OBJECTIVETo introduce statistical methods of time trend analysis on cancer rates.

METHODSCancer incidence data collected by the Shanghai Cancer Registry during 1991 to 1999 was used in the analysis to calculate the crude and age-adjusted rates, percent changes (PCs) and annual percent changes (APCs). APCs were estimated by a linear regression of the logarithm on the incidence rates during the nine years. It also introduced a method for partitioning a linear trend in age-adjusted rates into site-specific contributions to the overall floating trend. 95% confidence intervals for the APCs and contributions were described in the paper.

RESULTSA decreasing rates were observed for cancers of stomach and esophagus among both men and women in urban Shanghai from 1991 to 1999. The increasing rates among men would include cancers of colon, rectum, gall bladder, pancreas, prostate, urinary bladder, kidney and leukemia. The rates of cancers among women increased for colon, rectum, lung, breast, gall bladder, endometrium, ovary, urinary bladder and kidney. The changes of above cancers over time were statistically significant (P < 0.05 or P < 0.01), but rates for other cancer sites changed little. The APCs (weighted method) and contributions for the cancers of stomach, esophagus, colon, rectum and prostate were -2.99% and -65.72%, -2.90% and -17.07%, 12.30% and 21.46%, 2.94% and 18.62%, and 3.11% and 15.09% among men, and -6.05% and -39.55%, -1.08% and -35.19%, 2.81% and 28.64%, and 3.69% and 15.70% for the cancers of stomach, esophagus, breast and colon in women, respectively.

CONCLUSIONAPC, and related statistics could be used to describe and analyze the time trend of cancer rates rather than PC or/and graphical method alone.

Algorithms ; China ; epidemiology ; Female ; Humans ; Incidence ; Linear Models ; Male ; Neoplasms ; epidemiology ; Time Factors

Objective To discuss the influence of solution-focused approach on self-management ability of patients with maintenance hemodialysis , so as to provide objective evidence for improving nursing quality . Methods One hundred and twenty patients with maintenance homodialysis ( MHD) were randomly divided into 2 groups: the observation group and the control group , each with 60 cases.Both groups received health education and conventional treatment during dialysis , and the control group received traditional nursing while the observation group adopted solution-focused approach .Patients ’ knowledge about hemodialysis and changes of their self-management ability were evaluated after 6 months in both groups .Results After nursing with solution-focused approach , compared to control group , scores of hemodialysis related knowledge of patients in observation group were significantly higher, including dry weight concept [(4.03 ±0.84) vs (3.51 ±0.81)], self-monitoring [(15.21 ±1.58) vs (14.26 ±1.45)], dietary [(18.16 ±1.98) vs (18.90 ±1.84)], prevention of complications [(19.81 ±1.53) vs (18.68 ±1.32)], emergency medical procedure [(14.13 ±1.71) vs (14.90 ±1.68)], and total score [(76.18 ±3.73) vs (74.0 ±3.16)](t =-3.42, -3.41, 2.10,-4.33, 2.44, -3.46; P<0.05).Scores of self-management of patients in observation group , including regular dialysis [(11.47 ±1.53) vs (10.88 ±1.64)], sensible diet [(13.73 ±1.93) vs (12.95 ±1.92)], compliance [(11.33 ±1.59) vs (10.50 ±1.63)], appropriate physical activity [(11.57 ±1.34) vs (10.80 ±1.57)], nursing of arteriovenous fistula [(18.88 ±1.74) vs (17.53 ±1.91)], and total score [(69.35 ±4.12) vs (64.83 ±4.39)] were also significantly higher than that in control group (t=-2.01, -2.23, -2.83, -2.87, -4.03, -5.80; P <0.05).Conclusions Application of solution-focused approach can improve the self-management ability and treatments compliance of maintenance homodialysis patients, as well as their nursing efficiency .

Objective:To investigate the prevalence of thyroid nodule in middle-aged and elderly people in Heilongjiang Province, and to analyze its epidemiological characteristics and influencing factors.Methods:From December 2017 to December 2018, middle-aged and elderly people aged 40-70 years old were recruited through probability proportional sampling (PPS) method for a cross-sectional survey. The respondents were stratified by age (40-49, 50-59, 60-70 years old), urine samples were collected at random once during the day, and urinary iodine was detected by arsenic-cerium catalytic spectrophotometry (WS/T 107.1-2016). At the same time, questionnaire surveys and thyroid ultrasound examinations were conducted on the respondents. Logistic regression was used to analyze the relationship between the related investigation factors and the thyroid nodule.Results:A total of 2 771 middle-aged and elderly people were included, and their age was (54.32 ± 8.24) years old. The median of urinary iodine was 157.04 μg/L, which was an iodine appropriate level. The prevalence of thyroid nodule was 43.63% (1 209/2 771), and the prevalence increased with age(χ 2trend=49.400, P < 0.01). The prevalence of thyroid nodule in females [46.98% (917/1 952)] was significantly higher than that in males [35.65% (292/819), χ 2=30.082, P < 0.01]. In patients with thyroid nodule, small nodule accounted for 57.65% (697/1 209), large nodule accounted for 42.35% (512/1 209), and the proportion of large nodule increased with age (χ 2trend=18.751, P<0.01). Solitary nodule accounted for 42.76% (517/1 209), multiple nodule accounted for 57.24% (692/1 209), and the proportion of multiple nodule increased with age(χ 2trend=18.437, P<0.01). Cystic-solid nodule was the most common[47.97%(580/1 209)], followed by solid nodule [44.25% (535/1 209)], and cystic nodule was the least common [7.78% (94/1 209)]. Logistic regression analysis showed female [odds ratio ( OR)=1.868, 95% confidence interval ( CI): 1.538-2.269, P < 0.01], age (50-59 years old: OR=1.258, 95% CI: 1.020-1.550, P < 0.05; 60-70 years old: OR=1.762, 95% CI: 1.407-2.207, P < 0.01), overweight ( OR=1.303, 95% CI: 1.078-1.574, P < 0.01), hypertension ( OR=1.332, 95% CI: 1.037-1.712, P < 0.05), and diabetes ( OR=1.604, 95% CI: 1.077-2.387, P < 0.05) were independent risk factors affecting the occurrence of thyroid nodule in middle-aged and elderly people. Conclusions:The epidemiological characteristics of thyroid nodule in middle-aged and elderly people in Heilongjiang Province have obvious age trends and gender differences. The proportion of large nodule and multiple nodule increase with age. Early screening and attention to the prognosis of women, older, overweight, hypertension and diabetes people should be strengthened.

As a new concept in clinical research,the real world research(RWR) has attracted the attention of researchers in the world with its unique advantages. This research mainly analyzed it through visual methods,the specific steps were as follows. Firstly,the Chinese Biomedical Literature Database,China National Knowledge Infrastructure,Wan Fang Database,Medline and EMbase were searched and RWS were included,414 articles in Chinese and 2 158 articles in English were included in this research after layer-bylayer screening; secondly,the main information was extracted and sorted by BICOMS 2 software and generated its co-occurrence matrix; the network relationship diagram was drawn by Net Draw software; the cluster analysis was carried out by using g CLUTO software;finally,this research results show that the numbers of domestic and foreign literatures have shown an overall growth trend,but compared with foreign countries,China's research on the real world started late,the overall strength of research was not as good as abroad;and the domestic and foreign research on the real world was uneven in the region,the research in China was mainly distributed in developed provinces and cities,such as Beijing,Guangdong,Shanghai,etc,and there was a lack of close cooperation between provinces and cities; the foreign research are mainly distributed in developed countries such as the United States,the United Kingdom,Germany,et al; the cooperation between countries was relatively close. And the hotspots and core directions of domestic and foreign research were also different. This research was intended to provide reference for the further research of Chinese researchers through the current description of the themes and capability of the real world research in the world.
China ; Databases, Bibliographic ; Germany ; Research ; trends ; United Kingdom ; United States

Background: Disease-modifying therapy is the standard treatment for patients with multiple sclerosis (MS) in remission. The primary objective of the current analysis was to assess the efficacy and safety of two teriflunomide doses (7 mg and 14 mg) in the subgroup of Chinese patients with relapsing MS included in the TOWER study. Methods: TOWER was a multicenter, multinational, randomized, double-blind, parallel-group (three groups), placebo-controlled study. This subgroup analysis includes 148 Chinese patients randomized to receive either teriflunomide 7 mg (n = 51), teriflunomide 14 mg (n = 43), or placebo (n = 54). Results: Of the 148 patients in the intent-to-treat population, adjusted annualized relapse rates were 0.63 (95% confidence interval [CI]: 0.44, 0.92) in the placebo group, 0.48 (95% CI: 0.33, 0.70) in the teriflunomide 7 mg group, and 0.18 (95% CI: 0.09, 0.36) in the teriflunomide 14 mg group; this corresponded to a significant relative risk reduction in the teriflunomide 14 mg group versus placebo (-71.2%, P = 0.0012). Teriflunomide 14 mg also tended to reduce 12-week confirmed disability worsening by 68.1% compared with placebo (hazard ratio: 0.319, P = 0.1194). There were no differences across all treatment groups in the proportion of patients with treatment-emergent adverse events (TEAEs; 72.2% in the placebo group, 74.5% in the teriflunomide 7 mg group, and 69.8% in the teriflunomide 14 mg group); corresponding proportions for serious adverse events were 11.1%, 3.9%, and 11.6%, respectively. The most frequently reported TEAEs with teriflunomide versus placebo were neutropenia, increased alanine aminotransferase, and hair thinning. Conclusions: Teriflunomide was as effective and safe in the Chinese subpopulation as it was in the overall population of patients in the TOWER trial. Teriflunomide has the potential to meet unmet medical needs for MS patients in China. Trial Registration ClinicalTrials.gov, NCT00751881; https://clinicaltrials.gov/ct2/show/NCT00751881?term=NCT00751881&rank=1.
China ; Crotonates ; administration & dosage ; adverse effects ; therapeutic use ; Double-Blind Method ; Drug Administration Schedule ; Humans ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; therapeutic use ; Multicenter Studies as Topic ; Multiple Sclerosis ; drug therapy ; metabolism ; Proportional Hazards Models ; Toluidines ; administration & dosage ; adverse effects ; therapeutic use