each street / town set up a chronic disease self-management group and carried out group activities. The awareness rate of chronic disease related knowledge, health management behavior and health status of the group members after and before the activities were compared to evaluate the short-term effect of the self-management group project. Results A total of 89 chronic disease self-management groups were set up in Suzhou in 2020. Among them, there were 47 hypertension groups and 42 diabetes groups. A total of 1176 people were surveyed at baseline, and 1161 people participated in the evaluation survey after the group activities. By setting up self-management groups, the awareness rates of chronic disease-related knowledge (BMI range, variety of food intake per day per week, moderate-intensity activity time per week, daily salt intake, harm of excessive salt intake, diagnostic criteria for hypertension, sodium content in low sodium salt, fasting blood glucose criteria, low-density lipoprotein control targets) in hypertension and diabetes patients after the intervention were improved compared with those before the intervention, and the differences were statistically significant (P“self-monitoring blood pressure” increased from 52.80% before the intervention to 66.32%, while the proportion of "having a blood glucose monitoring system at home" increased from 52.80% before the intervention to 66.32%, and the proportion of “self-monitoring blood glucose” increased from 25.67% before the intervention to 38.67%. The percentage of "drinking alcohol in the past 30 days" dropped from 12.14% before the intervention to 8.35%. All these differences were statistically significant. There was no difference in the number of "smoking in the past 30 days" compared with before the activity (P≥0.05). The number of days with poor health resulting from injuries in the past 30 days also decreased but the difference was not statistically significant (P≥0.05). In terms of the severity of depression, the number of people with moderate and severe depression decreased after the intervention, and the number of people who turned into mild depression increased, and the difference was statistically significant (P<0.05). Conclusion The self-management group project for chronic disease patients in Suzhou has achieved good results and is suitable for continued promotion and application in this region.

Change trend and prediction of lung cancer mortality in Suzhou in 2001-2020 / 公共卫生与预防医学

Objective To explore the epidemiological characteristics and trend of lung cancer mortality in Suzhou, to predict the future lung cancer mortality by ARIMA model, and to provide a scientific basis for the research of lung cancer prevention and control strategy. Methods The annual change percentage (APC) was used to analyze the annual change trend of lung cancer mortality from 2001 to 2020, and the ARIMA optimal model was employed to predict the lung cancer mortality from 2021 to 2025. Results The average annual crude mortality of lung cancer in Suzhou from 2001 to 2020 was 46.45/100 000, while the standardized mortality was 23.51/100 000. In recent 20 years, the crude mortality showed an upward trend and the standardized mortality showed a downward trend (APC crude rate = 2.51%, APC standardized rate = -0.78% , P < 0.001). The standardized mortality of lung cancer in men was 3.22 times that in women. The mortality of lung cancer in people over 45 years old increased with the increase of age, but the mortality in the 30-59 years old group showed a downward trend year by year. ARIMA model predicted that the annual trend of lung cancer crude mortality will tend to be flat in the next five years. Conclusion The crude mortality rate of lung cancer in Suzhou shows an upward trend, while the standardized mortality rate decreases year by year, suggesting that we should pay attention to the prevention and control of lung cancer in the elderly, accurately identify high-risk population of lung cancer, promote health publicity and education, carry out lifestyle intervention, and popularize the early screening of lung cancer.

Incidence of gastric cancer and risk factors in Suzhou cohort / 中华流行病学杂志

Objective: To describe gastric cancer incidence in Suzhou cohort, explore the environmental risk factors of gastric cancer in Suzhou, and provide appropriate suggestions for gastric cancer prevention and control. Methods: The participants were from the Suzhou cohort of China Kadoorie Biobank. Baseline survey was conducted from 2004 to 2008, followed by long-term follow-up until December 31, 2013. After the exclusion of those who had been previously diagnosed with peptic ulcer and malignant tumor reported at baseline survey and gastric cancer within six months after enrollment, a total of 50,136 participants were included. Cox proportional risk models were used to identify risk factors of gastric cancer and their hazard ratios in Suzhou. The effect modifications of gender on the association between risk factors and gastric cancer were analyzed. Results: In the follow-up of 7.19 years (median), 374 gastric cancers cases occurred. The standardized incidence was 94.57 per 100 000 person-years. Multivariate Cox proportional risk model analysis found that age (10 years old as a age group, HR=2.20, 95%CI: 1.92-2.53, P<0.001), current smoking (HR=1.84, 95%CI: 1.10-3.07 P=0.020), consumption of preserved vegetables weekly (HR=2.28, 95%CI: 1.28-4.07, P=0.005) and daily (HR=2.05, 95%CI: 1.16-3.61, P=0.013) were risk factors for gastric cancer. Female (HR=0.44, 95%CI: 0.25-0.76, P=0.003) and refrigerator use (10 years as a limit, HR=0.85, 95%CI: 0.74-0.97, P=0.016) were protective factors for gastric cancer. Further analysis showed that there was heterogeneity between males and females in the association between refrigerator use years and the incidence of gastric cancer (P=0.009), and there was an interaction effect between gender and refrigerator use on the incidence of gastric cancer (P=0.010). Conclusions: The incidence of gastric cancer in Suzhou cohort was high. The risk factors of gastric cancer varied. There was a synergistic interaction effect between gender and refrigerator use years on the incidence of gastric cancer.

A multicenter study on the establishment and validation of autoverification rules for coagulation tests / 中华检验医学杂志

Objective:To establish autoverification rules for coagulation tests in multicenter cooperative units, in order to reduce workload for manual review of suspected results and shorten turnaround time (TAT) of test reports, while ensure the accuracy of results.Methods:A total of 14 394 blood samples were collected from fourteen hospitals during December 2019 to March 2020. These samples included: Rules Establishment Group 11 230 cases, including 1 182 cases for Delta check rules; Rules Validation Group 3 164 cases, including 487cases for Delta check; Clinical Application Trial Group 77 269 cases. Samples were analyzed for coagulation tests using Sysmex CS series automatic coagulation analyzers, and the clinical information, instrument parameters, test results, clinical diagnosis, medication history of anticoagulant and other relative results such as HCT, TG, TBIL, DBIL were summarized; on the basis of historical data, the 2.5 and 97.5 percentile of all data arranged from low to high were initially accumulated; on the basis of clinical suggestions, critical values and specific drug use as well as relative guidelines, autoverification rules and limits were established.The rules were then input into middleware, in which Stage I/Stage II validation was done. Positive coincidence, negative coincidence, false negative, false positive, autoverification pass rate, passing accuracy (coincidence of autoverification and manual verification) were calculated. Autoverification rules underwent trial application in coagulation results reports.Results:(1) The autoverification algorisms involve 33 rules regarding PT/INR, APTT, FBG, D-dimer, FDP,Delta check, reaction curve and sample abnormalities; (2)Autoverification Establishment Group showed autoverification pass rate was 68.42% (7 684/11 230), the false negative rate was 0%(0/11230), coincidence of autoverification and manual verification was 98.51%(11 063/11 230), in which positive coincidence and negative coincidence were respectively 30.09% (3 379/11 230) and 68.42%(7 684/11 230); Autoverification Validation Group showed autoverification pass rate was 60.37%(1 910/3 164), the false negative rate was 0%(0/11 230), coincidence of autoverification and manual verification was 97.79%(3 094/3 164), in which positive coincidence and negative coincidence were respectively 37.42%(1 184/3 164) and 60.37%(1 910/3 164); (3) Trialed implementation of these autoverification rules on 77 269 coagulation samples showed that the average TAT shortened by 8.5 min-83.1 min.Conclusions:This study established 33 autoverification rules in coagulation tests. Validation showedthese rules could ensure test quality while shortening TAT and lighten manual workload.

Association between PM2.5 pollution in ambient air and cardio-cerebrovascular mortality in Suzhou in 2016：a time series analysis / 中华疾病控制杂志

Objective To explore the effect of PM2.5 on the mortality of cardio-cerebrovascular disease in Suzhou, China. Methods The death data, air pollutant data and meteorological data from January 1, 2016 to December 31, 2017 in Suzhou were collected. The general additive Poisson regression model was used to analyse the association of exposure to PM2.5 with the daily deaths due to cardio-cerebrovascular disease, and to calculate the relative risk (RR) and 95% confidence intervals (95%CI) for an interquartile range (IQR) increase in PM2.5. Results The number of deaths from cardio-cerebrovascular disease was 30 200. On average, there were approximately 41 deaths per day. The daily median concentration of PM2.5 was 37.13 μg/m3 and IQR was 30.75 μg/m3. The RR values of single-day death and average death from cardio-cerebrovascular disease were 1.017(1.001-1.034) and 1.055(1.019-1.093)with an IQR increase of PM2.5 concentration, respectively. Stratified by gender and age, female and the elderly aged over 65 had higher risks of death from the cardio-cerebrovascular disease. Conclusion The elevated level of ambient PM2.5was positively associated with the increase of mortality of cardio-cerebrovascular disease.

Application of Lee-Carter model in the prediction of mortality risk in digestive tract cancer in Suzhou / 中华疾病控制杂志

Objective A Lee-Carter model was used to predict the risk and trend of mortality in the digestive tract cancer in Suzhou from 2002 to 2016. Methods The crude and standardized mortality rates were calculated based on deaths of digestive tract cancer which was identified from Suzhou chronic disease surveillance system.We used Lee-Carter model to predict the trend of mortality in digestive tract cancer. Results The effectiveness of the results forecasted by Lee-Carter model was validated in the data of digestive tract cancer mortality from 2012 to 2016 in Suzhou. The mean absolute percentage error (MAPE) values for the model were 2.48% and 4.13% for the age and year respectively, which indicated a well accepted prediction value. The mortality index was on the down trend in overall digestive tract cancer from 2002 to 2016, among which the mortality index in upper digestive tract cancer decreased, while the mortality index in lower digestive tract cancer increased. The mortality rate of upper digestive tract cancer was 4.23 fold higher than that of lower digestive tract cancer, and mortality rate in male was 2.17 times higher than that in female. Conclusions Our study observed a downward mortality trend in digestive tract cancer overall. Notably, the male mortality rate of lower digestive tract cancer was on an upward trend. In recent years, Suzhou has been undergoing a rapid population aging with medical and health level was increasing as well.

The clinical curative effect of transcranial direct current stimulation on patients with disorders of consciousness / 中华物理医学与康复杂志

Objective To assess the clinical efficacy of transcranial direct current stimulation (tDCS) in improving consciousness in patients with severe disorders of consciousness.Methods Thirty-eight patients with disorders of consciousness were divided into an observation group and a control group according to a random number table,each of 19.Both groups received conventional rehabilitation therapy,while the observation group was additionally provided with tDCS at the intensity of 2 mA for 20 minutes per day,6 days per week,for 20 times,with the anodal electrode (isotonic saline gelatin sponge,7 cm×5 cm) placed over the left dorsolateral prefrontal cortex and the cathodal stimulation over the right eye socket or right shoulder.The patients were evaluated with brainstem auditory evoked potential (BAEP),upper limb somatosensory evoked potential (USEP),electroencephalogram (EEG) and Glasgow coma scale (GCS) and persistent vegetative state (PVS) scores before and after the treatment.Results There were no significant differences between the two groups with regard to BAEP,USEP,EEG,GCS and PVS scores (P＞0.05).After the treatment,significant improvement was observed in all the measurements,with those of the observation group superior to the control group (P＜0.05).In the evaluation of clinical efficacy,the total effective rate and the significant effective rate of the observation group was 89.47％ and 78.95％,respectively,significantly higher than those of the control group (84.21％ and 42.11％) (P＜0.05).Conclusions Conventional rehabilita tion treatment can improve the BAEP,USEP,EEG,GCS and PVS scores of patients with severe disorders of con sciousness,and the addition of tDCS on the basis of conventional rehabilitation treatment is more effective.

Gastrointestinal cancer influenced by genetic effect of cancer history of first-degree relatives / 上海预防医学

[Objective] To compare the influence of first-degree relatives' cancer history on the genetic tendency of gastric and colorectal cancer. [Methods] Patients with gastric and colorectal cancer from six towns of Suzhou City were investigated by means of face-to-face survey based on the "Family History and History of Population Diseases Questionnaire"which included general conditions, family composition and cancer occurrence of all their three degree relatives. [Results] If there were first-degree relatives with history of cancer, individual risk of gastric cancer would be higher than that of colorectal cancer by 55％, with the adjusted OR (95％ CI) being 1.551 (1.021, 2.356). If there were first-degree relatives with history of digestive tract cancer, the risk of the subject would increase to 104％, with the adjusted OR (95％CI) being 2.037 (1.279, 3.246). Men with first-degree relatives who had cancer history was at91％ higher risk of developing gastric cancer than colorectal cancer, with the adjusted OR (95％CI) being1.911 (1.080, 3.381). And for history of digestive tract cancer, the risk would reach 156％, with the adjusted OR (95％ CI) being 2.559 (1.337, 4.897). The number of cancers suffered by first-degree relatives of those patients with gastric cancer was higher than that of patients with colorectal cancer, with Z =-6.873, P<0.001, while the number of digestive tract cancer was also higher, with Z =-6.137, P<0.001. [Conclusion] The history of cancer and digestive tract cancer with first-degree relatives, is more common in patients with gastric cancer than with colorectal cancer. It is necessary to focus health education on men with first-degree relatives suffering from cancer or digestive tract cancer and suggest some changes in their living habits and regular medical examinations to reduce the occurrence of gastric cancer.

Predictive value of radiological parameter for re-displacement of conservative treatment of distal radius fracture / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the radiological parameters of the conservatively in treating distal radius fracture and investigate whether the final re-displacement can be predicted after primary reduction.</p><p><b>METHODS</b>From January 2013 to June 2014,212 patients with distal radial fracture conservatively were treated in our hospital, 107 patients of them were excluded because of their incomplete radiological parameters;the remaining 105 patients were available for radiological were assessed after injury, there were 56 male patients and 49 female patients in this study, the average age of the patients was 51 years old (ranged from 22 to 80 years). According to AO classification, there were 47 cases of type A2 and C1, and 58 cases of type A3, C2, C3. All patients were treated by closed reduction and below-elbow cast immobilization for 4 to 6 weeks. All patients were followed up for 3 to 6 months (means 4.5 months) by X-ray, all fractures were healed. Standard AP and lateral radiographic examination was conducted before reduction and after reduction and bony consolidation,the dorsal angulation and the radial angle were measured at each time point. The linear regression was used for the analysis to find out whether the final re-displacement can be predicted after primary reduction.</p><p><b>RESULTS</b>Among 105 patients,the significant correlations were found for the dorsal angulation between the reduction time and the end time (r = 0.82) and for the radial angulation between the reduction time and end time (r = 0.85).</p><p><b>CONCLUSION</b>The dorsal angulation and the radial angulation after complete healing can be predicted from linear the regression functions. Due to the possibility of predicting the end result, whether the fracture should receive further conservative treatment or surgical treatment can be decided immediately.</p>

Oncocytic Lipoadenoma: A Rare Case of Parotid Gland Tumor and Review of the Literature

Oncocytic lipoadenoma is a rare tumor, with only 18 cases having been reported since the first in 1998. We encountered a case of oncocytic lipoadenoma presenting as a slowly growing parotid mass in a 71-year-old man. This tumor is characteristically comprised of a mixture of oncocytes and adipocytes. The present case is one of five reported cases of oncocytic lipoadenoma showing sebaceous differentiation. The results of immunohistochemical study with DOG1 antibody supported the origination of this tumor in the striated duct.

Characteristics and replantation of degloving injury of distal finger / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical characteristics and replantation methods of degloving injury of distal finger.</p><p><b>METHODS</b>From 2004 to 2009,18 cases of 19 distal finger degloving were admitted, and included 14 males and 4 femals with an average age of 31 years old ranging from 18 to 51 years old. The distal finger degloving injury was divided into 3 types according to the different levels of degloveing digital artery and skin involving 6 fingers of type I, 10 fingers of type II, 3 fingers of type III. Among them, 3 cases of 4 fingers were failed to be replantaed due to severed injured digital artery, and 15 cases of 15 distal finger degloving injury were replanted with microsurgical technique.</p><p><b>RESULTS</b>Among 15 patients (15 fingers) conpleted the reimplant operation, 13 fingers were survived, 2 fingers were necrosis after operation. Thirteen survived fingers were followed up from 6 to 24 months (averaged 14 months). The appearance of injured fingers and nails obtained satisfactory results. According to Chinese Hand Surgery Society Criteria for function assessment replantation, the results were excellent in 9 cases, good in 3 cases and poor in 1.</p><p><b>CONCLUSION</b>Replantation of distal degloving injury is effective and it should strive for replantation.</p>

Relationship between peroxisome proliferator-activated receptor alpha intron 1A/C genetic polymorphism and metabolic syndrome / 中华预防医学杂志

<p><b>OBJECTIVE</b>To identify the relationship between genetic polymorphisms of peroxisome proliferator-activated receptor alpha (PPARalpha) intron 1A/C and metabolic syndrome (MS) in a Chinese population.</p><p><b>METHODS</b>A population-based case-control study was conducted in Suzhou city, Changshu County and Ganyu County in Jiangsu Province China, on the basis of an ongoing cohort study and 2348 cases were investigated. After the exclusion of the known MS cases, 1847 eligible subjects were successfully followed-up and their waist circumference (WC), body mass index, blood pressure, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglycerides (TG) and fasting plasma glucose were measured. Newly diagnosed MS patients were recruited as cases, controls were individual matched with each case. TaqMan fluorescence probe method was used to detect the genetic polymorphism of PPARalpha intron 1A/C.</p><p><b>RESULTS</b>The current analysis consisted of 389 MS patients and 389 matched controls. The C allele gene frequency of PPARalpha intron 1A/C in the case group was 22.24% (173/778), lower than that in the control group, which was 24.68% (192/778); whereas the difference was not statistically significant (chi(2) = 1.29, P > 0.05). In the genotypes AA + AC and CC, MS patients were accounted for 50.70% (363/716) and 41.94% (26/62) and hyperglycemia accounted for 21.37% (153/716) and 11.29% (7/62). Compared to the genotypes AA + AC, genotype CC was observed to be inversely associated with hyperglycemia (the adjusted OR = 0.39; 95%CI: 0.17 - 0.90) but not related to the occurrence of MS (OR = 0.75; 95%CI: 0.44 - 1.28) and other components of MS e.g., abdominal obesity (the adjusted OR = 0.67; 95%CI: 0.38 - 1.17), hypertriglyceridemia (the adjusted OR = 0.97; 95%CI: 0.53 - 1.76), low HDL-C (the adjusted OR = 0.72; 95%CI: 0.41 - 1.25) and hypertension (the adjusted OR = 0.72; 95%CI: 0.42 - 1.25) all P values > 0.05.</p><p><b>CONCLUSION</b>C allele of PPARalpha intron 1A/C is not found to be associated with MS in the Chinese population. But comparing with the genotypes AA + AC, there is an inverse association between CC genotype and hyperglycemia.</p>

A nested case-control study on the relationship between occupational physical activity,heredity factors and metabolic syndrome / 中华流行病学杂志

Objective To examine the associations between occupational physical activity,heredity factors and metabolic syndrome (MS) in a Chinese population.Methods Based on the MS cohort study in Jiangsu province,subjects were followed-up,and blood samples were collected at the same time for biochemical indicators measurement.Newly confirmed MS patients according to US.National Cholesterol Education Program Adult Treatment Guidelines Ⅲ (NCEP-ATP Ⅲ ) were recruited as eases.Controls were 1 :1 matched with eases by region,gender and age (±2 years).In total,389 MS patients and 389 eontrols were recruited as study subjects.Nested ease-control study was applied for the present analysis.TaqMan fluorescence probe method was used to detect the genetic polymorphism of PPARα intron 1A/C (rs135539).Results (1)Compared to low physical activity group,the subjects with heavy physical activity were positively associated with MS (OR=2.18,95%CI:1.08-4.38).(2)The subjects,with a family history of hypertension (OR= 1.44,95% CI:1.02-2.03 )or type 2 diabetes (OR=3.25,95CI:1.28-8.20),were significantly indreased the occurrence of MS.(3)The genotype(AA,AC,CC) of PPARα intron 1A/C was not found to be related to MS.The OR of AC and CC genotype (compared to the genotype AA) were 0.98(95%CI:0.70-1.36) and 0.75 (95% CI:0.44-1.29) ,respectively.(4) Effect modifications were observed between family history of hypertension and moderate physical activity (OR=2.47,95% CI:1.00-6.06 ) or heavy physical activity (OR=3.82,95%CI:1.31-11.15) on the development of MS.Conclusion Heavy physical activity,with family history of hypertension or type 2 diabetes,seemed to be positively correlated with the risk of MS.Effect modifications were observed between occupational physical activity and family history of hypertension which might be associated with an increased risk of MS.