Cystatin C predicts the risk of incident cerebrovascular disease in the elderly: A meta-analysis on survival date studies.

BACKGROUND: Stroke is the third leading cause of global year of life lost in all-age and second-ranked cause of disability adjusted life years in middle-aged and elder population. Therefore, it is critical to study the relationship between vascular-related risk factors and cerebrovascular diseases. Several cross-sectional studies have shown that Cystatin C (Cys C) is an independent risk factor for cerebrovascular diseases and levels of Cys C are significantly higher in stroke patients than in healthy individuals. In this meta-analysis, we introduce a Cox proportional hazards model to evaluate the causality between Cys C and the risk of cerebrovascular accident in the elderly. METHODS: We searched PubMed, EMBASE, the Web of Science, and the Cochrane Library from 1985 to 2019 for studies on the relationship between serum Cys C and incidence stroke with Cox proportional hazards models. We conducted a subgroup analysis of the selected studies to determine a connection between atherosclerosis and stroke. Finally, 7 research studies, including 26,768 patients without a history of cerebrovascular, were studied. RESULTS: After comparing the maximum and minimum Cys C levels, the hazard ratio for all types of stroke, including ischemic and hemorrhagic stroke, was 1.18 (95% confidence interval 1.04-1.31) with moderate heterogeneity (I2 = 43.0%; P = .119) in a fixed-effect model after pooled adjustment for other potential risk factors. In the subgroup analysis, the hazard ratio and 95% confidence interval for Cys C stratified by atherosclerosis was 1.85 (0.97-2.72). As shown in Egger linear regression test, there was no distinct publication bias (P = .153). CONCLUSION: Increased serum Cys C is significantly associated with future stroke events in the elderly, especially in patients with carotid atherosclerosis. Thus, serum levels of Cys C could serve as a predicted biomarker for stroke attack.

First-line treatment strategies for newly diagnosed chronic myeloid leukemia: a network meta-analysis.

OBJECTIVES: With bosutinib proven to be available for frontline treatment, there are currently four frontline treatments as well as an additional strategy with high-dose imatinib for newly diagnosed chronic myeloid leukemia (CML). Due to the lack of direct comparison of high-dose imatinib, dasatinib, nilotinib, and bosutinib, we summarized the evidence to indirectly compare the efficacy among these treatment options. METHODS: In total, 14 randomized clinical trials including 5,630 patients were analyzed by direct and mixed-treatment comparisons. Outcomes assessed were the following: complete cytogenetic response at 12 months; major molecular response at 12, 24, and 36 months; deep molecular response at 12, 24, 36, and 60 months; early molecular response at 3 months; progression-free survival (PFS); overall survival (OS); and Grade 3 or 4 adverse events (AEs). RESULTS: The Bayesian network meta-analysis demonstrated that high-dose imatinib was less effective than all new-generation tyrosine kinase inhibitors and had a higher probability of Grade 3 or 4 AEs. For molecular response, 300 mg of nilotinib was likely to be the preferred frontline treatment, as demonstrated by higher response rates and faster, deeper, and longer molecular response. For PFS and OS, there were high likelihoods (79% and 74%, respectively) that 400 mg of nilotinib was the preferred option. For AEs, standard-dose imatinib has the highest probability (65%) of being the most favorable toxicity profile. CONCLUSION: Considering the efficacy and toxicity profile, it is not recommended to use high-dose imatinib for treatment. This analysis also showed that nilotinib has the highest probability to become the preferred frontline agents for treating CML.

Predictable weathering of puparial hydrocarbons of necrophagous flies for determining the postmortem interval: a field experiment using Chrysomya rufifacies.

Preadult development of necrophagous flies is commonly recognized as an accurate method for estimating the minimum postmortem interval (PMImin). However, once the PMImin exceeds the duration of preadult development, the method is less accurate. Recently, fly puparial hydrocarbons were found to significantly change with weathering time in the field, indicating their potential use for PMImin estimates. However, additional studies are required to demonstrate how the weathering varies among species. In this study, the puparia of Chrysomya rufifacies were placed in the field to experience natural weathering to characterize hydrocarbon composition change over time. We found that weathering of the puparial hydrocarbons was regular and highly predictable in the field. For most of the hydrocarbons, the abundance decreased significantly and could be modeled using a modified exponent function. In addition, the weathering rate was significantly correlated with the hydrocarbon classes. The weathering rate of 2-methyl alkanes was significantly lower than that of alkenes and internal methyl alkanes, and alkenes were higher than the other two classes. For mono-methyl alkanes, the rate was significantly and positively associated with carbon chain length and branch position. These results indicate that puparial hydrocarbon weathering is highly predictable and can be used for estimating long-term PMImin.

Colorectal Cancer Mortality Characteristics and Predictions in China, 1991-2011.

BACKGROUND: To identify the epidemiological characteristics of colorectal cancer mortality in China during the period of 1991-2011, and forecast the future five-year trend. MATERIALS AND METHODS: Mortality data for colorectal cancer in China from 1991 to 2011 was used to describe epidemiological characteristics in terms of age group, gender, and rural/urban residence. Trend surface analysis was performed to analyze the geographical distribution of colorectal cancer. Four models including curve estimation, time series modeling, gray modeling and joinpoint regression were applied to forecast the trends for the future five years. RESULTS: Since 1991 the colorectal cancer mortality rate increased yearly, and our results showed that the trend would continue to increase in the ensuing 5 years. The mortality rate in males was higher than that of females and the rate in urban areas was higher than in rural areas. The mortality rate was relatively low for individuals less than 60 years of age, but increased dramatically afterwards. People living in the northeastern China provinces or in eastern China had a higher mortality rate for colorectal cancer than those living in middle or western China provinces. CONCLUSIONS: The steadily increasing mortality of colorectal cancer in China will become a substantial public health burden in the foreseeable future. For this increasing trend to be controlled, further efforts should concentrate on educating the general public to increase prevention and early detection by screening. More effective prevention and management strategies are needed in higher mortality areas (Eastern parts of China) and high-risk populations (60+ years old).

Cervical Cancer Mortality Trends in China, 1991-2013, and Predictions for the Future.

BACKGROUND: To analyze cervical cancer mortality trends in China from 1991-2013 and forecast the mortality distribution in future five years (2014-2018), and provide clues for prevention and treatment. MATERIALS AND METHODS: Mortality data for cervical cancer in China from 1991 to 2013 were used to describe the epidemiological characteristics and distribution, including the trend of the standardized mortality rate, urban-rural differences, and age variation. Trend-surface analysis was used to analyze the geographical distribution of mortality. Curve estimation, time series, gray modeling, and joinpoint regression were performed to predict and forecast mortality trends. RESULTS: In recent years, the mortality rate of cervical cancer has increased, and there is also a steady increase in the incidence from 2003 to 2013 in China. Mortality rates in rural areas are higher than in urban areas. The mortality dramatically increases in the 40+ yr age group, reaching a peak in the >85 yr age group. In addition, geographical analysis showed that the cervical cancer mortality increased from the southwest to west-central and from the southeast to northeast of the country. CONCLUSIONS: The incidence rate and the mortality rate are increasing from 1991 to 2013, and the predictions show this will continue in the future. Thus, implementation of prevention and management programs for cervical cancer are necessary in China, especially for rural areas, young women in urban areas, and high risk regions (the west-central).

Mortality Characteristic and Prediction of Nasopharyngeal Carcinoma in China from 1991 to 2013.

BACKGROUND: To analyze the mortality distribution of nasopharyngeal carcinoma in China from 1991 to 2013, to predict the mortality in the ensuing five years, and to provide evidence for prevention and treatment of nasopharyngeal carcinoma. MATERIALS AND METHODS: Mortality data for Nasopharyngeal Carcinoma in China from 1991 to 2013 were used to describe its epidemiological characteristics, such as the change of the standardized mortality rate, sex and age differences, urban-rural differences. Trend-surface analysis was used to study the geographical distribution of the mortality. Curve estimation, time series, gray modeling, and joinpoint regression were used to predict the mortality for the ensuing five years in the future. RESULTS: In China, the standardized mortality rate of Nasopharyngeal Carcinoma increased with time from 1996, reaching the peak values of 1.45 /105 at the year of 2002, and decreased gradually afterwards. With males being 1.51 times higher than females, and the city had a higher rate than the rural during the past two decades. The mortality rate increased from age 40. Geographical analysis showed the mortality rate increased from middle to southern China. CONCLUSIONS: The standardized mortality rate of Nasopharyngeal Carcinoma is falling. The regional disease control for Nasopharyngeal Carcinoma should be focused on Guangdong province of China, and the key targets for prevention and treatment are rural men, especially after the age of 40. The mortality of Nasopharyngeal Carcinoma will decrease in the next five years.

Characteristics and Prediction of Lung Cancer Mortality in China from 1991 to 2013.

OBJECTIVE: To describe and analyze the epidemiological characteristics of lung cancer mortality in China from 1991 to 2013, forecast the future five-year trend and provide scientific evidence for prevention and management of lung cancer. MATERIALS AND METHODS: Mortality data for lung cancer in China from 1991 to 2013 were used to describe epidemiological characteristics. Trend surface analysis was applied to analyze the geographical distribution of lung cancer. Four models, curve estimation, time series modeling, gray modeling (GM) and joinpoint regression, were performed to forecast the trend for the future. RESULTS: Since 1991 the mortality rate of lung cancer increased yearly. The rate for males was higher than that for females and rates in urban areas were higher than in rural areas. In addition, our results showed that the trend will continue to increase in the ensuing 5 years. The mortality rate increased from age 45-50 and peaked in the group of 85 years old. Geographical analysis indicated that people living in northeast China provinces and the coastal provinces in eastern China had a higher mortality rate for lung cancer than those living in the centre or western Chinese provinces. CONCLUSIONS: The standardized mortality rate of lung cancer has constantly increased from 1991 to 2013, and been predicted to continue in the ensuing 5 years. Further efforts should be concentrated on education of the general public to increase prevention and early detection. Much better prevention and management is needed in high mortality areas (northeastern and eastern parts of China) and high risk populations (45-50-year-olds).

Liver cancer mortality characteristics and trends in China from 1991 to 2012.

PURPOSE: To investigate the distribution of liver cancer mortality as well as its developing trend from l991 to 2012, forecast the future five-year trend, and provide a basis for the comprehensive prevention and management. MATERIALS AND METHODS: Mortality data for liver cancer in China from 1991 to 2012 were used to describe characteristics and distribution of liver cancer mortality. Trend surface analysis was used to study the geographical distribution of liver cancer mortality. Curve estimation, time series modeling, gray modeling (GM) and joinpoint regression were used to predict and forecast future trends. RESULTS: The mortality rate of liver cancer has constantly increased in China since 1991. Rates in rural areas are higher than in urban areas, and in males are higher than in females. In addition, our data predicted that the trend will continue to increase in the next 5 years. The age-specific mortality of liver cancer increases with age and peaks in the group of 80-84 years old. Geographical analysis showed the liver mortality rate was higher in the southeast provinces, such as Jiangsu, Zhejiang and Guangdong, and southwest regions like Guangxi Province. CONCLUSIONS: The standardized mortality rate of liver cancer in China has consistently increased from 1991 to 2012, and the upward trend is predicted to continue in the future. Much better prevention and management of liver cancer is needed in high mortality areas (the southwestern and southeastern parts of China) and high mortality age groups (80- to 84-year-olds), especially in rural areas.

Epidemiological characteristics and prediction of esophageal cancer mortality in China from 1991 to 2012.

BACKGROUND: To analyze the mortality distribution of esophageal cancer in China from 1991 to 2012, to forecast the mortality in the future five years, and to provide evidence for prevention and treatment of esophageal cancer. MATERIALS AND METHODS: Mortality data for esophageal cancer in China from 1991 to 2012 were used to describe its epidemiological characteristics, such as the change of the standardized mortality rate, urban-rural differences, sex and age differences. Trend-surface analysis was used to study the geographical distribution of the mortality. Curve estimation, time series, gray modeling, and joinpoint regression were used to predict the mortality for the next five years in the future. RESULTS: In China, the incidence rate of esophageal cancer from 2007 and the mortality rate of esophageal cancer from 2008 increased yearly, with males at 8.72/105 being higher than females, and the countryside at 15.5/105 being higher than in the city. The mortality rate increased from age 45. Geographical analysis showed the mortality rate increased from southern to eastern China, and from northeast to central China. CONCLUSIONS: The incidence rate and the standardized mortality rate of esophageal cancer are rising. The regional disease control for esophageal cancer should be focused on eastern, central and northern regions China, and the key targets for prevention and treatment are rural men more than 45 years old. The mortality of esophageal cancer will rise in the next five years.

Mortality characteristics and prediction of female breast cancer in China from 1991 to 2011.

AIMS: To analyze time-dependent changes in female breast cancer (BC) mortality in China, forecast the trend in the ensuing 5 years, and provide recommendations for prevention and management. MATERIALS AND METHODS: Mortality data of breast cancer in China from 1991 to 2011 was used to describe characteristics and distribution, such as the changes of the standardized mortality rate, urban-rural differences and age differences. Trend-surface analysis was used to study the geographical distribution of mortality. In addition, curve estimation, time series modeling, Gray modeling (GM) and joinpoint regression were performed to estimate and predict future trends. RESULTS: In China, the mortality rate of breast cancer has increased yearly since 1991. In addition, our data predicted that the trend will continue to increase in the ensuing 5 years. Rates in urban areas are higher than those in rural areas. Over the past decade, all peak ages for death by breast cancer have been delayed, with the first death peak occurring at 55 to 65 years of age in urban and rural areas. Geographical analysis indicated that mortality rates increased from Southwest to Northeast and from West to East. CONCLUSIONS: The standardized mortality rate of breast cancer in China is rising and the upward trend is predicted to continue for the next 5 years. Since this can cause an enormous health impact in China, much better prevention and management of breast cancer is needed. Consequently, disease control centers in China should place more focus on the northeastern, eastern and southeastern parts of China for breast cancer prevention and management, and the key population should be among women between ages 55 to 65, especially those in urban communities.

[Comparative study on soil and vegetation characteristics from high- and low risk areas of esophageal cancer in China].

OBJECTIVE: To study the types of soil and vegetation as well as soil organic carbon densities (SOCD) from high and low risk areas of esophageal cancer (EC) in China. METHODS: Database from EC mortality survey in 1990-1992 in China was established in Excel. Digital polygon maps of study areas were created in ArcGIS 9.1 and linked with the database. The types of soil and vegetation from sampling areas were extracted from digital maps of soil type, vegetation type while the map of distribution on EC mortality was using the polygon overlay analysis. SOCD at depths of 100 cm and 20 cm of these areas were calculated, and spearman correlation analysis was used to evaluate the relationship between EC mortality and SOCD. RESULTS: The types of soil and vegetation and related distributions from high and low risk areas of EC in China showed obvious differences. There were both negative correlations between EC mortality and SOCD at depths of 100 cm and 20 cm. The correlation coefficients for man were -0.504 and -0.575 (P = 0.004, 0.001 respectively), and that for woman were -0.487 and -0.526 (P = 0.003, 0.001 respectively). CONCLUSION: Mortality rate of esophageal cancer might correlate to SOCD, the types of soil and vegetation which called for further studies.

Relationships between esophageal cancer and spatial environment factors by using Geographic Information System.

To explore the relationships between esophageal cancer (EC) and climatic, geographic factors in China by using Geographic Information System, database of EC mortality of 237 sampling areas surveyed in 1990-1992 was established in Excel and linked with the digital polygon maps of study areas. Geographic and climate data of sampling areas were extracted from the raster dataset and finished in Arc/Info 9.0 and ENVI4.2 software by using spatial analysis. Spearman correlation analysis and multiple regression analysis after principal component analysis (PCA) were performed to analyze the relationship between EC and these factors. The counties that have the highest EC morality show significant aggregation. Spearman correlation analysis shows weak negative correlation between precipitation, water-heat index (WHI), highest/lowest temperature and EC mortality, and weak positive correlation between drought index (DI), wind speed, population density and EC mortality. Multiple linear regression analysis indicated that the variables associated with EC mortality were precipitation, temperature, wind speed, elevation, DI, WHI and normalized difference vegetation index (NDVI) of July. Our study suggested that the high-risk areas of EC in China are mostly drought and low altitude areas relatively. There were relatively lower NDVI in summer and higher wind speed in these areas. GIS can be applied to cancer epidemiology study and will exert active effect, which should be further explored.

Soil and vegetation characteristics of high- and low-risk areas of esophageal cancer in China.

OBJECTIVES: The purpose of this study is to explore the relationship between esophageal cancer (EC) and soil, vegetation types as well as soil organic carbon densities (SOCD) at depths of 100cm and 20cm in China. METHODS: Database of EC mortality surveyed in 1990-1992 in China was established in Excel. Digital polygon maps of study areas were created in Arc/Info 9.0 software and linked with the database. Soil and vegetation types of sampling areas were extracted from digital maps of soil types, vegetation types and distribution map of EC mortality by using overlay analysis. Mean SOCD at depths of 100cm and 20cm of these areas were calculated, and spearman correlation analysis was used to evaluate the relationship between EC mortality and SOCD. RESULTS: Soil and vegetation types of high and low-risk areas of EC in China were different. There were both negative correlations between EC mortality and SOCD at depths of 100cm and 20cm. The correlation coefficient for men is -0.504 and -0.575 (p< 0.01 respectively), for women is -0.487 and -0.526 (p<0.01 respectively). CONCLUSIONS: EC may correlate to SOCD, soil and vegetation types, which needs further studies. GIS-based spatial techniques can provide an opportunity to connect diseases with ambient environment, and lay a foundation to pursue further investigation into the environmental factors responsible for disease risk.