1.Analysis on long-term trends of cervical cancer mortality and years of life lost in Tianjin, 1999-2015.
W L ZHENG ; H ZHANG ; D Z WANG ; S ZHANG ; S PANG ; C K LI ; G H JIANG
Chinese Journal of Epidemiology 2019;40(1):64-69
Objective: To analyze the mortality and years of life lost (YLL) trends of cervical cancer in Tianjin, and provide references for the research and prevention programs of cervical cancer. Methods: Mortality rate, standard mortality rate, cumulative rate (0-74 years-old) and truncated rate (35-64 years-old) of cervical cancer from 1999 to 2015 were calculated. The annual percentage change of the mortality rate and YLL rate were analyzed by using Joinpoint regression analysis, and the trend in different age-groups were analyzed. Results: From 1999 to 2015, 1 741 cases died of cervical cancer in Tianjin, the average crude mortality rate was 2.15/100 000. The average age-standardized rate of (ASR) China and ASR world were 1.47/100 000 and 1.50/100 000 respectively. The average YLL was 3 347.97 person-years. Deaths occurred in those aged 0-34 years, 35-64 years and 65 years and over accounted for 3.10%, 57.84% and 39.06% of the total, respectively. The mortality rate of cervical cancer in urban area was higher than that in rural area, with a ratio of 1.37∶1 between urban area and rural area. The age-specific mortality rate of cervical cancer during 1999-2015 increased with age. Two peaks of mortality rate were observed in those aged 50 years and aged 75 years, during 2014-2015. From 1999 to 2011, the mortality rate of cervical cancer was stable (APC=-0.2%, P=0.80), but there was a rapid increase from 2011 to 2015 (APC=21.6%, P<0.01). But group aged 20-49 years, it showed an upward trend from 1999 to 2015 (APC=6.9%, P<0.01). For group aged 50-69 years, it showed a downward trend from 1999 to 2007 (APC=-9.2%, P<0.01), and an upward trend from 2007 to 2015 (APC=14.5%, P<0.01). For group aged 70 years and over, it showed a downward trend from 1999 to 2009 (APC=-10.2%, P<0.01), but the difference in the mortality were not significant from 2009 to 2015 (APC=7.8%, P=0.10). Since 2008, the YLL rate of cervical cancer in group aged 50-70 years had exceeded that in group aged >70 years and the gap gradually widened. Conclusions: There had been a rapid increase trend of cervical cancer mortality since 2011 in Tianjin. Women aged 50-70 years were the main group of life loss.
Adolescent
;
Adult
;
Aged
;
China/epidemiology*
;
Female
;
Humans
;
Incidence
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Middle Aged
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Mortality/trends*
;
Regression Analysis
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Residence Characteristics
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Survival Rate/trends*
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Uterine Cervical Neoplasms/mortality*
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Young Adult
2.Does Acupuncture Therapy Alter Activation of Neural Pathway for Pain Perception in Irritable Bowel Syndrome?: A Comparative Study of True and Sham Acupuncture Using Functional Magnetic Resonance Imaging.
Winnie C W CHU ; Justin C Y WU ; David T W YEW ; Liang ZHANG ; Lin SHI ; David K W YEUNG ; Defeng WANG ; Raymond K Y TONG ; Yawen CHAN ; Lixing LAO ; Ping C LEUNG ; Brian M BERMAN ; Joseph J Y SUNG
Journal of Neurogastroenterology and Motility 2012;18(3):305-316
BACKGROUND/AIMS: Patients with irritable bowel syndrome (IBS) are characterized by abnormal central processing with altered brain activation in response to visceral nociceptive signals. The effect of electroacupuncture (EA) on IBS patients is unclear. The study is set to study the effect of EA on brain activation during noxious rectal distension in IBS patients using a randomized sham-controlled model. METHODS: Thirty IBS-diarrhea patients were randomized to true electroacupuncture or sham acupuncture. Functional MRI was performed to evaluate cerebral activation at the following time points: (1) baseline when there was rectal distension only, (2) rectal distension during application of EA, (3) rectal distension after cessation of EA and (4) EA alone with no rectal distension. Group comparison was made under each condition using SPM5 program. RESULTS: Rectal distension induced significant activation of the anterior cingulated cortex, prefrontal cortex, thalamus, temporal regions and cerebellum at baseline. During and immediately after EA, increased cerebral activation from baseline was observed in the anterior cingulated cortex, bilateral prefrontal cortex, thalamus, temporal regions and right insula in both groups. However, true electroacupuncture led to significantly higher activation at right insula, as well as pulvinar and medial nucleus of the thalamus when compared to sham acupuncture. CONCLUSIONS: We postulate that acupuncture might have the potential effect of pain modulation in IBS by 2 actions: (1) modulation of serotonin pathway at insula and (2) modulation of mood and affection in higher cortical center via ascending pathway at the pulvinar and medial nucleus of the thalamus.
Acupuncture
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Acupuncture Therapy
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Brain
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Cerebellum
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Electroacupuncture
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Humans
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Irritable Bowel Syndrome
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Magnetic Resonance Imaging
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Magnetic Resonance Spectroscopy
;
Magnetics
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Magnets
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Neural Pathways
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Pain Perception
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Prefrontal Cortex
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Pulvinar
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Salicylamides
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Serotonin
;
Thalamus
3.Interferon beta-1b is effective and has a favourable safety profile in Chinese patients with relapsing forms of multiple sclerosis
ZX Li ; CZ Lu ; XH Zhang ; LY Cui ; XH Xu ; E Radue ; SG Chu ; LR Wang ; K Beckmann ; J Lampe ; C Pohl ; B Stemper ; R Sandbrink
Neurology Asia 2014;19(2):179-189
Background & Objective: No clinical study of any interferon beta therapy has yet been successfully conducted in Chinese multiple sclerosis patients, probably due to the low incidence of this disease in China. The primary objective of this study was to demonstrate that treating multiple sclerosis patients of Chinese origin with interferon beta-1b has a beneficial effect on disease course, as measured by the decrease of newly active lesions on magnetic resonance imaging. Methods: Chinese patients diagnosed with relapsing-remitting or secondary-progressive multiple sclerosis were enrolled in this multicenter, open label, single-arm study. Following a 3-month pre-treatment phase, patients were treated with 250 µg interferon beta-1b subcutaneously every other day for 6 months. Patients had regular assessments for treatment safety and efficacy of the treatment. Results: Thirty seven patients completed the trial. Significant decreases in the number of newly active lesions were observed in the 6-month treatment period compared with the pre-treatment period (median decrease 1.5 lesions, p<0.001). Most adverse events were mild and transient and no serious ones were observed. Conclusions: Treatment with interferon beta-1b significantly reduced the occurrence of new lesions and was well tolerated in this Chinese population. These findings support the use of interferon beta- 1b for treating Chinese MS patients.
5.A case of human infection with highly pathogenic avian influenza A (H7N9) virus through poultry processing without protection measure.
Y MA ; Z B ZHANG ; L CAO ; J Y LU ; K B LI ; W Z SU ; T G LI ; Z C YANG ; M WANG
Chinese Journal of Epidemiology 2018;39(6):799-804
Objective: To investigate the infection pattern and etiological characteristics of a case of human infection with highly pathogenic avian influenza A (H7N9) virus and provide evidence for the prevention and control of human infection with highly pathogenic avian influenza virus. Methods: Epidemiological investigation was conducted to explore the case's exposure history, infection route and disease progression. Samples collected from the patient, environments and poultry were tested by using real time reverse transcriptase-polymerase chain reaction (RT-PCR). Virus isolation, genome sequencing and phylogenetic analysis were conducted for positive samples. Results: The case had no live poultry contact history, but had a history of pulled chicken processing without taking protection measure in an unventilated kitchen before the onset. Samples collected from the patient's lower respiratory tract, the remaining frozen chicken meat and the live poultry market were all influenza A (H7N9) virus positive. The isolated viruses from these positive samples were highly homogenous. An insertion which lead to the addition of multiple basic amino acid residues (PEVPKRKRTAR/GL) was found at the HA cleavage site, suggesting that this virus might be highly pathogenic. Conclusions: Live poultry processing without protection measure is an important infection mode of "poultry to human" transmission of avian influenza viruses. Due to the limitation of protection measures in live poultry markets in Guangzhou, it is necessary to promote the standardized large scale poultry farming, the complete restriction of live poultry sales and centralized poultry slaughtering as well as ice fresh sale.
Animals
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Chickens
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China
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Commerce
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Humans
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Influenza A Virus, H7N9 Subtype/pathogenicity*
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Influenza in Birds/virology*
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Influenza, Human/virology*
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Phylogeny
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Poultry/virology*
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Real-Time Polymerase Chain Reaction
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Zoonoses
6.Preoperative evaluation of gastric cancer and risk factors for postoperative complications.
K C ZHANG ; C R LU ; B L ZHANG ; L CHEN
Chinese Journal of Gastrointestinal Surgery 2023;26(2):144-147
Surgical resection plays pivotal role in the treatment of gastric cancer. Adequate preoperative evaluation, precise intraoperative maneuver and delicate postoperative management lay the foundation for successful gastrectomy. The aim of preoperative evaluation is to stage tumor and identify potential risk factors (including preoperative factors like age, ASA status, body mass index, comorbidity, hypoalbuminemia, and intraoperative factors like blood loss and combined resection) which could lead to postoperative complication. With the management of prehabilitation, adequate medical decision could be made and patient's fast recovery could be ensured. With the rapid adoption of ERAS concept, there is increasing attention to prehabilitation which focus on optimization of cardio-pulmonary capacity and muscular-skeletal capacity. Despite of the efficacy of prehabilitation demonstrated by randomized controlled trials, consensus has yet to be reached on the following items: specific intervention, optimal measurement, candidate population and optimal timing for intervention. Balancing the efficiency and safety, preoperative evaluation could be put into clinical practice smoothly.
Humans
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Stomach Neoplasms/complications*
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Preoperative Care/adverse effects*
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Postoperative Complications/etiology*
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Gastrectomy/adverse effects*
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Risk Factors
7. Correlation between incidence of dengue and climatic factors in the Philippines: An ecological study
Ann Kashmer D. Yu ; Sophia Isabel E. Ytienza ; Airees Mae D. Yu ; Vincent Christopher S. Yu ; Keith Alexius K. Wangkay ; Maria Antonia R. Wong ; Marielle Alyanna B. Zamudio ; Eljine Mae T. Zhang ; Wally D. Yumul ; Zakhira Maye R. Zipagan ; Arianna Krystelle R. Yaranon ; Jake Byron C. Zapanta ; Gija B. Ysip ; Catherine Danielle Duque-Lee
Health Sciences Journal 2020;9(2):60-68
INTRODUCTION:
Dengue continues to be a major health concern in the Philippines. This study aimed to establish trends and correlations between the incidence of dengue and rainfall, humidity and temperature, respectively, in the different regions.
METHODS:
Using 2018 records obtained from DOH and PAGASA, correlations were made between monthly
measurements of climatic factors and the incidence of dengue using Pearson’s r, while maps and interpolations were generated using quantum geographical information system software.
RESULTS:
There was a significant positive but weak correlation between the incidence of dengue and rainfall
(r = 0.379, 95% CI 0.255, 0.491; p < 0.001) and humidity (r = 0.215, 95% CI 0.080, 0.342; p = 0.002).
There was a significant negative but weak correlation between the incidence of dengue and temperature (r = -0.145, 95% CI -0.277, -0.008; p = 0.039). A strong positive correlation was noted between the incidence of dengue, and rainfall and humidity, respectively, in several regions. Multiple regression indicates that rainfall, humidity and temperature are poor predictors of the incidence of dengue (R2 = 0.1436, 0.0461 and 0.0209, respectively).
CONCLUSION
This study showed overall a significant but weak correlation between an increased incidence
of dengue and heavy rainfalls and high relative humidity, and a weak negative correlation for temperature. A high positive correlation of an increased incidence of dengue and heavy rainfalls and high relative humidity was observed in several regions.
Dengue
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humidity
;
temperature
8.A medium- and long-term comparative observation on volumetric changes of cervical disc herniation after symmetrically or asymmetrically decompression and conservative treatment for cervical spondylotic myelopathy.
A D ZHU ; C L ZHANG ; X YAN ; S FU ; D Z LI ; C DONG ; Y K WANG
Chinese Journal of Surgery 2023;61(8):666-674
Objective: To compare the volumetric changes of cervical disc herniation (CDH) after cervical microendoscopic laminoplasty(CMEL),expansive open-door laminoplasty (EOLP) and conservative treatment. Methods: A retrospective study was conducted involving 101 patients with cervical spondylotic myelopathy(CSM),at the Department of Orthopaedic Surgery,the First Affiliated Hospital of Zhengzhou University from April 2012 to April 2021. The patients included 52 males and 49 females with an age of (54.7±11.8) years(range:25 to 86 years). Among them, 35 patients accepted CMEL treatment,33 patients accepted EOLP treatment,while 33 patients accepted conservative treatment. Volume data of CDH were measured by three-dimensional analysis of the initial and follow-up MRI images. The absorption rate and reprotrusion rate of CDH were calculated. The happening of resorption or reprotrusion was defined when the ratio was greater than 5%. The clinical outcomes and quality of life were evaluated by the Japanese Orthopaedic Association (JOA) score and the neck disability index (NDI).Quantitative data was analyzed by one-way ANOVA with post LSD-t test (multiple comparison) or Kruskal-Wallis test. Categorical data was analyzed by χ2 test. Results: The follow-up time of the CMEL group,EOLP group and the conservative treatment group were (27.6±18.8)months,(21.6±6.9)months and(24.9±16.3)months respectively with no significant difference(P>0.05). Changes of CDH volume in patients:(1) There were 96 CDH of 35 patients in the CMEL group,among which 78 showed absorption. The absorption frequency was 81.3%(78/96) and the absorption rate was ranged 5.9% to 90.9%;9 CDH showed reprotrusion,the reprotrusion frequency was 9.4% (9/96) and the reprotrusion rate was 5.9% to 13.3%;(2) There were 94 CDH of 33 patients in the EOLP group,of which 45 showed absorption. The absorption prevalence was 47.9% (45/94) and the absorption rate was 5.0% to 26.7%;20 CDH showed reprotruded,with the reprotrusion frequency of 21.3% (20/94) and the reprotrusion rate was 5.8% to 28.3%;(3) There were 102 CDH in 33 patients of the conservative group. Among them, 5 showed absorption. The absorption frequency was 4.9% (5/102),and the absorption rate was 7.2% to 14.3%;58 CDH showed reprotruded with the re-protrusion ratio of 56.9% (58/102) and the re-protrusion rate was 5.4% to 174.1%. The absorption ratio and reprotrusion ratio of the CMEL group were statistically different from EOLP group or the conservative group (P<0.01).The absorption ratio and reprotrusion ratio of the EOLP group was different from conservative group (all P<0.01). In terms of clinical outcomes, the excellent/good rate of the JOA score and NDI scores in the CMEL group were different from that of conservative group (all P<0.01) but not from that of the EOLP group(P>0.05). Conclusions: CMEL is an effective method for the treatment of CSM,making CDH easier to resorption compared to the EOLP or conservative treatment,thus making a better decompression effect on the nerves. This study enlightened on a new strategy for the clinical treatment of CSM.
Male
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Female
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Humans
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Adult
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Middle Aged
;
Aged
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Aged, 80 and over
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Retrospective Studies
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Intervertebral Disc Displacement/surgery*
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Conservative Treatment
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Quality of Life
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Treatment Outcome
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Spondylosis/surgery*
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Cervical Vertebrae/surgery*
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Spinal Cord Diseases
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Laminoplasty/methods*
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Decompression
10.Characteristic and dynamic of HIV-1 subtype distribution in men who have sex with men in Guangzhou, 2008-2015.
Z G HAN ; Y L ZHANG ; H WU ; W B CHENG ; C Y LIANG ; F ZHONG ; K GAO ; H F XU
Chinese Journal of Epidemiology 2018;39(1):67-71
Objective: To understand the characteristics and dynamic of HIV-1 subtype distribution in men who have sex with men (MSM) in Guangzhou between 2008 and 2015. Methods: HIV-1 RNAs were extracted from serum samples of the individuals newly diagnosed with HIV-1 infection among MSM living in Guangzhou between 2008 and 2015. The pol gene segments of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and were sequenced. Subsequently, the phylogenetic tree was reconstructed using pol sequences of samples and references together and the subtype of HIV-1 was determined. The distributions of HIV-1 subtypes detected in MSM with different demographic characteristics in different years were compared. Results: A total of 2 210 pol gene segments were successfully obtained from 2 473 serum samples of the MSM. The average age of 2 210 MSM was 30.19 years with standard deviation of 8.22 years, the unmarried MSM and those in Han ethnic group accounted for 73.39% and 90.81%, respectively. The proportion of subtype CRF07_BC (38.10%) was highest, followed by CRF01_AE (34.84%), CRF55_01B (14.62%), B (6.06%), URFs (3.58%), CRF59_01B (2.17%) and other subtypes (0.63%). The annual proportions of subtype B (P=0.000, 99%CI:0.000-0.000), CRF07_BC (χ(2)=14.965, P=0.036), CRF55_01B (χ(2)=18.161, P=0.011) and URFs (P=0.001, 99% CI: 0.000-0.001) were significantly different. The proportion of subtype B showed a gradual decrease from 14.08% to 4.33% (P=0.000, 99%CI: 0.000-0.000), while the proportion of URFs rapidly increased from 0% to 6.40% (P=0.000, 99% CI: 0.000-0.000). The rate of URFs was significantly higher in farmers and migrant workers than in other groups (P=0.017, 99%CI: 0.014- 0.020) and the rate of URFs was higher in individuals who had multi sexual partners (χ(2)=5.733, P=0.017). Conclusions: CRF07_BC and CRF01_AE were the predominant HIV-1 subtypes and multiple subtypes co-circulated among MSM in Guangzhou between 2008 and 2015. The recombinations of HIV-1 continue to occur in MSM. Strengthening behavioral intervention for farmers, migrant workers and individuals who have multi sexual partners has the important epidemiological significance against the emerging and circulating of the novel recombinant virus among MSM in Guangzhou.
China/epidemiology*
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Genes, pol
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Genotype
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HIV Infections/virology*
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HIV Seropositivity/genetics*
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HIV-1/isolation & purification*
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Homosexuality, Male
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Humans
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Male
;
Phylogeny
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Polymerase Chain Reaction
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RNA, Viral/blood*
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Sexual Behavior