Objective: To analyze the effect of colorectal cancer screening in the general population in Guangzhou, and provide evidence for the for development of colorectal cancer screening policy and strategy. Methods: The data of colorectal cancer screening in Guangzhou during 2015- 2016 were collected. The participation, the positive rate of fecal occult blood test, the detection rate of colonoscopy and screening effect of colonoscopy were evaluated. Results: A total of 220 834 residents aged 50-74 years received the screening, and the positive rate of the screening was 16.77% (37 040 cases). Colonoscopy was performed for 7 821 cases (21.12%). Colorectal lesions were found in 4 126 cases (52.76%), of which 614 (7.85%) and 73 (0.93%) and 230 (2.94%) were identified as advanced adenoma, severe dysplasia lesions and colorectal cancers, respectively. The detection rates of all colorectal lesions were higher in men than in women (all P<0.01). The diagnostic rate of early lesion was 87.24%, and 99 early cancer cases were found, accounting for 46.26% of the total cases. The overall screening detection rate of colorectal cancer was 104.15/100 000, higher than the incidence rate (81.18/100 000) in colorectal cancer surveillance (P<0.001), but age group <70 years had higher detection rate, age group ≥70 years had higher incidence rate. Conclusions: The colorectal cancer screening strategy in Guangzhou is effective in the detection of the population at high risk, increase the detection rate of colorectal lesions, early diagnosis rate of precancerous lesions and diagnosis rate of early colorectal cancer. The benefit in those aged ≤69 years was more obvious than that in those aged 70-74 years. It is necessary to improve the compliancy of colorectal cancer screening in population at high risk.
Adenoma/prevention & control* ; Aged ; China/epidemiology* ; Colonoscopy/statistics & numerical data* ; Colorectal Neoplasms/prevention & control* ; Early Detection of Cancer/methods* ; Female ; Humans ; Immunochemistry ; Male ; Mass Screening/statistics & numerical data* ; Middle Aged ; Occult Blood ; Predictive Value of Tests

Objective: To explore the characteristics of distribution on Chinese adult body mass index (BMI) in different age groups and genders and to provide reference related to obesity and related chronic diseases. Methods: Data from the China Health and Nutrition Survey in 2009 were used. Sequential sample cluster method was used to analyze the characteristics of BMI distribution in different age groups and genders by SAS. Results: Our results showed that the adult BMI in China should be divided into 3 groups according to their age, as 20 to 40 years old, 40 to 65 years old, and> 65 years old, in females or in total when grouped by difference of 5 years. For groupings in male, the three groups should be as 20 to 40, 40 to 60 years old and>60 years old. There were differences on distribution between the male and female groups. When grouped by difference of 10 years, all of the clusters for male, female and total groups as 20-40, 40-60 and>60 years old, became similar for the three classes, respectively, with no differences of distribution between gender, suggesting that the 5-years grouping was more accurate than the 10-years one, and BMI showing gender differences. Conclusions: BMI of the Chinese adults should be divided into 3 categories according to the characteristics of their age. Our results showed that BMI was increasing with age in youths and adolescents, remained unchanged in the middle-aged but decreasing in the elderly.
Adolescent ; Adult ; Age Distribution ; Aged ; Asian People/statistics & numerical data* ; Body Mass Index ; China/epidemiology* ; Female ; Humans ; Male ; Middle Aged ; Nutrition Surveys ; Obesity/ethnology* ; Sex Distribution ; Sex Factors ; Young Adult

Objective: To understand the characteristics of HIV infected persons without long term disease progress [also known as long term non-progressors (LTNPs)], and related factors in Guangxi Zhuang Autonomous Region (Guangxi). Methods: Data of persons living with HIV and receiving no antiretroviral therapy in Guangxi by the end of 2016 were collected from the national HIV/AIDS comprehensive control and prevention information system of China. Results: By the end of 2016, there were 313 LTNPs in Guangxi, accounting for 2.3% of those being reported for more than 10 years, 5.4% of those being reported for more than 10 years and surviving, and 26.6% of those being reported for more than 10 years, surviving and receiving no antiretroviral therapy. Among the LTNPs, 87.2%(273) were men, 94.9% (297) were aged ≤ 40 years, 32.3% (101) were farmers, 55.6% (174) were single, divorced or widowed, 69.3% (217) were of Han ethnic group, 68.1% (213) were injecting drug users, and 52.1% (163) were from custody facilities. Multiple logistic regression analysis indicated that factors associated with delayed disease progression included age ≤40 years (compared with age >40 years, aOR=1.55, 95%CI: 1.31-3.12) and injection drug use (compared with sexual transmission, aOR=1.23, 95%CI: 1.10-1.74). Conclusions: A number of LTNPs existed in HIV-infected individuals in Guangxi. Further research are needed to identify the related factors, and it is necessary to conduct large sample size studies on host immunology, genetics and the virology of HIV to explore the related mechanism.
Adolescent ; Adult ; Age Distribution ; China/epidemiology* ; Drug Users/statistics & numerical data* ; Ethnicity/statistics & numerical data* ; HIV Infections/ethnology* ; Humans ; Male ; Socioeconomic Factors

Objective: To investigate the rates on prevalence, awareness, treatment and control of hypertension in population older than 15 years of age in Beijing, 2013-2014. Methods: A cross-sectional survey was conducted in Beijing between 2013-2014. Stratified multistage random sampling method was used to select representative sample of 13 057 Chinese individuals aged over 15 years, from the general population. Blood pressure was measured for three readings at sitting position after resting for at least five minutes with an average reading recorded. A standardized structured questionnaire was developed to collect history of hypertension and antihypertensive treatment. Results: A total of 4 663 community residents aged over 15 years were hypertensive among the 13 057 individuals, with the standardized prevalence rate as 32.7%, in Beijing area. The age-standardized prevalence rates of hypertension appeared 34.6% in men and 30.8% in women. The age-and sexstandardized prevalence of hypertension rates were 33.3% in urban and 24.6% in rural areas. The prevalence of hypertension increased with age and appeared higher in men than in women, in urban than in rural residents. Among the hypertensive patients, rates of awareness, treatment and control were 66.8%, 64.6% and 31.6%, respectively. Conclusion: High prevalence of hypertension with low rates on awareness and treatment and control, appeared in the general population of Beijing. Related strategies should be developed regarding prevention, control and management of hypertension, to reduce the burden of this disease.
Adolescent ; Adult ; Age Distribution ; Aged ; Antihypertensive Agents/therapeutic use* ; Asian People/statistics & numerical data* ; Awareness ; Blood Pressure ; Blood Pressure Determination ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hypertension/epidemiology* ; Male ; Middle Aged ; Prevalence ; Rural Population ; Sex Distribution ; Surveys and Questionnaires ; Urban Population ; Young Adult

Objective: To assess the implementation and impact of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases. Methods: Both sociological and epidemiological methods were used to collect qualitative and quantitative data in November and December, 2016 in order to conduct on process and outcome evaluation of the above mentioned objective. In the meantime, case study was also conducted. Results: All the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were found well implemented across the country, with health education and health promotion, surveillance and safeguard measures in particular. A government-led and inter-sector coordination and communication mechanism had been well established, with more than 16 non-health departments actively involved. 28.7% of the residents living in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were aware of the key messages related to chronic diseases. Among the residents, 72.1% of them consumed vegetables and 53.6% consumed fruits daily, with another 86.9% walked at least 10 minutes per day. Over 70% of the patients with hypertension or diabetes reported that they were taken care of by the Community Health Centers, and above 50% of them were under standardized management. Residents, living in the National Demonstration Areas under higher ranking of implementation scores, were more likely to be aware of relevant knowledge on chronic disease control and prevention (OR=6.591, 95%CI: 5.188-8.373), salt reduction (OR=1.352, 95%CI: 1.151-1.589), oil reduction (OR=1.477, 95%CI: 1.249-1.746) and recommendation on physical activities (OR=1.975, 95%CI: 1.623- 2.403). Conclusion: The implementation of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases had served a local platform for the control and prevention of non-communicable diseases, and thus become an important 'carrier' for chronic disease prevention and control programs in China.
China/epidemiology* ; Chronic Disease/epidemiology* ; Delivery of Health Care ; Health Promotion/organization & administration* ; Humans ; National Health Programs ; Noncommunicable Diseases/prevention & control* ; Outcome Assessment, Health Care ; Population Surveillance ; Preventive Health Services/organization & administration* ; Program Evaluation ; Public Health

Objective: To understand the prevalence and distribution of hypertension in population aged 15 years and over in Guizhou province and provide evidence for the prevention and management of hypertension. Methods: Face to face interviews using national standard questionnaire were conducted among the study subjects selected in Guizhou through multi-stage random sampling. Blood pressure measurement for them was done with Omron HEM-1300 professional portable blood pressure monitor. SPSS 19.0 software was used for statistical analysis. The ratio was compared by the χ(2) test. The influencing factors of hypertension was analyzed by multivariate logistic regression analysis. Results: A total of 13 480 participants were investigated, including 5 509 (40.8%) men and 7 971 (59.2%) women; 6 558 (48.6%) urban residents and 6 922 (51.4%) rural residents. Among the subjects surveyed, 3 232 (23.9%) were smokers, 2 412 (17.9%) were alcoholic and 4 859 (36.0%) were obese or overweight. A total of 3 937 (29.2%) hypertension patients were found. The prevalence of hypertension was 29.2%. The standardized prevalence of hypertension were 18.97% (compared with national population composition) and 21.16% (compared with Guizhou province population composition), respectively. The hypertension prevalence in men and women were 29.8% and 28.8%, respectively. The hypertension prevalence in rural population (35.8%) was higher than that in urban population (22.2%). The difference was statistically significant (P<0.001). The hypertension prevalence in people aged 65 years and over was 56.2%. The prevalence of hypertension were 34.3% and 27.6% in smokers and non-smokers, 39.2% and 27.0% in alcoholic and non-alcoholic and 40.7% and 22.7% in obese or overweight group and normal or less weight group, respectively. There were significant statistical differences in prevalence of hypertension among the population in urban area and rural area, with different age, education levels, smoking status, drinking status and BMI (P<0.001). Conclusions: The prevalence of hypertension in Guizhou was at a high level. The hypertension prevalence in rural area was higher than that in urban area. Hypertension prevalence increased significantly with age. The prevalence of hypertension was negatively associated with the education level of the people. Older age, living in rural area, smoking, drinking, obesity were the risk factors for hypertension.
Adolescent ; Adult ; Aged ; Blood Pressure/physiology* ; Body Weight ; China/epidemiology* ; Female ; Humans ; Hypertension/epidemiology* ; Life Style/ethnology* ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Rural Population ; Surveys and Questionnaires ; Urban Population ; Young Adult

Objective: To investigate the clinicopathological characteristics, diagnosis and differential diagnosis of intravascular large B-cell lymphoma (IVLBCL) and its collision tumors. Methods: Five cases of IVLBCL were collected, including 2 cases of collision tumors, and 1 case complicated with liver cirrhosis. The morphology and immunophenotype were analyzed. The related literature was reviewed. Results: There were 2 females and 3 males, aged from 53 to 73 years, with a median age of 65 years. The tumors were located in the lower extremities, right cerebellar hemisphere, left kidney, bilateral nasal cavity, and liver, respectively. Cases 2 and 3 were incidentally found in meningioma and renal cell carcinoma tissues, respectively. Case 5 had a background of liver cirrhosis. Morphologically, atypical large lymphoid cells were located in small blood vessels and capillary lumen, with little cytoplasm, hyperchromasia, prominent nucleoli, and obvious mitotic figures. Immunohistochemically, the IVLBCL tumor cells expressed CD20 and PAX5; 2 cases were CD5 positive. One of the 5 cases was GCB phenotype, and 4 cases were non-GCB phenotype. All cases expressed C-MYC (positive rate was 10%-40%). PD-L1 was positive in 4 cases (positive rate was 60%-90%). Ki-67 proliferation index was 70%-90%. CKpan, CD3, TDT, and CD34 were negative. In case 2, meningioma cells were positive for PR, EMA, and vimentin, but negative for CKpan and PD-L1. In case 3, renal carcinoma cells were positive for CKpan, PAX8, EMA, vimentin, CAⅨ and CD10, while PD-L1 was negative. No EBER expression (by in situ hybridization) or C-MYC gene translocation (FISH, break-apart probe) was detected in any of the 5 cases. Three patients were followed up, and all died within 1-13 months. Conclusions: IVLBCL is a highly aggressive lymphoma, with occult clinical manifestations and poor prognosis. Collision tumors of IVLBCL are extremely rare. A better understanding of IVLBCL would help pathologists avoid misdiagnoses.
Male ; Female ; Humans ; Aged ; B7-H1 Antigen ; Vimentin ; Meningioma ; Lymphoma, Large B-Cell, Diffuse/pathology* ; Carcinoma, Renal Cell ; Kidney Neoplasms/pathology* ; Meningeal Neoplasms ; Liver Cirrhosis

Objective: To investigate the clinicopathological, immunophenotypic, and genetic features of malignant peripheral nerve sheath tumor (MPNST). Methods: Twenty-three cases of MPNST were diagnosed at the Jiangsu Province Hospital (the First Affiliated Hospital of Nanjing Medical University), China, between January 2012 and December 2022 and thus included in the study. EnVision immunostaining and next-generation sequencing (NGS) were used to examine their immunophenotypical characteristics and genomic aberrations, respectively. Results: There were 10 males and 13 females, with an age range of 11 to 79 years (median 36 years), including 14 cases of neurofibromatosis type I-associated MPNST and 9 cases of sporadic MPNST. The tumors were located in extremities (7 cases), trunk (4 cases), neck and shoulder (3 cases), chest cavity (3 cases), paraspinal area (2 cases), abdominal cavity (2 cases), retroperitoneum (1 case), and pelvic cavity (1 case). Morphologically, the tumors were composed of dense spindle cells arranged in fascicles. Periphery neurofibroma-like pattern was found in 73.9% (17/23) of the cases. Under low magnification, alternating hypercellular and hypocellular areas resembled marbled appearance. Under high power, the tumor cell nuclei were irregular, presenting with oval, conical, comma-like, bullet-like or wavy contour. In 7 cases, the tumor cells demonstrated marked cytological pleomorphism and rare giant tumor cells. The mitotic figures were commonly not less than 3/10 HPF, and geographic necrosis was often noted. Immunohistochemically, tumor cells were positive for S-100 (14/23, 60.9%) and SOX10 (11/23, 47.8%). The loss of the CD34-positive fibroblastic network encountered in neurofibromas was observed in 14/17 of the MPNST cases. The loss of H3K27me3 expression was observed in 82.6% (19/23) of the cases. Moreover, SDHA and SDHB losses were presented in one case. NGS revealed that NF1 gene loss of function (germline or somatic) were found in all 5 cases tested. Furthermore, four cases accompanied with somatic mutations of SUZ12 gene and half of them had somatic mutations of TP53 gene, while one case with germline mutation in SDHA gene and somatic mutations in FAT1, BRAF, and KRAS genes. Available clinical follow-up was obtained in 19 cases and ranged from 1 to 67 months. Four patients died of the disease, all of whom had the clinical history of neurofibromatosis type Ⅰ. Conclusions: MPNST is difficult to be differentiated from a variety of spindle cell tumors due to its wide spectrum of histological morphology and complex genetic changes. H3K27me3 is a useful diagnostic marker, while the loss of CD34 positive fibroblastic network can also be a diagnostic feature of MPNST. NF1 gene inactivation mutations and complete loss of PRC2 activity are the common molecular diagnostic features, but other less commonly recurred genomic aberrations might also contribute to the MPNST pathogenesis.
Female ; Male ; Humans ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Neurofibrosarcoma ; Neurofibromatosis 1 ; Histones ; Genes, p53 ; Nerve Sheath Neoplasms

Objective: To study the willingness and influence factors related to "centralized slaughtering, fresh poultry listing and marketing" strategy, among the household chefs, and provide reference for government to adjust and optimize the strategy on avian influenza prevention. Methods: According to the geographical characteristics and regional functions, 6 'monitoring stations' were selected from 12 residential districts of Guangzhou, respectively. Another 21 meat markets which selling live poultry, were selected in each station and 5 household chefs of each market were invited to attend a face to face interview. Basic information, personal cognitive, willingness and influencing factors to the policy were under study. Univariate and multivariate logistic regression methods were used. Results: A total of 664 household chefs underwent the survey and results showed that the rate of support to the "centralized slaughtering, fresh poultry listing and marketing" strategy was 44.6% (296/664). Results from the multi-factor logistic regression showed that those household chefs who were males (OR=1.618, 95% CI: 1.156-2.264, P=0.005), having received higher education (OR=1.814, 95% CI: 1.296-2.539, P=0.001), or believing that the existence of live poultry stalls was related to the transmission of avian influenza (OR=1.918, 95% CI: 1.341-2.743, P<0.001) were factors at higher risk. These household chefs also intended to avoid the use of live poultry stalls (OR=1.666, 95%CI: 1.203-2.309, P=0.002) and accept the "centralized slaughtering, fresh poultry listing and marketing" strategy. Conclusion: Detailed study on this subject and, setting up pilot project in some areas as well as prioritizing the education programs for household chefs seemed helpful to the implementation of the 'freezing-fresh poultry' policy.
Animals ; Attitude to Health ; China ; Humans ; Influenza A Virus, H7N9 Subtype ; Influenza in Birds ; Influenza, Human/prevention & control* ; Male ; Marketing ; Meat-Packing Industry ; Multivariate Analysis ; Pilot Projects ; Poultry/virology* ; Surveys and Questionnaires

Objective: To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population. Methods: All participants were selected from a prospective cohort study based on a rural population from Henan province, China. Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality. Restricted cubic spline models were used to detect the dose-response relation. Results: Among the 5 461 hypertensive patients, a total of 31 048.38 person-years follow-up was conducted. The median of follow-up time was 6 years, and 589 deaths occurred during the follow-up period. Compared to normal weight group (18.5 kg/m(2)%CI: 0.37-1.87), 0.81 (95%CI: 0.67-0.97), and 0.72 (95%CI: 0.56-0.91), respectively. The dose-response analysis showed a nonlinear, reverse "S" shaped relationship (non-linearity P<0.001). Conclusion: Overweight or obese might have a protective effect on all-cause mortality in hypertensive population, which supports the "obesity paradox" phenomenon.
Adult ; Asian People/statistics & numerical data* ; Blood Pressure/physiology* ; Body Mass Index ; Cause of Death ; China/epidemiology* ; Humans ; Hypertension/mortality* ; Middle Aged ; Mortality ; Obesity/mortality* ; Overweight ; Prospective Studies ; Risk Factors ; Young Adult