OBJECTIVETo understand the current status and trends of tuberculosis mortality rates in China.

METHODSIn 2010, 161 National Disease Surveillance Points representing all 31 mainland provinces, municipalities, and autonomous regions of China collected tuberculosis mortality surveillance data, including age, sex, region, and type of tuberculosis (all, pulmonary, and extra-pulmonary). The mortality rates of the three types of tuberculosis were compared between 2004 and 2010.

RESULTSIn 2010, the mortality rates due to all tuberculosis, pulmonary tuberculosis, and extra-pulmonary tuberculosis were 4.69 (95% CI 4.54-4.84), 4.38 (4.23-4.52), and 0.31 (0.27-0.35) per 100 000 population, respectively. Mortality rates due to all tuberculosis and pulmonary tuberculosis were higher in males, the elderly, and those living in western and rural areas. From 2004 to 2010, the mortality rates due to all tuberculosis and pulmonary tuberculosis decreased by 36.02% and 37.70%, respectively, with an average annual rate of decline of 7.20% and 7.61%, respectively.

CONCLUSIONMortality rates due to tuberculosis have declined rapidly in China. The target of reducing the 1990 mortality rate by 50% by 2015 has already been achieved. However, the tuberculosis control program should pay more attention to high-risk groups, including the elderly and those living in underdeveloped areas.

China ; epidemiology ; Female ; Humans ; Male ; Tuberculosis ; epidemiology ; mortality

OBJECTIVETo study the protective effects of lycopene (LP) on cerebral ischemia-reperfusion injury induced by focal cerebral ischemia and oxidative stress in rats.

METHODS48 male Sprague-Dawley (SD) rats were randomly assigned into five groups: A (20 mg/kg LP), B (5 mg/kg LP), C (salad oil), D (salad oil) and E (basic feed control). A, B and C groups were given LP or salad oil orally for 15 d, then cerebral ischemia-reperfusion injury was established by middle cerebral artery occlusion (MCAO) and D group was used as fake surgery control. The contents of reactive oxygen species (ROS), nitric oxide (NO), lactic acid (LD) and the activities of nitric oxide synthetase (NOS) in cortex were measured at 24 h after reperfusion. The levels of HIF-1alpha mRNA and Bcl-2 mRNA in hippocampi were determined by using reverse transcription polymerase chain reaction (RT- PCR) technique.

RESULTSROS levels of A, B, C, D and E groups were (114.23 +/- 18.91), (135.89 +/- 14.17), (171.37 +/- 25.76), (94.24 +/- 2.23) and (92.06 +/- 5.59) fluorescence intensity value/g protein, respectively (F = 9.038, P < 0.01); levels of NO were (6.60 +/- 0.77), (7.13 +/- 0.47), (8.38 +/- 0.80), (5.52 +/- 0.16) and (5.23 +/- 0.51) micromol/g protein respectively (F = 10.197, P < 0.01); levels of NOS were (0.817 +/- 0.016), (0.875 +/- 0.095), (1.030 +/- 0.101), (0.557 +/- 0.094) and (0.595 +/- 0.066) U/mg protein respectively (F = 14.555, P < 0.01); levels of LD were (0.381 +/- 0.069), (0.446 +/- 0.012), (0.576 +/- 0.059), (0.359 +/- 0.021) and (0.310 +/- 0.036) mmol/g protein respectively (F = 10.043, P < 0.01); HIF-1alpha mRNA expression levels in hippocampi were 0.865 +/- 0.274, 0.635 +/- 0.069, 0.491 +/- 0.067, 0.375 +/- 0.052 and 0.361 +/- 0.087, respectively (F = 40.520, P < 0.01); and Bcl-2 mRNA expression levels in hippocampi were 0.263 +/- 0.033, 0.330 +/- 0.028, 0.198 +/- 0.034, 0.304 +/- 0.039 and 0.236 +/- 0.025, respectively (F = 11.003, P < 0.01).

CONCLUSIONThe protective effects of LP may be related with its abilities of decreasing ROS and LD cumulation, alleviating inflammation and up-regulating the expression of protective genes.

Animals ; Antioxidants ; pharmacology ; Brain Ischemia ; metabolism ; Carotenoids ; pharmacology ; Hippocampus ; metabolism ; Infarction, Middle Cerebral Artery ; metabolism ; Lactic Acid ; metabolism ; Male ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; metabolism ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Reperfusion Injury ; metabolism

OBJECTIVETo study the quality of reporting network system on death cases among county and above levels' medical institutions.

METHODSData on variables related to county reporting rate, unit reporting rate, timeliness of reporting, eligibility rate of reporting, auditing rate, timeliness of auditing, eligibility rate of auditing, percentage of reporting deaths of medical institutes to deaths among total population, percentage of reporting deaths of county and above levels' medical institutes to deaths among estimated deaths at these institutes were collected and distribution of common coding errors was applied to the assessment of reporting deaths.

RESULTSThe total reporting rates were: 82.58% at the county level, 42.79% at the units with auditing rate as 96.96%. The eligibility rate of reporting was 69.10% with eligibility rate of auditing as 73.58%. The percentage of reporting deaths from medical institutes to deaths among total population was 8.91%, and the percentage of reporting deaths of county and above levels' medical institutes to deaths among estimated deaths of these institutes was 30.76%. The percentage of obvious coding errors among deaths reported by county and above levels' medical institutes was as high as 22.87%.

CONCLUSIONNetwork reporting system of death cases among county and above levels' medical institutes had remarkably increased the timeliness of data reporting system. Network reporting of data on death was the best opportunity to expand the coverage and to improve the quality of data reporting. Based on network reporting of death cases among county and above levels' medical institutes as well as deaths accrued at the communities should also be reported via this network in the eligible areas. The quality of coding on death causes among medical institutes were commonly poor, indicating that the training on ascertainment and coding of underlying death causes were quite essential.

China ; epidemiology ; Death Certificates ; Forms and Records Control ; standards ; Health Facilities ; statistics & numerical data ; Humans ; Mortality ; Quality Control

OBJECTIVETo analyze epidemiological characteristics of burn inpatients in Hainan province over 8 years.

METHODSSix thousand and ninety-nine burn patients admitted to 6 hospitals of Hainan province from January 2002 to December 2009 were enrolled in the study. The clinical data of these patients were analyzed retrospectively, including age, gender, injury cause, wound position, burn area, ailment prior to admission, admission time, medical insurance, length of hospital stay, and mortality rate, relationship among inpatient distribution, admission time, and ambient temperature at the time of admission. Data were processed with SPSS 13.0 software.

RESULTSThere were more burn male patients than female, with ratio of 2.1: 1.0. Most patients were younger than 13 years (57.2%, 3488/6099). The most common burn area was smaller than or equal to 10% TBSA (67.4%, 4108/6099), and the fewest patients had burn areas of over 50% TBSA (2.0%, 121/6099). The main causative agents were hot liquid and flame, accounting for 71.5% (4358/6099), 17.9% (1092/6099), respectively. Most patients had injuries of more than two body areas (60.7%, 3705/6099), and lower extremity injury (17.1%, 1042/6099) was predominant in wound of single body area. Among 703 cases who had other ailments prior to admission (11.5%), the highest rate of prior ailments was found in patients older than 60 years (18.5%, 48/260), it was lowest in children younger than 1 year (8.0%, 32/398). The length of hospital stay was 1 to 375 day, and the admission time was 10 minutes to 90 days after burn. Total mortality rate was 0.4% (26 cases). The number of inpatients aged from 19 to 59 was obviously higher in months with high ambient temperature (from June to August), and for inpatients younger than 13 years the incidence of burn injury showed no obvious seasonal change. The inpatients who had medical insurance accounted for 10.9% (66/603) to 19.5% (121/619) from 2002 to 2005, which increased to 46.0% (372/808) in 2007 and 79.1% (869/1098) in 2009.

CONCLUSIONSFor burn inpatients in Hainan province, the main injury cause of burn injury is hot liquid, the number of burn adults aged from 19 to 59 seems to increase in months with high ambient temperature, while the incidence of burn in children showed no obvious seasonal change. The number of inpatients and those with medical insurance showed a tendency of increase from 2005 to 2009 in Hainan province.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Burns ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Inpatients ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVETo understand the underreporting on death cases through web-based reporting system from medical institutions at county level and above as well as to evaluate the quality of death cases reporting through the system.

METHODSA large-scale survey was conducted at 130 medical institutions based on stratified random sampling and to evaluate the underreporting and the quality of death cases reporting from medical institutions through data from survey and reporting system.

RESULTSIn 2005, the total reporting rates were 78.25% at the county level and 37.93% at the institutes. Comparing with the results of 2004, these rates were going down slightly. The eligibility rate of reporting was 79.62%, increased when comparing with results of 2004. The percentage of obvious coding errors among deaths reported by county level and above medical institutions was 24.68%. A total of 5226 death cases were recorded from medical (outpatient and inpatient) sources. An average underreporting rate of 33.07% was found at the selected medical institutions. Statistical difference of underreporting rate was not found at medical institutions at different levels.

CONCLUSIONSince the initiation of the web-based reporting system of death cases at medical institutes from county level and above, the timeliness of data reporting had been increasing remarkably. The system showed irreplaceable advantages. However, there still existed some problems such as the underreporting of death cases,the poor timeliness of reporting, and the poor accuracy of coding. In the meantime, it was noticed that repetitive work existed among medical institutions due to multi-systems, suggesting that it was necessary to establish a national life registration in China.

China ; epidemiology ; Death Certificates ; Forms and Records Control ; standards ; Health Facilities ; standards ; statistics & numerical data ; Humans ; Local Government ; National Health Programs ; standards ; statistics & numerical data ; Public Health Informatics ; standards ; Quality Control

Objective To analyze the epidemiological characteristics of imported cases of dengue fever in Guangdong province (GD) and in I-long Kong (HK) during 2004-2006 to provide evidence for further cooperation in the prevention and control programs on dengue fever in the two places.Methods Descriptive statistical analysis was performed on data obtained from dengue fever surveillance and reporting network in GD and from Centre for Health Protection,Department of Health,HK.Results Both from GD and HK 44 and 93 imported cases of Dengue fever were reported during 2004-2006.Most patients from GD acquired their infection from Singapore (13 cases),Indonesia (9 cases) or Cambodia (6 cases) while patients in HK mainly were imported from Indonesia (31 cases),the Philippines (16 cases) and Thailand (15 cases).The peak seasons of the two places were both from July to September.During the non-peak season period,the number of cases in Hong Kong was higher than that in Guangdong.Male/ female ratio was 1.2 : 1 in GD and 1.1 : 1 in HK.Age of patients in GD appeared to range from 6-80 years,with 63.6% (28/44) of them aged 20-39 years.40.9% (18/44) of the cases were engaged in business,services,housework or unemployed.Those cases in HK were between 10-72 years of age,with 63.6%(28/44) of them aged 20-39 years while 47.3%(44/93) of the patients were with the occupation of business,services and industry.More cases in GD had a onset of disease before entering the border (27 : 17) than the cases in HK (35 : 57).The average time interval between onset and diagnosis were 7 and 9 days for GD and HK respectively.Conclusion Frequent travel between Southeast Asia in summer among the working class appeared to be the main factor,causing imported cases of dengue fever in GDand HK.It is crucial to provide health education targeted at these high risk groups in order to prevent importation of dengue fever in the two areas.

Objective To better understand and measure the status of hepatitis C virus (HCV) infection, we conducted a sero-epidemiological study using the remaining blood samples and data of the nationwide survey of hepatitis B in Chinese residents which was carried out in 2006.Methods The anti-HCV reagent was screened out from the reagents by the HCV infection blood serum plate with anti-HCV positives or negatives. This plate recognized the Murex 3.0 and Ortho 3.0 reagents as gold standards. Anti-HCV in the blood samples were tested using this reagent and confirmed by Chiron HCV RIBA 3.0 reagents. Results Among the population aged 1 year to 59 year-olds, the overall prevalence rate of anti-HCV was 0.43％ (95％CI: 0.33％-0.53％ ), with the rates of anti-HCV among males and females as 0.46％ and 0.40％, respectively. The prevalence rate of anti-HCV in urban area was 0.43％,and in rural area it was 0.43％. The prevalence rate of anti-HCV in the Eastern, Middle and Western areas were 0.37％ (95％ CI: 0.21％-0.53％ ) , 0.67％ (95％ CI: 0.40％-0.94％ ) and 0.31％ (95％CI: 0.20％-0.42％ ) respectively. The prevalence rates of anti-HCV for the three areas did not show significant differences, statistically. The prevalence rate of anti-HCV in the South and North areas were 0.29％(95％CI:0.21％-0.52％) and 0.53％ (95％CI:0.38％-0.64％)respectively. Conclusion Our data revealed that China was in the low prevalence area for hepatitis C infection and the results also suggested that the comprehensive measures for HCV control and prevention had been successfully achieved in the country.

OBJECTIVETo study the prevalence rates of birth defects in high and low risk areas in China.

METHODSA population-based surveillance system on birth defects was used to obtain the prevalence rates of 24 kinds of major external birth defects from > or = 20 weeks of gestation to 7 days of life in selected areas in Shanxi and Jiangsu provinces.

RESULTSThe birth prevalence of birth defects (232.4 per 10,000 births) and neural tube defects (NTDs) (138.7 per 10,000 births) in four counties of Shanxi province were significantly higher than that in Taiyuan city (75.3 and 28.2 per 10,000 births, respectively). There was no significant difference for all selected birth defects between Wuxi city and Xishan counties in low risk areas. There was a 6.1-fold of higher prevalence for NTDs in Taiyuan city compared with that in Wuxi areas (4.6 per 10,000 births). In four counties of Shanxi province, the prevalence rates of anencephaly, spina bifida, hydrocephaly, cleft palate alone and polydactyly were significantly higher than in Wuxi areas. The NTDs prevalence rate in four counties of Shanxi was 30.2 times higher than in Wuxi areas. When compared with previous surveillance data, the NTDs prevalence rate did not present obvious declining trend in high risk areas. The birth prevalence rate had a 31.8% decrease when births were calculated after 28 gestational weeks and compared with those from 20 gestational weeks.

CONCLUSIONNTDs remained to be the most common birth defect seen in Shanxi province. The birth prevalence rate of NTDs in some areas of Shanxi province was among the highest that ever reported in the world in comparison with data from other countries and regions. The current prevalence rate in high risk areas in Shanxi province did not clearly show a declining trend. Programs on surveillance and prenatal diagnosis were proved to have made big impact on the rates of major external birth defects.

China ; epidemiology ; Congenital Abnormalities ; epidemiology ; Female ; Humans ; Male ; Neural Tube Defects ; epidemiology ; Prevalence ; Surveys and Questionnaires

PURPOSE: The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC. MATERIALS AND METHODS: In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary end-point was progress-free survival (PFS). RESULTS: The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the high-SAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors. CONCLUSION: The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.
C-Reactive Protein* ; DNA* ; Herpesvirus 4, Human* ; Humans ; Observational Study ; Prognosis ; Prospective Studies* ; Serum Amyloid A Protein* ; Survival Analysis

PURPOSE: Little is known about combination of the circulating Epstein-Barr viral (EBV) DNA and tumor volume in prognosis of stage II nasopharyngeal carcinoma (NPC) patients in the intensity modulated radiotherapy (IMRT) era. We conducted this cohort study to evaluate the prognostic values of combining these two factors. MATERIALS AND METHODS: By Kaplan-Meier, we compare the differences of survival curves between 385 patients with different EBV DNA or tumor volume levels, or with the combination of two biomarkers mentioned above. RESULTS: Gross tumor volume of cervical lymph nodes (GTVnd, p < 0.001) and total tumor volume (GTVtotal, p < 0.001) were both closely related to pretreatment EBV DNA, while gross tumor volume of nasopharynx (GTVnx, p=0.047) was weakly related to EBV DNA. EBV DNA was significantly correlated with progress-free survival (PFS, p=0.005), locoregional-free survival (LRFS, p=0.039), and distant metastasis-free survival (DMFS, p=0.017), while GTVtotal, regardless of GTVnx and GTVnd, had a significant correlation with PFS and LRFS. The p-values of GTVtotal for PFS and LRFS were 0.008 and 0.001, respectively. According to GTVtotal and pretreatment EBV DNA level, patients were divided into a low-risk group (EBV DNA 0 copy/mL, GTVtotal < 30 cm³; EBV DNA 0 copy/mL, GTVtotal ≥ 30 cm³; or EBV DNA > 0 copy/mL, GTVtotal < 30 cm³) and a high-risk group (EBV DNA > 0 copy/mL, GTVtotal ≥ 30 cm³). When patients in the low-risk group were compared with those in the high-risk group, 3-year PFS (p=0.003), LRFS (p=0.010), and DMFS (p=0.031) rates were statistically significant. CONCLUSION: Pretreatment plasma EBV DNA and tumor volume were both closely correlated with prognosis of stage II NPC patients in the IMRT era. Combination of EBV DNA and tumor volume can refine prognosis and indicate for clinical therapy.
Biomarkers ; Cohort Studies* ; DNA* ; Herpesvirus 4, Human* ; Humans ; Lymph Nodes ; Nasopharynx ; Plasma ; Prognosis ; Radiotherapy* ; Tumor Burden*