Objective:To evaluate the new model of group screening combined with opportunistic screening for the diagnosis and treatment of gastric cancer.Methods:Group screening combined with opportunistic screening was used for gastric cancer screening. (1) Group screening. Cluster sampling was used to screen gastric cancer by endoscopy in high-risk population (aged 40-<70 years) of rural residents in Weihai from July 2017 to December 2020, and biopsy was obtained for histopathology if necessary. Main collection parameters included the detection rate of advanced gastric cancer, early gastric cancer and high-grade intraepithelial neoplasia (HGIN). (2) Opportunistic screening. The changes of the detection rates of early gastric cancer in opportunistic screening in 2 hospitals in Weihai area were observed during the same period of time.Results:(1) In group screening, from July 2017 to December 2020, the first batch of 8 000 cases of gastric cancer screening were completed. The cases of advanced gastric cancer, early gastric cancer and HGIN were 36, 28, and 62, respectively. The detection rates of gastric cancer and early gastric cancer were 0.80% (64/8 000) and 43.75% (28/64), respectively. The proportion of early gastric cancer+HGIN who received endoscopic submucosal dissection (ESD) was 77.78% (70/90), and the rate of curative resection was 100.00%(70/70). (2) Opportunistic screening: from July 2017 to December 2020, the annual early gastric cancer detection rates in opportunistic screening in Wendeng District Traditional Chinese and Western Medicine Hospital were 16.67% (1/6), 20.00% (3/15), 23.53% (4/17), and 33.33% (6/18) in the consecutive 4 years, respectively. The annual detection rates of early gastric cancer in opportunistic screening in Ru Shan Peoples Hospital were 14.74% (14/95), 23.80% (60/252), 25.49% (65/255), and 24.04% (50/208), respectively. The detection rates of opportunistic screening for early gastric cancer in hospitals in Weihai city increased year by year.Conclusion:In areas with high incidence of gastric cancer, a certain scale of group screening can lead to a wider range of opportunistic screening, resulting in the increase of the detection rate of early gastric cancer. The new model of diagnosis and treatment of gastric cancer is worth recommendation.

Objective:To explore the relationship between self-rated health status and risk of stroke in Chinese adults.Methods:Data was collected from the Chronic Disease Risk Factor Surveillance in China (2010) as baseline. A total of 60 follow-up monitors (25 urban and 35 rural) in 11 provinces were selected. A total of 36 195 participants without prior cardiovascular diseases were followed and investigated 27 441 people in 2016 and 2017. Cox proportional hazard regression model was used to analyze the self-assessed health status and stroke onset hazard ratio ( HR), further conducted several subgroup analyses by demographic characteristics such as age and gender, and sensitivity analysis was performed by excluding death and baseline diabetes. Results:A total of 26 699 study subjects were included according to the inclusion criteria. We identified 1 332 stroke cases (32 subarachnoid hemorrhage, 197 cerebral hemorrhage, and 1 149 cerebral infarction) during an average of 6.4 years (171 431.1 person-years) of follow-up, and the incidence density was 7.77/1 000 person-years. After adjusting the related factors, the risk of stroke in participants with poor self-related health increased by 68% ( HR=1.68, 95% CI:1.22-2.32) and the risk of ischemic stroke increased by 47% ( HR=1.47, 95% CI:1.05-2.05), with a reference of excellent ones. In subgroup analysis, only age and BMI had an effect-modifying effect on the association between self-rated health and risk of stroke. Only age and dyslipidemia had an effect-modifying effect on the association between self-rated health and ischemic stroke risk (interaction P<0.05). The results of the sensitivity analysis were consistent with the results of the total population. Conclusion:People with poor self-assessed health, especially for those who were overweight/obesity with poor self-assessed health or age less than 60 or dyslipidemia are at increased risk of stroke and ischemic stroke and should be targeted for intervention.

Objective:To explore the relationship between body mass index (BMI), waist circumference (WC) and the risk for ischemic stroke in adults in China.Methods:A total of 36 632 adults were selected from 60 surveillance areas (25 urban surveillance areas and 35 rural surveillance areas) in China Chronic Disease Surveillance Project in 2010 for a follow up study from 2016 to 2017 based on the baseline data in 2010. The follow up was completed for 27 762 adults. Cox proportional hazard regression model was used to analyze the association of body mass index and waist circumference with the risk for ischemic stroke in different populations. The death and hypercholesterolemia cases were excluded by sensitivity analysis.Results:A total of 26 907 adults were included in the analysis. During the follow up period, 1 128 ischemic stroke events were observed (491 in men and 637 in women). After adjusting the related confounding factors and taking normal BMI/normal WC group as the reference, the risk for ischemic stroke increased by 50% in normal BMI/abdominal obesity group ( HR=1.50, 95% CI:1.07-2.08), 51% in overweight/abdominal obesity group ( HR=1.51, 95% CI:1.20-1.91), 46% in obesity/abdominal obesity group ( HR=1.46, 95% CI:1.09-1.96), and 63% in normal BMI/abdominal obesity group ( HR=1.63, 95% CI:1.12-2.38), 56% in overweight/abdominal obesity group ( HR=1.56, 95% CI: 1.20-2.03) and 45% in obesity/abdominal obesity group ( HR=1.45, 95% CI: 1.05-2.01) respectively in men and in men with CVD risk factors. There was no increased risks in the overweight/normal WC group. The risk increased by 40% in overweight/abdominal obesity group ( HR=1.40, 95% CI:1.15-1.72) and 46% in obesity/abdominal obesity group ( HR=1.46, 95% CI:1.16-1.83), and 35% in overweight/abdominal obesity group ( HR=1.35, 95% CI:1.08-1.69) and 30% in obesity/abdominal obesity group ( HR=1.30, 95% CI:1.01-1.67) respectively in women and women with CVD risk factors. There were no risk increases in overweight/normal WC group and normal BMI/abdominal obesity group. Sensitivity analysis results showed no change. Conclusion:Overweight/obesity with abdominal obesity or abdominal obesity alone could increase the risk for stroke in men, and overweight/obesity with abdominal obesity could increase the risk for ischemic stroke in women; suggesting that BMI and WC should be used jointly to evaluate obesity in population for weight control to prevent ischemic stroke.

Objective:To analyze the association between waist-to-height ratio and the overall and type specific incidence of stroke in adults in China.Methods:A total of 36 632 people were selected from 60 surveillance sites (25 in urban area and 35 in rural area) in China Chronic Disease Surveillance Project in 2010. The China Chronic Disease Surveillance Project data in 2010 were used as baseline data. A total of 27 762 people were followed up from 2016 to 2017. Cox proportional risk regression model was used to analyze the risk ratio of waist-to-height ratio for the overall and type specific incidence of stroke. Subgroup analyses were performed based on baseline characteristics such as age and sex, and sensitivity analysis was performed by excluding those who died and those with diabetes at baseline survey.Results:A total of 27 112 subjects were included in the stroke analysis, and 1 333 stroke events were observed. A total of 26 907 subjects were included in the ischemic stroke analysis, and 1 128 ischemic stroke events were observed. A total of 25 984 subjects were included in the hemorrhagic stroke analysis, and 205 cases of hemorrhagic stroke were observed. After adjusting for relevant confounders and taking group with waist-to-height ratio of 0-0.45 as a reference, the stroke analysis indicated that in groups with waist-to-height ratio of 0.46-0.49, 0.50-0.54 and ≥0.55 the risk for stroke increased by 21% ( HR=1.21, 95% CI:1.00-1.46), 26% ( HR=1.26, 95% CI:1.04-1.53) and 60% ( HR=1.60, 95% CI:1.29-1.99) respectively. Subgroup analysis revealed that age specific waist-to-height ratio had modification effect on the risk for stroke (interaction P=0.001). Ischemic stroke analysis indicated that in groups with waist-to-height ratio of 0.46-0.49, 0.50-0.54 and ≥0.55 the risk for ischemic stroke increased by 30% ( HR=1.30, 95% CI: 1.05-1.60), 33% ( HR=1.33, 95% CI: 1.07-1.64) and 61% ( HR=1.61, 95% CI: 1.26-2.05) respectively. Subgroup analysis revealed that age specific waist-to-height ratio had modification effect on the risk for ischemic stroke (interaction P=0.024). Hemorrhagic stroke analysis indicated that in group with waist-to-height ratio of ≥0.55 the risk for hemorrhagic stroke increased by 73% ( HR=1.73, 95% CI: 1.02-2.94), but the differences in the risk increase in groups with waist-to-height ratio of 0.46-0.49 and 0.50-0.54 were not significant. The sensitivity analysis showed no changes. Conclusions:In the prevention and control of stroke by body weight control, it is necessary to take waist to height ratio as one of the indicators of body weight control. Particular attention needed to be paid to the people aged <50 years with waist-to-height ratio of ≥0.55 as well as those with waist-to-height ratio of <0.5 (i.e., 0.46-0.49).

Objective:To explore the relationship between sedentary time and the incidence of type 2 diabetes in adults in China.Methods:Data collected from the Chinese Chronic Disease and Risk Factor Surveillance (CCDRFS) in 2010 were used as baseline data. Eight provinces where CCDRFS were conducted in 2010 were selected, and two surveillance spots (one in urban area and another one in rural area) of each provinces were further selected for the follow-up studies. After excluding diagnosed diabetes patients according to baseline data, a total of 8 625 of subjects were recruited as participants. In the follow up carried out from 2016 to 2017, a total of 5 991 people received complete follow up. Cox proportional hazards models were used to analyze the relationship between sedentary time and the incidence of type 2 diabetes, and subgroup analysis was conducted based on variables such as gender, geographic area, and urban area or rural areas.Results:A total of 5 782 subjects were included in final analysis. During an average 6.4 years of follow up (36 927.0 person-years), 592 participants developed type 2 diabetes, the incidence rate was 16.0 per 1 000 person years. Multivariate Cox regression analysis showed that after adjustment for possible confounders, compared with the 0.0-h/d group, the risk of diabetes incidence increased by 33% ( HR=1.33, 95 %CI: 1.05-1.68) for those who had sedentary time for more than 6.0 h every day. The subgroup analysis showed that the significant association was only observed in those who were men, current smokers, central obese, had family history of diabetes, had rural residency, and lived in eastern and central areas of China. Conclusions:Longer sedentary time can increase the risk of type 2 diabetes. Lifestyle intervention should be strengthened to reduce sedentary time, especially for people who had sedentary time for more than 6.0 h every day.

Objective: To learn the epidemiological characteristics of fall mortality among the elderly people in Taizhou，and to provide basis for intervention strategies of fall in the elderly. Methods: Data of fall mortality among residents aged 60 years or over in Taizhou from 2016 to 2018，collected from Zhejiang Chronic Disease Surveillance Information Management System，was used for analysis of time，population and geographical characteristics of fall deaths. The epidemic trend of fall mortality in the elderly was described by annual percentage change（APC）. Results: From 2016 to 2018，3 699 cases of fall death in Taizhou were reported，the crude and standardized mortality were 116.90/100 000 and 97.88/100 000. The standardized mortality of fall in women was 106.11/100 000，which was higher than 90.13/100 000 in men（P<0.05）. The standardized mortality of fall in rural residents was 131.20/100 000，which was higher than 28.15/100 000 in urban residents（P<0.05）. The mortality of fall in residents aged 65-69 years from 2016 to 2018 showed an upward trend（APC=4.20%，P<0.05），while the mortality trend of fall in other age groups was not statistically significant（P>0.05）. Conclusion Fall was the first cause of injury death in the elderly aged 60 years or over in Taizhou. Females and rural residents have relatively higher fall mortality.

Objective: To evaluate chemiluminescence immunoassay (CLIA) for detecting blood levels of aldosterone and rennin with its diagnostic value of primary aldosteronism (PA) with comparison to radio immunoassay (RIA). Methods: According to American protocols of CLSI, we conducted a veriifcation study between RIA and CLIA for their precision, accuracy, linearity and reference ranges; meanwhile, taking clinical diagnosis as golden standard, examined renin activity or concentration and aldosterone concentration in 20 healthy volunteers and 40 hypertension patients by both RIA and CLIA, compared the ratios of ARR (aldosterone concentration/renin activity) or ADRR (aldosterone concentration/renin concentration) for the speciifcity and sensitivity of PA diagnosis. Results: Within-lot and between-lot accuracies of CLIA for detecting aldosterone levels were below 5% and 10%, the recoveries were 102% and 95% respectively. There was a good linear correlation in the range of aldosterone at (3-74) ng/dl and renin at (0.99-330) μIU/ml. In healthy volunteers, renin level was higher in 2 subjects, while aldosterone level and ADRR ratio were within normal references in all subjects by the manufacturer. In hypertension patients, the sensitivity and speciifcity for aldosterone and rennin detections by CLIA were at 85.7% and 97.0%, by RIA were at 85.7% and 94.0%. Conclusion: CLIA has the superiority of simple performance, repeatable and without radioactive contamination; it is recommended for replacing RIA as necessity.

Objective To evaluate the utility of MMP9,MPO and sCD40L in detection of the character of coronary artery plaque.Methods From April 2008 to January 2010,118 patients from outpatient of Fu Wai Hospital with chest pain were enrolled.All of them underwent 64 Multiple-detector row spiral computer tomography (64-MDCT),the CT value ＜ 130 Hu patients were enrolled in non-calcified plaque group (71 cases),CT value ≥ 130 Hu patients were enrolled in the calcified plaque group (47 cases).Ninty healthy volunteers were selected as the control group.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum markers,including MMP9,MPO and sCD40L.Levels of MMP9,MPO and sCD40L of each group were compared.ROC curve was used to evaluate the sensitivity and specificity of the markers in diagnosis of non-calcified plaque.Results MMP9,MPO and sCD40L levels of non-calcified were ( 762.25 ± 368.71 ),[ 844.10 (582.00 - 1220.70) ],(9.37 ± 3.15) μg/L,higher than the healthy control group (342.70 ± 178.53),[426.35 ( 283.20 - 592.00) ],(6.55 ± 2.96) μg/L and calcified plaque group ( 483.12 ± 219.09 ),[ 469.00 ( 302.45 - 723.55) ],( 7.24 ± 2.86) μg/L The difference was statistically significant ( F =42.47,H =50.28,F =17.94,all P ＜ 0.01 ). Areas of MMP9,MPO and sCD40L under the ROC curve to predict non-calcified plaque were 0.854,0.792,0.751 respectively,when the identification threshold for non-calcified plaque were 510.13,537.82,7.05 μg/L respectively,the diagnostic sensitivity was 80％,80％,80％ respectively,and specificity was 80％,67％ and 55％ respectively.Conclusion The serum MMP9,MPO and sCD40L levels can help to determine the　character of coronary plaque.

Objective To investigate plasma levels of high-sensitivity C-reactive protein (hs-CRP) in patients with coronary heart disease (CHD) and relationship between hs-CRP levels and cardiac function. Methods The serum hs-CRP concentrations in 894 CHD patients diagnosed by coronary angiography and 141 healthy controls were measured by particle enhanced immunoturbidimetric assay. Results The median of hs-CRP levels was 1.70 (0.13-19.53 ) mg/L and abnormal ratio was 37.6% (336/894), that were significantly higher in CHD group than healthy controls [0. 99(0. 13-19. 53) rag/L, 7. 1% (10/141) ] (Z=-6. 476,X<'2> = 50. 882, P <0.01 ). The median of hs-CRP levels was 5.35 (0. 18-19. 10) mg/L and abnormal ratio was 63.9% (92/144), that were much higher in acute myocardial infarction (AMI) group than in old myocardial infarction (OMI) group [2.27 (0.13-19.19) mg/L, 43.7% (129/295) ] (Z = -3.353 ,X<'2> = 15. 732, P <0. 01 ). The median of hs-CRP levels was 1.45 (0.19-19.53) mg/L in unstable angina pectoris(UAP) group and abnormal ratio was 29.1% (73/251), that were was higher in stable angina pectoris (SAP) group [1.04 (0.13-16.31 ) mg/L, 20. 6% (42/204) ] (Z=-2.981, P = 0.003;X<'2> = 4.30, P=0.038 ) . Furthermore, Kruskal-Wallis test showed the concentrations of hs-CRP and NT-proBNP was increased along with increment of CHD severity (NYHA functional classification) (X<'2> = 120.185,424.945, P <0.001 ). Multivariate analysis showed that hs-CRP levels positively correlated with NYHA functional classification ( r = 0.328, P <0.01 ) as well as NT-proBNP levels (r=0.413, P <0.01 ). Conclusion Serum hs-CRP level increases along with CHD severity, indicating that hs-CRP may play a certain role in the occurrence and development of CHD.

AIM: To investigate the effect of homocysteine(Hcy) on the apoptosis of endothelial cells (EC). METHODS: First-passaged human umbilical vein endothelial cells (hUVEC) were cultured with M199 containing 3 mmol/L Hcy. hUVEC apoptosis was detected as follow: demonstration of nuclear changes by Hoechst 33258 staining, agarose gel electrophoresis of DNA fragments, detection of apoptotic cells by flow cytometry following Annexin V-PI doubled stain, Western blot for P53 and Bax protein detection and colorimetry detecting caspase-3 activity. RESULTS: Compared with control, homocysteine induced characteristic apoptotic changes in hUVEC. The chromosomal DNA of hUVEC appeared “DNA ladder” by agarose gel electrophoresis. Apoptotic cells were increased significantly (P