1.Exploration of the classification of public health intervention and its implication for China.
Zhen Zhong WANG ; Yi Hao ZHAO ; Zheng Yan ZHANG ; En Ying GONG ; Rui Tai SHAO
Chinese Journal of Preventive Medicine 2023;57(10):1655-1662
Public health interventions refer to a series of organized and specific measures implemented in specific situations to achieve goals related to improving health, preventing and controlling diseases, and more. As research on intervention measures has deepened, the classification of public health interventions has gradually developed, clarifying the nature, categories and intervention targets of these measures. This typological study can help standardize the concepts of public health interventions, develop, select, and evaluate the effectiveness of intervention measures, and improve the effectiveness of public health actions. This paper reviews the main international classification models of intervention measures, analyzes and summarizes five classification methods of public health interventions, namely, based on goals, nature, objects, hierarchies, and modes of action, and introduces relevant cases. The paper proposes that China should conduct further in-depth and systematic research on public health interventions, develop evidence-based intervention measures and practices, promote the effective transformation of intervention measures and results, and facilitate the development of public health.
Humans
;
Public Health
;
China
2.Efficacy and safety of bevacizumab biosimilars versus original drugs for patients with metastatic colorectal cancer:a Meta-analysis
En-Hui WEN ; Ying LI ; Zhi-Ying WANG ; Li-Hui LONG
Chinese Journal of Pharmacoepidemiology 2023;32(12):1401-1407
Objective To systematically review the efficacy and safety of bevacizumab biosimilars versus original drugs in treatment of metastatic colorectal cancer.Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched to collect the randomized controlled trials(RCTs)of bevacizumab biosimilar in patients with metastatic colorectal cancer from inception to June 18,2023.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies,and a meta-analysis was conducted using Stata 17.0 software.Results A total of 4 RCTs involving 1 052 patients were included.The results of meta-analysis showed that no significant difference was found in overall response rate(RD=﹣0.01,95%CI ﹣0.06 to 0.05,P=0.86),progression free survival(HR=1.00,95%CI 0.91 to 1.09,P=0.94),the total incidence of adverse drug reactions(RR=1.05,95%CI 0.85 to 1.31,P=0.91)and the incidence of severe adverse events(RR=0.886,95%CI 0.377 to 2.081,P=0.60)between bevacizumab biosimilars group and original drugs group.Conclusion The current evidence shows that bevacizumab biosimilar is equivalent to original drugs in treatment of metastatic colorectal cancer.Due to limited quality and quantity of the included studies,more high quality studies are required to verify the above conclusions.
3.Evaluation of the clinical effect of acupuncture in treatment of neck pain in cervical spondylosis based on propensity score matching.
Yin-Juan ZHANG ; Jia-Qi YANG ; Jie WU ; Jian-En GUO ; Zhi-Xin YANG ; Jin-Ying LIU ; Yu-Man WANG
Chinese Acupuncture & Moxibustion 2023;43(8):907-910
OBJECTIVE:
To observe the clinical effect and safety of acupuncture in treatment of neck pain due to cervical spondylosis.
METHODS:
According to the patients' preference and acceptance for the interventions of neck pain induced by cervical spondylosis, an acupuncture group (221 cases) and a non-acupuncture group (251 cases) were divided. After the control of confounding factors with propensity score matching, 218 cases were included in either acupuncture group or non-acupuncture group. In the acupuncture group, acupuncture was applied to Dazhui (GV 14), Baihui (GV 20), ashi points, bilateral neck-Jiaji (EX-B 2), Fengchi (GB 20), Houxi (SI 3), Shenmai (BL 62), etc. The treatment was given once daily, one course of intervention was composed of 5 treatments and 3 courses were included. In the non-acupuncture group, the oral administration of imrecoxib tablets and cobalt tablets was prescribed for 2 weeks. Before and after treatment, the scores of Northwick Park questionnaire (NPQ) and the simplified McGill pain questionnaire (SF-MPQ) were observed, and the safety was assessed in patients of the two groups.
RESULTS:
After treatment completion, the scores of NPQ and SF-MPQ were all reduced when compared with those before treatment in each group (P<0.001), and the scores of NPQ and SF-MPQ in the acupuncture group were lower than those of the non-acupuncture group (P<0.001). The incidence of adverse reactions was 6.0% (13/218) in the acupuncture group and was 10.1% (22/218) in the non-acupuncture group, without statistical significance in comparison (P>0.05).
CONCLUSION
Acupuncture is effective and safe in the relief of neck pain and the improvement of comprehensive quality of life in the patients with cervical spondylosis.
Humans
;
Neck Pain/therapy*
;
Propensity Score
;
Quality of Life
;
Acupuncture Points
;
Acupuncture Therapy
;
Spondylosis/therapy*
;
Treatment Outcome
4.Progress in research of risk prediction of non-syndromic oral clefts using genetic information.
Si Yue WANG ; He Xiang PENG ; En Ci XUE ; Xi CHEN ; Xue Heng WANG ; Meng FAN ; Meng Ying WANG ; Nan LI ; Jing LI ; Zhi Bo ZHOU ; Hong Ping ZHU ; Yong Hua HU ; Tong WU
Chinese Journal of Epidemiology 2023;44(3):504-510
Non-syndromic oral cleft (NSOC), a common birth defect, remains to be a critical public health problem in China. In the context of adjustment of childbearing policy for two times in China and the increase of pregnancy at older childbearing age, NSOC risk prediction will provide evidence for high-risk population identification and prenatal counseling. Genome-wide association study and second generation sequencing have identified multiple loci associated with NSOC, facilitating the development of genetic risk prediction of NSOC. Despite the marked progress, risk prediction models of NSOC still faces multiple challenges. This paper summarizes the recent progress in research of NSOC risk prediction models based on the results of extensive literature retrieval to provide some insights for the model development regarding research design, variable selection, model-build strategy and evaluation methods.
Humans
;
Cleft Palate/genetics*
;
Cleft Lip/genetics*
;
Genome-Wide Association Study
;
Genetic Predisposition to Disease
;
Risk Factors
;
Polymorphism, Single Nucleotide
5.Exploration of the classification of public health intervention and its implication for China.
Zhen Zhong WANG ; Yi Hao ZHAO ; Zheng Yan ZHANG ; En Ying GONG ; Rui Tai SHAO
Chinese Journal of Preventive Medicine 2023;57(10):1655-1662
Public health interventions refer to a series of organized and specific measures implemented in specific situations to achieve goals related to improving health, preventing and controlling diseases, and more. As research on intervention measures has deepened, the classification of public health interventions has gradually developed, clarifying the nature, categories and intervention targets of these measures. This typological study can help standardize the concepts of public health interventions, develop, select, and evaluate the effectiveness of intervention measures, and improve the effectiveness of public health actions. This paper reviews the main international classification models of intervention measures, analyzes and summarizes five classification methods of public health interventions, namely, based on goals, nature, objects, hierarchies, and modes of action, and introduces relevant cases. The paper proposes that China should conduct further in-depth and systematic research on public health interventions, develop evidence-based intervention measures and practices, promote the effective transformation of intervention measures and results, and facilitate the development of public health.
Humans
;
Public Health
;
China
6.Antimicrobial susceptibility of Gram-positive organisms:Results from China antimicrobial resistance surveillance trial(CARST)program,2021-2022
Yun LI ; Bo ZHENG ; Feng XUE ; Xiu-Zhen ZHANG ; Yun-Jian HU ; Yu-Fen JIN ; Jian-Hong ZHAO ; Shi-Yang PAN ; Wei GUO ; Feng ZHAO ; Yun-Song YU ; Xuan CAI ; Wen-En LIU ; De-Hua LIU ; Ying FEI ; Jia-Yun LIU ; Feng-Yan PEI ; Ling MENG ; Ping JI ; Jin TANG ; Kai XU ; Lei ZHU ; Cun-Wei CAO ; He-Ping XU ; Shan WANG ; Lan-Qing CUI ; Jia ZHANG ; Yao-Yao LIU
The Chinese Journal of Clinical Pharmacology 2023;39(23):3509-3524
Objective To investigate the Gram-positive coccus resistance in nationwide's tertiary hospitals and understand the trend of antimicrobial resistance.Methods All the clinical isolates were collected from 19 hospitals and the minimal inhibitory concentrations(MICs)were tested using agar/broth dilution method recommended.Results A total of 1 974 pathogenic Gram-positive coccus from 19 tertiary hospitals in 19 cities nationwide over the period from July 2021 to June 2022 were studied.Based on the MIC results,the prevalence of methicillin resistant Stapylococcus aureus(MRSA)and methicillin resistant Stapylococcus epidermidis(MRSE)were 36.4%and 79.9%respectively.No vancomycin insensitivity Staphylococcus was detected.Staphylococcus aureus were 100%susceptibility to linezolid and teicoplanin.Antibiotic resistance rate of Enterococcus faecalis and Enterococcus faecium to ampicillin were 3.1%and 92.9%.The detectation rate of vancomycin resistant Enterococcus(VRE)was 1.6%.Nonsusceptibility rate of Enterococcus faecalis to linezolid was 32.2%,two consecutive monitoring rises and nonsusceptibility rate of Enterococcus faecium(12.5%)was also significantly increased.The prevalence of penicillin non-susceptible Streptococcus pneumoniae(PNSSP)was 0.8%based on non-meningitis and parenteral administration criterion,decrease of nearly 30 percentage points from the previous surveillance.While for cases of oral penicillin,the rate was 71.8%,showing similar to last time.The results indicated that the number of strains with higher MIC value of penicillin(MIC ≥4 mg·L-1)decreased significantly.There were no significant differences of resistance rates of Stapylococcus aureus,Stapylococcus epidermidis,Enterococcus faecalis,Enterococcus faecium and Streptococcus pneumoniae among various groups such as different department,age,or specimen source.Conclusion VRE detection ratio stablized at a relatively low level.The number of Streptococcus pneumoniae with higher MIC value of penicillin decreased significantly compared with the previous monitoring.The increase of linezolidin-insensitive Enterococcus was noteworthy.
7.Antimicrobial susceptibility of Gram-negative organisms:Results from China antimicrobial resistance surveillance trial(CARST)program,2021-2022
Yun LI ; Bo ZHENG ; Feng XUE ; Xiu-Zhen ZHANG ; Yun-Jian HU ; Yu-Fen JIN ; Jian-Hong ZHAO ; Shi-Yang PAN ; Wei GUO ; Feng ZHAO ; Yun-Song YU ; Xuan CAI ; Wen-En LIU ; De-Hua LIU ; Ying FEI ; Jia-Yun LIU ; Feng-Yan PEI ; Ling MENG ; Ping JI ; Jin TANG ; Kai XU ; Lei ZHU ; Cun-Wei CAO ; He-Ping XU ; Shan WANG ; Lan-Qing CUI ; Jia ZHANG ; Yao-Yao LIU
The Chinese Journal of Clinical Pharmacology 2023;39(23):3525-3544
Objective To investigate the Gram-negative bacteria resistance in nationwide's tertiary hospitals and understand the trend of antimicrobial resistance.Method All the clinical isolates were collected from 19 hospitals and the minimal inhibitory concentrations(MICs)were tested using agar/broth dilution method recommended.Results A total of 4 066 pathogenic isolates from 19 tertiary hospitals in 19 cities nationwide over the period from July 2021 to June 2022 were studied.Based on the MIC results,Escherichia coli and Klebsiella pneumoniae showed extended spectrum β-lactamase(ESBLs)phenotype rates of 55.0%and 21.0%,respectively,ESBLs phenotype rate of Klebsiella pneumoniae keep going down.The ratios of carbapenems resistance Klebsiella pneumoniae increased by 5 percentage points compared with the previous monitoring.Carbapenems,moxalactam,sitafloxacin,β-lactam combination agents,fosfomycin trometamol,and amikacin displayed desirable antibacterial activity against Enterbacterales,susceptibal rates were above 75%.In addition,tigacycline,omacycline,colistin and fluoxefin maintained good antibacterial activity against their respective effective bacteria/species,and the bacterial sensitivity rates by more than 80%.Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannnii to imipenem were 26.3%and 72.1%and multidrug-resistant(MDR)detection rates were 41.1%and 77.3%,extensively drug-resistant(XDR)were 12.0%and 71.8%,respectively.Comparison of drug resistance rates from different wards,ages and specimen sources indicated that the proportion of resistance in Klebsiella pneumoniae and Acinetobacter baumannii isolated from intensive care unit(ICU)were significantly higher than non-ICU.Carbapenem resistance rates of Klebsiella pneumoniae isolated from ICU were more than 35%.Resistance rates of Haemophilus influenzae isolated in children to β-lactam,macrolide,clindamycin and ESBLs detection rate in Klebsiella pneumoniae isolated from children were more than those from adults and the old people,so bacterial resistance in children is an important problem in China.Conclusion ESBLs detection rate of Escherichia coli increased slightly after years of continuous decline.The proportion of carbapenem resistant Pseudomonas aeruginosa was stable,but the resistance rate of Klebsiella pneumoniae and Acinetobacter baumannii to carbapenems was still increased,which should be paid more attention.
8.Progress in research of risk factors of iron deficiency and intervention in blood donors.
Xue Heng WANG ; Yan QIU ; Hong Chen ZHENG ; En Ci XUE ; Si Yue WANG ; Meng Ying WANG ; Tao WU
Chinese Journal of Epidemiology 2022;43(3):440-444
Long-term repeated regular blood donation may result in the loss and deficiency of iron. Epidemiological studies have indicated that blood donation frequency, demographical characteristics, and genetic factors are associated with iron deficiency. Our review summarizes the progress in research of etiology of iron deficiency in blood donors and intervention measures to provide evidence for the health management of non-remunerated blood donors in China.
Blood Donors
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Ferritins
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Humans
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Iron
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Iron Deficiencies
;
Risk Factors
9.Characteristics of fusion gene expression in acute lymphoblastic leukemia.
Xian Qi HUANG ; Ya Ni LIN ; En Bin LIU ; Fei XING ; Zhe WANG ; Xue Jing CHEN ; Long CHEN ; Jing Ting MA ; Ying Chang MI ; Kun RU
Chinese Journal of Pathology 2022;51(4):307-313
Objective: To analyze the genetic landscape of 52 fusion genes in patients with de novo acute lymphoblastic leukemia (ALL) and to investigate the characteristics of other laboratory results. Methods: The fusion gene expression was retrospectively analyzed in the 1 994 patients with de novo ALL diagnosed from September 2016 to December 2020. In addition, their mutational, immunophenotypical and karyotypical profiles were investigated. Results: In the 1 994 patients with ALL, the median age was 12 years (from 15 days to 89 years). In the panel of targeted genes, 15 different types of fusion genes were detected in 884 patients (44.33%) and demonstrated a Power law distribution. The frequency of detectable fusion genes in B-cell ALL was significantly higher than that in T-cell ALL (48.48% vs 18.71%), and fusion genes were almost exclusively expressed in B-cell ALL or T-cell ALL. The number of fusion genes showed peaks at<1 year, 3-5 years and 35-44 years, respectively. More fusion genes were identified in children than in adults. MLL-FG was most frequently seen in infants and TEL-AML1 was most commonly seen in children, while BCR-ABL1 was dominant in adults. The majority of fusion gene mutations involved signaling pathway and the most frequent mutations were observed in NRAS and KRAS genes. The expression of early-stage B-cell antigens varied in B-cell ALL patients. The complex karyotypes were more common in BCR-ABL1 positive patients than others. Conclusion: The distribution of fusion genes in ALL patients differs by ages and cell lineages. It also corresponds to various gene mutations, immunophenotypes, and karyotypes.
Adolescent
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Adult
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Aged
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Aged, 80 and over
;
Child
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Child, Preschool
;
Gene Expression
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Genes, ras
;
Humans
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Infant
;
Infant, Newborn
;
Middle Aged
;
Oncogene Fusion
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism*
;
Retrospective Studies
;
Young Adult
10.Exploring the association between de novo mutations and non-syndromic cleft lip with or without palate based on whole exome sequencing of case-parent trios.
Xi CHEN ; Si Yue WANG ; En Ci XUE ; Xue Heng WANG ; He Xiang PENG ; Meng FAN ; Meng Ying WANG ; Yi Qun WU ; Xue Ying QIN ; Jing LI ; Tao WU ; Hong Ping ZHU ; Jing LI ; Zhi Bo ZHOU ; Da Fang CHEN ; Yong Hua HU
Journal of Peking University(Health Sciences) 2022;54(3):387-393
OBJECTIVE:
To explore the association between de novo mutations (DNM) and non-syndromic cleft lip with or without palate (NSCL/P) using case-parent trio design.
METHODS:
Whole-exome sequencing was conducted for twenty-two NSCL/P trios and Genome Analysis ToolKit (GATK) was used to identify DNM by comparing the alleles of the cases and their parents. Information of predictable functions was annotated to the locus with SnpEff. Enrichment analysis for DNM was conducted to test the difference between the actual number and the expected number of DNM, and to explore whether there were genes with more DNM than expected. NSCL/P-related genes indicated by previous studies with solid evidence were selected by literature reviewing. Protein-protein interactions analysis was conducted among the genes with protein-altering DNM and NSCL/P-related genes. R package "denovolyzeR" was used for the enrichment analysis (Bonferroni correction: P=0.05/n, n is the number of genes in the whole genome range). Protein-protein interactions among genes with DNM and genes with solid evidence on the risk factors of NSCL/P were predicted depending on the information provided by STRING database.
RESULTS:
A total of 339 908 SNPs were qualified for the subsequent analysis after quality control. The number of high confident DNM identified by GATK was 345. Among those DNM, forty-four DNM were missense mutations, one DNM was nonsense mutation, two DNM were splicing site mutations, twenty DNM were synonymous mutations and others were located in intron or intergenic regions. The results of enrichment analysis showed that the number of protein-altering DNM on the exome regions was larger than expected (P < 0.05), and five genes (KRTCAP2, HMCN2, ANKRD36C, ADGRL2 and DIPK2A) had more DNM than expected (P < 0.05/(2×19 618)). Protein-protein interaction analysis was conducted among forty-six genes with protein-altering DNM and thirteen genes associated with NSCL/P selected by literature reviewing. Six pairs of interactions occurred between the genes with DNM and known NSCL/P-related genes. The score measuring the confidence level of the predicted interaction between RGPD4 and SUMO1 was 0.868, which was higher than the scores for other pairs of genes.
CONCLUSION
Our study provided novel insights into the development of NSCL/P and demonstrated that functional analyses of genes carrying DNM were warranted to understand the genetic architecture of complex diseases.
Asians
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Case-Control Studies
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Cleft Lip/genetics*
;
Cleft Palate/genetics*
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Genetic Predisposition to Disease
;
Genome-Wide Association Study
;
Genotype
;
Humans
;
Mutation
;
Parents
;
Polymorphism, Single Nucleotide
;
Whole Exome Sequencing

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