[Effectiveness of Different Testing Strategies Applied for Cervical Cancer Screening in Shuangliu District, Chengdu City].

Objective: To evaluate the clinical value of different combination strategies of high-risk HPV (hr-HPV) testing and Thinprep cytology test (TCT), a cervical cytology test, for cervical cancer screening, especially for high or higher-grade squamous intraepithelial lesion (HSIL+) in Shuangliu District, Chengdu City. Methods: The study is a population-based randomized clinical trial. Women aged 35 to 65 years meeting the inclusion criteria were enrolled for the study. At the baseline screening conducted in the first year, the participants were randomly assigned to either cytology test or hr-HPV testing at a ratio of 1∶2. If the paticipants had positive results for the baseline hr-HPV test, they would then undergo either cytology test or colposcopy by random assignment. After 24 months, all participants were called back, and combined screening of cytology test and hr-HPV test were performed. Women who had negative results at baseline screening and who entered and completed the third-year follow-up were selected as the subjects of the study. Based on the aforementioned testing findings, the related data were extracted and four different screening protocols were simulated: 1) combined TCT and hr-HPV screening, with referral for colposcopy when there was positive results for either one of the two; 2) combined TCT and hr-HPV screening, with referral for colposcopy when both tests had positive results at the same time; 3) TCT was done for preliminary screening and those who were found to be positive would then undergo hr-HPV test for triage purpose, with subsequent referral made for colposcopy if the hr-HPV results were positive; 4) hr-HPV was done for preliminary screening and those who were found to be positive would then undergo TCT, with subsequent referral made for colposcopy if TCT results were positive. With the detection of HSIL+ on histological examination as the endpoint event, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve ( AUC) of different combination screening models were calculated. Results: A total of 3102 women were screened, and 2967 women were included in the statistical analysis in this study. Among the 2967 women, 979 were randomized to cytology and 1988 to hr-HPV genotyping. For prescreening, the positive rate of the cytology group was 5.6% (55/979), with of HSIL+ positive rate being 0.2% (2/979), while the positive rate of the hr-HPV group was 7.5% (149/1988), with HSIL+ positive rate being 0.9% (18/1988). After 24 months, 2456 women were called back and were given cervical cytology test and hr-HPV test at the same time. Among them, the positive rate of the cytology group was 3.2% (78/2456), while the positive rate of hr-HPV group was 8.7% (215/2456). The overall positive rate of HSIL+ was 0.69%(17/2456). Women with a negative baseline hr-HPV had a lower incidence of HSIL+ lesions in the long term. The strategy of cervical cytology screening combined with hr-HPV test for triage purpose is the best method, with a sensitivity of 88.9%, a specificity of 58.3%, a PPV of 44.4%, a NPV of 93.3%, and an AUC of 0.736, P=0.039 (95% CI: 0.555-0.917). Conclusion: This randomized clinical trial from Shuangliu District, Chengdu City shows that the sensitivity of hr-HPV testing is better than that of cytology test, and the prevalence of HSIL+ in women with negative baseline hr-HPV results is lower than that of women with negative baseline cytology results. The screening program of TCT for prescreening plus subsequent hr-HPV test for triage purpose shows better value for the detection of HSIL+.

[Interactive Effects of the Influencing Factors on the Changes of O3 Concentrations Based on GAMs Model in Chengdu].

To explore the influence characteristics of the interaction effects between meteorological factors on ozone(O3) concentration in Chengdu, daily air pollutants and meteorological data from 2014 to 2019 were collected. Generalized additive models(GAMs) were adopted to explore the effects of different factors on O3 concentration. The results showed that the relationship between O3 and maximum temperature, sunshine hours, relative humidity, wind speed, precipitation, maximum mixed depth(MMD), and ventilation coefficient(VC) was non-linear. Specifically, the maximum temperature, sunshine hours, MMD, and relative humidity had a significant influence on O3 concentration throughout the year. It is worth noting that the influence of relative humidity and precipitation on O3 concentration during summer was more significant than that for the whole year. In the multi-meteorological factors GAMs of O3 concentration, the meteorological factors mentioned above, except average wind, had significant impacts on O3 concentration change. For the whole year, the judgment coefficient(R2) was 0.849 and the variance explanation rate was 85.1%. The maximum temperature was the most important influencing factor on O3 concentration throughout the year. During summer, corresponding R2 was 0.811 and the explanation rate of variance was 81.3%; however, maximum temperature and MMD were the dominant meteorological factors. In the interaction GAMs, for the whole year, the interaction between maximum temperature and sunshine hours, relative humidity, and precipitation, and the interaction between sunshine hours and MMD had a significant impact on O3 concentrations. The interaction between maximum temperature and sunshine hours played a leading role in changes of O3 concentration. The high temperature+strong radiation+MMD(about 2000 m) +no precipitation were conducive to the formation of O3 concentration, but in summer, only the maximum temperature, sunshine hours, and VC had the most significant effect on the O3 concentration, and strong high temperatures+strong radiation+the little horizontal wind in summer were conducive to the formation of O3 concentration near the surface. In summary, GAMs model can not only be used to identify the dominant influencing factors of O3 pollution, but also quantitatively analyze the influence of single effects and interaction of influencing factors on O3 concentration, which has great significance for the prevention and control of O3 pollution.

Spatiotemporal variation and exposure risk to human health of potential toxic elements in suburban vegetable soils of a megacity, SW China, 2012-2016.

Trace element contamination in soils of vegetable fields can threat public health. Seven potential toxic elements (As, Cd, Cr, Cu, Ni, Pb, and Zn) in suburban vegetable soils of Chengdu city, Southwest China, in 2012 and 2016, were analyzed to identify their sources with the spatiotemporal variation and assess their contamination and health risk for residents. The results showed that the concentrations of soil elements did not increase significantly in 2016 compared with that in 2012, whereas their spatial distributions altered markedly. The hot spots of soil As, Cd, and Pb as well as Cu and Zn in 2016 revealed the anthropogenic sources including agricultural activities, industrial emissions, road dust with heavy traffic, and open burning of solid waste. The apparent spatial difference of anthropogenic elements was related to the layout of land use surrounding the vegetable field. The contamination of soil elements decreased in the order of Cd > As ≈ Zn > Cu ≈ Pb > Cr ≈ Ni in 2012 and Cd > Zn > As ≈ Cu ≈ Pb > Cr ≈ Ni in 2016, and the vegetable soils were slightly to moderately contaminated by these elements through integrated contamination index. The sites affected by the trace elements did not increase in 2016 than in 2012, whereas the sites with relatively high contamination increased markedly. The non-carcinogenic risk of trace elements was generally acceptable, and children showed higher health risk than adults. The As carcinogenic risk for children varied between 5.48 × 10-5 and 1.59 × 10-4 in 2012 and between 4.40 × 10-5 and 1.82 × 10-4 in 2016, and the sites above acceptable levels (> 10-4) reached 60.6% and 48.5% in 2012 and 2016, respectively. The health risk of As in the vegetable soils should be paid more attention due to its high toxicity.

Practice and thinking on the construction of pilot medical alliances in Chengdu / 中华医院管理杂志

Described in the paper is the practice of Chengdu in its pilot of medical alliances in 2015 ,which effectively elevated the medical capacity and quality of care of medical institutions within Pujiang county. Such measures as enhanced management and mechanism ,clarified government responsibility ,standardized medical service quality ,and enhanced coordination within the healthcare system are proposed to enhance the medical alliances and the hierarchical medical system .

[A survey on knowledge of acupuncture disease spectrum and expectation of acupuncture treatment in Chengdu residents].

OBJECTIVE: To understand the knowledge of acupuncture disease spectrum, expectation of acupuncture treatment in Chengdu residents. METHODS: A questionnaire regarding the knowledge of acupuncture disease spectrum and expectation of acupuncture treatment in Chengdu residents was established. By field sampling and internet survey, related data were collected and analyzed. RESULTS: Totally 1 548 valid questionnaires were collected, including 1 041 from field survey and 507 from internet survey. The results indicated the knowledge of acupuncture and its disease spectrum were moderate in Chengdu residents; among the disease spectrum of acupuncture, the disease with the highest cognition was insomnia, accounting for 45.0% in field survey and 75.4% in internet survey; while the disease with the lowest cognition was infertility, accounting for 8.3% in field survey and 34.3% in internet survey. CONCLUSIONS: The knowledge of acupuncture in Chengdu residents could be further improved, and the promotion of popular science of acupuncture should be strengthened in future.

[Epidemic situation of imported malaria in Chengdu City from 2012 to 2016].

Objective To understand the malaria epidemic situation in Chengdu City, so as to provide the evidence for effectively carrying out the malaria elimination work. Methods The data of imported malaria in Chengdu City from 2012 to 2016 were collected from the Disease Surveillance Information Reporting System of Chinese Center for Disease Control and Prevention and analyzed respectively. Results A total of 240 imported malaria cases were reported in Chengdu City from 2012 to 2016. In detail, 68.75% of the cases were falciparum malaria cases, 20.41% were vivax malaria cases, 2.50% were quartan malaria cases, 6.25% were ovale malaria cases, and 2.08% were mixed Plasmodium infections. Among them three patients died, with a mortality of 1.25%. All of the cases were infected overseas, among which 224 patients returned from Africa and 16 patients from Southeast Asia. The annual average morbidity was 0.28/100 000, and there was a significantly difference among annual average morbidities (χ2 = 23.87, P < 0.001). There were malaria cases reported in every month, and no significantly difference among seasons (χ2 = 0.833, P > 0.05). Conclusion The number of overseas imported malaria in Chengdu City increases year by year. The effective measures to control the overseas imported malaria should be strengthened to consolidate the achievements of malaria elimination.

Epidemic situation of imported malaria in Chengdu City from 2012 to 2016 / 中国血吸虫病防治杂志

Objective To understand the malaria epidemic situation in Chengdu City,so as to provide the evidence for effec-tively carrying out the malaria elimination work. Methods The data of imported malaria in Chengdu City from 2012 to 2016 were collected from the Disease Surveillance Information Reporting System of Chinese Center for Disease Control and Prevention and analyzed respectively. Results A total of 240 imported malaria cases were reported in Chengdu City from 2012 to 2016. In de-tail,68.75％of the cases were falciparum malaria cases,20.41％were vivax malaria cases,2.50％were quartan malaria cases, 6.25％were ovale malaria cases,and 2.08％were mixed Plasmodium infections. Among them three patients died,with a mortali-ty of 1.25％. All of the cases were infected overseas,among which 224 patients returned from Africa and 16 patients from South-east Asia. The annual average morbidity was 0.28/100000,and there was a significantly difference among annual average mor-bidities(χ2=23.87,P0.05). Conclusion The number of overseas imported malaria in Chengdu City increases year by year. The effective measures to control the overseas imported malaria should be strengthened to consolidate the achievements of malar-ia elimination.

A survey on knowledge of acupuncture disease spectrum and expectation of acupuncture treatment in Chengdu residents / 中国针灸

<p><b>OBJECTIVE</b>To understand the knowledge of acupuncture disease spectrum, expectation of acupuncture treatment in Chengdu residents.</p><p><b>METHODS</b>A questionnaire regarding the knowledge of acupuncture disease spectrum and expectation of acupuncture treatment in Chengdu residents was established. By field sampling and internet survey, related data were collected and analyzed.</p><p><b>RESULTS</b>Totally 1 548 valid questionnaires were collected, including 1 041 from field survey and 507 from internet survey. The results indicated the knowledge of acupuncture and its disease spectrum were moderate in Chengdu residents; among the disease spectrum of acupuncture, the disease with the highest cognition was insomnia, accounting for 45.0% in field survey and 75.4% in internet survey; while the disease with the lowest cognition was infertility, accounting for 8.3% in field survey and 34.3% in internet survey.</p><p><b>CONCLUSIONS</b>The knowledge of acupuncture in Chengdu residents could be further improved, and the promotion of popular science of acupuncture should be strengthened in future.</p>

Building of the evaluation index system of clinical key disciplines at county level hospitals in Chengdu city / 中华医院管理杂志

Objective To build a clinical key disciplines evaluation index system for county level hospitals in Chengdu city.Methods Literature meta analysis, focus group discussion, expert consultation method, boundary value method, brainstorming and hierarchy analysis method were comprehensively used.Results The clinical key disciplines evaluation index system for county level hospitals in Chengdu city comprises 5 level-1 indexes,1 6 level-2 indexes,47 level-3 indexes.Among the level-1 indexes,service capacity,medical quality,technical personnel,scientific research and education, and foundation of specialty was 0.474 6,0.202 7,0.148 2,0.097 7,0.076 8 respectively.Conclusion The clinical key disciplines evaluation index system for county level hospitals in Chengdu city is scientific, guiding and practical,which can be used to evaluate the status of the clinical key disciplines for county level hospitals in Chengdu city.

The incidence and clinical characteristics of gastroenteropancreatic neuroendocrine neoplasm in Chengdu City in 2010 / 中华消化杂志

Objective To investigate the incidence of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) in Chengdu City in 2010 and summarize clinical characteristics of GEP-NEN.Methods The incidence of GEP-NEN was estimated with the data in 2010 from the databases of West China Hospital and Chengdu Health Information Centre.Results A total of 77 cases of GEP-NEN were diagnosed in West China Hospital in 2010.Ten cases from other hospitals or non-Chengdu citizenship were excluded,so a total of 67 cases were included in this study.In 2010,the incidence of GEP-NEN was 1.86/105 in Chengdu City.Among 67 GEP-NEN cases,most lesions were located in pancreas and rectum (38 cases,56.7％),followed by stomach (10 cases),esophagus (seven cases) and duodenum (four cases).Among 57 GEP-NEN cases which had pathotogial grading,26 cases (45.6 ％) had neuroendocrine carcinomas or mixed adenoneuroendocrine carcinomas when diagnosed.Conclusions In 2010,the incidence of GEP-NEN in Chengdu City is similar to the reports from other countries.Pancreas,rectum and upper gastrointestinal tract are predilection sites of GEP-NEN.The diagnosis rate of early GEP NEN needs to be raised.