BACKGROUND: Previous studies have found that nerve growth factors play an important role in the process of wound healing, but there is less research for the low-affinity nerve growth factor receptor p75 and sortilin in fibroblasts, and no reports on whether there are differences in expression of p75 and sortilin in the scar fibroblasts and normal skin fibroblasts. OBJECTIVE: To study the expression of low-affility nerve growth factor receptor p75 and sortilin in the normal human skin fibroblasts and the human keloid fibroblasts. METHODS: The keloid fibroblasts and normal hunman skin fibroblasts were cultured in vitro, and the immortalized epithelial cells HaCaT were used as the positive control. The real-time PCR was used to detect the mRNA expression of the p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts, and western blot and immunocytochemical staining were used to detect the protein expression of p75 and sortilin. RESULTS AND CONCLUSION: The real-time PCR and western blot results showed that in the protein and mRNA levels, p75 and sortilin showed positive expression in the keloid fibroblasts and normal human skin fibroblasts, and there was no significant difference in the expression of p75 between keloid fibroblasts and normal human skin fibroblasts, and the expressions of p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts were significantly lower than those in HaCaT. There was no significant difference of p75 expression between keloid fibroblasts and normal human skin fibroblasts, and the expression of sortilin in the keloid fibroblasts was significantly lower than that in the normal human skin fibroblasts (P < 0.05). Immunocytochemical staining result showed that the expression of p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts were distributed in the membrane and cytoplasm. Precursor nerve growth factor combined with high-affinity p75 receptor could promote the apoptosis of the cells with the help of sortilin, and the expression of sortilin in the keloid fibroblasts was significantly lower than that in the normal human skin fibroblasts, which may associated with the high proliferation of the keloid fibroblasts. The results provide a new target for the prevention and treatment of pathological scars.

OBJECTIVETo investigate the burden of infectious disease of the Chinese population in 1990 and 2010 and changing pattern in the past 20 years.

METHODSResults of the Global Burden of Disease Study 2010 (GBD 2010) were used to demonstrate the burden of infectious disease of the Chinese population in 1990 and 2010 and changing pattern from 1990 to 2010 by gender and age groups, including indicators of incidence, mortality, years of life lost due to premature mortality (YLL), years lived with disability (YLD), disability-adjusted life years (DALY), and their age-standardized rates using data of the 2010 National Census as a standard population.

RESULTSIn 1990 incidence, standardized incidence rate, mortality, standardized mortality rate, DALY, standardized DALY rate, YLL, standardized YLL rate, YLD, and standardized YLD rate of infectious disease in China were 3 067 469 200 cases, 242 669.34 cases/100 000, 824 300 cases, 72.27 cases/100 000, 58 937 700 person-years (PYRS), 3 992.85 PYRS/100 000, 46 504 100 PYRS, 2 932.99 PYRS/100 000, 12 433 600 PYRS, and 1 059.86 PYRS/100 000, respectively. All the aboved indicators were declined from 1990 to 2010, in 2010 they were 3 065 985 800 cases, 224 351.66 cases/100 000, 388 600 cases, 30.74 cases/100 000, 19 492 200 PYRS, 1 440.75 PYRS/100 000, 12 045 700 PYRS, 891.87 PYRS/100 000, 7 446 500 PYRS, and 548.89 PYRS/100 000, respectively. When 2010's indicators were compared to those in 1990, the rates of increase of incidence, incidence rate, mortality, mortality rate, DALY, DALY rate, YLL, YLL rate, YLD, and YLD rate were 56.84%, -9.85%, -33.07%, -61.54%, -27.68%, -58.42%, -32.46%, -61.17%, -16.75%, and -52.13% for 50-69 age group; for ≥ 70 age group, 57.90%, -5.86%, 7.41%, -36.12%, -5.00%, -43.51%, -5.14%, -43.59%, -4.52%, and -43.2%.

CONCLUSIONSThe burden of infectious disease of the Chinese population was declined from 1990 to 2010; however, the incidence of infectious disease was increased in ≥ 50 age groups.

Asian Continental Ancestry Group ; China ; Communicable Diseases ; Cost of Illness ; Disabled Persons ; Humans ; Incidence ; Mortality ; Quality-Adjusted Life Years ; Reference Standards

Adenovirus Infections, Human ; epidemiology ; Child ; China ; epidemiology ; Disease Outbreaks ; Female ; Humans ; Incidence ; Male ; Respiratory Tract Infections ; epidemiology ; virology

ObjectiveTo investigate related factors for stone recurrence after endoscopic minimally invasive gallbladder-preserving cholecystolithotomy, and to establish a nomogram model for predicting the risk of stone recurrence after surgery based on independent risk factors. MethodsA retrospective analysis was performed for the clinical data of 144 patients with gallstones who underwent endoscopic minimally invasive gallbladder-preserving cholecystolithotomy in Qinghai University Affiliated Hospital from January 2012 to January 2018, and according to postoperative stone recurrence, the patients were divided into non-recurrence group and recurrence group. The chi-square test was used for comparison of categorical data between two groups. LASSO and logistic regression analyses were used to analyze independent risk factors for postoperative stone recurrence, and the corresponding nomogram prediction model was plotted according to regression coefficient. The calibration curve was plotted to evaluate the reliability of the predictive nomogram; Harrell consistency index was used to quantify the discriminatory performance of the predictive nomogram; the receiver operating characteristic (ROC) curve was used to evaluate the sensitivity, specificity, and area under the ROC curve (AUC) of this predictive nomogram. ResultsAll 144 patients underwent successful endoscopic minimally invasive gallbladder-preserving cholecystolithotomy, among whom 14 patients (9.7%) experienced stone recurrence after surgery. The multivariate analysis showed that family history (odds ratio ［OR］= 3.245, 95% confidence interval ［CI］: 0.752-13567, P=0.104), regular diet (OR=3.752, 95% CI: 1.067-14.141, P=0.041), stone homogeneity (OR=5.871, 95% CI: 1636-25.390, P=0.010), and medication compliance (OR=0.225, 95% CI: 0.057-0.799, P=0.024) were independent risk factors for recurrence. The nomogram model had an index of concordance (C-index) of 0.835 (95% CI: 0.732-0.938) in the modeling sample and 0.7925 in the verification sample, suggesting that the nomogram model in this study had good accuracy and discrimination. The predictive nomogram had an AUC of 0.835, suggesting that this nomogram had a relatively high predictive value. ConclusionFamily history, regular diet, stone homogeneity, and medication compliance are independent risk factors for stone recurrence after endoscopic minimally invasive gallbladder-preserving cholecystolithotomy, and the nomogram constructed based on these independent risk factors may help to predict the risk of postoperative stone recurrence.

Multistage sampling is a frequently-used method in random sampling survey in public health.Clustering or independence between observations often exists in the sampling,often called complex sample,generated by multistage sampling.Sampling error may be underestimated and the probability of type Ⅰ error may be increased if the multistage sample design was not taken into considerationin analysis.As variance (error) estimator in complex sample is often complicated,statistical software usually adopt ultimate cluster variance estimate (UCVE) to approximate the estimation,which simply assume that the sample comes from one-stage sampling.However,with increased sampling fraction of primary sampling unit,contribution from subsequent sampling stages is no more trivial,and the ultimate cluster variance estimate may,therefore,lead to invalid variance estimation.This paper summarize a method of variance estimation considering multistage sampling design.The performances are compared with UCVE and the method considering multistage sampling design by simulating random sampling under different sampling schemes using real world data.Simulation showed that as primary sampling unit (PSU) sampling fraction increased,UCVE tended to generate increasingly biased estimation,whereas accurate estimates were obtained by using the method considering multistage sampling design.

OBJECTIVETo compare design-based and model-based methods in descriptive analysis of complex sample.

METHODSA total of 1 000 samples were selected and a multistage random sampling design was used in the analysis of the 2010 China chronic disease and risk factors surveillance. For each simulated sample, cases with probability proportional age were randomly deleted so that sample age structure was deviated systematically from that of the target population. Mean systolic blood pressure (SBP) and prevalence of raised blood pressure, as well as their 95% confidence intervals (95%CI) were determined using design-based and model-based methods (routine method and multi-level model). For estimators generated from those 3 methods, mean squared error(MSE) was computed to evaluate their validity. To compare performance of statistical inference of these methods, the probability of 95%CI covering the true parameter(mean SBP and raised blood pressure prevalence of the population) was used.

RESULTSMSE of mean estimator for routine method, design-based analysis and multilevel model was 6.41, 1.38, and 5.86, respectively; and the probability of 95%CI covering the true parameter was 24.7%, 97.5% and 84.3%, respectively. The routine method and multi-level model probably led to an increased probability of type I error in statistical inference. MSE of prevalence estimator was 4.80 for design-based method, which was far lower than those for routine method (20.9) and multilevel model (17.2). Probability of 95%CI covering the true prevalence for routine method was only 29.4%, and 86.4% for multilevel model, both of which were lower than that for design-based method (97.3%).

CONCLUSIONCompared to routine method and multi-level model, design-based method had the best performance both in point estimation and confidence interval construction. Design-based method should be the first choice when doing statistical description of complex samples with a systematically biased sample structure.

Blood Pressure ; China ; Humans ; Hypertension ; Models, Statistical ; Prevalence

Objective: To investigate the current status, temporal trend and achieving Health China 2030 reduction target of probability of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, tumour, diabetes, and chronic respiratory disease in China both at national and provincial level during 1990 to 2015. Methods: Using the results of Global Burden of Disease study 2015 (GBD 2015), according to the method of calculating premature mortality probability recommended by WHO, the current status and temporal trend by different gender from 1990 to 2015 were calculated, analyzed, and compared. Referring to " Health China 2030" target of reduction 30% of probability of premature mortality caused by major NCDs, we evaluated the difficulty of achieving the reduction target among provinces (not including Taiwan). Results: From 1990 to 2015, the probabilities of premature mortality in cardiovascular and cerebrovascular diseases, tumour, and chronic respiratory disease were all declined consistently for both men and women in China, the total of four main NCDs decreased from 30.69% to 18.54% with higher decreasing in women (from 25.97% to 12.40%) than that in men (from 34.94% to 24.19%). In 2015, the top five provinces in terms of probability of premature mortality caused by four main NCDs were Qinghai (28.81%), Tibet (25.88%), Guizhou (24.67%), Guangxi (23.56%), and Xinjiang (23.21%) in turn, while the top five provinces with the lowest probability were Shanghai (8.40%), Beijing (9.39%), Hong Kong (10.10%), Macao (10.31%), and Zhejiang (11.70%). If achieving the " Health China 2030" target, the probabilities of premature mortality in Qinghai and Tibet with the highest probability should decline to about 20.17%, and 18.12%, respectively in 2030, while 5.88%, and 6.57% in Shanghai and Beijing, respectively. From 1990 to 2015, the probability of premature mortality of four main NCDs declined by 2.00% a year on average, the top five provinces with the fastest decline were Beijing (3.48%), Shanghai (3.24%), Zhejiang (2.81%), Fujian (2.75%), and Guangdong (2.67%), and 11 provinces including these five provinces could achieve the " Health China 2030" target by the usual rate of decline, while other 22 provinces could not achieve the target, they need greater rate of decline in order to achieve the target. Conclusion From 1990 to 2015, the probabilities of premature mortality of four main NCDs were declined consistently in China both at national and provincial level, compared with women, the men had higher probabilities and declined slower, there were significant different in probabilities of premature mortality and their change speed among provinces. Based on the results from 1990 to 2015, there were about two thirds of the provinces, which the task of achieving the Health China 2030 target will be daunting.

Objective: To analyze the burden of disease attributable to low fruit intake among Chinese population aged ≥15 years old between 1990 and 2013. Methods: We used data from the 2013 Global Burden of Disease Burden of Disease Study to study the situation in China. The population attributable fraction was calculated to estimate and compare the death and disability-adjusted life years (DALY) attributed to low fruit intake between 1990 and 2013 in China (excluded Taiwan, China). An average world population age structure of the period 2000-2025 was adopted to calculate age-standardized rates. Results: Deaths attributable to low fruit intake accounted for 11.02% of all death in 2013, which were higher than it in 1990 (10.38%). In 2013, the number of deaths attributed to low fruit intake in China increased to 1 046 500 from 793 800 in 1990. From 1990-2013, the age-standardized death rate attributable to low fruit intake decreased from 113.04/100 000 to 79.80/100 000. DALYs caused by low fruit intake increased from 18.346 5 million in 1990 to 21.296 7 million in 2013. Compared with 1990, the age-standardized DALY rate attributed to low fruit intake decreased by 34.67%. In 2013, the top three provinces with the highest burden of disease attributed to low fruits intake were Tibet, Guizhou and Xinjiang provinces, with standardized DALY rate at 2 612.53/100 000, 2 281.85/100 000 and 2 198.22/100 000, respectively. Compared with the results in 1990, the standardized DALY attributed to low fruits intake decreased, especially in Tianjin, where decreased by 63.61%; followed by Aomen, Zhejiang, Shanghai and Beijing, where decreased by 59.74%, 59.53%, 56.64% and 53.88%, respectively. Conclusion Compared with the situation in 1990, the burden of disease attributable to low fruit intake decreased in 2013, but the situation is still serious, especially in Tibet, Guizhou and Xinjiang provinces, where the burden decreased comparatively slowly.

Objective: To estimate the impact of risk factors control on non-communicable diseases (NCDs) mortality, life expectancy and the numbers of labor force lost in China in 2030. Methods: We used the results of China from Global Burden of Disease Study 2013, according to the correlation between death of NCDs and exposure of risk factors and the comparative risk assessment theory, to calculate population attributable fraction (PAF) and disaggregate deaths of NCDs into parts attributable and un-attributable. We used proportional change model to project risk factors exposure and un-attributable deaths of NCDs in 2030, then to get deaths of NCDs in 2030. Simulated scenarios according to the goals of global main NCDs risk factors control proposed by WHO were constructed to calculate the impact of risk factors control on NCDs death, life expectancy and the numbers of labor force lost. Results: If the risk factors exposure changed according to the trend of 1990 to 2013, compared to the numbers (8.499 million) and mortality rate (613.5/100 000) of NCDs in 2013, the death number (12.161 million) and mortality rate (859.2/100 000) would increase by 43.1% and 40.0% respectively in 2030, among which, ischemic stroke (increasing by 103.3% for death number and 98.8% for mortality rate) and ischemic heart disease (increasing by 85.0% for death number and 81.0% for mortality rate) would increase most quickly. If the risk factors get the goals in 2030, the NCDs deaths would reduce 2 631 thousands. If only one risk factor gets the goal, blood pressure (1 484 thousands NCDs deaths reduction), smoking (717 thousands reduction) and BMI (274 thousands reduction) would be the most important factors affecting NCDs death. Blood pressure control would have greater impact on ischemic heart disease (662 thousands reduction) and hemorrhagic stroke (449 thousands reduction). Smoking control would have the greatest effect on lung cancer (251 thousands reduction) and chronic obstructive pulmonary disease (201 thousands reduction). BMI control would have the greatest impact on ischemic heart disease (86 thousands reduction) and hypertensive heart disease (45 thousands reduction). If the risk factors exposure changed according to the trend of 1990 to 2013, in 2030, the life expectancy of Chinese population would reach to 79.0 years old, compared to 2013, increasing by 3.3 years old, the labor force at the age of 15-64 years old would loss 1.932 million. If the risk factors get the goals in 2030, life expectancy would increase to 81.7 years old and the number of labor force lost would decrease to 1.467 million. Blood pressure, smoking and BMI control would have much greater impact on life expectancy (4.9, 4.0 and 3.8 years old respectively) and labor force lost (630 thousands, 496 thousands and 440 thousands respectively). Conclusion Risk factors control would play an important role in reducing NCD death, improving life expectancy of residents and reducing loss of labor force. Among them, the control of blood pressure raising, smoking and BMI raising would have a greater contribution to the improvement of population health status.

Objective: To investigate the prevalence of hypercholesterolemia among Chinese adults in different geographic areas, and to analyze the related factors. Methods: China Chronic and Non-Communicable Disease and Risk Factor Surveillance was conducted in 2013, based on 298 counties/districts in 31 provinces of Chinese mainland. The adults aged 18 years old were randomly selected using multi-stage stratified clustering sampling method. Information on chronic disease and risk factors was collected using face-to-face questionnaire interview and physical measurement. Blood samples were collected by local staffs. Serum total cholesterol (TC) was determined using standard method in a central laboratory. After excluding 565 participants missing key variables and 1 558 participants with abnormal TC values, a total of 174 976 participants were included. Weighted prevalence of hypercholesterolemia was calculated. Hypercholesterolemia related individual or geographic determinants were defined using multilevel logistic regression. Results: The prevalence of hypercholesterolemia in Chinese adults age 18 years old and above was 6.9% (95%CI: 6.4%-7.3%), ranged from 3.0% (95%CI: 2.5%-3.4%) in the northwest of China to 14.2% (95%CI: 12.9%-15.5%) in the south (χ²=183.42, P<0.001). The prevalence of hypercholesterolemia was higher in 6 provinces including Tianjin, Liaoning, Fujian, Guangdong, Guangxi, and Hainan (≥9.0%), but lower in 7 provinces including Shanxi, Shannxi, Gansu, Qinghai, Ningxia, Xinjiang, and Tibet (<3.9%). There was a 1.27 fold variation in hypercholesterolemia prevalence by provincial level, and 72.5% of the geographical variation in hypercholesterolemia prevalence was account for by area-level determinants. With multilevel logistic analysis, the individual risk factors associated with hypercholesterolemia included aging, higher education level or annual household income per capita, regular drinking, too much red meal intake, inactivity, overweight or obesity. For geographic factors, residents living at south China, counties/districts with higher urbanization rates, higher education level or lower standardized death rates were more likely to have hypercholesterolemia (all P<0.05). Conclusion The prevalence of hypercholesterolemia was high in Chinese adults, it was different between regions and related with characteristics of population, individual behaviors and geographical regions.