Objective To analyze the factors affecting the development of genome technology-based genetic testing services. Methods Purposive sampling was used to select experts in the field of genome or genetic testing. Following interview with 11 experts,data was obtained from 25 individuals and analyzed by using quantitative SWOT analysis, including the concept of SWOT method, Analytic Hierarchy Process,Internal Factor Evaluation ( IFE ) Matrix, and External Factor Evaluation ( EFE ) Matrix. Consistent ratio (CR) was chosen to test the logic. Results Of the 15 critical affecting factors, the weighting coefficient of deficiency of laws and market regulations, state supporting policies, and lack of intellectual property protection was 0. 099,0. 091 and 0. 087, respectively. The development of genetic testing services was found in the third quadrant of SWOT analysis. Conclusion These findings suggest that defensive strategy should be taken to improve genetic testing services and to reduce the risk of genetic testing.

Cervical cancer is one of the most common malignancies among women. Screening programs for cervical cancer have been implemented in many developed countries. Comprehensive systems for cervical cancer prevention and control have improved over the past 30 years, which has led to a significant decline in the morbidity and mortality of cervical cancer. Since 2009, the Chinese government has conducted the Cervical Cancer and Breast Cancer Screening Program for Rural Women on a national scale, which has substantially improved cervical cancer prevention and control. However, a comprehensive system for cervical cancer prevention has been not established in China. It is essential to investigate suitable strategies for cervical cancer prevention system in the country by referring to the experiences of developed nations in comparison with the situation in China, with respect to system operations, compatibility with the existing health care system, choice of suitable technologies, and information and evaluation platforms.

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.

Objective To understand the prevalence of chronic obstructive pulmonary disease (COPD) among the community population aged ≥40 years in China from 1990 to 2014.Methods The studies on the prevalence of COPD among the community population in China published from 1990 to 2014 were retrieved from the following databases:Chinese BioMedical Literature Database (CBM),Chinese Journal Full-text Database (CNKI),Wanfang Database,PubMed and EBSCO.Mantel-Haenszel fixed effect and random effect model and software Stata were used for statistical analysis.Results A total 30 studies were included in the Meta analysis.The pooled prevalence of COPD was 9.9％ (95％ CI:8.8％-11.0％).The prevalence was higher in males (13.0％,95％ CI:11.5％-14.4％) than in females (5.8％,95％CI:4.9％-6.6％),and the prevalence of COPD increased with age obviously from 3.2％ in age group 40-49 years (95％ CI:2.5％-3.9％) to 20.3％ in age group ≥70 years (95％CI:18.2％-22.4％).The differences in prevalence among different areas had no statistical significance.Conclusions The prevalence of COPD in population aged ≥40 years increased gradually in China in recent 20 years.Obvious heterogeneity was found among the results of the studies due to the different diagnostic standards and sample sizes.

Objective To analyze the relationship between N-nitrosodimethylamine (NDMA) and the risk of digestive tract cancers.Methods The papers about the relationship between NDMA and the risk of digestive tract cancers published from 1980 to 2012 were retrieved following databases:Chinese BioMedical Literature Database (CBM),the Chinese Journal Full-text Database (CNKI),Wanfang Database,PubMed and EBSCO.The fix and random effect model was used and statistical analyses were conducted by using RevMan 5.1 software.Results Thirteen papers were found,in which 7 about digestive tract cancers were used in this Meta analysis.The NDMA had significant positive effect on the incidence of digestive tract cancers (RR=1.12,95％ CI:1.03-1.21).The relationship between NDMA and esophageal cancer was not significant (RR =1.18,95 ％CI:0.98-1.41) but NDMA could increase the risk of gastric cancer (RR=1.08,95％ CI:1.00-1.18).For the subtypes of esophageal and gastric cancer,NDMA had positive relationship with esophageal squamous cell carcinoma (RR=l.72,95％ CI:1.01-2.96),but had no significant relationship with esophageal adenocarcinoma,cardiac carcinoma and gastric adenocarcinoma.Conclusion The population-based cohort studies have showed that the NDMA could significantly increase the risk of digestive tract cancers,but the effects differed with subtypes of esophageal and gastric cancer.However,it is necessary to collect more evidence due to the limited studies and obvious differences in the study design,sampling and exposure measurement of these cohort studies.

Objective: To assess the impact of Chinese Cervical Cancer Screening Program for Rural Area (NACCSPRA) on population-based screening rates. Methods: The subjects were selected from 2013-2014 Chinese Chronic Diseases and Risk Factors Surveillance (CDRFS2013), which adopting multi-stage stratified cluster sampling from 31 provinces. A total of 169 632 participants aged 18 years and older in 297 surveillance points were interviewed, of whom 65 476 women aged 35-64 years were included in the analysis. The surveillance points in CDRFS 2013 were divided into the screening areas and the control areas by matching points in CDRFS2014 with counties in NACCSPRA. The difference in socioeconomic status between areas was compared. The screening rates and 95% confidence interval (95%CI) were estimated by Tylar series variance method. The Propensity Score was evaluated for individuals by multivariate logistic regression and the greedy matching method based on propensity score value was used to conduct 1∶1 matching sample for the screening areas and the control areas. After matching, multivariate conditional logistic regression model was fitted to assess the impact of national cervical cancer screening intervention on the likelihood of undergoing cervical cancer screening at population level. Results: Among 65 476 subjects, 48.6% (n=31 794) was in the screening areas. Before matching, in the rural area the screening rate in the screening areas (24.0% (4 763/19 838), 95%CI: 21.8%-26.3%) was higher than that in the control areas (15.6% (2 331/14 942), 95%CI: 13.4%-17.8%); whereas in the urban area the screening rate in the screening areas (28.5% (3 413/11 956), 95%CI: 26.1%-31.0%) was similar to that in the control areas (26.3% (4 923/18 740), 95%CI: 24.1%-28.4%). After matching, in rural area the screening rate in the screening areas (23.2% (3 454/14 875), 95% CI: 20.9%-25.5%) was higher than that in the control areas (15.6% (2 315/14 875), 95% CI: 13.3%-17.8%); in urban area the screening rate in the screening areas (28.7% (3 202/11 146), 95% CI: 26.2%-31.2%) was higher than that in the control areas (23.1% (2 571/11 146), 95%CI: 20.9%-25.3%). Multivariate conditional logistic regression model showed that the cervical cancer screening rates in intervention areas significantly increased among women aged 35-64 years both in urban areas (OR=1.44, 95%CI: 1.34-1.54) and rural areas (OR=1.78, 95%CI: 1.67-1.90) as compared with those in control areas. Conclusion The implementation of Chinese cervical cancer screening program during the five years substantially increased the population-based screening rates both in urban and rural areas.

Objective To analyze the mortality of cervical cancer and its temporal trend in women in China between 2006 and 2012.Methods The cause-of-death data about cervical cancer,which was abstracted from National Disease Surveillance Points and adjusted by special survey for underreporting,was used to analyze the age and area specific crude mortality rates of cervical cancer in China during 2006-2012.The age-standardized mortality rate was calculated by using world standardized population (Segi's).The Joinpoint regression model was used to obtain annual percentage change and 95％CI for assessing the time trend of mortality rate of cervical cancer from 2006 to 2012.Results In 2012,the crude mortality rate of cervical cancer was 3.15 per 100 000 in women in China.The mortality rate in rural area (3.45/100 000) was higher than that in urban area (2.76/100 000),while the central area had the highest mortality rate of cervical cancer (3.77/100 000) compared with western area (3.23/100 000) and eastern area (2.54/100 000).The Segi's age-standardized mortality rate in eastern area increased by 2.9％ (95％CI:0.8％-5.0％) annually,an increase of 6.0％ was observed in age group 30-59 years (95％CI:1.6％-10.5％).However,the Segi's age-standardized mortality rate in central area declined by 4.6％ (95％CI:-5.9％--3.3％),where the declines of 3.2％ and 5.7％ were observed in age groups 30-59 years and ≥60 years (95％ CI:-5.0％--1.4％ and 95％ CI:-9.3％--2.0％) and respectively.There was no significant change in cervical cancer mortality in western area.The similar trends were observed in the age-standardized mortality rate calculated according to the population of China.Conclusions The decline of overall mortality rate of cervical cancer tended to stop in China and significant differences still exist among different areas.Our results suggest that the central/western areas and rural areas are still key areas for cervical cancer prevention and control and close attention should be paid to the increase of cervical cancer mortality in women aged 35-59 years in eastern area.It is essential to establish a systematic cervical cancer prevention network with larger population coverage to reduce the deaths caused by cervical cancer.