Analysis and predication of tuberculosis registration rates in Henan Province, China: an exponential smoothing model study.

BACKGROUND: The World Health Organization End TB Strategy meant that compared with 2015 baseline, the reduction in pulmonary tuberculosis (PTB) incidence should be 20 and 50% in 2020 and 2025, respectively. The case number of PTB in China accounted for 9% of the global total in 2018, which ranked the second high in the world. From 2007 to 2019, 854 672 active PTB cases were registered and treated in Henan Province, China. This study was to assess whether the WHO milestones could be achieved in Henan Province. METHODS: The active PTB numbers in Henan Province from 2007 to 2019, registered in Chinese Tuberculosis Information Management System were analyzed to predict the active PTB registration rates in 2020 and 2025, which is conductive to early response measures to ensure the achievement of the WHO milestones. The time series model was created by monthly active PTB registration rates from 2007 to 2016, and the optimal model was verified by data from 2017 to 2019. The Ljung-Box Q statistic was used to evaluate the model. The statistically significant level is α = 0.05. Monthly active PTB registration rates and 95% confidence interval (CI) from 2020 to 2025 were predicted. RESULTS: High active PTB registration rates in March, April, May and June showed the seasonal variations. The exponential smoothing winter's multiplication model was selected as the best-fitting model. The predicted values were approximately consistent with the observed ones from 2017 to 2019. The annual active PTB registration rates were predicted as 49.1 (95% CI: 36.2-62.0) per 100 000 population and 34.4 (95% CI: 18.6-50.2) per 100 000 population in 2020 and 2025, respectively. Compared with the active PTB registration rate in 2015, the reduction will reach 23.7% (95% CI, 3.2-44.1%) and 46.8% (95% CI, 21.4-72.1%) in 2020 and 2025, respectively. CONCLUSIONS: The high active PTB registration rates in spring and early summer indicate that high risk of tuberculosis infection in late autumn and winter in Henan Province. Without regard to the CI, the first milestone of WHO End TB Strategy in 2020 will be achieved. However, the second milestone in 2025 will not be easily achieved unless there are early response measures in Henan Province, China.

Epidemiology of Diabetes in Adults Aged 35 and Older from Shanghai, China.

OBJECTIVE: This study aimed to investigate the epidemiology of diabetes in adults from Shanghai, aged 35 and older, in 2013. METHODS: We estimated the diabetes prevalence in a representative sample of 18,736 adults who were selected through a multistage stratified cluster sampling process. A standard questionnaire containing questions about demographic characteristics and lifestyle factors was distributed. After an overnight fast of at least 10 hours, a venous blood sample was collected from each participant. For each patient without a history of diabetes, another blood sample was drawn 120 min after an oral glucose tolerance test to identify undiagnosed diabetes and prediabetic condition. RESULTS: Among Shanghai residents aged 35 and above, the overall weighted prevalence of diabetes was 17.6% [95% confidence interval (CI): 16.4%-18.8%]. The prevalences were 19.3% in men and 15.8% in women as well as 19.1%, 15.4%, and 16.1% in urban, suburban, and rural residents, respectively. In addition, the weighted prevalence of prediabetes was 16.5% (95% CI: 15.3%-17.8%), with the prevalences of 16.5% in men, 16.6% in women, 15.2% in urban residents, 18.0% in suburban residents, and 18.5% in rural residents. Among all patients with diabetes, 68.1% (95% CI: 64.3%-71.6%) were aware of their status, 63.5% (95% CI: 60.0%-66.9%) received diabetes treatment, but only 35.1% (95% CI: 32.4%-37.8%) had adequate glycemic control. CONCLUSION: In Shanghai, diabetes and prediabetes are highly prevalent. However, 1/3rd of diabetes cases are undiagnosed, and the rate of glycemic control is low.

[Study on risk factors and behavior features related to chronic diseases among adults in Shanghai].

OBJECTIVE: To investigate the risk factors and behavior features related to chronic diseases among adults in Shanghai. METHODS: A total of 15 516 subjects aged over 18 years old were selected from the investigation project on chronic diseases and relevant risk factors in Shanghai in 2010. Questionnaire were used to investigate the general information of the subjects, such as behavior features as smoking, drinking, diet, physical activity as well as the prevalence and control of chronic diseases as hypertension and diabetes. The physical examination included height, weight, waist circumference, blood pressure, blood glucose and blood lipids. RESULTS: Being preprocessed by complex weighting method, the data showed that the overweight rate of Shanghai adults aged above 18 was 32.4% (5288), separately 32.2% (2506) and 32.5% (2782) (χ(2) = 0.10, P = 0.844) in urban and rural areas; the obesity rate was 8.8% (1538), separately 8.7% (738) and 8.8% (800) (χ(2) = 0.06, P = 0.901) in urban and rural areas. The overweight rate was separately 36.0% (2888) in males and 28.6% (2400) in females (χ(2) = 96.61, P < 0.01); while the obesity rate was separately 8.7% (745) in males and 8.9% (793) in females (χ(2) = 0.06, P = 0.851). Abdominal obesity rate was 44.3% (7419), separately 47.8% (3892) in males and 40.6% (3527) in females (χ(2) = 81.23, P < 0.01), 46.5% (3703) in urban areas and 42.6% (3716) in rural areas (χ(2) = 24.37, P = 0.069). Current smoking rate was 25.0% (3813), separately 48.4% (3722) and 1.2% (91) in males and females (χ(2) = 4572.06, P < 0.01); 23.6% (1609) and 26.0% (2204) in urban and rural areas (χ(2) = 11.92, P = 0.018). The regular smoking rate was 22.1% (3402). The rate of having the habit of drinking at least once a month in males was 39.5% (3102), separately 35.1% (1262) and 42.7% (1840) in urban and rural areas (χ(2) = 45.98, P = 0.012). The rate of drinking almost every day was 16.3% (1380), and the percentage of excessive alcohol consumption was 28.9% (2483). The percentage in group of subjects aging between 45-59 years old was 38.5% (1191), which was higher than that in any other groups (22.8% (641) in group aging 18-44 years old and 22.9% (651) in group aging ≥ 60 years old) (χ(2) = 241.38, P < 0.01). The percentage of over-drinking in rural area was higher than that in urban area, which was 33.5% (1578) and 22.8% (905) respectively (χ(2) = 117.12, P < 0.01). The percentage of once over-drinking was 11.3% (903). It was higher in group aging between 45-49 years old (15.3% (461)) than in other groups (9.0% (222) in group aging 18-44 years old and 8.2% (220) in group aging ≥ 60 years old) (χ(2) = 78.21, P < 0.01). It was also higher in rural area (13.5% (605)) than in urban area (8.3% (298)) (χ(2) = 51.74, P < 0.01). There were 75.0% (11 993) of the Shanghai adults never took physical activity. And the most important problems in dietary habit were insufficient intake of dairy products (98.0%, 15 218), vegetables (53.0%, 7864) and fruits (84.6%, 13 372), excess consumption of sodium (52.0%, 8257) and oil (51.7%, 7884). CONCLUSION: The risk factors of chronic diseases were highly prevalent in Shanghai. The prevalence of risk factors as overweight or obesity, lack of physical activity, smoking, over-drinking and unhealthy dietary habits were higher among adults living in suburban areas than those living in urban areas; the prevalence was also higher among the young adults than that among the elderly people, higher among males than that among females.

[Detection of single-walled carbon nanotube bundles by tip-enhanced Raman spectroscopy].

Raman spectroscopy is a powerful technique in the characterization of carbon nanotubes (CNTs). However, this spectral method is subject to two obstacles. One is spatial resolution, namely the diffraction limits of light, and the other is its inherent small Raman cross section and weak signal. To resolve these problems, a new approach has been developed, denoted tip-enhanced Raman spectroscopy (TERS). TERS has been demonstrated to be a powerful spectroscopic and microscopic technique to characterize nanomaterial or nanostructures. Excited by a focused laser beam, an enhanced electric field is generated in the vicinity of a metallic tip because of the surface plasmon polariton (SPP) and lightening rod effect. Consequently, Raman signal from the sample area illuminated by the enhanced field nearby the tip is enhanced. At the same time, the topography is obtained in the nanometer scale. The exact corresponding relationship between the localized Raman and the topography makes the Raman identification at the nanometer scale to be feasible. In the present paper, based on an inverted microscope and a metallic AFM tip, a tip-enhanced Raman system was set up. The radius of the Au-coated metallic tip is about 30 nm. The 532 nm laser passes through a high numerical objective (NA0.95) from the bottom to illuminate the tip to excite the enhanced electric field. Corresponding with the AFM image, the tip-enhanced near-field Raman of a 100 nm diameter single-walled carbon nanotube (SWNT) bundles was obtained. The SWNTs were prepared by arc method. Furthermore, the near-field Raman of about 3 SWNTs of the bundles was received with the spatial resolution beyond the diffraction limit. Compared with the far-field Raman, the enhancement factor of the tip-enhanced Raman is more than 230. With the super-diffraction spatial resolution and the tip-enhanced Raman ability, tip-enhanced Raman spectroscopy will play an important role in the nano-material and nano-structure characterization.

[A survey on the infection rate of tuberculosis among employees of the antituberculosis institutions in Henan province, China].

OBJECTIVE: To study the situation of tuberculosis (TB) infection among the employees of the anti-TB institutions in Henan. METHODS: Cross-sectional study was adopted the employees working in all municipal-level- anti-TB institutions and 40 anti-TB institutions at county-level selected randomly from 109 counties of the province were regarded as surveyed objects. Tuberculin skin test (TST) was used to test the infection with PPD. RESULTS: 2153 employees accepting the TST and the positive rate was 60.6%, of which the positive rate was 66.1% among healthcare workers. Among the employees and healthcare workers, the positive rates of TST adjusted by the stratum weights between municipal-level and county-level institutions were 57.3% and 62.8% respectively with Chi-square test the analysis of multivariate logistic vegression, both positive rate and strong positive rate among healthcare workers, the employees older than 30 years of age and working in municipal-level institutions were significantly higher than those among non-healthcare workers, the employees younger than 30 years old and working in county-level institutions, respectively. There were not significant differences of positive and strong positive rates between employees with and without BCG-history, or between male employees and female employees. CONCLUSION: Program on TB infection control in anti-TB institutions of Henan were weak and the employees especiolly healthcare workers had a high vocational exposure.

[Impact of anti-tuberculosis drug resistance on treatment outcome of pulmonary tuberculosis patients receiving directly observed treatment strategy in Henan Province, China].

OBJECTIVE: To study the impact of anti-tuberculosis drug resistance on treatment outcome of pulmonary tuberculosis (TB) patients receiving directly observed treatment strategy (DOTS) in Henan Province, China. METHODS: From Aug. 2001 to Jun. 2002, the second round surveillance of anti-TB drug resistance was carried out in cooperation with WHO in Henan Province, China. The proportion method was used for drug susceptibility test and all enrolled patients were administrated with DOTS. RESULTS: The treatment success rate of smear-positive patients was 85.5% (1,343/1,571), of which the treatment success rate of initial-treatment cases was 89.6% (1,159/1,293). The treatment success rates among 565 anti-TB drug resistant cases and 215 multi-drug-resistant-TB (MDR-TB) cases were 76.6% (433/565), (initial treatment cases: 86.8%, 341/393; re-treated cases: 53.5%, 92/172; being significantly different), 58.6% (126/215), (initial treatment cases: 75.4%, 83/110; re-treated cases: 41.0%, 43/105; being significantly different), respectively. For the cases being resistant to 2, 3 or 4 drugs, the treatment success rates in initial treatment cases were all higher than those in re-treatment cases. Multivariate analysis showed that re-treatment, resistance to 2 plus drugs or MDR were the significant risk factors for treatment failure, and that re-treatment, older age and MDR were the significant risk factors for TB death. CONCLUSION: The treatment outcome of initial treatment of smear-positive patients with DOTS in Henan was satisfying, but that of retreated patients, especially retreated patients of MDR was very poor. Re-treatment, older age, resistance to 2 anti-TB drugs or MDR were the risk factors for the poor outcome of treatment with DOTS.