Objective: To analyze the trends in incidence of thyroid cancer in Fuling District, Chongqing Municipality from 2016 to 2020 and predict the incidence of thyroid cancer from 2021 to 2023, so as to provide insights into thyroid cancer control. Methods: The data pertaining to incidence of thyroid cancer in Fuling District from 2016 to 2020 were collected through National Central Cancer Registry of China. The crude incidence rate ( CR ) of thyroid cancer, the standardized incidence rate of thyroid cancer by Chinese standard population ( ASR China ) and by world standard population ( ASR world ) were calculated. The trend in thyroid cancer incidence was analyzed using annual percent change ( APC ). The GM ( 1, 1 ) grey model was created to predict the crude incidence of thyroid cancer in Fuling District from 2021 to 2023, and the fitting effect and predictive accuracy of the model were evaluated using posterior error ratio ( C ), small probability error ( p ) and mean absolute percent error ( MAPE ). Result: A total of 686 new cases of thyroid cancer were reported in Fuling District from 2016 to 2020, with CR of 11.84/105, ASR China of 11.93/105 and ASR world of 10.02/105. Among the 686 new cases of thyroid cancer, there were 165 male cases, with CR of 5.69/105, ASR China of 5.66/105 and ASR world of 4.81/105, and 521 female cases, with CR of 18.02/105, ASR China of 18.17/105 and ASR world of 15.24/105. The CR appeared a tendency towards a rise among the whole population and women in Fuling District from 2016 to 2021, with APC values of 38.40% ( t=3.369, P=0.043 ) and 38.68% ( t=4.035, P=0.027 ). The incidence of thyroid cancer peaked among patients at ages of 25 to 34 years and 50 to 54 years, with CR of 22.82/105 and 39.06/105, respectively. The GM ( 1, 1 ) grey model was qualified to fit the incidence of thyroid cancer among the whole population ( C=0.56, p=0.75 ) and women ( C=0.53, p=1.00 ). In addition, the CR of thyroid cancer was predicted to be 19.48/105, 22.51/105 and 26.03/105 ( MAPE=9.93% ) among the whole population, and 31.43/105, 37.37/105 and 44.46/105 ( MAPE=11.30% ) among women, respectively. Conclusions The incidence of thyroid cancer appeared a tendency towards a rise in Fuling District from 2016 to 2021, and is projected to increase among the whole population and women from 2021 to 2023. Women and the elderly are at high risk of thyroid cancer.

Objective To observe neurophysiological changes and pulmonary function in obstructive sleep apnea syndrome (OSAS) and analyze their inter-relationship. Methods Sixty OSAS patients were studied. Their lung function and phrenic motor nerve conduction (PNC) were examined. Thirty cases without respiratory disorder served as controls. The lung function tests included percentage of the predicted value of vital capacity ( VC% ), percentage of the predicted value of maximal voluntary ventilation ( MVV% ), percentage of the predicted value of forced expiratory volume in one second ( FEV1% ), inspiratory capacity ( IC), and expiratory reserve volume (ERV). The phrenic nerve was stimulated electrically, and the latent period and the diaphragmatic compound muscle action potential (dCMAP) were recorded. Results The VC%, MVV%, FEV1% , IC and ERV of the patients with OSAS were significantly lower than those of the controls. There was no significant difference between the patients and the controls with regard to their PNC latency. In the OSAS patients the amplitude ratio of their dCMAPs was positively correlated with VC% , MVV% , FEV1% , IC and ERV, and negatively with an apnea hypopnea index (AHI).Conclusions PNC examination can provide valuable information for evaluating diaphragmatic dysfunction in those with abnormal lung function. Decreased dCMAP might be associated with abnormal lung function.

Objective: To investigate the relationship between exercise and serum lipid level in middle-aged population. Methods: Based on “multicenter collaborative study of cardiovascular epidemiology” research, a total of 3482 subjects at the age of (35-59) years from urban and rural areas of Beijing and Guangzhou were enrolled in this study. According to daily energy expenditure of exercise (EEexer), the participants were divided into 3 groups: No exercise group, (daily) EEexer below median group and (daily) EEexer above median group. The type and duration of exercise were collected by the questionnaire, daily EEexer was calculated and the relationship between exercise and serum lipid level was estimated by covariance analysis. Results: There were 47.1% (807/1712) male and 41.1% (727/1770) female participants having exercise. With controlled age, area, education level, smoking, drinking, BMI and energy expenditure of physical activity outside of exercise (EEPA), serum levels of TC, LDL-C, non-HDL-C and TG were decreased in women by elevated EEexer groups accordingly, and among them, there were significant differences in LDL-C and non-HDL-C levels between groups, P<0.05; compared with No exercise group, in female daily EEexer above median group, LDL-C and non-HDL-C levels decreased about 0.14 mmol/L,P=0.0063 and 0.14 mmol/L, P=0.0155 respectively; while in men, TC, LDL-C, non-HDL-C and TG levels showed a decreasing trends by elevated EEexer groups but with no statistical significance. No association was found for HDL-C in men and women. Conclusion: Serum levels of LDL-C and non-HDL-C were lower in female daily EEexer above median group than No excise group, the effects were independent from working and other physical activities.

ObjectiveTo explore the predictive effect of serum TC/HDL-C ratio on ischemic and hemorrhagic stroke incidence in middle aged Chinese population.MethodsA prospective study was conducted based on the PRC-USA Collaborative Study on Cardiovascular and Cardiopulmonary Epidemiology. A total of 10 121 individuals (4921 men and 5200 women), aged 35—59 years were selected from 4 cohorts, in Beijing and Guangzhou, urban and rural. The average following up time was 15.9 years. During the follow-up period, 277 ischemic and 125 hemorrhagic stroke cases were diagnosed.ResultsThe age adjusted incidence rate of ischemic stroke was 144.1,169.4,166.7,226.9 and 282.2 in the group of TC/HDL-C ratio

Paroxysmal sympathetic hyperactivity (PSH),which recognized in a subgroup of survivors of severe acquired brain injury,is a syndrome of simultaneous,paroxysmal transient increases in sympathetic (elevated heart rate,blood pressure,respiratory rate,temperature,sweating) and motor (posturing) activity.These symptoms are not specific and can occur in sepsis,epilepsy,malignant hyperthermia,hydrocephalus and many other complications,which is related to confused diagnosis and delayed treatment of PSH.In addition,Patients with PSH have prolonged ICU stays and added healthcare costs.This article discusses the pathophysiological mechanism,clinical diagnostic criteria,and current drug treament measures of PSH,so as to guide rapid diagnosis.

Objective With the encouragement of Shenzhen government and medical institutions,the investment in clinical research projects is keep increasing,it is urgent to explore the construction of a well-functioning and effective clinical research technical support and supervision system.Methods The unmet needs were obtained and identified by survey and interview at first.The work plan has been made on the basis of the requirements and followed to building the infrastructure.Results The recent actions and achievements for setting up the support and supervision infrastructure have been listed in summary:(1) the government initiated the construction of support system and technical platform for clinical research;(2) set up multiple levels biomedical ethical review board in Shenzhen;(3) conduct comprehensive trainings for clinical research investigators.Conclusions To summarize the advantages and disadvantages of conducting clinical research in Shenzhen,through the systematic planning and top-level design from the government,establish a multidimensional talent training system and construct the technical platform to ensure the sustainable development of clinical research.

Objective To evaluate the influence of 125I seed implantation brachytherapy on QOL of patients with salivary gland malignant tumor which couldn't be treated by conventional surgery and its influence factors. Methods 23 patients with malignant salivary gland cancer which couldn't be treated by conventional surgery were selected from Peking University School of Stomatology from 2013 to 2017. The patients were treated by 125I seed implantation brachytherapy. EORTC QLQ-C30 ( V3. 0 ) as well as QLQ-H&N35 QOL scale ( Chinese version) were used for the assessment of post-treatment QOL. Results The survival rate of one year and three years after treatment in 23 patients was 100％ and 67％, respectively. The score of the quality of life before and after treatment was 201. 48 and 199. 48, respectively. The difference was not significant after the test ( P>0. 05 ) . The level of total QOL and function score were relatively high. Among the influence factors, location of tumor significantly influenced QOL( F=9. 127,P<0. 05). Other factors still needed research based on larger sample. Conclusions 125I seed implantaion brachytherapy can better protect the head and neck function and maintain the quality of life of patients with salivary gland malignant tumor.

Objective: To explore the relationship between overnight urinary sodium to potassium ratio and the risk of cardiovascular disease (CVD). Methods: A subsample of 10 percent of the participants (35-59 years old) from the People's Republic of China-United States Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology (prospective survey) were used. Three consecutive overnight urine samples were collected in the autumn of 1983-1984 and the spring in 1985-1986, respectively. Urinary sodium and potassium were detected and calculated for 8 hours excretion. The occurrences of cardiovascular events were recorded in 2 years interval from 1987-1988 until December 31, 2005. Participants were divided into first ratio group, second ratio group, and third ratio group based on the tertiles of sodium to potassium ratio. Cox proportional hazard regression model was used to determine the relationship between sodium to potassium ratio and risk of CVD. In addition, participants were divided into 2 subgroups by the median of overnight urinary sodium and potassium, and then combined each other for 4 subgroups including low sodium-low potassium group, low sodium-high potassium group, high sodium-low potassium group, and high sodium-high potassium group, to explore the relationship between different sodium-potassium combinations and the risk of CVD. Results: A total of 954 participants were included in the final analysis, of whom 459 (48.1%) were males. There were 318 cases in the first, second and third ratio group, respectively. There were 347 cases in low sodium-low potassium group and high sodium-high potassium group, and 130 cases in low sodium-high potassium group and high sodium-low potassium group. After a median follow-up of 18.6 (18.3, 19.3) years, cardiovascular events occurred in 81 participants, including 64 stroke and 20 coronary heart disease events. Multivariate analysis showed that comparing with the first ratio group, the hazard ratios (HR) in the second and the third ratio groups were 2.04 (95%CI 1.06-3.95, P=0.034) and 2.07 (95%CI 1.07-4.03, P=0.032), respectively. The CVD risk in low sodium-low potassium group was 24% higher than the low sodium-high potassium group (reference), but this result did not reach statistical significant level (P=0.685). The risks in high sodium-high potassium group (HR=3.32, 95%CI 1.26-8.76,P=0.015) and high sodium-low potassium (HR=3.04, 95%CI 1.05-8.83, P=0.041) group were both significantly increased. Conclusions Overnight urinary sodium to potassium ratio is positively correlated with the risk of cardiovascular events. High urinary sodium plays a more important role for the increased risk of cardiovascular events than low potassium.

OBJECTIVEThis research project aimed to evaluate whether a simplified method for identifying high-risk individuals for cardiovascular diseases proposed by the China Rural Health Initiative (CRHI) was feasible in the rural areas in China.

METHODS2 036 adults, aged 20 years or older were stratified-randomly sampled from 12 villages in Luquan county and Anguo county (Hebei province) respectively, to receive physical examination and filling in administered questionnaires. "Gold Standard" was used on high risk in Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults to evaluate the CRHI standards:people with a history of coronary heart disease or stroke, or elderly as men ≥50 years or women ≥60 years with diabetes, or elderly with systolic blood pressure ≥160 mmHg. Sensitivity, specificity, positive and negative predictive values related to the identification of high-risk individuals for cardiovascular diseases were assessed.

RESULTSThe concordance rate between the CRHI standard and the gold standard was 92.9% , with sensitivity as 77.2%, specificity as 98.5%, Youden's Index as 0.76, positive predictive value as 94.7% and negative predictive value as 92.5%. Under CRHI standard, 21.3% of the adults were identified as high risk. The rate was increasing with age (P < 0.001), reaching 44% among those who were over 60 years old.

CONCLUSIONThe CRHI standard seemed simple and easy and was suitable for identifying high-risk individuals for cardiovascular diseases in the resource-constrained rural areas.