The correlation between temperature and the incidence of COVID-19 in four first-tier cities of China: a time series study.

The COVID-19 outbreak emerged in Wuhan, China, and was declared a global pandemic in March 2020. This study aimed to explore the association of daily mean temperature with the daily counts of COVID-19 cases in Beijing, Shanghai, Guangzhou, and Shenzhen, China. Data on daily confirmed cases of COVID-19 and daily mean temperatures were retrieved from the 4 first-tier cities in China. Distributed lag nonlinear models (DLNMs) were used to assess the association between daily mean temperature and the daily cases of COVID-19 during the study period. After controlling for the imported risk index and long-term trends, the distributed lag nonlinear model showed that there were nonlinear and lag relationships. The daily cumulative relative risk decreased for every 1.0 °C change in temperature in Shanghai, Guangzhou, and Shenzhen. However, the cumulative relative risk increased with a daily mean temperature below - 3 °C in Beijing and then decreased. Moreover, the delayed effects of lower temperatures mostly occurred within 6-7 days of exposure. There was a negative correlation between the cumulative relative risk of COVID-19 incidence and temperature, especially when the temperature was higher than - 3 °C. The conclusions from this paper will help government and health regulators in these cities take prevention and protection measures to address the COVID-19 crisis and the possible collapse of the health system in the future.

Improving the precision of modeling the incidence of hemorrhagic fever with renal syndrome in mainland China with an ensemble machine learning approach.

OBJECTIVE: Hemorrhagic fever with renal syndrome (HFRS), one of the main public health concerns in mainland China, is a group of clinically similar diseases caused by hantaviruses. Statistical approaches have always been leveraged to forecast the future incidence rates of certain infectious diseases to effectively control their prevalence and outbreak potential. Compared to the use of one base model, model stacking can often produce better forecasting results. In this study, we fitted the monthly reported cases of HFRS in mainland China with a model stacking approach and compared its forecasting performance with those of five base models. METHOD: We fitted the monthly reported cases of HFRS ranging from January 2004 to June 2019 in mainland China with an autoregressive integrated moving average (ARIMA) model; the Holt-Winter (HW) method, seasonal decomposition of the time series by LOESS (STL); a neural network autoregressive (NNAR) model; and an exponential smoothing state space model with a Box-Cox transformation; ARMA errors; and trend and seasonal components (TBATS), and we combined the forecasting results with the inverse rank approach. The forecasting performance was estimated based on several accuracy criteria for model prediction, including the mean absolute percentage error (MAPE), root-mean-squared error (RMSE) and mean absolute error (MAE). RESULT: There was a slight downward trend and obvious seasonal periodicity inherent in the time series data for HFRS in mainland China. The model stacking method was selected as the best approach with the best performance in terms of both fitting (RMSE 128.19, MAE 85.63, MAPE 8.18) and prediction (RMSE 151.86, MAE 118.28, MAPE 13.16). CONCLUSION: The results showed that model stacking by using the optimal mean forecasting weight of the five abovementioned models achieved the best performance in terms of predicting HFRS one year into the future. This study has corroborated the conclusion that model stacking is an easy way to enhance prediction accuracy when modeling HFRS.

Comparison of ARIMA model and XGBoost model for prediction of human brucellosis in mainland China: a time-series study.

OBJECTIVES: Human brucellosis is a public health problem endangering health and property in China. Predicting the trend and the seasonality of human brucellosis is of great significance for its prevention. In this study, a comparison between the autoregressive integrated moving average (ARIMA) model and the eXtreme Gradient Boosting (XGBoost) model was conducted to determine which was more suitable for predicting the occurrence of brucellosis in mainland China. DESIGN: Time-series study. SETTING: Mainland China. METHODS: Data on human brucellosis in mainland China were provided by the National Health and Family Planning Commission of China. The data were divided into a training set and a test set. The training set was composed of the monthly incidence of human brucellosis in mainland China from January 2008 to June 2018, and the test set was composed of the monthly incidence from July 2018 to June 2019. The mean absolute error (MAE), root mean square error (RMSE) and mean absolute percentage error (MAPE) were used to evaluate the effects of model fitting and prediction. RESULTS: The number of human brucellosis patients in mainland China increased from 30 002 in 2008 to 40 328 in 2018. There was an increasing trend and obvious seasonal distribution in the original time series. For the training set, the MAE, RSME and MAPE of the ARIMA(0,1,1)×(0,1,1)12 model were 338.867, 450.223 and 10.323, respectively, and the MAE, RSME and MAPE of the XGBoost model were 189.332, 262.458 and 4.475, respectively. For the test set, the MAE, RSME and MAPE of the ARIMA(0,1,1)×(0,1,1)12 model were 529.406, 586.059 and 17.676, respectively, and the MAE, RSME and MAPE of the XGBoost model were 249.307, 280.645 and 7.643, respectively. CONCLUSIONS: The performance of the XGBoost model was better than that of the ARIMA model. The XGBoost model is more suitable for prediction cases of human brucellosis in mainland China.

Dynamic changes in T-cell subsets and C-reactive protein after radiation therapy in lung cancer patients and correlation with symptomatic radiation pneumonitis treated with steroid therapy.

OBJECTIVES: To investigate relationships among serum T-cell subsets, CRP, levels and radiation pneumonitis (RP) in lung cancer patients receiving radiotherapy. METHODS: A case-control study with frequency matching was carried out. The case group comprised 36 lung cancer patients who had developed grade ≥2 RP after thoracic radiotherapy. The control group was 36 patients with lung cancer without RP. Patients in the case group received steroid therapy for 1 month after diagnosis of RP and were followed up for 3 months. T-cell subsets, CRP, and pulmonary function were detected at three time points (onset of RP and 1 and 3 months after diagnosis). Data for the control group were collected 3 months after radiotherapy. Treatment effectiveness was evaluated at 1 and 3 months after diagnosis of RP. RESULTS: Of the 36 patients in the case group, three with grade5 RP died from respiratory failure. The other 33 cases had all improved with steroid therapy at 3 months after RP diagnosis. In these 33, CD3+T-cell quantity, CD4+T-cell quantity, and of CD4+:CD8+ ratio in T-cell subsets decreased significantly and CRP increased (P<0.05) at the onset of RP compared with the control group. After steroid therapy, CD4+T-cell quantity increased significantly compared to before treatment. The same change was seen in CD4+:CD8+ ratio, whereas CRP levels decreased obviously, with treatment effectiveness improved. In addition, with the damage level of RP increased, CD4+ T -cell quantity decreased obviously and CRP levels increased accordingly at the onset of RP (P<0.05). CONCLUSION: T-cell subsets and CRP may become effective immunological biomarkers for predicting damage from RP and evaluating treatment effectivesness of steroid therapy.

Time series analysis of human brucellosis in mainland China by using Elman and Jordan recurrent neural networks.

BACKGROUND: Establishing epidemiological models and conducting predictions seems to be useful for the prevention and control of human brucellosis. Autoregressive integrated moving average (ARIMA) models can capture the long-term trends and the periodic variations in time series. However, these models cannot handle the nonlinear trends correctly. Recurrent neural networks can address problems that involve nonlinear time series data. In this study, we intended to build prediction models for human brucellosis in mainland China with Elman and Jordan neural networks. The fitting and forecasting accuracy of the neural networks were compared with a traditional seasonal ARIMA model. METHODS: The reported human brucellosis cases were obtained from the website of the National Health and Family Planning Commission of China. The human brucellosis cases from January 2004 to December 2017 were assembled as monthly counts. The training set observed from January 2004 to December 2016 was used to build the seasonal ARIMA model, Elman and Jordan neural networks. The test set from January 2017 to December 2017 was used to test the forecast results. The root mean squared error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE) were used to assess the fitting and forecasting accuracy of the three models. RESULTS: There were 52,868 cases of human brucellosis in Mainland China from January 2004 to December 2017. We observed a long-term upward trend and seasonal variance in the original time series. In the training set, the RMSE and MAE of Elman and Jordan neural networks were lower than those in the ARIMA model, whereas the MAPE of Elman and Jordan neural networks was slightly higher than that in the ARIMA model. In the test set, the RMSE, MAE and MAPE of Elman and Jordan neural networks were far lower than those in the ARIMA model. CONCLUSIONS: The Elman and Jordan recurrent neural networks achieved much higher forecasting accuracy. These models are more suitable for forecasting nonlinear time series data, such as human brucellosis than the traditional ARIMA model.

A review of documents prepared by international organizations about influenza pandemics, including the 2009 pandemic: a bibliometric analysis.

BACKGROUND: World Health Organization (WHO), the World Bank, UN System Influenza Coordination (UNSIC) and other international organizations released a series of documents to fight against the influenza pandemic. Those documents have great significance on guiding influenza pandemic preparedness and responses and providing a multilevel, multi-directional influenza pandemic prevention and control network for their member countries. This study focuses on the above-mentioned influenza pandemic preparedness guidelines with the aim of exploring the roles of the society, defining the relationship of different interventions and evaluating the planning on influenza pandemic preparedness. METHODS: Documents about pandemic influenza preparedness were retrieved from the official websites of the following three international organizations, World Health Organization (WHO), the World Bank, UN System Influenza Coordination (UNSIC) with the key words 'pandemic', 'influenza' and the Boolean combinations of these words as the retrieval strategy. Guidelines, research study and meeting reports were included in the study. The categories of the ministries/departments involved and their roles/responsibilities in pandemic influenza preparedness were summarized. Word frequency of selected vocabularies about pandemic influenza preventive measures were collected from the documents and the correlations between the word frequency of these measures were analyzed. Ochiai coefficient was employed to show the correlation between the word vocabularies. RESULTS: A total of 38 records on the topic of pandemic influenza preparedness were included. The responsibilities of the whole-of-society mentioned in the international organizations' documents varied across the 2009 influenza pandemic period. Meanwhile, it had been emphasized that a comprehensive influenza prevention and control plan in every sector should be developed and evaluated. Because various measures were emphasized in the guidelines after 2009 pandemic influenza, the correlations between the word frequencies of the various influenza preventive measures became stronger after the pandemic influenza. CONCLUSIONS: Responsibilities of ministries of education, ministries of energy, ministries of agriculture and animal health, ministries of communication and the business sector in the pandemic influenza preparedness were described more comprehensively in the international organizations' documents in 2017. Better understanding the variations of the guidelines delivered by international organizations would be useful for the member countries to strengthen their influenza control network.

The Risk Factors of Acquiring Severe Hand, Foot, and Mouth Disease: A Meta-Analysis.

OBJECTIVES: The incidence of severe hand, foot, and mouth disease (HFMD) is not low, especially in mainland China in almost every year recently. In this study, we conducted a meta-analysis to generate large-scale evidence on the risk factors of severe HFMD to provide suggestions on prevention and controlling. METHODS: PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang (Chinese) were searched to identify relevant articles. All analyses were performed using Stata 14.0. RESULTS: We conducted a meta-analysis of 11 separate studies. Fever (odds ratio (OR) 7.396, 95% confidence interval (CI) 3.565-15.342), fever for more than 3 days (OR 5.773, 95% CI 4.199-7.939), vomiting (OR 6.023, 95% CI 2.598-13.963), limb trembling (OR 42.348, 95% CI 11.765-152.437), dyspnea (OR 12.869, 95% CI 1.948-85.017), contact with HFMD children (OR 5.326, 95% CI 1.263-22.466), rashes on the hips (OR 1.650, 95% CI 1.303-2.090), pathologic reflexes (OR 3057.064, 95% CI 494.409-19000), Lethargy (OR 31.791, 95% CI 3.369-300.020), convulsions (OR 23.652, 95% CI 1.973-283.592), and EV71 infection (OR 9.056, 95% CI 4.102-19.996) were significantly related to the risk of severe HFMD. We did not find an association between female sex (OR 0.918, 95% CI 0.738-1.142), scatter-lived children (OR 1.347, 95% CI 0.245-7.397), floating population (OR 0.847, 95% CI 0.202-3.549), rash on the hands (OR 0.740, 95% CI 0.292-1.874), rash on the foot (OR 0.905, 95% CI 0.645-1.272), the level of the clinic visited first (below the country level) (OR 5.276, 95% CI 0.781-35.630), breast feeding (OR 0.523, 95% CI 0.167-1.643), and the risk of severe HFMD. CONCLUSIONS: Fever, fever for more than 3 days, vomiting, limb trembling, dyspnea, contact with HFMD children, rashes on the hips, pathologic reflexes, lethargy, convulsions, and EV71 infection are risk factors for severe HFMD.

Dual-specificity phosphatase 6 genetic variants associated with risk of lung squamous cell carcinoma in Han Chinese.

BACKGROUND: Nonsmall cell lung cancer (NSCLC) mainly contains adenocarcinoma (AC) and squamous cell carcinoma (SqCC). This study investigated single nucleotide polymorphism (SNP) of topoisomerase II alpha (TOP2A) and dual-specificity phosphatase 6 (DUSP6) in a hospital-based case and control cohort of individuals for association with risk of different histological subtypes of NSCLC. MATERIALS AND METHODS: A total of 454 (237 SqCC and 217 AC) NSCLC patients, and 454 healthy controls were recruited for analysis of TOP2A rs471692 and DUSP6 rs2279574 genotypes using the TaqMan polymerase chain reaction technique. RESULTS: TOP2A rs471692 and DUSP6 rs2279574 SNPs were in complete linkage disequilibrium; however, frequency of DUSP6 rs2279574 genotype was significantly different between the case and control, that is, DUSP6 rs2279574a/A and A/C genotypes might contribute to an increased risk of lung squamous carcinoma compared with the C/C genotype. Moreover, DUSP6 rs2279574 AA genotype was also significantly associated with advanced stages of lung cancer. In contrast, frequency of the TOP2A rs471692 genotype had no association between cases and controls (P = 0.906). Genotype frequency of DUSP6 rs2279574 was 11.9% for C/C, 43.6% for C/A, and 44.5% for A/A in the case versus 16.7% C/C, 43.4% C/A, and 39.9% A/A in the control population (χ2 = 3.136, P= 0.077 by Hardy-Weinberg equilibrium test [HWE]). The genotype frequency of TOP2A rs471692 was 50.0% for C/C, 41.6% for C/T, and 8.4% for T/T in the case versus 50.2% C/C, 43.0% C/T, and 6.8% T/T in the control populations (χ2 = 0.023, P= 0.879 by HWE test). CONCLUSION: Individuals are carrying DUSP6 rs2279574 AA and AC genotypes associated with an increased risk in developing lung squamous carcinoma in Han Chinese and with advanced NSCLC stages.

Polymorphisms of cancer stem cell marker gene CD133 are associated with susceptibility and prognosis of gastric cancer.

AIM: This study was aimed to investigate the associations between single nucleotide polymorphisms of cancer stem cell marker genes, CD44 and CD133, and susceptibility and prognosis of gastric cancer. PATIENTS & METHODS: Five single nucleotide polymorphisms in CD44 and CD133 genes were genotyped in 898 gastric cancer cases and 992 controls. RESULTS: The A/C or C/C genotypes of CD133 rs2240688 were associated with decreased risk of gastric cancer comparing with the A/A genotype (odds ratio: 0.81; 95% CI: 0.67-0.97; p = 0.023). The T allele of CD133 rs3130 predicted a worse survival for gastric cancer patients receiving tumorectomy (hazard ratio: 1.28; 95% CI: 1.04-1.58; p = 0.020), independent from tumor node metastasis stage, vessel invasion and postoperational chemotherapy. CONCLUSION:  CD133 polymorphisms are promising biomarkers for genetic susceptibility and prognosis prediction of gastric cancer.

Interaction between Helicobacter pylori and host genetic variants in gastric carcinogenesis.

Helicobacter pylori (H. pylori) is the definite carcinogen of gastric cancer. H. pylori infection induces chronic inflammation, causes DNA damage and aberrant methylation of genes and these pathways are involved in H. pylori-related gastric carcinogenesis. Polymorphisms of the genes involved in these pathways could alter susceptibility to gastric cancer. In this mini review, we focused on the role of polymorphisms in these genes on the susceptibility to gastric cancer, with a particular emphasis on their possible interactions with H. pylori infection. We found that many studies on this theme did not simultaneously report H. pylori infection and the interactions remained inconclusive.

Dual Specificity Phosphatase 6 (DUSP6) Polymorphism Predicts Prognosis of Inoperable Non-Small Cell Lung Cancer after Chemoradiotherapy.

BACKGROUND: Dual-specificity phosphatase 6 (DUSP6) inactivates different target kinases to regulate cell proliferation and differentiation. Altered DUSP6 expressions or gene polymorphisms are associated with human cancer development including non-small cell lung cancer (NSCLC). DNA topoisomerase II alpha (TOP2A) regulates chromosome condensation and chromatid separation, and altered TOP2A expressions are associated with drug resistance development. This study assessed DUSP6 and TOP2A single nucleotide polymorphisms (SNPs) associated with NSCLC patient survival. METHODS: This study included 152 surgically resected NSCLC patients and 277 chemoradiotherapy treated inoperable cases. DNA samples from each patient were genotyped for DUSP6 and TOP2A SNPs. Kaplan-Meier survival analysis, log-rank test, and Cox proportional hazard model were used to evaluate the association between these variants and NSCLC overall survival. RESULTS: DUSP6 rs2279574 A/A genotype was associated with significantly poor inoperable NSCLC patient overall survival (A/A vs. C/C, adjusted HR = 1.549, 95% CI = 1.019-2.355). Stratification analysis against clinical stage, histology, weight loss, and ECOG performance status revealed that the DUSP6 rs2279574 A/A variant homozygous genotype is associated with a decrease in survival of stage IV NSCLC patients compared to those with the C/C genotype (log-rank, p = 0.003). No association was found among histology, weight loss, and ECOG performance status. Moreover, there was no association of TOP2A SNPs between clinicopathological and survival data. CONCLUSIONS: Data obtained from the current study demonstrated that functional DUSP6 rs2279574 polymorphism was able to predict inoperable NSCLC patient survival after chemoradiotherapy.

CD24 genetic variants contribute to overall survival in patients with gastric cancer.

AIM: To investigate the role of single nucleotide polymorphisms (SNPs) in CD24 gene in susceptibility and overall survival of gastric cancer (GC). METHODS: We genotyped 3 tagging SNPs of CD24-P-534 in the promoter region, P170 in the coding region of exon 2 and P1527 in the 3' untranslated region - using polymerase chain reaction-restriction fragment length polymorphism in specimens from 679 histologically-confirmed GC cases, 111 gastric atrophy (GA) cases and 976 tumor-free controls. Serum immunoglobulin G antibodies to Helicobacter pylori (H. pylori) of all subjects were detected by enzyme-linked immunosorbent assay. CD24 expression was evaluated by immunohistochemistry in 131 GC specimens. Correlations between SNPs and risk of GC or GA were shown by P values and odd ratios (ORs) with 95% confidence intervals (95%CI) compared with the most common genotype of each SNP using the unconditional logistic regression model after adjusting for age, sex and H. pylori infection. Survival within each SNP group was plotted by Kaplan-Meier method and compared by log-rank test (recessive model). Hazard ratios with 95%CIs were computed by Cox regression model after adjusting for age, sex, histological type, tumor differentiation, clinical stage and post-operational chemotherapy. RESULTS: All of the three loci were in Hardy-Weinberg equilibrium in the control group. Median follow-up time for the 600 GC patients included in the survival analysis was 36.2 mo (range, 2.1-66.7 mo; 95%CI: 34.3-36.5 mo). Patients with the P-534 A/A genotype had significantly shorter survival (HR = 1.38, 95%CI: 1.01-1.88, P = 0.042) than did the C/C or C/A genotype carriers after adjusting for age, sex, histological type, tumor differentiation, clinical stage and post-operational chemotherapy. This trend was more evident in patients who lived longer than 2.5 years (HR = 7.55, 95%CI: 2.16-26.32, P = 0.001). The P170 T/T genotype was associated with a shorter lifespan than the non-T/T genotypes, but not significantly so. None of the three genetic variants was found to be associated with risk of GC (including tumor stage, grade and distant metastasis) or with risk of gastric atrophy. Furthermore, no difference of CD24 expression was found among the genotypes. CONCLUSION: The P-534 site in CD24 gene affects the overall survival of gastric cancer and may serve as a prognostic marker for gastric cancer.

Prognostic significance of distal subtotal gastrectomy with standard D2 and extended D2 lymphadenectomy for locally advanced gastric cancer.

This study was conducted to investigate prognosis and survival of patients undergoing distal subtotal gastrectomy with D2 and D2+ lymphadenectomy for patients with locally advanced gastric cancer. Overall survival rates of 416 patients with locally advanced gastric cancer were compared between D2 and D2+ lymphadenectomy. Univariate analysis and multivariate analysis was used to identify significant prognostic factors correlated with LN metastasis and prognosis. Univariate analysis identified tumor size, lymphatic vessel invasion, pT stage, pN stage, TNM stage, locoregional recurrence, and distant recurrence, to significantly correlate with prognosis; Tumor size, LVI, and pT stage were identified as independent factors correlating with LN metastasis. Multivariate analysis demonstrated that tumor size, pT stage, pN stage, locoregional recurrence, and distant recurrence were independent prognostic factors; Tumor size and pT stage were independent prognostic factors predicting LN metastasis. When comparing 5-year survival rates of patients who underwent D2 and D2+ lymphadenectomy, as stratified by pT stage and pN stage, a significant difference was found in pN3 patients, but not for pT2-4 and pN0-2 patients, or the patient cohort as a whole. In conclusion, D2 lymphadenectomy for patients with locally advanced gastric cancer undergoing distal subtotal gastrectomy was recommended, especially in eastern Asia.

The relationship between LAPTM4B polymorphisms and cancer risk in Chinese Han population: a meta-analysis.

LAPTM4B is a newly cloned gene that shows an active role in many solid tumors progression in substantial researches, mainly through the autophage function. Accumulated studies have been conducted to determine the association of LAPTM4B polymorphism with cancer risk. While the results are inconsistent, we conducted the meta-analysis to determine the strength of the relationship. Results showed that allele*2 carriers exhibited a significantly increased risk of cancer development with comparison to allele*1 homozygote (for *1/2, OR = 1.55, 95% CI 1.367-1.758; for *2/2, OR = 2.093, 95%CI 1.666-2.629; for *1/2 + *2/2, OR = 1.806, 95%CI 1.527-2.137). We also observed a significant association between *2/2 homozygote and cancer risk with comparison to allele*1 containing genotypes (OR = 1.714, 95%CI 1.408-2.088). Allele*2 is a risk factor for cancer risk (OR = 1.487, 95%CI 1.339-1.651). Stratified analysis by tumor type exhibits the significant association of this genetic variants with various cancers. In conclusion, LAPTM4B polymorphism is associated with cancer risk and allele*2 is a risk factor.

Polymorphisms of TERT and CLPTM1L and the risk of hepatocellular carcinoma in Chinese males.

BACKGROUND: Telomerase reverse transcriptase (TERT) and cleft lip and palate trans-membrane 1 like (CLPTM1L) genes located on chromosome 5p15.33 are known to influence the susceptibility to various cancers. Here, we examined the association of TERT and CLPTM1L single nucleotide polymorphisms (SNPs) with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Genotyping of TERT SNP rs2736098 and CLPTM1L SNP rs401681 was performed using TaqMan allelic discrimination assays in a case-control study of 201 HCC cases and 210 controls in a Chinese male population. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression analyses. RESULTS: Both the rs2736098 T allele of TERT and the rs401681 T allele of CLPTM1L were associated with a significantly increased risk of HCC (adjusted odds ratio [OR]=1.605, 95% confidence interval [CI]=1.164-2.213; adjusted OR=1.399, 95%CI=1.002-1.955, respectively). Individuals carrying both TERT and CLPTM1L risk genotypes had an even higher risk of HCC (adjusted OR=4.420, 95%CI= 2.319-8.425). The TERT rs2736098 T allele was also significantly associated with the level of the HCC clinical indicator alpha-fetoprotein (P=0.026). CONCLUSIONS: Our results show that genetic variants of TERT and CLPTM1L may contribute to HCC susceptibility in Chinese males.

PARP-1 rs3219073 polymorphism may contribute to susceptibility to lung cancer.

OBJECTIVE: To investigate the relationship between the PARP-1 rs3219073 C>G polymorphism and susceptibility to lung cancer in Chinese people. METHODS: In accordance with the case-control study principle, 645 of the patients had histologically recognized primary lung cancer, among them 240 had squamous carcinoma, 217 had adenocarcinoma, and 188 had small-cell lung cancer. The control group consisted of 643 healthy subjects who had received a physical examination. Extracts of peripheral blood were taken from all subjects, and genomic DNA was extracted by the phenol-chloroform method. RESULTS: After adjusting for age and smoking status, the results show significant association between genetic variations in the rs3219073 C/C genotype and an increased risk of lung cancer (p=0.045, odds ratio [OR]=0.625). After combining C/G, G/G is still statistically significant (p=0.042, OR=0.637). Hierarchical analysis found that the number of subjects with a G/G genotype in the adenocarcinoma group is lower than in the control group (p=0.015, OR=0.543). After combining C/G, G/G is still statistically significant (p=0.027, OR=0.595). After correcting for age and smoking status, the group with C/G genotype and the group with G/G genotype both appear to have a reduced risk for lung cancer compared with the control group (p=0.045, OR=0.566; p=0.013, OR=0.489). The combination of C/G and G/G displays a more statistically significant difference (p=0.018, OR=0.528). CONCLUSIONS: The study found that PARP-1 rs3219073 C>G polymorphism is indeed associated with lung cancer susceptibility. The carriers of G alleles may have reduced risk of lung cancer, especially adenocarcinoma.

N-acetyltransferase 2 gene polymorphisms are associated with susceptibility to cancer: a meta-analysis.

N-acetyltransferase 2 (NAT2) is a polymorphic enzyme that plays an important role in the metabolism of various potential carcinogens. In recent years, a number of studies have been carried out to investigate the relationship between the rs1799930 and rs1799931 polymorphism in NAT2 and cancer risk in multiple populations for different types of cancer. However, the results were not consistent. Therefore, we performed a meta-analysis to further explore the relationship between NAT2 polymorphism and the risk of cancer. A total of 21 studies involving 15, 450 subjects for rs1799930 and 13, 011 subjects for rs1799931 were included in this meta-analysis. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess strength of associations. We also evaluated the publication bias and performed a sensitivity analysis. Overall, our results showed an apparent significant association between the NAT2 rs1799930 polymorphism and cancer susceptibility in Asians (GA vs. GG: OR=1.22, 95% CI=1.03-1.45; dominant model: OR=1.22, 95% CI=1.03-1.43) and population-based controls (GA vs. GG: OR=1.10, 95% CI=1.01-1.19; dominant model: OR=1.09, 95% CI=1.01-1.18). In contrast, a significant association was observed between the NAT2 rs1799931 G>A polymorphism and decreased cancer susceptibility in overall meta-analysis (AA vs. GG: OR=0.55, 95% CI=0.33-0.93; GA vs. GG: OR=1.00, 95% CI=0.88-1.14; dominant model: OR=0.97, 95% CI=0.86-1.10; recessive model: OR=0.56, 95% CI=0.34-0.94) and the Asian group (AA vs. GG: OR=0.50, 95% CI=0.26-0.94; recessive model, OR=0.50, 95% CI=0.27-0.94). We found that the NAT2 rs1799930 may be a risk factor, while the NAT2 rs1799931 polymorphism is associated with a decreased risk of cancer and is likely a protective factor against cancer development.

Health economics evaluation of a gastric cancer early detection and treatment program in China.

OBJECTIVE: To use health economics methodology to assess the screening program on gastric cancer in Zhuanghe, China, so as to provide the basis for health decision on expanding the program of early detection and treatment. MATERIALS AND METHODS: The expense of an early detection and treatment program for gastric cancer in patients found by screening, and also costs of traditional treatment in a hospital of Zhuanghe were assessed. Three major techniques of medical economics, namely cost-effective analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA), were used to assess the screening program. RESULTS: RESULTS from CEA showed that investing every 25, 235 Yuan on screening program in Zhuanghe area, one gastric cancer patient could be saved. Data from CUA showed that it was cost 1, 370 Yuan per QALY saved. RESULTS from CBA showed that: the total cost was 1,945,206 Yuan with a benefit as 8,669,709 Yuan and an CBR of 4.46. CONCLUSIONS: The early detection and treatment program of gastric cancer appears economic and society-beneficial. We suggest that it should be carry out in more high risk areas for gastric cancer.

Genetic variations in TERT-CLPTM1L genes and risk of lung cancer in a Chinese population.

BACKGROUND: This study was conducted to investigate the association between single nucleotide polymorphisms (SNPs) in telomerase reverse transcriptase (TERT) and cleft lip and palate transmembrane1-like (CLPTM1L) and lung cancer risk in a Chinese population. METHODS: We performed a hospital-based case-control study, including 980 lung cancer cases and 1000 cancer-free controls matched for age and sex. Each case and control was interviewed to collect information by well-trained interviewers. A total of 5 ml of venous blood was collected for genotype testing of TERT rs2736098 and CLPTM1L rs401681 using TaqMan methodology. RESULTS: The results revealed that the variant homozygote TERT rs2736098TT was associated with an increased risk of lung cancer (OR=2.017, 95%CI=1.518-2.681), especially lung adenocarcinoma (OR=2.117, 95%CI=1.557-3.043) and small cell carcinoma (OR=1.979, 95%CI: 1.174-3.334), compared with the TERT rs2736098CC genotype. Similar results were observed in non-smokers. CONCLUSION: The TERT rs2736098 polymorphism might affect the susceptibility to lung cancer in Chinese populations. The associations need to be verified in larger and different populations.

Association of oral contraceptives use and lung cancer risk among women: an updated meta-analysis based on cohort and case-control studies.

BACKGROUND: Previous studies on the association of oral contraceptives (OC) use and lung cancer generated inconsistent findings. The aim of this study was to confirm any definite correlation between OC use and lung cancer risk. METHODS: Publications were reviewed and obtained through PubMed and EMBASE databases literature search up to November, 2013. Reference lists from retrieved articles were also reviewed. The language of publication was restricted to English. A meta-analysis was performed to evaluate the association by calculating pooled odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: A total of 14 studies consisting of 9 case- control studies and 5 cohort studies were finally included in this meta-analysis. There was no significant association observed between OC use and lung cancer risk in the overall analysis (OR=0.91; 95% CI=0.81-1.03). There was a significant protective effect in Europe (OR=0.74; 95% CI=0.60-0.91) and a borderline significant protective effect with an adenocarcinoma histology (OR=0.90; 95% CI=0.80-1.01) in subgroup analyses. No association was observed for methodological quality of study, study design, smoking status and case number of study. CONCLUSION: This meta-analysis suggests that OC use is not likely to be associated with the risk of lung cancer at all. While a significant protective effect of OC use on lung cancer was observed in Europe, interpretation should be cautious because of the potential biases of low-quality studies. At the same time, more attention should be paid to the possible association of OC use with adenocarcinoma of lung. Our findings require further research, with well-conducted and large-scale epidemiological studies to confirm effects of OC use on lung cancer.