Humans ; Female ; Pregnancy ; Placenta ; Lung/pathology* ; Tomography, X-Ray Computed

Radical gastrectomy with D2 lymphadenectomy has been widely performed as the standard surgery for patients with gastric cancer in major medical centers in China and abroad. However, the exact extent of lymph node dissection is still controversial. In the latest version of the Japanese Gastric Cancer Treatment Guidelines, No. 14v lymph nodes (along the root of the superior mesenteric vein) are again defined as loco-regional lymph nodes, and it is clarified that distal gastric cancer presenting with infra-pyloric regional lymph node (No.6) metastasis is recommended for D2+ superior mesenteric vein (No. 14v) lymph node dissection. To explore the relevance and clinical significance of No.6 and No.14v lymphadenectomy in radical gastric cancer surgery, a review of the national and international literature revealed that No.6 lymph node metastasis was associated with No.14v lymph node metastasis, that No.6 lymph node status was a valid predictor of No.14v lymph node negative status and false negative rate, and that for gastric cancer patients with No. 14v lymph node negative and No.6 lymph node positive, the dissection of No.14v lymph node may also have some significance. The addition of No. 14v lymph node dissection in radical gastrectomy is safe, but it is more important to distinguish the patients who can benefit from it. Professor Liang Han of Tianjin Medical University Cancer Hospital is currently leading a multicenter, large-sample, prospective clinical trial (NCT02272894) in China, which is expected to provide higher level evidence for the clinical significance of lymph node dissection in No.14v.
Humans ; Stomach Neoplasms/pathology* ; Lymphatic Metastasis/pathology* ; Prospective Studies ; Retrospective Studies ; Lymph Nodes/pathology* ; Lymph Node Excision ; Gastrectomy ; Multicenter Studies as Topic

Objective: To understand the prevalence of hepatitis C virus (HCV) infection in 5 populations in China during 2016-2017 and provide evidence for the estimation of prevalence trend of hepatitis C and evaluation on the prevention and control effect. Methods: A total of 87 national sentinel surveillance sites for hepatitis C were set up in 31 provinces (autonomous regions and municipalities) of China to obtain the information about HCV infection prevalence in 5 populations, including volunteer blood donors, people receiving physical examination, patients receiving invasive diagnosis and treatment, patients receiving hemodialysis, and clients visiting family planning outpatient clinics. From April to June, 2016 and 2017, cross-sectional surveys were repeatedly conducted in the 5 populations and blood samples were collected from them for HCV antibody detection. Results: In 2016, 86 sentinel sites completed the surveillance (one sentinel site was not investigated), and 115 841 persons were surveyed. The overall HCV positive rate was 0.38% (442/115 841, 95%CI: 0.23%-0.53%). In 2017, all the 87 sentinel sites completed the surveillance, and 120 486 persons were surveyed. The overall HCV positive rate was 0.37% (449/120 486, 95%CI: 0.23%-0.52%). In 2016 and 2017, the anti-HCV positive rates were 4.46% (223/5 005, 95%CI: 2.18%-6.73%) and 4.39% (216/4 919, 95%CI: 2.29%-6.50%) respectively in hemodialysis patients, 0.85% (44/5 200, 95%CI: 0.27%-1.42%) and 0.70% (36/5 150, 95%CI: 0.15%-1.24%) respectively in patients receiving invasive diagnosis and treatment and remained to be ≤0.25% in volunteer blood donors, people receiving physical examination and clients visiting family planning outpatient clinics. Results for the comparison of the anti-HCV positive rates in the 5 populations indicated that the differences were significant (F=23.091, P<0.001 in 2016 and F=20.181, P<0.001 in 2017). Conclusions: Data from the sentinel surveillance of HCV infection on prevalence in China showed that the anti-HCV positive rates varied in the 5 populations during 2016-2017. The anti-HCV positive rate appeared the highest in the hemodialysis patients, followed by that in the patients receiving invasive diagnosis and treatment, and the prevalence of HCV infection in other 3 populations were at low levels.
China/epidemiology* ; Cross-Sectional Studies ; Hepacivirus ; Hepatitis C/epidemiology* ; Hepatitis C Antibodies ; Humans ; Prevalence ; Sentinel Surveillance

Objective: To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016. Methods: Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI. Measurements for attributable BOD of diabetes included disability adjusted life years (DALY), years of lost life (YLL), years living with disability (YLD), death number and mortality rate. The average world population from 2010 to 2035 was used as a reference. Results: In 2016, death number of diabetes attributable to high BMI was 40 310, which was significantly higher than that in 1990 (15 008). Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016, which showed a more significant increasing trend in both males and people aged 15-49 years. DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years. YLL and YLD also showed increasing trends. The highest increasing rate of YLD was in people aged 15-49 years. High BMI was responsible for 26.01% of the diabetes deaths in 2016 in China, an increase of 39.39% compared with that in 1990 (18.66%). Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016. Inner Mongolia, Xinjiang, Zhejiang, Macao SAR, Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period. Conclusions: There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI, causing a heavy disease burden, in China from 1990 to 2016. The BOD varied in both different age and gender groups. More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.
Adolescent ; Adult ; Body Mass Index ; China/epidemiology* ; Cost of Illness ; Diabetes Mellitus/ethnology* ; Disabled Persons ; Humans ; Macau ; Male ; Middle Aged ; Quality-Adjusted Life Years ; Sickness Impact Profile ; Young Adult

Objective: To understand the characteristics of HIV infected persons without long term disease progress [also known as long term non-progressors (LTNPs)], and related factors in Guangxi Zhuang Autonomous Region (Guangxi). Methods: Data of persons living with HIV and receiving no antiretroviral therapy in Guangxi by the end of 2016 were collected from the national HIV/AIDS comprehensive control and prevention information system of China. Results: By the end of 2016, there were 313 LTNPs in Guangxi, accounting for 2.3% of those being reported for more than 10 years, 5.4% of those being reported for more than 10 years and surviving, and 26.6% of those being reported for more than 10 years, surviving and receiving no antiretroviral therapy. Among the LTNPs, 87.2%(273) were men, 94.9% (297) were aged ≤ 40 years, 32.3% (101) were farmers, 55.6% (174) were single, divorced or widowed, 69.3% (217) were of Han ethnic group, 68.1% (213) were injecting drug users, and 52.1% (163) were from custody facilities. Multiple logistic regression analysis indicated that factors associated with delayed disease progression included age ≤40 years (compared with age >40 years, aOR=1.55, 95%CI: 1.31-3.12) and injection drug use (compared with sexual transmission, aOR=1.23, 95%CI: 1.10-1.74). Conclusions: A number of LTNPs existed in HIV-infected individuals in Guangxi. Further research are needed to identify the related factors, and it is necessary to conduct large sample size studies on host immunology, genetics and the virology of HIV to explore the related mechanism.
Adolescent ; Adult ; Age Distribution ; China/epidemiology* ; Drug Users/statistics & numerical data* ; Ethnicity/statistics & numerical data* ; HIV Infections/ethnology* ; Humans ; Male ; Socioeconomic Factors

Objective: To investigate the utilization of reproductive health services and relating factors among internal migrant population in Beijing, Shanghai and Chongqing. Methods: A multi-stage cluster sampling method was adopted in this cross-sectional study, conducted in Beijing, Shanghai and Chongqing from August 2014 to August 2015. Standard methods on statistics and nonlinear canonical correlation were applied. Results: Out of the 6 545 internal migrant persons, 41.76% ever used the reproductive health services in the past year. Results from the nonlinear canonical correlation analysis revealed that the utilization of reproductive health services was correlated with the demographic features (=0.28, P<0.000 1) and characteristics of the population mobility (=0.21, P<0.000 1), respectively. For the above said demographic features, canonical variable L(1) which represented the demographic features was mainly determined by area, occupation and education attainment. Canonical variable M(1) that reflected the utilization of reproductive health services, was mainly determined by factors as free contraceptives, education on contraception/reproductive health, and pregnancy diagnosis/antenatal care. As for the characteristics of the population mobility, canonical variable U(1), which represented population mobility characteristics, was mainly determined by factors as purpose of migration, current pattern of residence and the length of annual stay in the area. Again, the canonical variable V(1), reflecting the use of reproductive health services was mainly determined by factors as free contraceptives, check-up on reproductive tract infection, education on contraception/reproductive health, and pregnancy diagnosis/antenatal care. Conclusions: The utilization of reproductive health services was low among the internal migrant population under study. Responsible departments for health and family planning in those cities should make internal migrants attach importance to reproductive health.
China ; Cities ; Cross-Sectional Studies ; Demography ; Female ; Health Care Surveys ; Humans ; Patient Acceptance of Health Care ; Pregnancy ; Reproductive Health Services ; Transients and Migrants

Objective: To investigate the distribution patterns of mosquitoes, midges and related arboviruses in Sichuan province. Methods: Blood-sucking insects were collected from houses and pens, using the ultraviolet lights. Mosquito samples were classified according to morphologic characteristics and then stored at liquid nitrogen. All samples were incubated with BHK-21 and C6/36 cells for virus isolation and then detected for their viral genes. Sequences of the virus were identified and analyzed by molecular biological software, such as BioEdit 7.0.5.3, MEGA 6.0. Results: In total, 17 019 mosquitoes from 3 genera and 4 species and 12 700 midges were collected from the southeast regions of Sichuan province in 2016 and 2017. Among them, 79.4% (13 519/17 019) belonged to Culex tritaeniorhynchus with 11.1% (1 897/17 019) as Armigeres subalbatus, 5.5% (930/17 019) were Anopheles sinensis and 4.0% (673/17 019) were Anopheles sinensis 3 virus strains that isolated from Culex tritaeniorhynchus were identified as typeⅠ Japanese encephalitis virus. Seven pools of mosquitoes isolated from Hejiang county were identified Japanese encephalitis virus gene positive through PCR amplification. With 4 pool midges were detected positive for Akabane virus through PCR gene amplification while midges samples didn't have virus isolates. Conclusions: Culex tritaeniorhynchus appeared the predominant species in the southeast regions of Sichuan. Japanese encephalitis virus transmitted by mosquitoes and Akabane virus by midges were prevalent in southeast Sichuan province.
Animals ; Arboviruses ; Culicidae ; Encephalitis Virus, Japanese/isolation & purification* ; Encephalitis, Japanese/diagnosis* ; Genes, Viral ; Nucleic Acid Amplification Techniques ; Phylogeny ; Polymerase Chain Reaction

Objective: To analyze the deaths attributed to ambient air pollution in China between 2006 and 2016. Methods: The data were collected from the project of Global Burden of Disease in 2016 (GBD2016). The Data Integration Model for Air Quality were used to estimate exposure to particulate matter smaller than 2.5 μm in aerodynamic diameter (PM(2.5)). The attributable death number was calculated based on the calculation of population attributable fraction (PAF), and the results were compared by gender, diseases and provinces. An average world population age structure was adopted to calculate age-standardized rates. Results: In 2016, a total of 1 075 000 deaths attributed to ambient air pollution occurred in China, accounting for 11.1% of the total deaths, and 57.6% of the deaths attributed to ambient air pollution were due to ischemic heart disease and stroke. The death number among men was 1.7 times higher than that in women, Compared with 2006, the proportion of ambient air pollution related deaths in total deaths decreased by 6.8%; the age- standardized death rate attributed to ambient air pollution decreased by 26.5% and the decrease rate of lower respiratory infections (37.6%) and chronic obstructive pulmonary disease (42.1%) were greater than ischemic heart disease (5.3%). The age-standardized rate of death attributed to ambient air pollution decreased both in men and in women, but the decrease rate was higher in women (34.8%) than that in men (20.4%). The PAFs varied among provinces, it was highest in Tianjin (13.9%), lowest in Tibet (6.1%), and it was relatively higher in Beijing, Hebei, Shandong, Henan and the three provinces in the northeast and relatively lower in Hong Kong, Macao, Fujian and Hainan etc.. The age-standardized rate of death attributed to ambient air pollution was highest in Xinjiang (120.1/100 000) and lowest in Hong Kong (30.9/100 000), and it was relatively higher in Qinghai, Guizhou, Henan and relatively lower in Macao, Shanghai and Fujian, etc.. Compared with 2006, the PAFs of 17 provinces decreased, the decrease rate ranged from 4.1% to 16.8%, whereas the PAF of Jilin (5.0%) and Heilongjiang (8.1%) increased, and the PAFs of other 14 provinces showed no significant change. The attributable age-standardized death rate decreased in all provinces with the decrease rate ranging from 11.9% (Heilongjiang) to 43.2% (Fujian), and the decrease rate was relatively higher in Guangdong, Zhejiang and Guizhou, and lower in the three provinces in the northeast, Hubei and Hebei etc. Conclusions: In 2016, the disease burden attributable to PM(2.5) in China was heavy, but mitigated compared with 2006. The gender and area specific distributions of deaths attributed to ambient air pollution were observed.
Adolescent ; Adult ; Air Pollution/adverse effects* ; Asian People/statistics & numerical data* ; Cause of Death ; China/epidemiology* ; Female ; Humans ; Male ; Middle Aged ; Mortality ; Pulmonary Disease, Chronic Obstructive/mortality* ; Sex Distribution ; Young Adult

Objective: To understand the seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China. Methods: This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout 7 geographic areas in the mainland of China (northeast, north, central, east, south, northwest and southwest). The numbers of asthmatic patients and total inpatients of the respiratory department of each hospital were recorded. The monthly ratio of asthmatic patients to the total inpatients in every area was calculated and compared. Results: During the study period, 6 480 patients were admitted for asthma exacerbation, accounting for 3.14% of all the 206 135 patients admitted to the respiratory departments in the 29 hospitals. The ratio of asthmatic patients to total inpatients in the northeast area (5.61%) was highest, and the ratio in east area was lowest (1.97%). Statistical analysis showed that the difference among different areas was significant (P<0.000 1). In most areas, both the number and proportion of hospitalized asthmatic patients peaked in spring (February-April) and autumn (September-October). In the northeast area, east area and south area, the peaks in spring were more obvious, while in the north area and southwest area, the peaks in autumn were more obvious. In the northwest area the peaks occurred in winter (December-January) and summer (June-August), respectively. The differences in hospitalization due to asthma among different months were significant in the northeast, north, and southwest areas (P<0.005). Conclusion: The number of patients hospitalized for asthma exacerbation fluctuated with season in different areas in China. In most areas, more asthmatic patients were admitted to hospitals in spring and autumn.
Asthma ; China/epidemiology* ; Hospitalization/statistics & numerical data* ; Humans ; Retrospective Studies ; Seasons

Objective: To investigate the prevalence and associated factors of chronic kidney diseases (CKD) in adult residents living in a community of Songjiang district, Shanghai. Methods: A total of 9 257 residents aged 20-75 years old in Xinqiao township of Songjiang district were selected by random cluster sampling. All the participants were interviewed to complete a set of personal questionnaire and undergo physical examinations. Urine and blood tests including markers of kidney damage and related associated factors with CKD, were carried out. Results: Eligible data from 8 207 subjects were enrolled in the study. After adjustment for age and gender, the prevalence of CKD was 8.4% (95%CI: 7.8%-9.0%), with majority of the patients (76.5%) appeared in the early stage (Ⅰ and Ⅱ) of the disease. The prevalence of CKD increased with age and higher prevalence was seen in females than in males (P<0.001). Results from logistic regression analysis showed that factors as: being elderly or female, having hypertension, hyperuricemia, and hyperlipidemia were all independently associated with CKD. Conclusions: The prevalence of CKD appeared relatively high in adult residents of Xinqiao township, Songjiang district where CKD had become a public health problem. Factors as: being female or elderly, hypertension, hyperuricemia, and hyperlipidemia were found to be associated with CKD. Our findings suggested that early prevention and control on CKD to reduce the incidence of end-stage renal diseases and related complications had called for more urgent attention.
Adult ; Age Factors ; Aged ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Hyperlipidemias/epidemiology* ; Hypertension/epidemiology* ; Hyperuricemia/ethnology* ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic/ethnology* ; Risk Factors ; Sex Factors ; Young Adult