Objective To evaluate the performance of Beckman Coulter Enhanced troponin Ⅰ immunoassay system (including the limit of detection and total imprecision) and establish the 99th percentile of Enhanced troponin Ⅰ in apparently healthy Chinese people in Kunming and Wuhan.Methods Evaluated the limit of detection and total imprecision of Beckman Enhanced troponin Ⅰ according to protocols EP of Clinical Laboratory Standards Institute; chose apparently healthy people from Wuhan (average altitude of 27 m) which represents plain regions,and Kunming (average altitude of 1895 m) which represents plateau regions.760 subjects from Wuhan were selected,aging from 30 to 91,included 400 males and 360 females.A total of 192 subjects from Kunming were selected,aging from 30 and 77,60 patients,which included 60 male and 132 female cases.To calculate the 99th percentile of Enhanced troponin Ⅰ by region,age,and gender.Results The limit of detection of Beckman Enhanced troponin Ⅰ is 0.013 μg/L,the cTnI concentration is 0.025 μg/L at 10％ CV.The 99th percentile of Enhanced troponin Ⅰ of the total population in Wuhan is 0.036 μg/L,the 99th percentile of men and women are 0.038 μg/L and 0.035 μg/L respectively,the 99th percentile in the 30-69 years group and over 70 years group are 0.038 μg/L and 0.035 μg/L respectively.The 99th percentile of Enhanced troponin Ⅰ of the total population in Kunming is 0.040 μg/L.To keep the 2nd digit after decimal point for results from Wuhan and Kunming,the 99th percentile of Enhanced troponin Ⅰ of the apparently healthy Chinese in 0.04 μg/L,where the CV is 8.23％.The percentage of positive samples detected below the 99th percentile in the normal reference population in Wuhan is 94％.Conclusions The 99th percentile of Beckman Enhanced troponin Ⅰ of the Chinese apparently healthy people is 0.04 μg/L,where the total imprecision is 8.23％,and the detection performance reach the acceptable levels per the guideline.

Objective: To investigate the incidence and survival of esophageal cancer with different histological types and to understand the incidence trend and burden of esophageal cancer in Linzhou during 2003-2012. Methods: All incidence records of esophageal cancer and population reported were collected from Linzhou Cancer Registry during 2003-2012. Incidence rate was calculated using gender and histological types. Age standardized incidence rate was calculated according to world Segi's population and Chinese census data in 2000. Age standardized incidence rate by world population between 2003 and 2012 was analyzed with JoinPoint regression model and estimated annual percentage change (EAPC) was calculated. 5-year survival rate was calculated with Kaplan-Meier model. Results: There were 8 229 esophageal cancer cases in Linzhou during 2003-2012. The average annual incidence rate was 80.08/100 000 (8 229/10 276 481). Among all esophageal cancer cases, 7 019 (85.3%) were diagnosed as esophageal squamous cell carcinoma (ESCC). In Linzhou, the age standardized incidence rate by Chinese standard population and by world standard population was 80.92/100 000 and 81.85/100 000 in 2003, 67.97/100 000 and 68.63/100 000 in 2012. JoinPoint regression model showed that EAPC was-12.9% (95%CI:-16.4%--9.1%) for other and unspecified histological type between 2003 and 2012. The EAPC was-5.5% (95%CI:-9.2%--1.6%) for esophageal cancer between 2007 and 2012,-5.4% (95%CI:-7.0%--3.9%) for esophageal cancer in female between 2006 and 2012,-4.9% (95%CI:-9.5%--0.1%) for ESCC between 2007 and 2012. The 5-year prevalence of esophageal cancer was 215.49 per 100 000 (2 337/1 084 493), and 5 489 died within 5 years after incidence. 5-year survival rate of esophageal cancer was 34.6% (95%CI: 33.5%-35.6%). Conclusion Esophageal cancer had a decreasing trend in Linzhou. The survival rate was increasing. But, esophageal cancer was still a major burden in Linzhou. The major histological type was ESCC. ESCC had a similar decreasing trend with esophageal cancer.

Objective:To describe the cancer incidences and mortalities in Henan cancer registries in 2013.Methods:Registration data were evaluated according to the criteria of quality control of cancer registry,and the qualified data were analyzed based on areas(urban/rural), gender,age and cancer sites.The age-standardized rates were applied according to Segi's population and the fifth Chinese population census in 2000.Results:The total coverage of population from 19 qualified cancer registries data was 16,225,815(15.13%),Among which,8,370, 772(51.59%)were males and 7,855,043(48.41%)were females;and 2,819,817(17.38%)live in urban areas and 13,405,998(82.62%) live in rural areas.The crude incidence rate in Henan was 250.34/105(males:264.35/105,females:235.42/105),whereas the age-standardized incidence rates by Chinese standard population and by world standard population were 208.66/105and 207.25/105,respectively.The cumulative incidence rate(0-74 years old)was 24.31%.The cancer mortality in Henan was 161.05/105(males:185.50/105,females:134.98/105),whereas the age-standardized mortality by Chinese standard population and by world standard population were 131.18/105and 131.52/105,respectively.The cumulative mortality rate(0-74 years old)was 15.05%.Cancer incidence and mortality rates were increasing by age, reaching the peak values at 80 age group and 85 plus age group,respectively.Lung cancer,gastric cancer,esophageal cancer,liver cancer and colorectal cancer were the most common cancers ranked by the incidence rate,and the most common cause of cancer death was lung cancer,followed by gastric cancer,esophageal cancer,liver cancer and colorectal cancer.Incidence rate and mortality rate of breast cancer ranked the first and the fifth among the females,respectively.Conclusion:Cancer incidence and mortality rates were higher in the rural areas and in males than in the urban areas and in females.Lung cancer,digestive system cancers,and female breast cancer are the major cancer types that require attention for the prevention and control in Henan.

Objective To explore the influence of health education and treatment compliance on COPD patients' outcome.Methods 258 subjects (186 males,72 females,average age 75.2±8.5 years) were enrolled from patients diagnosed with COPD between June 2013 to June 2014 in huashan hospital north compus.Study began in July 2014,health condition assessment and grading、telephone follow-up and education were performed once every half a year together with COPD lectures,the number of patients participated in education sessions,and status of smoking cessation,exercise\home oxygen therapy and medication were recorded as indicators for health education compliance.Clinic/hospital stay and cost,condition change were also recorded.The study ended in December 2015 with final assessments of conditions and classification of patient outcome.Multiple logistic regression was used to analyze factors influencing the COPD patient's outcome;Independent sample t test was applied to compare different compliance in patients with outpatient and hospitalization per-time cost difference.Results Higher reimbursement ratio,the better adherence for health education,no complications and the low grade of disease classification at the beginning of the study were protective factors (OR=10.35,2.147,5.791,4.51,P＜0.05);Underweight to normal weight,5 times or more acute attacks during during the study,poor health education compliance were risk factors for disease progression (OR=0.031,0.131,0.010,P＜ 0.05);Never exercise and never participating in health education management are the risk of illness/death((OR=6.793,P=0.005,95％CI:1.766～26.125) vs.(OR=11.872,P=0.002,95％CI:2.525～55.815));for mild COPD patients,these never participating in health education management had a higher per hospitalization than patients with health education management (6 619 yuan,t=2.681,P=0.010).The outpatient cost of more severe COPD patients who are smoking or quitted smoking in less than 5 years was higher than these quitted smoking more than 5 years (985 yuan,t=-2.225,P=0.028).Conclusions Health education management can help medical staff to provide guidance to patients to quit smoking,encouraging the regular use of home oxygen therapy,doing more exercise,taking prescription of preventive drugs,these will in turn improve patient compliance for disease control and prevention.These efforts can effectively slow disease progression and improve patient outcomes,reduce medical costs,reduce the burden of the family and society.

Objective: To evaluate effect of screening of esophageal cancer though comparing difference of survival level between screening and non-screening patients in Linzhou city. Methods: The records pathologically diagnosed as serious hyperplasia/carcinoma and esophageal cancer were drawn from database of first round screening in Linzhou city from 2005-2013 and were assigned to the screening group. The records of new esophageal cancer cases which diagnosed within 2 years before, screening from the same village aged from 40 to 69, were drawn from database of cancer registry in Linzhou city and were assigned to the non-screening group. Five or 10 year survival rate with 95%CI of patients with different malignant degree diseases in the screening group and the patients with esophageal cancer in the non-screening group was calculated respectively. The survival curves between the screening and non-screening group were compared by Log rank method. Results: All 26 908 persons were examined in first round screening in Linzhou city from 2005 to 2013. There were 374 persons with serious hyperplasia/carcinoma in situ, 157 persons with esophageal cancer (141 intramucosal carcinomas/submucosal cancers, 16 invasive cancers). The 5 year survival rate of serious hyperplasia/carcinoma, intramucosal carcinoma/submucosal cancer and invasive cancer were 95.0% (95%CI: 91.7%-97.0%) , 72.0% (95%CI: 62.7%-79.3%) and 41.7% (95%CI: 17.4%-64.6%) separately. The 5 year survival rate of esophageal cancer in screening and non-screening group were 68.7% (95%CI:59.9%-75.9%) and 40.8% (95%CI: 36.4%-45.2%). The 10 year survival rate of esophageal cancer in screening and non-screening group were 58.0% (95% CI: 44.6%-69.3%) and 34.3% (95% CI:29.1%-39.5%). The 5 or 10 year survival rate of esophageal cancer in the screening group were higher than that in the non-screening group in whatever sex or age. The survival distribution of the screening group was better than non-screening group (χ²=38.88, P<0.001). Conclusion More precancerous lesions and early esophageal cancer can be detected and patients' survival level was improved through organized esophageal cancer screening, which provided support to evaluate value of organized screening.

【Objective】 To establish reference intervals for serum soluble transferrin receptor (sTfR) and sTfR/log serum ferritin index (sTfR/lgSF) in apparently healthy adults in the Wuhan area, so as to provide reference for clinical diagnosis and treatment of iron deficiency and iron-deficiency anemia. 【Methods】 A total of 273 individuals from the Wuhan Aisa General Hospital, including health examination participants and blood donors, were selected to measure sTfR, other iron metabolism indicators and high sensitivity C-reactive protein(hsCRP). The sTfR/lgSF values were calculated and reference intervals for sTfR and sTfR /lgSF were established using the percentile method (P2.5 to P97.5). Spearman correlation analysis was used to evaluate the relationships between sTfR, sTfR/lgSF, and other iron metabolism indicators, as well as hsCRP. 【Results】 The sTfR levels (M, mg/L) between males and females (1.01 vs 1.07) were not statistically significant (P>0.05), but the sTfR/lgSF levels if males were significantly lower than those in females (0.45 vs 0.62)(P<0.05). There was no significant difference in sTfR (M, mg/L) and sTfR/lgSF (M) among different age groups, with values of 1.07 vs 1.02 vs 1.00 and 0.52 vs 0.53 vs 0.51, respectively(P>0.05). The reference interval for STfR was (0.72-1.68) mg/L, the sTfR/lgSF reference interval was (0.31-0.88) for males, and (0.37-1.19) for females. Correlation analysis showed no correlation between sTfR, sTfR/lgSF and hsCRP (r=0.043, P>0.05; r=-0.064, P>0.05), while serum ferritin(SF), serum iron(SI), transferrin saturation(TSAT)were correlated with hsCRP (r=0.128, P<0.05; r=-0.195, P<0.01; r=-0.173, P<0.01).There was no correlation between sTfR and SF (r=-0.115, P>0.05), while sTfR/lgSF was significantly correlated with and SF (r=-0.685, P<0.01). 【Conclusion】 Preliminary reference intervals for serum sTfR and sTfR/lgSF in apparently healthy adults in the Wuhan has been established. sTfR and sTfR/lgSF are not affected by inflammatory factors and are significant for identifying iron deficiency in anemia patients with elevated serum ferritin caused by inflammation.

Objective: To evaluate the efficacy of lung cancer screening in urban areas of Henan province by low-dose computed tomography (LDCT) from 2013 to 2017. Methods: A cluster sampling method was used to select the residents of 40-74 years old in Henan province to investigate the risk factors and conduct lung cancer risk assessment. Subjects with high risk of lung cancer received LDCT for screening. Results: A total of 179 002 residents completed the lung cancer risk assessment, and 35 672 subjects were identified as high risk of lung cancer, with a high risk rate of 19.93%. A total of 13 383 subjects with high risk received LDCT, and the screening rate was 37.52%. There were 786 cases diagnosed as positive nodules, and the detection rate was 5.87%. Among them, 755 cases of solid/partial solid nodule were ≥5 mm, 23 cases of non-solid nodules were ≥8 mm, 8 cases were intratracheal nodules, and 115 cases were diagnosed as suspicious lung cancer. The detection rate in males was 6.74%, which was higher than 5.02% in females. The detection rate was positively related with age (P<0.05). Conclusions The application of LDCT is a useful screening method which can elevate the early detection rate of positive nodules and other related diseases in lungs. In the future, males and older populations should be paid more attention to improve screening efficacy.