Humans ; Diverticulum, Colon ; Fecal Impaction ; Hydrodynamics

Objective: To investigate the effects of high iodine intake on thyroid function in pregnant and lactating women. Methods: A cross sectional epidemiological study was conducted among 130 pregnant women and 220 lactating women aged 19-40 years in areas with high environment iodine level (>300 μg/L) or proper environment iodine level (50-100 μg/L) in Shanxi in 2014. The general information, urine samples and blood samples of the women surveyed and water samples were collected. The water and urine iodine levels were detected with arsenic and cerium catalysis spectrophotometric method, the blood TSH level was detected with electrochemiluminescence immunoassay, and thyroid stimulating hormone (FT(4)), antithyroid peroxidase autoantibody (TPOAb) and anti-thyroglobulin antibodies (TGAb) were detected with chemiluminescence immunoassay. Results: The median urine iodine levels of the four groups were 221.9, 282.5, 814.1 and 818.6 μg/L, respectively. The median serum FT(4) of lactating women in high iodine area and proper iodine area were 12.96 and 13.22 pmol/L, and the median serum TSH was 2.45 and 2.17 mIU/L, respectively. The median serum FT(4) of pregnant women in high iodine area and proper iodine area were 14.66 and 16.16 pmol/L, and the median serum TSH was 2.13 and 1.82 mIU/L, respectively. The serum FT(4) levels were lower and the abnormal rates of serum TSH were higher in lactating women than in pregnant women in both high iodine area and proper iodine area, the difference was statistically significant (FT(4): Z=-6.677, -4.041, P<0.01; TSH: Z=8.797, 8.910, P<0.01). In high iodine area, the abnormal rate of serum FT(4) in lactating women was higher than that in pregnant women, the difference was statistically significant (Z=7.338, P=0.007). The serum FT(4) level of lactating women in high iodine area was lower than that in proper iodine area, the difference was statistically significant (Z=-4.687, P=0.000). In high iodine area, the median serum FT(4) in early pregnancy, mid-pregnancy and late pregnancy was 16.26, 14.22 and 14.80 pmol/L, respectively, and the median serum TSH was 1.74, 1.91 and 2.38 mIU/L, respectively. In high iodine area, the serum FT(4) level in early pregnancy was higher than that in mid-pregnancy and late pregnancy, and the serum TSH level was lower than that in mid-pregnancy and late pregnancy, the difference was statistically significant (FT(4): Z=-2.174, -2.238, P<0.05; TSH: Z=-2.985, -1.978, P<0.05). There were no significant differences in the positive rates of serum thyroid autoantibodies among the four groups of women and women in different periods of pregnancy (P>0.05). The morbidity rates of subclinical hyperthyroidism in pregnant women and lactating women in high iodine area were obviously higher than those in proper iodine areas, the difference was statistically significant (χ(2)=5.363, 5.007, P<0.05). Conclusions: Excessive iodine intake might increase the risk of subclinical hypothyroidism in pregnant women and lactating women. It is suggested to strengthen the iodine nutrition and thyroid function monitoring in women, pregnant women and lactating women in areas with high environmental iodine.
Adult ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Hypothyroidism/epidemiology* ; Iodides/administration & dosage* ; Iodine/urine* ; Lactation ; Nutritional Status ; Pregnancy ; Prevalence ; Thyroid Diseases/epidemiology* ; Thyroid Function Tests ; Thyroid Gland/physiology* ; Young Adult

Objective: To understand the epidemiological and etiological characteristics of mumps in Fujian province, 2005-2017. Methods: All the reported mumps cases were collected through the National Notifiable Disease Information Management System, 2005-2017. Active search and interviews were conducted to collect the information on vaccination of mumps. Throat swab specimens were collected for cells culture, genotyping and gene sequence analysis on mumps virus (MuV). Results: A total of 83 959 cases of mumps were reported in Fujian province from 2005 to 2017, with an average annual incidence of 17.6 per 100 000. Since 2007, the incidence appeared increasing but then decreasing, reaching the lowest level (7.5 per 100 000), after the setup of a monitoring program. Annually, the onset time of mumps showed an obvious two seasonal peaks, one from April to July, with a weakening trend, and the other from October to January with a rising trend. Most of the mumps cases occurred among students, kindergarten and scattered children (89.2%, 5 814/6 517), children aged 5-9 years (38.8%, 2 527/6 517), with cases reported from every region. Program from the pathogen surveillance showed that the transmission chain of G genotype mumps virus did exist in Fujian. Data from the sequence analysis revealed that mutations in the nucleotide of G genotype strain in 2015 had led to mutation of 6 amino acid sites in the SH gene coding region, resulting in the differences appearing in both nucleotide and amino acid homology with type A vaccine strain. Conclusions: The incidence of mumps decreased annually, in Fujian. Prevention programs should focus on primary and secondary school students. In Fujian province, we also noticed the transmission chain of mumps G genotype with some amino acid mutations in the SH gene coding region. Monitor programs on both epidemiologic and etiology, should be strengthened.
Child ; Child, Preschool ; China/epidemiology* ; Genotype ; Humans ; Incidence ; Mumps/epidemiology* ; Mumps virus/pathogenicity* ; Phylogeny ; Sequence Analysis

Objective: Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination, to promote the recommendation profile on Hepatitis E vaccination program, in China. Methods: Three phases of time span were divided as 2004-2007, 2008-2011 and 2012-2015, with age groups divided as <20, 20-29, 30-39 and ≥40. Incidence rates in both different phases and age groups were compared. Numbers of Hepatitis A and E vaccines released and used, were described. Results: Between 2004 and 2015, a declining trend in the reported incidence of hepatitis A (t=-12.15, P<0.001), but an increasing trend in hepatitis E (t=6.63, P<0.001) were noticed. The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015. The peaks of hepatitis E appeared persistent annually, in March. The incidence of hepatitis A declined in three regions, with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (χ(2)=32 630, P<0.01). The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000), but more in the eastern region (2.66/100 000) (χ(2)=6 009, P<0.01). Incidence of hepatitis A declined in all age groups and declined by 84.36% among the 0-19 group. However, the incidence of hepatitis E showed an increasing trend among the ≥20 group. Incidence rates appeared higher in the older age groups. The coverage of hepatitis A vaccine increased from 62.05% to 93.54%, but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69, χ(2)<0.05). Conclusion: The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004 to 2015, calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.
Adolescent ; Adult ; Aged ; China/epidemiology* ; Health Care Surveys ; Hepatitis A/epidemiology* ; Hepatitis A Vaccines/administration & dosage* ; Hepatitis E/epidemiology* ; Humans ; Immunization/statistics & numerical data* ; Immunization Programs ; Incidence ; Middle Aged ; Population Surveillance ; Vaccination/statistics & numerical data* ; Young Adult

Objective: To understand the distribution and trends in 30-day coronary heart disease (CHD) case fatality rate in patients hospitalized due to acute myocardial infarction (AMI) in Beijing during 2007-2012. Methods: The clinical data of patients hospitalized due to AMI in Beijing from 1 January 2007 to 31 December 2012 were collected from "The Cardiovascular Disease Surveillance System in Beijing" . A total of 77 943 local patients aged ≥25 years were hospitalized due to AMI in Beijing during the this period. After excluding duplicate records and validation for the completeness and accuracy of the records, the clinical characteristics of the patients and 30-day CHD case fatality rate in the patients were analyzed. Trends in 30-day CHD case fatality rate in the patients were analyzed with Poisson regression models. Results: The age-standardized average 30-day CHD case fatality rate was 9.7% in the 77 943 patients. During this period, a decreasing trend was observed in 30-day CHD case fatality rate after adjusting for age and gender (P<0.001). The age-standardized 30-day CHD case fatality rate decreased by 16.0%, from 10.8% in 2007 to 9.0% in 2012. The decreases of 30-day CHD case fatality rates were noted in both men and women, whereas 30-day CHD case fatality rate was higher in women (14.1%) than in men (7.6%) after adjusting for age. During this period, the proportion of ST-segment elevation myocardial infarction (STEMI) decreased, while the proportion of non-ST-segment elevation myocardial infarction (NSTEMI) increased with year. A significant decline (20.1%) in 30-day case fatality rate of STEMI was found, but no decline was found for 30-day mortality rate of NSTEMI. Conclusion: A decreasing trend in 30-day CHD case fatality rate was observed in the patients aged ≥25 years and hospitalized due to AMI in Beijing during 2007-2012, indicating the improvement in short-term prognosis of patients hospitalized due to AMI. Our findings highlight the urgent need to improve the treatment for woman and NSTEMI patients.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Beijing/epidemiology* ; Coronary Disease/mortality* ; Female ; Hospital Mortality ; Hospitalization/trends* ; Humans ; Male ; Middle Aged ; Myocardial Infarction/mortality* ; Prognosis ; Survival Analysis ; Time Factors

Objective: To explore the SNP effects of patatin-like phospholipase domain which containing 3 (PNPLA3), transmembrane 6 superfamily member 2 (TM6SF2) gene, environmental effects of smoking, alcohol drinking and interaction between gene-gene, gene-environment and drinking-smoking on hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC). Methods: We collected anticoagulant peripheral blood from patients of HBV-HCC, chronic hepatitis B (CHB), liver cirrhosis (LC) and from healthy controls to detect the single nucleotide polymorphism (SNP) of patatin-like phospholipase domain containing 3 (PNPLA3) gene loci rs738409 and transmembrane 6 superfamily member 2 (TM6SF2) gene loci rs58542926, using the flight mass spectrometry method. The optimal assignment value of gene polymorphisms was defined by using the online SNP stats. Hardy-Weinberg (H-W) balance was tested for SNP. Effects of the genetic and environmental factors to HBV-HCC were analyzed by using the multiple classification logistic regression method. The gene-gene, gene-smoking and alcohol drinking interaction effects were investigated by Fork-Life analysis and binary logistic regression methods. Results: The frequency distribution of CHB group rs738409 loci seemed not in conformity with the H-W balance (χ(2)=11.980, P<0.005). Two loci frequency distributions in the other groups were all in accordandce with the H-W balance. After adjusting for influences on age and sex and comparing to the healthy group, the rs58542926 mutation appeared as OR=1.659, 95%CI: 1.026-2.684, P=0.039, in the HBV-HCC group. When comparing to CHB group, the HBV-HCC group presented that drinking as OR=1.680, 95%CI: 1.121-2.519, P=0.012. When comparing to the LC group, the ORs of drinking and smoking were 1.539 (1.071-2.213) and 1.453 (1.005-2.099) respectively, in the HBV-HCC group. When comparing to the CHB+LC group, interactions between the HBV-HCC group were found rs738409 and rs58542926 on additive model OR=1.548 (U=1.885, P=0.029) and OR=1.658 (P=0.024) on logistic regression model while drinking was rs738409 on interaction additive model with OR=1.811(U=1.965, P=0.024). As for drinking and mutation of rs738409, the multiplication model of logistic regression showed no statistically significant differences. Interaction between smoking and drinking appeared as OR=1.756 (P<0.001) in the logistics regression multiplication model. Conclusions: Factors as mutation of TM6SF2, smoking and drinking all appeared as risk factors for HBV-HCC. Mutations of both PNPLA3 and TM6SF2, together with smoking and drinking all served as risk factors for HBV-HCC. However, the mutation of single PNPLA3 appeared as a protective factor on HBV-HCC.
Alcohol Drinking/adverse effects* ; Carcinoma, Hepatocellular/virology* ; Case-Control Studies ; Epistasis, Genetic ; Gene-Environment Interaction ; Genetic Predisposition to Disease ; Genotype ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Lipase/genetics* ; Liver Cirrhosis, Alcoholic/complications* ; Liver Neoplasms/virology* ; Membrane Proteins/genetics* ; Polymorphism, Single Nucleotide ; Smoking/adverse effects*

Adjacent segment disease (ASDis) is a common complication of posterior lumbar spine fusion and often requires surgical treatment. In the treatment of ASDis, percutaneous spinal endoscopy can be used for simple decompression without removal of the original internal fixation, or for posterior fixation and fusion under the scope or in combination with other access fixation and fusion techniques, with the advantages of less surgical trauma, less bleeding, and faster postoperative recovery. Traditional trajectory screw technique is one of the risk factors for adjacent segment degeneration because of its tendency to cause damage to the adjacent synovial joint during surgery. In contrast, the cortical tone trajectory (CBT) screw placement technique not only reduces the damage to the articular joint during the screw placement process, but also preserves the original internal fixation in the treatment of ASDis, which significantly reduces the surgical trauma. Secondly, the implantation of CBT screws with the aid of digital technologies such as three-dimentinal printed guides, CT navigation, and robotics allows for more precise "double nailing" of ASDis patients to complete the fusion of adjacent segments, and is a minimally invasive procedure to be considered for patients who meet the clinical indications for fusion. This article reviews the literature on the use of percutaneous spinal endoscopy and CBT in the surgical management of ASDis.

Background: s/Aims: Socioeconomic determinants of health are incompletely characterized in cholangiocarcinoma (CCA). We assessed how socioeconomic status influences initial treatment decisions and survival outcomes in patients with CCA, additionally performing multiple sub-analyses based on anatomic location of the primary tumor. Methods: Observational study using the 2018 submission of the Surveillance, Epidemiology, and End Results (SEER)-18 Database. In total, 5,476 patients from 2004−2015 with a CCA were separated based on median household income (MHI) into low income (< 25th percentile of MHI) and high income (> 25th percentile of MHI) groups. Seventy-three percent of patients had complete follow up data, and were included in survival analyses. Survival and treatment outcomes were calculated using R-studio. Results: When all cases of CCA were included, the high-income group was more likely than the low-income to receive surgery, chemotherapy, and local tumor destruction modalities. Initial treatment modality based on income differed significantly between tumor locations. Patients of lower income had higher overall and cancer-specific mortality at 2 and 5 years. Non-cancer mortality was similar between the groups. Survival differences identified in the overall cohort were maintained in the intrahepatic CCA subgroup. No differences between income groups were noted in cancer-specific or overall mortality for perihilar tumors, with variable differences in the distal cohort. Conclusions Lower income was associated with higher rates of cancer-specific mortality and lower rates of surgical resection in CCA. There were significant differences in treatment selection and outcomes between intrahepatic, perihilar, and distal tumors. Population-based strategies aimed at identifying possible etiologies for these disparities are paramount to improving patient outcomes.

Objective: To analyze the characteristics of super-antigen (SAg) of group A Streptococcus pyogenes (GAS), isolated from patients with scarlet fever or pharyngeal infections in Beijing between 2015-2017. Methods: Throat swab specimens from patients with scarlet fever or pharyngeal infections were collected and tested for GAS. Eleven currently known SAg genes including SpeA, speC, speG, speH, speI, speJ, speK, speL, speM, smeZ and ssa were tested by real-time PCR while M protein genes (emm genes) were amplified and sequenced by PCR. Results: A total of 377 GAS were isolated from 6 801 throat swab specimens, with the positive rate as 5.5%. There were obvious changes noticed among speC, speG, speH and speK in three years. A total of 45 SAg genes profiles were observed, according to the SAgs inclusion. There were significant differences appeared in the frequencies among two of the highest SAg genes profiles between emm1 and emm12 strains (χ(2)=38.196, P<0.001; χ(2)=72.310, P<0.001). There also appeared significant differences in the frequencies of speA, speH, speI and speJ between emm1 and emm12 strains (χ(2)=146.154, P<0.001; χ(2)=52.31, P<0.001; χ(2)=58.43, P<0.001; χ(2)=144.70, P<0.001). Conclusions: Obvious changes were noticed among SAg genes including speC, speG, speH and speK from patients with scarlet fever or pharyngeal infections in Beijing between 2015-2017. SAg genes including speA, speH, speI and speJ appeared to be associated with the emm 1 and emm 12 strains. More kinds of SAg genes profiles were isolated form GAS but with no significant differences seen in the main SAg genes profiles, during the epidemic period.
Antigens, Bacterial/genetics* ; Bacterial Outer Membrane Proteins ; Bacterial Proteins ; Beijing/epidemiology* ; China/epidemiology* ; Exotoxins ; Female ; Humans ; Membrane Proteins ; Pharyngitis/microbiology* ; Pharynx/microbiology* ; Pregnancy ; Pregnancy Complications, Infectious/microbiology* ; Real-Time Polymerase Chain Reaction ; Scarlet Fever/microbiology* ; Streptococcal Infections ; Streptococcus pyogenes/isolation & purification* ; Superantigens/genetics*

BACKGROUNDHigh-voltage analog X-ray examination is a main tool for pneumoconiosis, which is challenged by digital radiography (DR). The tube voltage of DR chest films required for diagnosis and staging of pneumoconiosis is concerned technically. We investigated the influence of the tube voltage on chest X-ray DR image quality of patients exposed to occupational dust.

METHODSDR images of the CDRAD2.0model, an anatomical chest phantom, and 136 exposed workers were analyzed at different tube voltages by threereaders. Image quality factors (IQF) were calculated and compared using the CDRAD2.0 model. DR images of ten anatomic positions were scored against those of the high-kilovolt chest films in anatomical phantom and clinical cases, and differences in scores were analyzed.

RESULTSIn the CDRAD2.0 model, all three readers had a minimal IQF at 120 kV (mean: 22.25 kV). The differences in the mean IQF of DR images at different tube voltages was significant (F = 13.78, P < 0.001). The IQF of DR imaging at 120 kV was similar to high kilovolt analog imaging (t = -0.58, P > 0.05). In the anatomic phantom and clinical cases, the DR images at 120 kV were closest in anatomical detail to the high kV analog images, and the means were similar (P > 0.05).

CONCLUSIONSAmong different tube voltages, DR image quality is closest to the high kilovolt analog images at 120 kV in patients exposed to occupational dust.

Adult ; Aged ; Environmental Pollution ; Female ; Humans ; Male ; Middle Aged ; Phantoms, Imaging ; Pneumoconiosis ; diagnosis ; Radiographic Image Enhancement ; methods ; Radiography, Thoracic