[Clinical observation of effectiveness in the treatment of senile knee osteoarthritis with the inactivation of myofascial trigger points---108 cases reports].

OBJECTIVE: To study clinical treatment effects of inactivating myofascial trigger points with needling and muscle stretching for the treatment of knee osteoarthritis(OA). METHODS: Retrospective analyses were made to investigate the clinical data of pain clinic outpatient in our hospital from 2010 to 2014, and 108 patients with knee OA, including 35 males and 73 females, were treated with acupuncturing of myofascial trigger points and stretching of muscles and structure around knee. The puncturing of trigger points, and the back and forth movement of needle were required to elicit local twitch response of muscle. After acupuncture treatment, muscle stretch around the knee joint was performed by a therapist. All patients must do homework of self stretching exercise. The extent of stretching should be to gradually increased under a tolerable pain. The ROM and walking pain VAS scores were measured before and after whole therapy and were statistically analyzed during 1 year of follow up. RESULTS: All the patients were followed up, and 95 patients had no pain after 1 year. The VAS scores were improved from preoperative severe 7.6±0.5, moderate 4.9±0.7, to mild 1.9±0.6 and painless 0.3±0.2. CONCLUSIONS: The walking pain of knee OA might be alleviated by the acupuncture and stretch to inactivate the myofascial trigger point.

Increasing prevalence of type 2 diabetes in Chinese adults in Shanghai.

OBJECTIVE: Our objective was to determine the secular trend in prevalence of type 2 diabetes in Shanghai, China. RESEARCH DESIGN AND METHODS: Two consecutive population-based surveys for type 2 diabetes were conducted in randomly selected adults aged 35-74 years in Shanghai in 2002-2003 (n = 12,329) and in 2009 (n = 7,423). Diagnosed type 2 diabetes was determined based on self-report, whereas those undiagnosed were identified by measured fasting and postload glucose according to 2009 American Diabetes Association criteria. RESULTS: Age-standardized prevalence of diagnosed and undiagnosed type 2 diabetes increased from 5.1 and 4.6% in 2002-2003 to 7.4 and 5.2% in 2009. The prevalence of type 2 diabetes increased with age and was higher among men and in urban residents in both surveys (P < 0.001). Between the two surveys, the increase in the prevalence was more evident in the rural population (P < 0.001) and appeared more rapid in younger birth cohorts (P < 0.05). CONCLUSIONS: Our results suggest that Shanghai has experienced an increasing burden of type 2 diabetes.

Detection of mutant p53 protein in workers occupationally exposed to benzidine.

To investigate the expression of mutant p53 protein in workers occupationally exposed to benzidine, we detected mutant p53 protein by immuno-PCR assay in the serum of 331 benzidine-exposed healthy workers, while we classified exfoliated urothelial cells in urine samples with Papanicoloau's grading (PG). The Papanicoloau's grading classified exfoliated urothelial cells of the subjects from grade I (normal cells) to grade III (suspicious malignant cells). The subjects were also divided into high, medium and low exposure groups according to the exposure intensity index. The results revealed that mutant p53 protein in the medium and high exposure groups were significantly higher than the in low exposure group (p<0.05), and in PG II and III were significantly higher than in the PG I (p<0.05). There was no significant differences among Papanicoloau's gradings strata in the low exposure group on the incidence and quantity of mutant p53 protein. In the medium and high exposure groups, the incidence and/or quantity of mutant p53 protein in the stratum of PG II and/or III were significantly higher than that of PG I (p<0.05). Detection of mutant p53 protein in conjunction with benzidine exposure level and Papanicoloau's gradings of exfoliated urothelial cells could provide more information to help us elevate surveillance efficiency and diagnose bladder cancer in the early period.

Field data: a study on trend and prediction of fatal traffic injuries prevalence in Shanghai.

OBJECTIVE: The main objectives of the study are to analyze fatal traffic-injury trends in 1987-2003 in Shanghai and predict its prevalence in near future and provide scientific data for the local governmental decision on developing practical working methods on traffic-injury prevention and control. METHODS: In this study, epidemiological method and Grey dynamic model GM (1,1) were introduced to analyze and forecast traffic-injury mortality rates respectively. RESULTS: There was an apparent increasing trend of traffic-related injuries in Shanghai from 1987 to 2003 with the rate of growth in motorization. The average rates of annual increase are 3.59% in fatalities (from 7.78 per 100,000 population to 14.18 per 100,000 population) during the period. Pedestrians were the most common type of victims (29.6%), followed by bicyclists (25.1%), and motorcyclists (24.1%). Males accounted for the majority of all victims, over 69%. The population of high-school and lower high-school education level represented 66.4% victims of total road-traffic injuries. And if no special factors effect its development, the traffic fatalities would be up to 17.84 per 100,000 population in 2010, when calculating from equations we found and validated Y(t) = 359.90 x e0.027(t-1)-352.13, (t = 1, 2, ..., N) for Shanghai. CONCLUSION: Our data indicate the risk of fatal traffic injuries has increased in recent years and will go on growing in the near future in Shanghai. The findings showed that Grey dynamic model GM (1,1) is eligible on the prediction and can be a tool for injuries forecasting, implementing effective policies, programs, and interventions for reducing traffic injuries in the big cities.

[Epidemiological feature of metabolic syndrome in Shanghai residents aged 15 - 74 years].

OBJECTIVE: To assess the prevalence of the metabolic syndrome in Shanghai residents. METHODS: A cross-sectional study was conducted in Shanghai with a representative sample of 14,327 Chinese adults from 15 to 74 years of age. The sample was randomly selected using stratified cluster sampling. The criteria of International Diabetes Federation (IDF), the US National Cholesterol Education Program Adult Treatment Panel III (ATP III) guidelines and the China Diabetes Society (CDS), respectively, were applied for diagnosis. RESULTS: Diagnosed by using the IDF criterion, the crude prevalence of metabolic syndrome was 17.51%, and the age and gender-adjusted prevalence was 12.81% (95% CI: 12.26 - 13.36). The prevalence of the metabolic syndrome was higher in females than in males (14.79% and 10.93%, respectively), and higher in urban residents than in rural ones (13.71% and 10.72%, respectively). The age-specific prevalence of the metabolic syndrome increased in both male and female residents and the prevalence of metabolic syndrome in females 45 years of age or elder was significantly increased. The prevalence of having at least 3 parameters of metabolic syndrome was 22.28%. According to the ATP III guideline, the crude and age-adjusted prevalence of metabolic syndrome was 12.03% and 8.62%, respectively. Based on the criterion of CDS, they were 13.98% and 10.41%. CONCLUSION: There is a high prevalence of metabolic syndrome in Shanghai residents. Metabolic syndrome has become a noteworthy public health problem. It suggests that community-integrated control of metabolic syndrome should have its priority.

[Cross-sectional investigation of prevalence of type 2 diabetes in Shanghai].

OBJECTIVE: To investigate the prevalence of type 2 diabetes and impaired glucose regulation among the permanent urban and rural inhabitants in Shanghai. METHODS: Questionnaire survey, physical examination, and laboratory testing were conducted among 14401 urban and rural inhabitants aged 15 - 74 in Shanghai selected by multistage cluster random sampling. The data about the prevalence of type 2 diabetes and impaired glucose regulation were collected and analyzed. RESULTS: The respondent rate of this investigation was 80.5% (11,589/14,401). The prevalence rates of type 2 diabetes, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were 8.6% (1000/11,589), 6.9% (802/11,589), and 1.0% (120/11,589) respectively (the standardized rates were 6.2%, 5.1% and 0.8%). The prevalence rates of type 2 diabetes, IGT, and IFG were significantly higher in those with overweight, obesity, central obesity, and hypertension. The prevalence rates of type 2 diabetes, IGT, and IFG in men were 8.9% (412/4621), 6.4% (296/4621), and 1.0% (47/4621) respectively, all not significantly different from those of the women, i.e. e., 8.4% (588/6968), 7.3% (506/6968), and 1.0% (73/6968) respectively (all P > 0.05). The prevalence rates of type 2 diabetes and IGT in the urban area were 11.2% (730/6500) and 6.4% (419/6500) respectively, both significantly higher than those in the rural area, i.e., 5.3% (270/5089) and 7.5% (383/5089) respectively (both P < 0.05). The prevalence rate of IFG in the urban area was 1.2% (77/6500), not significantly different from that in the rural area (0.8%, 43/5039, P > 0.05). The prevalence of type 2 diabetes, IGT, and IFG increased apparently with age, body mass index, waist hip ratio, and waist circumference. The ratios of undiagnosed type 2 diabetes in the urban area and rural area were 39.6% (289/730) and 69.3% (187/270) respectively (chi(2) = 74.07, P < 0.01). CONCLUSION: The prevalence rate of type 2 diabetes in Shanghai is higher than the mean national level and shows an increasing tendency. Screening of type 2 diabetes in rich rural areas should be emphasized.

[Expression of protein p53 in workers occupationally exposed to benzidine and bladder cancer patients.].

OBJECTIVE: To study expression of mutant p53 protein in workers occupationally exposed to benzidine and bladder cancer patients. METHODS: Mutant p53 protein in serum from the workers occupationally exposed to benzidine and bladder cancer patients were determined with Immuno-PCR, while exfoliated urothelial cells in the urine samples were classified with Papanicolau grading. RESULTS: Positive rate of mutant p53 protein increased with the exposed intensity index in workers occupationally exposed to benzidine. The positive rate of mutant p53 protein in bladder cancer patients (83.3%) was significantly higher than that in the group 1 of exposed intensity index. The average scanning integrals of PCR amplified band in the group of bladder cancer patients and group 2 of exposed intensity index were both higher than that in the group 1 significantly. Workers in the groups of different exposed intensity indices were further stratified according to Papanicolau grades. In the group 2 of exposed intensity index, the average scanning integrals of PCR amplified band in the stratum of Papanicolau grade II and III were significantly higher than that in the strata of Papanicolau grade I. And in the group 3 of exposed intensity index, the positive rate of mutant p53 protein in the strata of Papanicolau grade III was higher than that in the strata of Papanicolau grade I significantly. CONCLUSION: The increase of exposed intensity may not only result in the positive rate of mutant p53 protein, but also the quantity of mutant p53 protein in serum within the low range of benzidine exposure. Once the exposed intensity was beyond that spectrum, the positive rate of mutant p53 protein in serum and the average scanning integrals of PCR amplified band were no longer enhanced with the increase of exposed intensity. There was tight correlation between Papanicolau grade of exfoliated urothelial cells and the positive rate or the quantity of mutant p53 protein for the higher benzidine exposure intensity.

[Epidemiological study on traffic accident in Shanghai from 2000 to 2002].

OBJECTIVE: Data on traffic accident from year 2000 to 2002 were collected and testified. Epidemiological study was carried out to find the main risk factors of traffic accident. METHODS: The spatial distribution was conducted by means of Geographic Information System (GIS) and were marked on Shanghai digitalized map with different layers by different colors. RESULTS: Results showed that during 2000, 2001 and 2002, 69,669 , 68,894, and 47,088 traffic accident episodes occurred in Shanghai, resulting in 1747, 1724, 1557 deaths respectively with direct economic lost: 2.1, 2.4, 3.0 billion RMB. The main risk factors causing traffic accident deaths would include drinking alcohol before driving, fatigue and speeding. The leading causes of death were head injury and complex injury of body. GIS showed that there was a homocentric circle with more traffic accidents in downtown city, but more deaths in the urban city. Disease burden caused by traffic accident was very heavy. CONCLUSION: In Shanghai, traffic accident has great impact on social and economic issues thus should be controlled effectively. Focus should be layed on control of traffic accident in downtown area and to decrease the number of deaths related to traffic accident in the urban area.

Disease control and prevention in China in the 20(th) century and prospects for the new millennium.

In the first part of the paper, the main achievements and experience of disease control and prevention in China during last 50 years are described. Infectious diseases and parasitosis have been successfully controlled and prevented and people's health enhanced owing to the establishment of an effective system of public health, the launch of a campaign called "Patriotic Public Health", immunization planning, and the improvement of economic and environmental conditions. In the second part, the challenges to public health in China are presented. The threat from old and emerging infectious diseases, especially sexually transmitted diseases, a sustained increase in the prevalence of chronic non-infectious diseases (cardiovascular diseases tumors and diseases of the respiratory system), environmental problems and the health problems of aging are discussed. Finally, strategies for disease control and prevention in the new century is suggested.