1.Analysis and prediction of epidemiological characteristics of tuberculosis deaths among Chinese residents from 2006 to 2021
Zheng LI ; Letian FANG ; Ming HU ; Huixian ZENG ; Hongsen CHEN ; Xiaojie TAN
Chinese Journal of Epidemiology 2024;45(6):824-832
Objective:The epidemiological characteristics of tuberculosis deaths among Chinese residents from 2006 to 2021 were analyzed, and the tuberculosis mortality rate from 2022 to 2027 was predicted to provide a reference for tuberculosis prevention and control in China.Methods:The data set of tuberculosis deaths from 2006 to 2021 was published regularly by the China CDC, and the crude mortality rate (CMR) and age-standardized mortality rates (ASMR) were calculated according to the population structure of China in 2000. The distribution characteristics of age, sex, region, and time of tuberculosis deaths were analyzed, the Joinpoint regression analysis model was used to analyze the changing trend, and the grey model was applied to predict CMR and ASMR from 2022 to 2027.Results:From 2006 to 2021, the CMR and ASMR of tuberculosis showed a downward trend among males and females, urban and rural areas, and all age groups, in a word, all the Chinese residents. Except for the age group ≥85 years old, the mortality trend was insignificant. In the eastern, central, or western regions. CMR and ASMR were significantly higher in males than in females.CMR and ASMR were significantly lower in urban areas than in rural areas. In general, active tuberculosis patients present a higher mortality rate. The CMR and ASMR in the western region were higher than those in the eastern and central regions and lower in the eastern region than in the central region, but the differences were less obvious. The ASMR of the eastern cities was lower than that of the central and western regions, and the ASMR of the central cities was higher than that of the western region from 2006 to 2009 and 2012 and lower than that of the western region in other years. The ASMR in the western countryside was higher than that in the eastern and central regions and lower in the eastern part than in the central region, but the difference was not obvious. The grey model prediction results show that the CMR (/100 000) of Chinese residents from 2022 to 2027 is 1.585, 1.471, 1.360, 1.250, 1.143, and 1.038, and the ASMR (/100 000) is 0.779, 0.653, 0.531, 0.411, 0.295 and 0.181, respectively.Conclusions:The CMR and ASMR of tuberculosis will continue to decline, and extraordinary achievements have been made in tuberculosis prevention and control in Chinese residents from 2006 to 2021 and, presumably, from 2022 to 2027. However, tuberculosis screening and treatment programs in the western region, men, the elderly population, and rural areas should be further strengthened, and targeted prevention and control measures should be formulated to reduce mortality.
2.Retrospective study of 121 patients with plexiform neurofibroma in head and neck
Wei WANG ; Yihui GU ; Beiyao ZHU ; Hao TAN ; Zicheng ZHU ; Bin GU ; Xiaojie HU ; Jun YANG ; Zhichao WANG ; Qingfeng LI
Chinese Journal of Plastic Surgery 2024;40(2):169-178
Objective:The treatment of head and neck in plexiform neurofibroma (PNF) is a major clinical problem, lacking consensus on surgical treatment, classification, operation timing, and treatment method. The purpose of this study was to provide a basis for further consensus formation by analyzing the clinical manifestations, surgical conditions, tumor recurrence, post-operation satisfaction, and changes in quality of life of patients undergoing PNF surgery in head and neck.Methods:Through medical record review and telephone follow-up, a retrospective analysis was conducted on neurofibromatosis type 1 (NF1) patients admitted for surgical treatment for PNF patient in head and neck from May 2012 to July 2022 in Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Complete collection and statistical analysis of patients’clinical data, using telephone follow-up to investigate the immediate postoperative satisfaction and long-term surgical satisfaction of patients and/or their families, as well as standardized quality of life questionnaires HRQol(health related quality of life) and PlexiQol(plexiform neurofibroma quality of life). Based on the data about changes in quality of life before and after surgery and long-term surgical satisfaction, patients were divided into surgical benefit and non-benefit groups. Binary and multivariate logistic regression analysis were used to analyze the clinical characteristics of patients with long-term surgical benefit.Results:Totally 512 patients with head and neck NF1 were admitted for surgery with complete medical records. 121 patients were identified as NF1 related PNF diagnosed by medical history and radiological examination, and effective follow-up was obtained. There were 70 males and 51 females, aged (25.60±12.85) years old, ranging from 7 to 63 years old, with 41 patients who were ≤ 18 years old and 80 patients over 18 years old. 62.81%(76/121) of patients exhibiting clinical dysfunctions, and the tumor mass were mainly characterized by invasive growth. 41.32%(50/121) of patients underwent multiple surgical treatments, with a total of 215 surgeries performed on 121 patients. The surgical objective included appearance improvement and functional repair. The incidence of postoperative complications was 6.05%(13/215). The follow-up period after last operation was (51.41±27.66) months, and 42.15%(51/121) of patients reported postoperative tumor recurrence. 76.03%(92/121) of patients were satisfied with immediate postoperative result, while the rate decreased to 46.28%(56/121) during long-term follow-up. Family members of patients who were ≤ 18 years old had a higher proportion of dissatisfaction with the scars caused by surgery and a stronger willingness to undergo another surgery. The tumor recurrence was closely related to surgical benefits ( OR=2.32, P<0.05). Further analysis found that the gender and age of patients were the main risk factors for the recurrence. The recurrence risk in patients ≤ 18 years old was significantly higher than in that over 18 years old( OR=3.49, P=0.004), and the highest in the 7-12 year-old group, reaching 68.42%(13/19). The recurrence risk in male patients was significantly lower than that in females ( OR=0.40, P=0.026). Conclusion:The clinical manifestations of PNF patients in head and neck region are complex. Clinical diagnosis and treatment in PNF should focus on the applications in comprehensive method such as full preoperative evaluation, active multi-disciplinary treatment cooperation and combined therapies in order to improve the safety and effectiveness of treatment and reduce tumor recurrence.
3.Retrospective study of 121 patients with plexiform neurofibroma in head and neck
Wei WANG ; Yihui GU ; Beiyao ZHU ; Hao TAN ; Zicheng ZHU ; Bin GU ; Xiaojie HU ; Jun YANG ; Zhichao WANG ; Qingfeng LI
Chinese Journal of Plastic Surgery 2024;40(2):169-178
Objective:The treatment of head and neck in plexiform neurofibroma (PNF) is a major clinical problem, lacking consensus on surgical treatment, classification, operation timing, and treatment method. The purpose of this study was to provide a basis for further consensus formation by analyzing the clinical manifestations, surgical conditions, tumor recurrence, post-operation satisfaction, and changes in quality of life of patients undergoing PNF surgery in head and neck.Methods:Through medical record review and telephone follow-up, a retrospective analysis was conducted on neurofibromatosis type 1 (NF1) patients admitted for surgical treatment for PNF patient in head and neck from May 2012 to July 2022 in Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Complete collection and statistical analysis of patients’clinical data, using telephone follow-up to investigate the immediate postoperative satisfaction and long-term surgical satisfaction of patients and/or their families, as well as standardized quality of life questionnaires HRQol(health related quality of life) and PlexiQol(plexiform neurofibroma quality of life). Based on the data about changes in quality of life before and after surgery and long-term surgical satisfaction, patients were divided into surgical benefit and non-benefit groups. Binary and multivariate logistic regression analysis were used to analyze the clinical characteristics of patients with long-term surgical benefit.Results:Totally 512 patients with head and neck NF1 were admitted for surgery with complete medical records. 121 patients were identified as NF1 related PNF diagnosed by medical history and radiological examination, and effective follow-up was obtained. There were 70 males and 51 females, aged (25.60±12.85) years old, ranging from 7 to 63 years old, with 41 patients who were ≤ 18 years old and 80 patients over 18 years old. 62.81%(76/121) of patients exhibiting clinical dysfunctions, and the tumor mass were mainly characterized by invasive growth. 41.32%(50/121) of patients underwent multiple surgical treatments, with a total of 215 surgeries performed on 121 patients. The surgical objective included appearance improvement and functional repair. The incidence of postoperative complications was 6.05%(13/215). The follow-up period after last operation was (51.41±27.66) months, and 42.15%(51/121) of patients reported postoperative tumor recurrence. 76.03%(92/121) of patients were satisfied with immediate postoperative result, while the rate decreased to 46.28%(56/121) during long-term follow-up. Family members of patients who were ≤ 18 years old had a higher proportion of dissatisfaction with the scars caused by surgery and a stronger willingness to undergo another surgery. The tumor recurrence was closely related to surgical benefits ( OR=2.32, P<0.05). Further analysis found that the gender and age of patients were the main risk factors for the recurrence. The recurrence risk in patients ≤ 18 years old was significantly higher than in that over 18 years old( OR=3.49, P=0.004), and the highest in the 7-12 year-old group, reaching 68.42%(13/19). The recurrence risk in male patients was significantly lower than that in females ( OR=0.40, P=0.026). Conclusion:The clinical manifestations of PNF patients in head and neck region are complex. Clinical diagnosis and treatment in PNF should focus on the applications in comprehensive method such as full preoperative evaluation, active multi-disciplinary treatment cooperation and combined therapies in order to improve the safety and effectiveness of treatment and reduce tumor recurrence.
4.Analysis of the Distribution Characteristics of Gene Polymorphism Related to Antihypertensive Drugs in 306 Patients with Essential Hypertension in Xi'an Area
Yu ZHANG ; Shangjun LÜ ; Qingyun QUAN ; Xiaoyan WANG ; Xiaojie ZHANG ; Yun TAN
Journal of Modern Laboratory Medicine 2024;39(3):90-97
Objective To analyze the distribution characteristics of 9 hypertension drug related gene polymorphisms in the population of essential hypertension(EH)in Xi'an area,providing an objective basis for personalized treatment.Methods A total of 306 EH patients who visited the Shaanxi Provincial Armed Police Force Hospital from January 2022 to December 2023 were selected as the research subjects.The PCR melting curve method was used to detect 9 hypertension drug related gene polymorphisms,their genotype and allele distribution frequency were analyzed,and the correlations of gene polymorphism among patients of different genders,ages,and hypertension grading groups were compared.Results Among 306 patients,the distribution frequencies of each gene were consistent with Hardy Weinberg equilibrium(x2=0.153~2.941,all P>0.05).Mutation rates of various gene were as follows:SLCO1B1 c.388A>G,ADRB1 c.1165G>C,MTHFR C677T,ADD1 c.1378G>T,CYP2D6 c.100C>T,ACE I/D,CYP3A5 c.806-4288C>T,SLCO1B1 c.521T>C,AGTR1 c.1166A>C and CYP2C9 c.1075A>C were 77.29%,73.20%,56.54%,48.37%,50.82%,35.13%,29.41%,11.76%,7.68%and 3.43%,respectively,and CYP2C9 c.403C>T had no mutation.Comparing with patients of different genders,the mutation rate of SLCO1B1 c.388A>G genotype and allele mutations in male group were higher than those in the female group(x2=5.221,8.237),the mutation rate of CYP2D6 c.100C>T genotype and allele in the female group were higher than those in the male group(x2=5.093,9.661),the mutation rate of ACE I/D allele in the male group was higher than that in the female group(x2=6.118,8.032),with significant differences(all P<0.05).The mutation rates of CYP2C9 c.1075A>C,SLCO1B1 c.388A>G,CYP2D6 c.100C>T genotypes and alleles in the middle-aged and young age group were higher than those in the elderly group,and the differences were statistically significant(x2=11.683,10.243;9.003,9.803;10.617,9.931,all P<0.05).There was no significant difference in the comparison of other genotypes and alleles among different gender and age groups and in the frequency of genotype and allele mutations among different hypertension grading groups(x2=1.321~7.733,1.031~5.198,all P>0.05).Conclusion The distribution of gene polymorphisms related to antihypertensive drugs in the Xi'an area was related to the gender and age of EH patients.Thus,the genotype testing of antihypertensive drugs may have important guiding significance for personalized medication treatment of EH patients.
5.Selection and application of statistical methods in medical research
Huixian ZENG ; Zhiyu YANG ; Donghong LIU ; Ruihua WANG ; Hongsen CHEN ; Hongwei ZHANG ; Xiaojie TAN ; Ping LI ; Guangwen CAO
Shanghai Journal of Preventive Medicine 2023;35(8):831-839
Statistics plays an important role in medical research, and the selection of appropriate statistical methods is crucial for drawing reliable and valuable conclusions. This paper provides a brief introduction to commonly used statistical analysis methods for medical data, covering descriptive analysis, parametric test, nonparametric test, correlation analysis, regression analysis, and analysis of survival data. It focuses on discussing the assumptions of multiple linear regression, logistic regression and Cox proportional risk regression, as well as how to choose the appropriate statistical methods for analyzing and interpreting medical data based on different research objectives and data types.
6.Drafting reports of clinical studies
Zhiyu YANG ; Huixian ZENG ; Ruihua WANG ; Hongsen CHEN ; Jiaying SHEN ; Xiaojie TAN ; Hongwei ZHANG ; Guangwen CAO
Shanghai Journal of Preventive Medicine 2023;35(9):941-947
Clinical research reports serve as the presentation of scientific research findings and directly reflect the quality of the research. This article describes the writing of different types of clinical research reports, such as observational studies and randomized controlled trial studies, with a particular focus on randomized controlled trials. Each scientific research design has its reporting focus, and the writing of scientific research papers has uniform requirements and a specific writing format. Mastering the proper format of drafting research reports is of practical value and significant importance for conduction high-quality clinical research.
7.Establishment and evaluation of the polygenic disease risk prediction model
Xiaoqiong ZHU ; Xiong ZHOU ; Peng CAI ; Yida HE ; Hongwei ZHANG ; Xiaojie TAN ; Guangwen CAO
Shanghai Journal of Preventive Medicine 2023;35(10):1044-1048
To establish a disease risk prediction model based on genetic susceptibility genes and environmental risk factors, which can target high-risk population as early as possible, and intervene in the environmental risk factors in this population. Moreover, accurate screening of genetically susceptible populations can enhance the efficiency of health system. In recent years, with the maturation and cost reduction of high-throughput gene testing, gene testing has been widely used in individual clinical decision-making and will play a more important role in medical and health decision-making. The correlation between genetic testing and disease risk prediction is increasing, making it a prominent research topic in this field. This review summarizes the approaches for establishing and evaluating risk prediction models and discusses potential future challenges and opportunities.
8.Exploring the application of decision analysis in public health emergencies
Zheng LI ; Ming HU ; Xiong ZHOU ; Hongwei ZHANG ; Guangwen CAO ; Xiaojie TAN
Shanghai Journal of Preventive Medicine 2023;35(11):1146-1152
When facing two or more choices, sound decision-making is critical. In the field of clinical medical practice and public health, more and more researchers use decision-making analysis as an important tool to assist in making the optimal choices. Public health emergencies have the characteristics of group cases, sudden and uncertain. In addition to causing serious damage to public health, they may also have varying degrees of impact on socio-economic, psychological and even social stability. At present, we have not seen the application of mature and sound decision analysis in public health emergency response. This paper reviewed the development of decision analysis in the medical field and the application of common decision-making models in clinical practice. Combined with the current situation of global infectious disease outbreaks and prevention and control, this paper puts forward the concepts and prospects of establishing an auxiliary decision-making system for public health emergencies, aiming to provide a scientific method for medical and health workers to respond to public health emergencies.
9.Global incidence and mortality of renal cell carcinoma in 2020.
Ming HU ; Jun Yan FAN ; Xiong ZHOU ; Guang Wen CAO ; Xiaojie TAN
Chinese Journal of Epidemiology 2023;44(4):575-580
Objective: To analyze the global epidemiology of renal cell carcinoma (RCC) in 2020. Methods: The incidence and mortality data of RCC in the cooperative database GLOBOCAN 2020 of International Agency for Research on Cancer of WHO and the human development index (HDI) published by the United Nations Development Programme in 2020 were collated. The crude incidence rate (CIR), age-standardized incidence rate (ASIR), crude mortality rate (CMR), age-standardized mortality rate (ASMR) and mortality/incidence ratio (M/I) of RCC were calculated. Kruskale-Wallis test was used to analyze the differences in ASIR or ASMR among HDI countries. Results: In 2020, the global ASIR of RCC was 4.6/100 000, of which 6.1/100 000 for males and 3.2/100 000 for females and ASIR was higher in very high and high HDI countries than that in medium and low HDI countries. With the rapid increase of age after the age of 20, the growth rate of ASIR in males was faster than that in females, and slowed down at the age of 70 to 75. The truncation incidence rate of 35-64 years old was 7.5/100 000 and the cumulative incidence risk of 0-74 years old was 0.52%. The global ASMR of RCC was 1.8/100 000, 2.5/100 000 for males and 1.2/100 000 for females. The ASMR of males in very high and high HDI countries (2.4/100 000-3.7/100 000) was about twice that of males (1.1/100 000-1.4/100 000) in medium and low HDI countries, while the ASMR of female (0.6/100 000-1.5/100 000) did not show significant difference. ASMR continued to increase rapidly with age after the age of 40, and the growth rate of males was faster than that of females. The truncation mortality rate of 35-64 years old was 2.1/100 000, and the cumulative mortality risk of 0-74 years old was 0.20%. M/I decreases with the increase of HDI, with M/I as 0.58 in China, which was higher than the global average of 0.39 and the United States' 0.17. Conclusion: The ASIR and ASMR of RCC presented significant regional and gender disparities globally, and the heaviest burden was in very high HDI countries.
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Carcinoma, Renal Cell/epidemiology*
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Databases, Factual
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China
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Kidney Neoplasms/epidemiology*
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Global Health
10.Research Progress of Key Molecular Events Related to Progression of Colorectal Cancer
Xiong ZHOU ; Ming HU ; Dongming JIANG ; Guangwen CAO ; Xiaojie TAN
Cancer Research on Prevention and Treatment 2023;50(6):609-615
The continuous development of high-throughput and single-cell sequencing technologies and the emergence of spatial transcriptome sequencing have allowed the continuous discovery of temporal and spatial molecular events in the progression of colorectal cancer (CRC) to better understand its mechanism of malignant progression. Genetic variations (mutation of APC and P53, etc.) and mismatch repair of DNA, posttranscriptional regulation, such as epigenetic alteration, and dynamic alteration of complex molecular networks have their own special molecules that play key roles. Drug resistance and metastasis in the late stage of CRC progression are closely related to these key molecular events. This article reviews the research progress and explores key molecular events in the malignant progression of CRC to provide scientific basis and ideas for elucidating the regulatory mechanism of CRC and evaluating its prognosis prediction and treatment.

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