Objective To evaluate the prognostic factors affecting recurrence,progression,bladder preservation,metastasis and cancer specific survival in patients with primary superficial transitional cell carcinoma of bladder. Methods Using Kaplan Meier method,Log rank test and Cox proportional hazards model,the retrospective survival analysis was performed in 198 patients with primary superficial transitional cell carcinoma of bladder. Results The mean follow up period was 79.76 months.The recurrence rates at 3 ,5 ,10 year were (28.75?0.78)%,(35.70?0.16)%,and (42.83?0.00)%,respectively.The main variables affecting recurrence were the duration of symptoms,histological grades and intra operative blood transfusion.The progression rates at 3 ,5 ,10 year were(8.89?0.33)%,(15.16?0.16)%,and (23.88?0.00)%,respectively.The main variables affecting progression were intra operative blood transfusion,histological grades,the number of reexaminations and recurrence free period (RFP).The rates of bladder preservation at 3 ,5 ,10 year were(94.68?0.23)%,(93.87?0.00)%,(91.51?0.00)%,respectively. The main variable affecting bladder preservation was RFP. The metastasis rates at 3 ,5 ,10 year were (8.25?0.22)%,(11.24?0.00)%,(28.94?0.00)%,respectively.The main variables affecting metastasis were tumor multifocality, hydronephrosis,microscopic growth pattern and RFP. The cancer specific survival at 3 ,5 ,10 year were (95.02?0.00)%,(90.70?0.46)%,(77.14?1.06)%,respectively.The variables that could predict cancer specific survival were microscopic growth pattern and RFP. Conclusions By cancer specific survival analysis of the follow up data,we can well identify the main prognostic factors from numerous ones,and also can design the therapeutic and follow up strategies for primary superficial transitional cell carcinoma of bladder.

Objective To investigate the infection of hemorrhagic fever with renal syndrome (HFRS) in host animals and inapparent infection of HFRS in general population in Dongting Lake areas after floods. Methods The night trapping method was used to capture rodents. The immunofluorescence assays were used to detect the hantavirus (HV) antigens and antibodies in rodents lung and in the serum of general population. Nonconditional logistic regression was applied to analyze risk factors for inapparent infection with HV. Results In flood region,draw-near flood region and new migration region,rodent density was 6.95%,6.28%, and 8.67%, respectively, and the virus-carrying rate in rodents was 15.07%,9.25%, and 4.47%, respectively. The virus-carrying rat index was the highest in flood region (0.10). Apodemus agrarius was the dominant species. The standardized positive rate of HV antibody in general population from above mentioned regions was 4.49%, 3.11%, and 3.13%, respectively. There was no significant difference among different age or gender groups. The results of logistic regression analysis indicated that people who were involved in construction of water conservancy facilities in winter or practice of rat extermination at home were the principal factors related to inapparent infection with HV. Conclusion The virus-carrying rate in main host animals of HV in the 3 regions is high, whereas the positive rate of HV antibody is low in general population. Comprehensive measures should be taken to prevent and control HFRS, such as reinforcing surveillance of HFRS, strengthening deratization, and preventive inoculation.

OBJECTIVE: To describe the attitude of elementary and middle school students and their parents toward children affected by HIV/AIDS and to analyze the determinants of such attitude. METHODS: A cross-sectional study with the stratified cluster sampling method was conducted to interview elementary and middle school students and their parents, and questionnaires were distributed to collect information about the basic characteristics, HIV/AIDS knowledge and attitude toward children affected by HIV/AIDS. Student's t-test, ANOVA and multilevel model were used to analyze the data. RESULTS: A total of 732 students and their parents finished the questionnaires. The students' and parents' awareness rates were 77.56% (95% CI: 63.08% - 92.05%)and 81.76% (95% CI: 72.33% - 91.20%), respectively. Questions with the lowest proportion of positive attitude included separating the children affected by HIV/AIDS and not studying with those children in the same class. Gender (b =-1.15, P =0.016) and knowledge (b =1.26, P <0.001) of students, as well as attitude (b =0.40, P <0.001) of parents were associated with the students' attitude, while parents' knowledge (b =0.93, P <0.001) was associated with parents' attitude. CONCLUSION Discrimination towards children affected by HIV/AIDS exists among students and their parents. HIV/AIDS knowledge education helps to improve the students' and parents' caring and supporting attitude toward children affected by HIV/AIDS.
Acquired Immunodeficiency Syndrome ; psychology ; transmission ; Adolescent ; Child ; China ; Female ; HIV Infections ; psychology ; transmission ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Parents ; psychology ; Sampling Studies ; Social Environment ; Students ; psychology ; Surveys and Questionnaires

OBJECTIVE: To evaluate the efficacy of health education on patients with hip replacement based on the Internet, and to establish a new health education model through modern technology. METHODS: A total of 300 patients with hip replacement from March to August, 2015 were enrolled in this study. The participants were divided into a control group and an experimental group according to months surgeries performed. Traditional education was applied in the control group while the multimedia source material plus the Internet platform of Joint Registration System were applied in the experimental group. Levels of anxiety, degree of satisfaction, and postoperative complications were analyzed. RESULTS: The levels of knowledge, attitude and behavior compliance in the patients of the experimental group were significantly improved, while the levels of postoperative anxiety were decreased compared with those in the control group (P<0.05). CONCLUSION Education based on the Internet platform of Joint Registration System and the computer video could improve patients' knowledge, attitude, and behavior, which is worthy of clinical spread.
Anxiety ; Arthroplasty, Replacement, Hip ; Humans ; Internet ; Multimedia ; Patient Compliance ; Patient Education as Topic

Objective To evaluate the association between organophosphorus pesticides and aplastic anemia,and provide scientific evidence for the primary prevention of aplastic anemia.Methods The published papers of case control studies on the association between organophosphorus pesticides and aplastic anemia from January 1990 to August 2014 were collected from Chinese BioMedical Literature Base (CBM),Chinese National Knowledge Infrastructure (CNKI),PubMed and EMBASE.The papers which met the inclusion criteria were evaluated.The pooled odds ratios (OR) and 95％ confidence interval (CI) of organophosphorus pesticides were calculated with software Review Manager 5.0.Subgroup analysis were conducted for different population and different usage of organophosphorus pesticides.Results A total of 9 papers were selected,involving 5 833 subjects (1 404 cases and 4 429 controls).The results showed that organophosphorus pesticides could increase the risk of aplastic anemia (OR=1.97,95％ CI:1.60-2.44).Subgroup analysis showed that Asian (OR=2.01,95％CI:1.52-2.66) had higher risk of aplastic anemia than American or European(OR=1.93,95％CI:1.39-2.67).Using pure organophosphorus pesticides (OR=2.15,95％ CI:1.60-2.88) was more prone to cause aplastic anemia than using the mixture of organophosphorus pesticides (OR=1.82,95％ CI:1.34-2.47).Conclusion The analysis indicated that organophosphorus pesticides might be a risk factor for aplastic anemia.Reducing organophosphorus pesticides exposure in daily life and industrial or agricultural production could prevent the incidence of aplastic anemia.

Objective:To analyze the prevalence and influential factors for asthma among adults in Chinese.Methods:Chinese residents aged ≥ 18 years in 12 regions were enrolled to estimate the prevalence of asthma in adults with different characteristics.Multivariate logistic regression analysis were adopted to determine the influential factors for asthma based on the China Health and Nutrition Survey in 2009 and 2011.Results:The prevalence of asthma was 1.25％ (95％CI 1.06％ to 1.43％) among the entire adult population in China.There were significant differences in terms of age,gender,regions,city and countryside,smoking,body mass index (BMI),education levels,marriage and subjective wellbeing (SWB)(all P＜0.05).Compared with normal people,the risk of asthma complicated with hypertension,diabetes,myocardial infarction and stroke was significantly increased (P＜0.01).The multiple logistic regression analysis showed that the influential factors for asthma included age (OR=1.042,95％CI 1.032 to 1.053),gender (male OR=1.533,95％CI 1.080 to 2.167),regions (Beijing OR=2.470,95％CI 1.155 to 5.308),urban area (OR=1.355,95％CI 1.026 to 1.786),BMI (OR=1.021,95％CI 1.000 to 1.037),smoking (OR=1.428,95％CI 1.028 to 1.989),drinking (OR=0.711,95％CI 0.976),education level (OR=0.964,95％CI 0.930 to 0.999),poor short-term health status (OR=5.295,95％CI 4.055 to 6.934),well-being (lowest OR=2.219,95％CI 1.272 to 3.887),playing games (OR=2.732,95％CI 1.023 to 6.088) and watching TV (OR=1.695,95％CI 1.036 to 2.941).Conclusion:Adult asthma is associated with multiple factors including age,gender,lifestyle,social environment,etc.

OBJECTIVE: To investigate the infection of leptospirosa of host animals and the immune level of healthy population in flood areas. METHODS: Korth culture was used to culture leptospira for rodent kidney and oxen urine sample. The serogroups of leptospira and leptospira antibody were tested by microscopic agglutination test (MAT). RESULTS: In flood regions, draw-near-flood region, and new migration region, rodent density was 6.95%, 6.28%, and 8.67%, respectively. The positive rates of rodent with leptospira was 4.63%, 1.35%, and 3.13%, respectively. Leptospira positive rates of oxen urine were 5.88%, 5.98%, and 1.75%, respectively. The main serogroup of leptospira was Icterhamorrhagic and Canicola serogroup. The positive rates of leptospirosa antibody in healthy population was 45.91%, 62.30%, and 58.67%in these 3 regions respectively, which was significantly higher than the average level in China. The dominant serogroups of leptospira in health population were icterhamorrhagic, autumnalis, canicola, pomona and bataviae. The positive rate of antibody had no difference among different age groups. CONCLUSION The main host animals are rodents and oxen infected with leptospira and the positive rate of leptospira antibody is high in healthy population in the study area. The dominant serogroups in host animals are similar to that in healthy population, which is mostly icterhaemorrhagic.
Animals ; Antibodies, Bacterial ; blood ; urine ; Cattle ; China ; epidemiology ; Disasters ; Floods ; Humans ; Leptospira interrogans ; immunology ; isolation & purification ; Leptospirosis ; epidemiology ; Prevalence ; Rats ; Seroepidemiologic Studies

OBJECTIVE: To estimate the benefit and cost of increasing the coverage of cervical cancer screening. METHODS: Using an eleven year conventional screening data (universal strategy) and a representative population sample (expanding strategy) to analyze the health and economic impact. RESULTS: The screening coverage for all 30-59 women in Liuyang was increased from 7.20% to 66.67%. Early detection cases were increased from 20 to 45, and life years saved in one screening term increased from 103.46 years to 925.83 years with expanding strategy as compared with the conventional strategy. The incremental cost per life year saved was 6 917.07 Yuan. The benefit/cost ratio was 1.80:1 at the screening coverage of 66.67%, which was higher than that of the conventional strategy (1.40:1). Both strategies were cost-effective. CONCLUSION With various uncertainties and data limitations, expanding screening coverage is more effective than conventional strategy, and more benefit is obtained when the number of early detection cases increases.
Adult ; China ; Cost-Benefit Analysis ; Female ; Humans ; Mass Screening ; economics ; Middle Aged ; Uterine Cervical Neoplasms ; pathology ; prevention & control ; Vaginal Smears

OBJECTIVE: To compare the efficacy of proximal femoral nail anti-rotation (PFNA) versus dynamic hip screw (DHS) in the treatment of trochanteric fractures in adults. METHODS: Reports of studies using randomized controlled trials (RCT) to compare PFNA with DHS in the management of intertrochanteric fractures were retrieved (up to December 5, 2011) from the Cochrane Library, MEDLINE, Elsevier, the Chinese Biomedical Database, Wanfang Data,and manually. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman? 5.0 was used for data-analysis. RESULTS: Thirteen RCTs involving 958 cases were included in the Meta-analysis. The results showed that, compared with DHS, PFNA significantly decreased the duration of surgery [WMD = -21.38, 95%CI (-33.05,-9.26), P<0.05], intra-operative blood loss [WMD = -176.36, 95%CI (-232.20, -120.52), P<0.05], the rate of post-operative complication [RR=0.46, 95%CI (0.31, 0.70), P<0.05], the rate of post-operative fixation failure[RR=0.27, 95%CI(0.11,0.62), P<0.05]. CONCLUSION PFNA for intertrochanteric fractures is superior to DHS in regards to the mean duration of surgery, mean intra-operative blood loss, the rate of post-operative complication, and the rate of post-operative fixation failure. But there is not enough evidence to show any difference between PFNA and DHS in regards to the mean duration of hospital, the mean duration of fracture healing, the rate of post-operative fracture, the rate of post-operative coxa vara, the rate of postoperative superficial wound infection, the rate of other post-operative complications or the Harris score after surgery.
Blood Loss, Surgical ; statistics & numerical data ; Bone Nails ; Bone Screws ; China ; epidemiology ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Hip Fractures ; surgery ; Humans ; Postoperative Complications ; epidemiology ; Randomized Controlled Trials as Topic

OBJECTIVE: To establish the evaluation index system for equalization of basic public health services and to test its value in practice. METHODS: We developed the index system through expert scored evaluation and then chose a city in Hunan for the research object. The sources of data and the methods of collection for each indicator were identified. The reliability and validity of index system was tested. The methods of AHP (analytic hierarchy process) and TOPSIS (technique for order preference by similarity to an ideal solution) were applied to comprehensively evaluate the public health services among nine counties in the city. RESULTS: The Cronbach's alpha coefficient, which described reliability test result on evaluation index system for equalization of basic public health services, was 0.750. The cumulative contribution rate reached 89.32% after validity test with extraction of 5 common factors through factor-analysis. The sorting results from AHP or TOPSIS method are very close except two districts. CONCLUSION Evaluation index system for equalization of basic public health services established in this study is in good validity and reliability, which can be objectively applied to analyze the current status of basic public health services.
China ; Health Services ; standards ; Health Services Research ; Public Health ; Reproducibility of Results ; Surveys and Questionnaires