1.Design and baseline characteristics of a population-based birth cohort in Shanghai
Huiting YU ; Xin CUI ; Zhou LIANG ; Renzhi CAI ; Lan CHEN ; Naisi QIAN ; Weixiao LIN ; Shan JIN ; Chunfang WANG ; Chen FU
Shanghai Journal of Preventive Medicine 2024;36(1):11-15
ObjectiveTo introduce the basic design, development plan and objectives of a population-based birth cohort in Shanghai, and further present the main data and baseline characteristics of enrolled participants in the cohort, and to provide key information for reproductive health-related studies. MethodsThe Shanghai population-based birth cohort initiated on January 1, 2005, included newborns born in Shanghai every year and their parents, and collected information on reproductive health, reproductive treatment, birth characteristics, growth and development status, as well as the incidence, treatment and death of diseases by employing data linkage technology and investigations. This formed a birth cohort spanning the entire life cycle. ResultsAs of October 2022, a total of 2 978 538 newborns and their parents were included in the cohort. Among them, 2 905 135 (97.54%) were naturally conceived (NC), and 73 403 (2.46%) were born through assisted reproductive technologies (ART). The average age of parents was (32.56±4.12) years old for females and (34.62±5.34) years old for males in the ART group, which was higher than (28.02±4.71) years and (30.07±5.54) years for parents in the NC group. Among parents, females and males aged 30 and above accounted for 77.12% and 85.08%, respectively, which were higher than that of parents (35.28% for females and 49.66% for males) in the NC group. Furthermore, the percentage of parents with a college degree or above in the ART group was 73.23% for females and 73.66% for males, which were higher than those in the NC group (49.98% and 50.91%, respectively). The multiple births rate in the ART group was 33.81%, which was higher than that in the NC group (1.88%). The incidence of premature birth and low birth weight in the ART group were 24.47% and 19.08%, respectively, which was higher than that in the NC group (5.47% and 3.73%). ConclusionThe comprehensive collection of reproductive health-related information in the birth cohort in Shanghai can provide essential resources to determine the influence of genetics, environment, reproductive treatment and other related factors on the health of offspring after birth.
2.Overview of the establishment of Shanghai twin birth cohort
Shan JIN ; Naisi QIAN ; Weixiao LIN ; Liping FANG ; Lei CHEN ; Bo FANG ; Tian XIA ; Chunfang WANG ; Huiting YU
Shanghai Journal of Preventive Medicine 2024;36(1):16-20
ObjectiveTo establish the Shanghai twin birth cohort (STBC) and analyze the effects of genetic factors, shared environment, and non-shared environment interactions on birth health and growth and development of newborns. MethodsBased on the population-wide birth cohort in Shanghai, a comprehensive survey was conducted on the families with double and multiple babies born after January 1, 2015 to collect information on birth health, growth and development, and the family environment of the babies. ResultsBy December 31, 2021, a total of 7 195 pairs (14 405 cases) of twins were successfully included in the STBC survey. The average birth length of twins was 47.2 cm and average birth weight was 2 465.3 g. Heterozygous twins accounted for 69.05% and preterm babies accounted for 57.07%. The average age of the mothers of twins was 31.82 years, and the average age of the fathers was 33.87 years, with more than 80% of the parents having a college degree or above. 44.50% of the mothers used assisted reproductive technologies, 7.40% had illnesses during pregnancy, and 15.90% were exposed to passive smoking during pregnancy. During the survey period, the average monthly increase in the length of the twin infants was 2.09 cm, and the average monthly weight gain was 0.53 kg. ConclusionThe incidence of adverse outcomes such as maternal cesarean section rate, preterm birth, and low birth weight is higher in the twin birth population. Information on birth health as well as growth and development in childhood and adolescence in the twin birth population is collected based on STBC, which can provide a solid data foundation for studying children’s chronic non-communicable diseases, psychological and behavioral disorders and other complex health problems caused by the combined effects of genetics and the environment.
3.Nested case-control study on children with severe birth defects in Shanghai
Naisi QIAN ; Shan JIN ; Wenwei ZHENG ; Lei CHEN ; Bo FANG ; Chunfang WANG ; Tian XIA ; Huiting YU
Shanghai Journal of Preventive Medicine 2024;36(5):463-468
ObjectiveTo design a prospective nested case-control study based on a city-wide birth cohort of Shanghai, so as to understand their health status and explore the influencing factors of birth defects. MethodsBased on the birth registration covering the entire city of Shanghai, the nested case-control study of children with severe birth defects was designed. Children born with severe birth defects were selected as the case group, and healthy children were matched as the control group. Basic information, health status, maternal pregnancy history, and survival outcome of children both in the case group and the control group were collected through medical history review and home visits. The logistic regression model was used for multivariate analysis. ResultsA total of 18 875 infants born between January 1, 2011, and December 31, 2021, were included, among which 11 500 (60.93%) were children with severe birth defects and 7 375 (39.07%) were healthy children. The logistic regression model analysis showed that being male (OR=1.20, 95%CI:1.13‒1.29), non-Shanghai residency (OR=1.16, 95%CI: 1.06‒1.25), multiple births (OR=8.41, 95%CI:6.25‒11.30), artificial insemination (OR=2.31, 95%CI:1.34‒3.99), in vitro fertilization (IVF) (OR=1.85, 95%CI:1.44‒2.38), maternal exposure to radiation (OR=1.83, 95%CI:1.07‒3.14), maternal illness during pregnancy (OR=1.61, 95%CI:1.49‒1.74), experiencing a traumatic event during pregnancy (OR=2.34, 95%CI:1.88‒2.92), paternal chemical exposure (OR=1.88, 95%CI:1.32‒2.69), paternal radiation exposure (OR=1.65, 95%CI: 1.18‒2.33), family history of birth defects (OR=8.18, 95%CI: 3.96‒16.89), being overweight before pregnancy (OR=1.16, 95%CI: 1.07‒1.27), being obese before pregnancy (OR=1.15, 95%CI:1.03‒1.30), and being excessively obese before pregnancy (OR=1.52, 95%CI:1.26‒1.83) were risk factors for the occurrence of birth defects. Analysis by type of birth defect found that prematurity was a risk factor for cardiac malformations and cheilopalatoschisis (OR=27.87, 95%CI: 20.84‒37.27), especially ranking first in cardiac malformations. ConclusionAfter controlling for influencing factors, maternal overweight, obesity, and excessive obesity before pregnancy, artificial insemination, and IVF are independent risk factors for the occurrence of birth defects. Choosing a healthy lifestyle, improving physical and mental health during pregnancy, and controlling BMI during pregnancy are beneficial in reducing the risk of birth defects.
4.Trend and gender difference of mortality rate of senile dementia: based on the method of annual percent change
Naisi QIAN ; Lei CHEN ; Bo FANG ; Huiting YU ; Jiaying QIAO ; Shan JIN ; Qi LI ; Chunfang WANG
Shanghai Journal of Preventive Medicine 2023;35(2):132-136
ObjectiveTo investigate the characteristics of gender difference and the trend of the mortality rate of senile dementia in registered population in Shanghai from year 2002 to 2018, and to provide the basis for formulating relative intervention measures before and after senile dementia from an public-health view. MethodsBased on the collected data of death registration, focused on the senile dementia disease codes F03,G30.0,G30.1,G30.8,G30.9 according to The International Classification of Diseases 10th revision (ICD-10). We analyzed the characteristics of gender difference in the mortality rate of senile dementia in registered population in Shanghai from year 2002 to 2018. According to ASR, we calculated the standardized mortality rate of senile dementia, and used the chi-square test to compare the difference between the gender mortality rates. The trend and the turning point of the mortality rate of senile dementia were determined by linear regression analysis by Join-point. ResultsThe crude mortality rate of senile dementia in the registered population in Shanghai from year 2002 to 2018 was 5.46/105, 3.50/105 in males and 7.43/105 in females. The standardized mortality rate of senile dementia was 2.61/105, 1.67/105 in males and 3.56/105 in females. The trend of the standardized mortality rate of senile dementia in 17 years decreased [APC=-5.5(-6.5,-4.5)%,P<0.01]. The trend of the standardized mortality rate of senile dementia decreased in both males [APC=-4.9(-6.2,-3.6)%,P<0.01] and females [APC=-5.9(-6.9,-4.9)%,P<0.01]. The trend of the gender difference decreased [APC=-6.8(-8.2,-5.3)%,P<0.01]. The mortality rate of senile dementia was higher in females than in males [(χ2=33.63,P<0.01)]. ConclusionThe mortality rate of senile dementia in females is higher than in males in Shanghai, though the trend of the gender difference decreased. This gender difference is worth of attention.
5.Dynamic relationship between changes of mortality rate and urban development level in Shanghai
Shan JIN ; Bo FANG ; Renzhi CAI ; Naisi QIAN ; Huiting YU ; Jiaying QIAO ; Lei CHEN ; Chunfang WANG
Shanghai Journal of Preventive Medicine 2023;35(7):654-659
ObjectiveTo analyze the dynamic response relationship between urban development and mortality rate in Shanghai, and to predict the trend of mortality rate changes. MethodsBy analyzing the total mortality rate (TMR), gross domestic product (GDP) and socio-demographic index (SDI) in Shanghai from 1978 to 2017, a vector autoregressive (VAR) model was constructed to evaluate the impact of urban development on the mortality rate. ResultsThe fitted
6.Clinicopathological analysis and literature review of Burkitt-like lymphoma with 11q aberration
Honglan ZHANG ; Chunmei YANG ; Congying YANG ; Chunfang ZHANG ; Yanhong NIE ; Yanling HE ; Qian WANG ; Wanneng HE ; Chang ZHANG ; Hao CHEN
Clinical Medicine of China 2022;38(3):222-227
Objective:To investigate the clinicopathological features,differential diagnosis,treatment and prognosis of Burkitt-like lymphoma with 11q aberration (BLL-11q).Methods:The clinical manifestations,histological morphology,immunophenotype and molecular genetic changes of 2 cases of BLL-11q admitted to the department of pathology of The First People's Hospital of Lianyungang in 2020 and 2021 were analyzed retrospectively,and the relevant literatures were reviewed.Results:Patients were found with right neck masses inadvertently and grew rapidly. They presented with localized disease with Ann Arbor stages IA and IIA. Microscopically, the normal structure of the lymph node disappeared and was replaced by a diffuse proliferation of lymphocytes, with consistent morphology and medium size. And the presence of "star-sky" phenomenon was obvious, the morphological characteristics were similar to Burkitt lymphoma. Immunophenotypically, tumor cells were diffusely positive for CD20, CD79α, PAX5, CD10 and Bcl-6, partly moderately positive for C-MYC and MUM-1, however, CD3, Bcl-2, CD30 and TDT were negative,Ki-67 positive index was more than 95%, and EBER was negative. FISH detection showed that MYC, Bcl-2, and Bcl-6 were negative. Both cases had the 11q23.3 gain and 11q24.3 loss. Both patients were treated with chemotherapy and followed up for 10-22 months,and achieved complete remission and disease-free survival.Conclusion:BLL-11q is a rare germinal center B-cell lymphoma with abnormal long arm of chromosome 11 and lack of MYC gene rearrangement. It should be distinguished from Burkitt lymphoma, diffuse large B-cell lymphoma, B-lymphoblastic lymphoma, large B-cell lymphoma with IRF4 rearrangement and high-grade B-cell lymphoma. On the basis of morphology and immunophenotype, the diagnosis depends on genetic detection. There may be a better prognosis.
7.Analysis on adult health life expectancy in Shanghai
Bo FANG ; Chunfang WANG ; Huiting YU ; Lei CHEN ; Renzhi CAI ; Naisi QIAN ; Tian XIA ; Fan WU
Chinese Journal of Epidemiology 2021;42(5):846-852
Objective:To investigate health status and calculate health life expectancy (HE) of residents in Shanghai, analyze health related factors and provided foundation of health policy.Methods:A multi-stage stratified random sampling was used to obtain self-reported health survey in Shanghai. WHO questionnaire was used to evaluate the health quality of life which was designed for the world health survey, Sullivan's method was used to calculate HE.Results:The self-assessment disability measure for adults over 18 years old in Shanghai was 0.25, higher for women (0.28) than for men (0.23). LE was 65.76 years for adults over 18 years old, higher for women (68.22) than for men (63.39). HE for adults over 18 years old was 47.99 years old, higher for men (49.05) than women (47.14). HE's proportion in LE gradually decreases with age. It accounts for 72.97% in the 18 years old and 39.00% in the 85 years old.Conclusions:The health of adult male in Shanghai is higher than that of female, and the proportion of HE loss of elderly is higher than young people. It is necessary to focus on the aging problem and strengthen the long-term care and health support system for the elderly. Improve the prevention and control of major diseases such as chronic diseases,which affect the quality of life expectancy seriously. Promotes the health level and quality of life in Shanghai.
8.Application of BACs-on-Beads in prenatal diagnosis.
Yan ZENG ; Ting WANG ; Tao ZHANG ; Jiaming FAN ; Lifang ZHANG ; Feiyan QIAN ; Tingting LUO ; Weiping CHEN ; Ming CHE ; Chunfang QIAN
Chinese Journal of Medical Genetics 2020;37(8):891-894
OBJECTIVE:
To explore the value of BACs-on-Beads (BoBs) for the practice of prenatal diagnosis.
METHODS:
The results of chromosomal karyotyping and BoBs of 1773 prenatal samples were compared. Microdeletions and microduplications detected by BoBs were subjected to chromosome microarray analysis (CMA) with informed consent from patients.
RESULTS:
BoBs has detected 46 cases of common aneuploidies involving chromosomes 13, 18, and 21, and 16 cases involving X and Y chromosomes. For 4 fetuses with normal results by BoBs, karyotyping analysis of amniotic fluid sample suggested low percentage mosaicisms (< 20%). BoBs has detected none of the 9 common microdeletions, but 14 male fetuses with Xp22 microdeletions and 5 with other microdeletions/microduplications. In 10 cases, the couples had chosen CMA verification, and the results were all consistent.
CONCLUSION
As a rapid diagnostic technique, BoBs has a high accuracy for common aneuploidies, and is capable of discovering certain chromosome microdeletions and microduplications. The difficulty lies in the inability to detect low proportion mosaicisms and the consultation following detection for male fetuses carrying Xp22 microdeletions.
9.Association between incidence of fatal intracerebral hemorrhagic stroke and fine particulate air pollution.
Yifeng QIAN ; Huiting YU ; Binxin CAI ; Bo FANG ; Chunfang WANG
Environmental Health and Preventive Medicine 2019;24(1):38-38
OBJECTIVE:
Few studies investigating associations between fine particulate air pollution and hemorrhagic stroke have considered subtypes. Additionally, less is known about the modification of such association by factors measured at the individual level. We aimed to investigate the risk of fatal intracerebral hemorrhage (ICH) incidence in case of PM (particles ≤ 2.5 μm in aerodynamic diameter) exposure.
METHODS:
Data on incidence of fatal ICH from 1 June 2012 to 31 May 2014 were extracted from the acute stroke mortality database in Shanghai Municipal Center for Disease Control and Prevention (SCDC). We used the time-stratified case-crossover approach to assess the association between daily concentrations of PM and fatal ICH incidence in Shanghai, China.
RESULTS:
A total of 5286 fatal ICH cases occurred during our study period. The averaged concentration of PM was 77.45 μg/m. The incidence of fatal ICH was significantly associated with PM concentration. Substantial differences were observed among subjects with diabetes compared with those without; following the increase of PM in lag2, the OR (95% CI) for subjects with diabetes was 1.26 (1.09-1.46) versus 1.05 (0.98-1.12) for those without. We did not find evidence of effect modification by hypertension and cigarette smoking.
CONCLUSIONS
Fatal ICH incidence was associated with PM exposure. Our results also suggested that diabetes may increase the risk for ICH incidence in relation to PM.
Air Pollutants
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analysis
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Cause of Death
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Cerebral Hemorrhage
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mortality
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China
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epidemiology
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Diabetes Mellitus
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mortality
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Environmental Exposure
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statistics & numerical data
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Female
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Humans
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Incidence
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Male
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Particle Size
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Particulate Matter
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analysis
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Stroke
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mortality
10.Comparison of the Improved Method and the Traditional Method for Toluidine Red Unheated Serum Test in Syphilis Screening
Jingxuan XU ; Yi XIA ; Wenhong PENG ; Chunfang ZHANG ; Xianhua ZHAO ; Yunfang QIAN ; Lei CHU ; Erfu XIE
Journal of Modern Laboratory Medicine 2017;32(3):133-136
Objective To compare the detection performance of the modified serum test (TRUST) method and the traditional method in syphilis screening.Methods A series of TRUST high titer syphilis serum was diluted,and the positive rate of each method was calculated by using the improved method and the traditional method.Comparison of two detection methods of C50,C5 ~ C95 interval,as well as the accuracy of the density curve,and the consistency of the two methods were compared,and diagnostic performance were compared.Results The improved method of C50 was less than the traditional method of C50,and the improved method of C5 ~ C95 range was narrower than the traditional method,compared with the traditional method.The improved method of the non precision density curve was steeper than the traditional method,and the two confidence interval of the consistency degree of the 95% methods was 73.4% to 95.8%.The diagnostic sensitivity (SEN),diagnostic specificity (SPE),positive predictive value (PPV),negative predictive value (NPV) and diagnostic efficiency(DF) of the improved method were 64.29 %,99.1%,85.71%,97.05 % and 96.39 %,respectively.The SEN,SPE,PPV,NPV and DF of the traditional methods were 3.75 %,98.49 %,75 %,96.18 % and 95 %,respectively.The improved method was superior to the traditional methods in the two aspects of SEN and PPV (x2 =8.25,10.03,all P<0.05),with the statistically significant difference.The improved method was slightly higher than the traditional method in SPE,NPV and DF (x2 =2.39,3.45,4.03,all P>0.05),with the no statistically significant difference.Conclusion The precision,diagnostic sensitivity and diagnostic specificity of the improved method was higher than that of the traditional method,and it can be applied to the detection of large batch samples with the aid of the full automatic enzyme immunoassay instrument.The improved method can be used to replace the traditional method for syphilis screening.

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