Disease burden and mortality forecast of prostate cancer in Wuhan in 2010-2019 / 公共卫生与预防医学

Objective To analyze the data of prostate cancer in Wuhan from 2010 to 2019, understand the characteristics and trends of incidence, mortality, and YLL, and provide decision-making basis for Wuhan's cancer prevention and control strategies. Methods Data on deaths and incident cases of prostate cancer in Wuhan from 2010 to 2019 and from 2013 to 2017, respectively, were collected from the Wuhan Death Monitoring System. Indicators such as incidence rate, mortality rate, and years of life lost due to premature death (YLL) of prostate cancer in Wuhan were calculated using Excel 2016 and Python. The Bayesian Age-Period-Cohort Model (BAPC) was used to predict the mortality rate of prostate cancer in Wuhan from 2020 to 2024. The trend changes were described using the annual average percentage change (AAPC). Results From 2010 to 2019, the incidence, mortality, and YLL rates of prostate cancer in Wuhan showed an overall increasing trend (AAPC >0, P <0.05). The standardized mortality and incidence rates in the central urban area were significantly higher than those in the outer urban area, and the age group of 85 and above had the highest incidence and mortality rates. The age group of 0-54 had the largest increase in incidence and mortality rates. From 2020 to 2024, prostate cancer in Wuhan is expected to continue to increase slightly (an increase of 0.94%). Conclusion The incidence, mortality, and YLL rates of prostate cancer in Wuhan are showing an overall increasing trend, and this trend may continue. The characteristics are higher in the central urban area than in the outer urban area, and higher in the older age group than in the younger age group. Targeted measures need to be taken, and screening for high-risk populations should be strengthened.

Mortality and potential years of life lost of major kidney diseases among residents in Wuhan in 2014 -2019 / 公共卫生与预防医学

Objective To investigate the epidemiological characteristics of major kidney disease deaths and the potential years of life lost among residents in Wuhan from 2014 to 2019, and to provide a scientific basis for the prevention and treatment of kidney diseases. Methods The major kidney diseases deaths among residents in Wuhan during 2014-2019 were collected from the population-based Mortality Surveillance System. The standardized mortality rate and potential years of life lost rate (PYLLR) of major kidney diseases among residents in different ages and genders were calculated, and the epidemiological characteristics and trends were analyzed. Results There were 4 100 deaths (2 380 in male and 1 720 in female) from major kidney diseases among residents in Wuhan between 2014 to 2019, with an age-standardized mortality rate of 6.22/100 000. The mortality rate of major kidney diseases showed an upward trend with the increasing age groups. The age-standardized mortality rate and the age-standardized potential years of life lost rate (SPYLLR) in glomerular disease and tubulo-interstitial diseases were significantly decreased (P＜0.05). The age-standardized mortality rate of the kidney failure was significantly increased (P＜0.05), especially in the male (APC=25.10% , P＜0.05). Conclusion From 2014 to 2019, there was no significant change in the overall mortality rate of major kidney diseases among residents in Wuhan. The death burden and disease burden of glomerular diseases and tubulo-interstitial diseases were significantly decreased, while the mortality rate of male kidney failure was significantly increased, indicating the need for targeted prevention and treatment of kidney diseases.

Physical, intellectual and genetic characteristics of 53 neonates with phenylketonuria / 预防医学

Objective@#To investigate the physical and intellectual development and mutation characteristics of the phenylalanine hydroxylase (PAH) gene among 53 newborns with phenylketonuria (PKU), so as to provide insights into the management and genetic counseling of PKU@*Methods@#The medical records of 54 children with definitive diagnosis of PKU and standardized therapy until 2 years at the Center for Neonatal Disease Screening of Shanxi Children' s Hospital from 2018 to 2021 were collected. Newborns' body weight and height developments were evaluated using the World Health Organization growth chart (2006 version), and the intellectual development was assessed using the national criteria of Development Behavior Assessment Scale among Children at Ages of 0 to 6 Years (WS/T 580-2017). The gene mutations were detected among neonates and their children, and the physical, intellectual developments and genetic characteristics of neonates with PKU were descriptively analyzed.@*Results@#The 53 PKU cases included 29 male children and 24 female children, 36 cases with classic PKU and 17 cases with mild PKU, and 30 cases from rural areas and 23 cases from urban areas. The study subjects had a median age of 30 (10) d at initial therapy, and a mean blood phenylalanine concentration of (1 507±685) μmol/L at definitive diagnosis. There were 52 cases with normal height developments (98.11%), and all cases had normal weight and intellectual developments. The mean developmental functional quotient (DFQ) was significantly greater among urban children with PKU than among rural children [(94.92±8.57) vs. (87.65±6.57); t=-3.498, P=0.001], and the mean DFQ was significantly higher among children with mild PKU than among those with classic PKU [(95.55±8.76) vs. (88.57±7.11); t=-3.095, P=0.003]. There were 37 mutations detected in the PAH gene, which were mainly distributed in exons 3, 6, 7, 11, 12 and intron 4. Three high-frequency mutation sites were detected, including c.728G>A, c.611A>G and c.1197A>T, including three novel mutations (c.674C>G, c.1316-2A>C and c.1069T>C).@*Conclusions@#Following standardized treatment, the children with PKU have comparable physical and intellectual developments as compared to normal children. c.728G>A, c.611A>G and c.1197A>T were predominant mutations in the PAH gene among these 53 children with PKU, and three novel mutations were identified, including c.674C>G, c.1316-2A>C and c.1069T>C.

Association between air pollution and death from respiratory diseases in Wuhan from 2014 to 2019 / 上海预防医学

ObjectiveTo determine the association between air pollutants （PM2.5， PM10， SO2， NO2） and death from respiratory diseases in Wuhan. MethodsDaily air pollutants， meteorological data and mortality from respiratory disease between 2014 and 2019 were collected for a descriptive analysis. A time series semi-parametric generalized additive model （GAM） was used to determine the exposure-effect relationship between atmospheric pollutants and daily mortality from respiratory diseases，and the excess risk （ER） was used to quantify the effects of air pollutants on death from respiratory diseases. ResultsThere was significant effect of PM2.5， PM10， SO2 and NO2 on respiratory diseases mortality. In the period with strongest effect， the ER of death from respiratory diseases were 2.803%（95%CI：2.151%‒3.460%）， 1.878%（95%CI：1.477%‒2.281%）， 10.210%（95%CI：7.922%‒12.549%）， 4.564%（95%CI：3.530%‒5.608%）， along with an incremental 10 μg·m-3 of PM2.5，PM10，SO2 and NO2， respectively. Furthermore， females were more sensitive to PM2.5， SO2 and NO2， while males were more sensitive to PM10. Residents aged less than 65 years were more sensitive to PM2.5 and NO2， and those older than 65 years were more sensitive to PM10 and SO2. ConclusionAir pollutants （PM2.5， PM10， SO2， and NO2） in Wuhan are associated with the death from respiratory diseases. Therefore， at-risk groups should be considered for formulating local policies against air pollution.

Early predictors for outcomes of congenital hypothyroidism in neonates / 中华全科医师杂志

Objective:To explore early predictive factors for outcomes of congenital hypothyroidism (CH) in neonates.Methods:A total of 242 neonates diagnosed as CH in Shanxi Provincial Newborn Disease Screening Center from October 2009 to October 2014 were enrolled in the study. All CH children were treated with levothyroxine sodium (L-T 4) for 2-3 years and continued to follow up for more than 1 year after drug withdrawal. Seventy two cases dropped out during the follow-up; among 170 patients entering the final analysis, there were 61 cases of permanent congenital hypothyroidism (PCH group) and 109 cases of transient congenital hypothyroidism (TCH group). The clinical data and the L-T 4 dose during follow-up period were compared between two groups; and the predicting factors of clinical outcomes were analyzed. Results:There were significant differences in baseline thyroid stimulating hormone(TSH)level [127.0 (83.7,175.4) μIU/ml vs. 55.8(22.1,102.5)μIU/ml], initial treatment timing [26.0(20.5,34.5)d vs. 31.0(24.0,37.5)d], time required for TSH to return to normal [52.0(33.0,71.5)d vs.36.0(32.0,41.5)d], and thyroid ultrasound results [18.3%(11/60) vs. 94.0%(78/83)] between PCH group and TCH group. The initial screening TSH levels in children (optimal cut-off: 71.29 μIU/ml) and L-T 4 dose at 7 months after diagnosis (optimal cut-off: 24.4 μg/d) can be used for early differentiation between children with PCH and TCH. Conclusion:The initial TSH screening levels and the dose of L-T 4 during the follow-up period have predictive value for early differentiation of PCH and TCH in children.

The relationship among depression, anxiety, stress and addictive substance use behavior in 5 935 secondary vocational students / 中华预防医学杂志

Objective@#To investigate the relationship among depression, anxiety, stress and addictive substance use behavior in secondary vocational students.@*Methods@#Cluster sampling method and the Adolescent Health-related Behaviors Questionnaire were used to collect demographic characteristics, psychological symptoms, and addictive substance usage among 5 935 students in nine vocational schools in Chongqing, Zhaoqing, Ningbo, and Taiyuan. Multivariate logistic regression analysis was used to analyze the relationship between the addictive substance use behavior and psychological factors.@*Results@#The detection rates of depression, anxiety and stress were 46.5% (n=2 762), 58.7% (n=3 483), and 29.8% (n= 1 770), respectively. The prevalence of addictive substances was 74.8% (n=4 440), traditional drugs was 0.8% (n=50), new drugs was 2.8% (n=166), other addictive drugs was 4.1% (n=241). Multivariate logistic regression analysis showed that compared with the normal psychological states of secondary vocational students, the OR value of mild depression tendency alcohol and tobacco use behavior of secondary vocational students was 1.45; the OR values of mild anxiety, moderate anxiety, severe anxiety and very serious anxiety were 1.46, 1.46, 1.71, and 1.83, respectively; the traditional drugs use behaviors were 5.51, and 2.61, respectively, for the severe anxiety and very serious anxiety. Compared with the normal psychological state of secondary vocational students, the OR values of the severe anxiety and very severe anxiety were 2.56, and 2.66, respectively, for severe anxiety and very serious anxiety. Compared with normal psychological status of secondary vocational students, the OR values of mild, moderate, severe, and very severe anxiety were 2.14, 2.47, 2.39, and 3.45, respectively; all P values <0.05.@*Conclusion@#Anxiety and mild depression were risk factors of tobacco and alcohol use in secondary vocational students; severe and above anxiety were the risk factors of drug use in secondary vocational students; anxiety was the risk factor for other addictive drug use in secondary vocational students.

Analysis of self-management status and influencing factors of patients with hypertension in community / 中华健康管理学杂志

Objective To reveal the self-management status of patients with hypertension in community, and to analyze the influencing factors of self-management behavior so as to provide theoretical basis for the formation and maintenance of self-management. Methods With the method of stratified random cluster sampling, 559 patients with hypertension were selected from twelve communities in six urban districts of Wuhan completed the questionnaire survey to analyze the demographic characteristics, executive condition of self-management behavior and related psychological behavior with hypertension patients. Results The average age was (61.2 ± 8.4) years. The rate of measuring blood pressure regularly was 38.39%, rate of regular medication was 63.83%, rate of low salt diet was 37.72%, and the rate of regular exercise was 50.45%. The score of self-management was 0.60 ± 0.21. Self efficacy was the influencing factor of self-management score (β=0.042 1,P<0.01). Conclusion Self assessed efficacy is closely related to self-management. Intervention should be guided by psychological behavior theory, and emphasized on psychological aspect.

Analysis of the compliance and the influencing factors of the treatments of children with congenital hypothy-roidism / 中国基层医药

Objective To analyze the compliance and the influencing factors of the children with congenital hypothyroidism (CH).Methods 231 children with CH were collected for this study.The questionnaire survey and referring the case were used to collect relative factors.According to regular follow -up treatment,the children were divided into two groups,one group was good compliance and the other one was bad compliance.The results were ana-lyzed by two -independent sample t -test,2 -test and unconditioned logistic regression analysis.Results (1)Blood TSH(χ2 =59.870,P =0.00) and blood FT4 (χ2 =6.468,P =0.01) were normal,short distance from the hospital (χ2 =16.375,P =0.00),level of education of their mothers was high(χ2 =7.483,P =0.02),and regular compli-ance treatment of children with CH(χ2 =7.483,P =0.024) was good.(2) Logistic stepwise regression analysis showed that serum TSH value(OR =17.135),the short distance(OR =1.692) and diagnosis of CH(OR =4.028) were introduced into the logistic regression model (all P <0.05).Conclusion It is essential to take measures actively and reinforce the management of children with long distance,low -educated,and the diagnosis of TSH.More-over,enhancing the regular treatment compliance of children with CH is the key to improve the growth and develop-ment status of children with CH.

Meta-analysis on risk factors of multidrug resistant tuberculosis in China / 中华流行病学杂志

Objective To synthetically evaluate the risk factors of multidrug resistant tuberculosis (MDR-TB) in China.Methods Chinese databases (CNKI,Wanfang,SinoMed and VIP) and English database(PubMed) were used to collect studies on risk factors for MDR-TB from 1990 to 2013.Meanwhile,relevant studies were manually retrieved.According to the inclusion and exclusion criteria,studies were screened,data were extracted and quality assessed.A Meta-analysis was performed by using Stata 11.0 software.Results Twenty five studies on the risk factors of MDR-TB were synthetically and quantitatively analyzed.The results of Meta-analysis showed that factors as:being Han ethnic group,history of tuberculosis treatment,pulmonary cavity,floating population,TB case contact history,regular medication,living in rural areas,and poor economy were associated with the incidence of MDR-TB,the pooled OR values were 3.12 (95％CI:1.16-8.40),5.27 (95％ CI:3.60-7.72),1.39 (95％ CI:1.03-1.87),1.69 (95％ CI:1.07-2.68),4.34 (95％ CI:1.91-9.86),0.23 (95％ CI:0.16-0.35),1.86 (95％CI:1.59-2.18) and 1.62 (95％ CI:1.34-1.96),respectively.Conclusion Factors as:being Han ethnic group,history of tuberculosis treatment,pulmonary cavity,floating population,TB case contact history,living in rural areas and poor economy were considered to be at risk of MDR-TB while regular medication might be a protective factor to MDR-TB.