BACKGROUND Mucosa-associated lymphoid tissue(MALT)lymphoma is a subtype of extranodal marginal zone lymphoma,typically occurring in mucosal sites such as the stomach,salivary glands,and lungs.This study aims to analyz...BACKGROUND Mucosa-associated lymphoid tissue(MALT)lymphoma is a subtype of extranodal marginal zone lymphoma,typically occurring in mucosal sites such as the stomach,salivary glands,and lungs.This study aims to analyze the demographic and clinicopathologic characteristics of patients with gastric MALT lymphoma in the United States and evaluate the interaction between age and gender on survival outcomes.AIM To analyze the demographic and clinicopathologic characteristics of patients with gastric MALT lymphoma in the United States and evaluate the interaction between age and gender on survival outcomes.METHODS A retrospective cohort study was conducted using the Surveillance,Epidemiology,and End Results(SEER)database,which included 2453 patients diagnosed with MALT lymphoma from 2010 to 2021.Data were analyzed for demographic factors,tumor characteristics,treatment modalities,and survival outcomes.A Cox proportional hazards regression model was used to identify predictors of overall mortality and cancer-specific mortality.RESULTS The study predominantly included Non-Hispanic White patients(62.78%),with nearly equal gender distribution(50.31%females,49.69%males),and most diagnoses occurring in individuals aged 60-79 years.The majority of tumors were localized(80.07%).Multivariate analysis identified older age,male gender,advanced tumor stage,and socioeconomic factors—such as annual income and marital status—as independent predictors of mortality.No significant interaction between age and gender on mortality outcomes was observed.CONCLUSION Sociodemographic factors,including advanced age,male gender,annual income,and marital status,as well as advanced tumor stage,significantly impacted survival outcomes in patients with MALT lymphoma.Radiotherapy was associated with a reduction in overall mortality.Early detection is crucial for optimizing outcomes,as localized disease responds well to available treatment modalities.展开更多
Associations of per-and polyfluoroalkyl substances(PFAS)on lipid metabolism have been documented but research remains scarce regarding effect of PFAS on lipid variability.To deeply understand their relationship,a step...Associations of per-and polyfluoroalkyl substances(PFAS)on lipid metabolism have been documented but research remains scarce regarding effect of PFAS on lipid variability.To deeply understand their relationship,a step-forward in causal inference is expected.To address these,we conducted a longitudinal study with three repeated measurements involving 201 participants in Beijing,among which 100 eligible participants were included for the present study.Twenty-three PFAS and four lipid indicators were assessed at each visit.We used linear mixed models and quantile g-computation models to investigate associations between PFAS and blood lipid levels.A latent class growth model described PFAS serum exposure patterns,and a generalized linear model demonstrated associations between these patterns and lipid variability.Our study found that PFDA was associated with increased TC(β=0.083,95%CI:0.011,0.155)and HDL-C(β=0.106,95%CI:0.034,0.178).The PFAS mixture also showed a positive relationship with TC(β=0.06,95%CI:0.02,0.10),with PFDA contributing most positively.Compared to the low trajectory group,the middle trajectory group for PFDA was associated with VIM of TC(β=0.756,95%CI:0.153,1.359).Furthermore,PFDA showed biological gradientswith lipid metabolism.This is the first repeated-measures study to identify the impact of PFAS serum exposure pattern on the lipid metabolism and the first to estimate the association between PFAS and blood lipid levels in middle-aged and elderly Chinese and reinforce the evidence of their causal relationship through epidemiological studies.展开更多
BACKGROUND The prevalence of negative emotional states,such as anxiety and depression,has increased annually.Although personal habits are known to influence emotional regulation,the precise mechanisms underlying this ...BACKGROUND The prevalence of negative emotional states,such as anxiety and depression,has increased annually.Although personal habits are known to influence emotional regulation,the precise mechanisms underlying this relationship remain unclear.AIM To investigate emotion regulation habits impact on students negative emotions during lockdown,using the coronavirus disease 2019 pandemic as a case example.METHODS During the coronavirus disease 2019 lockdown,an online cross-sectional survey was conducted at a Chinese university.Emotional states were assessed using the Depression,Anxiety,and Stress Scale-21(DASS-21),while demographic data and emotion regulation habits were collected concurrently.Data analysis was performed using SPSS version 27.0 and includedχ^(2)-tests for intergroup comparisons,Spearman’s rank-order correlation coefficient analysis to examine associations,and stepwise linear regression modeling to explore the relationships between emotion regulation habits and emotional states.Statistical significance was set atα=0.05.RESULTS Among the 494 valid questionnaires analyzed,the prevalence rates of negative emotional states were as follows:Depression(65.0%),anxiety(69.4%),and stress(50.8%).DASS-21 scores(mean±SD)demonstrated significant symptomatology:Total(48.77±34.88),depression(16.21±12.18),anxiety(14.90±11.91),and stress(17.64±12.07).Significant positive intercorrelations were observed among all DASS-21 subscales(P<0.01).Regression analysis identified key predictors of negative emotions(P<0.05):Risk factors included late-night frequency and academic pressure,while protective factors were the frequency of parental contact and the number of same-gender friends.Additionally,compensatory spending and binge eating positively predicted all negative emotion scores(β>0,P<0.01),whereas appropriate recreational activities negatively predicted these scores(β<0,P<0.01).CONCLUSION High negative emotion prevalence occurred among confined students.Recreational activities were protective,while compensatory spending and binge eating were risk factors,necessitating guided emotion regulation.展开更多
Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabo...Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabolites mediating the associations ofα-diversity with blood pressure(BP)and BP variability(BPV).Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study.The 24-hour,daytime,and nighttime BP and BPV were calculated based on ambulatory BP measurements.Linear mixed models were used to characterize the relationships betweenα-diversity(Shannon and Chao1 index)and BP indices.Mediation analyses were performed to assess the contribution of metabolites to the observed associations.The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants.Results Gut microbial richness(Chao1)was negatively associated with 24-hour systolic BP,daytime systolic BP,daytime diastolic BP,24-hour systolic BPV,and nighttime systolic BPV(P<0.05).Moreover,26 metabolites were strongly associated with richness(Bonferroni P<0.05).Among them,four key metabolites(imidazole propionate,2-hydroxy-3-methylbutyric acid,homovanillic acid,and hydrocinnamic acid)mediated the associations between richness and BP indices(proportions of mediating effects:14.1%–67.4%).These key metabolites were also associated with hypertension in the prospective cohort.For example,each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent(OR[95%CI]=0.90[0.82,0.99];P=0.03)and incident hypertension(HR[95%CI]=0.83[0.71,0.96];P=0.01).Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV,and that certain metabolites mediate these associations.These findings provide novel insights into the pathogenesis and prevention of hypertension.展开更多
Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank...Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank,sarcopenia was diagnosed according to European and Asian Working Groups for Sarcopenia criteria.Social isolation was assessed using standardized questionnaires,including questions on solitude,frequency of social activities,contact with others,and marital status(for the CLHLS only).Results During the follow-up period,8,249 deaths occurred in the CLHLS and 26,670 deaths in the UK Biobank groups.While no significant interaction was observed between sarcopenia and social isolation in predicting all-cause mortality in the CLHLS cohort,the association between social isolation and mortality was stronger among individuals with sarcopenia in the UK Biobank(P-interaction=0.03,relative risk due to interaction:0.23,95%confidence interval[CI]:0.06–0.41).Further joint analyses showed that participants with sarcopenia and high levels of social isolation had the highest mortality risk(hazard ration[HR]:1.99;95%CI:[1.74–2.28]in the CLHLS and 1.69[1.55–1.85]in the UK Biobank)compared to those without either condition.Conclusion The combination of social isolation and sarcopenia synergistically increases the risk of mortality in middle-aged and older adults across diverse populations.展开更多
Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Fa...Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Factors Surveillance)conducted between 2010 and 2018,a total of 645,420 adult participants(97,741 in 2010;175,749 in 2013;187,777 in 2015;and 184,153 in 2018)were included in the trend analysis.Linear and logistic regression models were utilized to assess trends in sleep duration.Results In 2018,the estimated overall mean sleep duration among the Chinese adult population was7.58(SD,1.45)hours per day,with no significant trend from 2010.A significant increase in short sleep duration(≤6 hours)was observed in the total population,from 15.3%(95%CI:14.1%–16.5%)in 2010 to18.5%(95%CI:17.7%–19.3%)in 2018(P<0.001).Similarly,the trend in long sleep duration(>9 hours)was also significant,increasing in weighted prevalence from 7.2%(95%CI:6.3%–8.1%)in 2010 to 9.0%(95%CI:8.2%–9.9%)in 2018(P<0.001).Conclusion The prevalence of both short and long sleep durations significantly increased among Chinese adults from 2010 to 2018,highlighting the urgency of health initiatives to promote optimal sleep duration in China.展开更多
In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing...In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.展开更多
Vitamin D deficiency(VDD)represents a significant nutritional concern among children and adolescents.The estimated prevalence of VDD in China is 46.8%in this population^([1]).VDD during childhood and adolescence has b...Vitamin D deficiency(VDD)represents a significant nutritional concern among children and adolescents.The estimated prevalence of VDD in China is 46.8%in this population^([1]).VDD during childhood and adolescence has been associated with the onset of various conditions,including acute respiratory infections,asthma,atopic dermatitis,and food allergies^([2]).Multiple factors,including age,sun exposure,adiposity,and genetics,influence vitamin D levels^([2,3]).Increasing attention has been directed toward understanding the environmental determinants that may influence vitamin D status.Given the potential of metallic pollutants to disrupt endocrine function and their ubiquity in the environment,investigating the effects of metal exposure on human vitamin D status,particularly in vulnerable populations,is imperative.展开更多
While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the assoc...While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the association between combined lifestyle factors and stroke incidence.Using data from 51929 participants free of major cardiovascular diseases or cancer at baseline,we employed structural equation modeling to assess the mediating effects of systolic(SBP)and diastolic(DBP)blood pressure.During the follow-up,2811 incident stroke cases were identified.A healthy lifestyle was significantly associated with a reduced risk of stroke,with SBP mediating 44.70%(β=-0.0014,95%confidence interval[CI]:-0.0016 to-0.0012)and DBP mediating 37.81%(β=-0.0012,95%CI:-0.0015 to-0.0009)of this association.The mediating effects were attenuated but remained significant for ischemic stroke(SBP:33.21%;DBP:27.24%).In conclusion,approximately two-fifths of the protective association between a healthy lifestyle and stroke may be mediated by BP.These findings suggest that BP control may serve as an important early indicator for evaluating the effectiveness of lifestyle interventions in reducing stroke risk.展开更多
Despite a decline in incidence and mortality during the last decades,stomach cancer is one of the main health challenges worldwide.According to the GLOBOCAN 2020 estimates,stomach cancer caused approximately 800000 de...Despite a decline in incidence and mortality during the last decades,stomach cancer is one of the main health challenges worldwide.According to the GLOBOCAN 2020 estimates,stomach cancer caused approximately 800000 deaths(accounting for 7.7%of all cancer deaths),and ranks as the fourth leading cause of cancer deaths in both genders combined.About 1.1 million new cases of stomach cancer were diagnosed in 2020(accounting for 5.6%of all cancer cases).About 75%of all new cases and all deaths from stomach cancer are reported in Asia.Stomach cancer is one of the most lethal malignant tumors,with a five-year survival rate of around 20%.There are some well-established risk factors for stomach cancer:Helicobacter pylori infection,dietary factors,tobacco,obesity,and radiation.To date,the most important way of preventing stomach cancer is reduced exposure to risk factors,as well as screening and early detection.Further research on risk factors can help identify various opportunities for more effective prevention.Screening programs for stomach cancer have been implemented in a few countries,either as a national or opportunistic screening of high-risk individuals only.Generally,due to its high aggressiveness and heterogeneity,stomach cancer still remains a severe global health problem.展开更多
Lung cancer is the leading cause of cancer death worldwide,with large variation of the incidence and mortality across regions.Although the mortality of lung cancer has been decreasing,or steady in the US,it has been i...Lung cancer is the leading cause of cancer death worldwide,with large variation of the incidence and mortality across regions.Although the mortality of lung cancer has been decreasing,or steady in the US,it has been increasing in Asia for the past two decades.Smoking is the leading cause of lung cancer,and other risk factors such as indoor coal burning,cooking fumes,and infections may play important roles in the development of lung cancer among Asian never smoking women.The median age of diagnosis in Asian patients with lung cancer is generally younger than Caucasian patients,particularly among never-smokers.Asians and Caucasians may have different genetic susceptibilities to lung cancer,as evidenced from candidate polymorphisms and genome-wide association studies.Recent epidemiologic studies and clinical trials have shown consistently that Asian ethnicity is a favorable prognostic factor for overall survival in non-small cell lung cancer(NSCLC),independent of smoking status.Compared with Caucasian patients with NSCLC,East Asian patients have a much higher prevalence of epidermal growth factor receptor(EGFR) mutation(approximately 30% vs.7%,predominantly among patients with adenocarcinoma and never-smokers),a lower prevalence of K-Ras mutation(less than 10% vs.18%,predominantly among patients with adenocarcinoma and smokers),and higher proportion of patients who are responsive to EGFR tyrosine kinase inhibitors.The ethnic differences in epidemiology and clinical behaviors should be taken into account when conducting global clinical trials that include different ethnic populations.展开更多
The incidence and mortality of gastric cancer have fallen dramatically in US and elsewhere over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cance...The incidence and mortality of gastric cancer have fallen dramatically in US and elsewhere over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cancer and the second leading cause of cancer death worldwide. Demographic trends differ by tumor location and histology. While there has been a marked decline in distal, intestinal type gastric cancers, the incidence of proximal, diffuse type adenocarcinomas of the gastric cardia has been increasing, particularly in the Western countries. Incidence by tumor sub-site also varies widely based on geographic location, race, and socioeconomic status. Distal gastric cancer predominates in developing countries, among blacks, and in lower socioeconomic groups, whereas proximal tumors are more common in developed countries, among whites, and in higher socio-economic classes. Diverging trends in the incidence of gastric cancer by tumor location suggest that they may represent two diseases with different etiologies. The main risk factors for distal gastric cancer include Helicobacter pylori （H pylori） infection and dietary factors, whereas gastroesophageal reflux disease and obesity play important roles in the development of proximal stomach cancer. The purpose of this review is to examine the epidemiology and risk factors of gastric cancer, and to discuss strategies for primary prevention.展开更多
AIM: To investigate hepatitis B virus(HBV) prevalence in the general population in China.METHODS: A total of 148931 individuals were investigated by multistage random sampling in Eastern China. Data were collected on ...AIM: To investigate hepatitis B virus(HBV) prevalence in the general population in China.METHODS: A total of 148931 individuals were investigated by multistage random sampling in Eastern China. Data were collected on demographics and hepatitis B vaccination history, and serum was tested for hepatitis B surface antigen(HBs Ag) by ELISA. RESULTS: A total of 11469 participants(7.70%, 95%CI: 7.57%-7.84%) were positive for HBs Ag. HBs Ag prevalence was 0.77% among children < 5 years old but increased progressively from adolescents(1.40%-2.55%) to adults(5.69%-11.22%). A decrease in HBs Ag prevalence was strongly associated with vaccination and familial history of HBV among both children and adult groups. Meanwhile, HBs Ag risk in adults was associated with invasive testing and sharing needles. The HBV immunization rate among participants aged < 20 years was 93.30%(95%CI: 93.01%-93.58%). Significant difference in HBs Ag prevalence appeared between vaccinated and unvaccinated participants(3.59% vs 10.22%). CONCLUSION: Although the national goal of HBs Ag prevalence < 1% among children < 5 years old has been reached, immunization programs should be maintained to prevent resurgence.展开更多
In many traditional Chinese medicine （TCM） hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections （nBSIs） are an important cause of morbidity and mortality. A retrospective s...In many traditional Chinese medicine （TCM） hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections （nBSIs） are an important cause of morbidity and mortality. A retrospective sur- veillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions Escherichia coli （25.5%） was the most common Gram-negative and coagulase-negative staphylococcus （CONS） （14.1%） was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsie/la pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7% were resistant to methicillin. Carbapenems and glyco- peptide were the most frequently used for nBSI therapy. Only about one-third of patients （157/482） received appro- priate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score 〉4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs.展开更多
Objectives Quality of life(QoL) is a priority outcome in older adults suffering from cardiovascular diseases. Frailty and poor nutritional status may affect the QoL through mobility disorders and exhaustion. The objec...Objectives Quality of life(QoL) is a priority outcome in older adults suffering from cardiovascular diseases. Frailty and poor nutritional status may affect the QoL through mobility disorders and exhaustion. The objective of this study was to determine if physical frailty and nutritional status were associated with QoL, in older cardiology patients. Methods Cross sectional, observational study conducted in a cardiology department from a university hospital. Participants(n = 100) were aged 70 and older. Collected data included age, sex, cardiac diseases, New York Heart Association(NYHA) classification, comorbidities(Charlson Index) and disability. A Short Physical Performance Battery(SPPB), including walking speed assessment was performed;handgrip strength were measured as well as Fried’s frailty phenotype. Nutritional status was assessed using the Mini Nutritional Assessment(MNA) and Body Mass Index(BMI), inflammation by C-reactive protein(CRP). QoL was assessed using the EORTC–QLQ questionnaire. Univariate and multivariate analyses were performed to study the associations between all recorded parameters and QoL. Results In participants(mean age: 79.3 ± 6.7 years;male: 59%), Charlson index, arrhythmia, heart failure, NYHA class III-IV, MNA, disability, walking speed, SPPB score, frailty and CRP were significantly associated with QoL in univariate analysis. Multivariate analysis showed that NYHA class III-IV(P < 0.001), lower MNA score(P = 0.03), frailty(P < 0.0001), and higher CRP(P < 0.001) were independently associated with decreased QoL. Conclusions Frailty, nutritional status and inflammation were independently associated with poor QoL. Further studies are needed to assess the efficacy of nutritional and physical interventions on QoL in this population.展开更多
In Iran,the prevalence of hepatitis C virus(HCV) infection is relatively low according to the populationbased epidemiological studies. However,the epidemiology of HCV is changing and the rate of HCV infection is incre...In Iran,the prevalence of hepatitis C virus(HCV) infection is relatively low according to the populationbased epidemiological studies. However,the epidemiology of HCV is changing and the rate of HCV infection is increasing due to the growth in the number of injecting drug users in the society. In addition,a shift has occurred in the distribution pattern of HCV genotypes among HCV-infected patients in Iran. Genotype 1a is the most prevalent genotype in Iran,but in recent years,an increase in the frequency of 3a and a decrease in 1a and 1b have been reported. These variations in the epidemiology of HCV reflect differences in the routes of transmission,status of public health,lifestyles,and risk factors in different groups and geographic regions of Iran. Health policy makers should consider these differences to establish better strategies for control and prevention of HCV infection. Therefore,this review was conducted to present a clear view regarding the current epidemiology of HCV infection in Iran.展开更多
Dear editor,Patients with supraventricular tachycardia(SVT)commonly present to the emergency department(ED).Current guidelines[1,2]do not recommend routine pathology testing and a report on the topic has questioned th...Dear editor,Patients with supraventricular tachycardia(SVT)commonly present to the emergency department(ED).Current guidelines[1,2]do not recommend routine pathology testing and a report on the topic has questioned their role.A systematic review concluded that troponin testing is commonly performed with a high proportion of positive fi ndings,but these results were not associated with major adverse cardiac events.[3]The conclusions of this review were limited by paucity of data and heterogeneity among studies.展开更多
AIM:To determine the prevalences of symptoms consistent with gastroesophageal reflux disease(GERD)and dyspepsia in South America.METHODS:A telephone survey was conducted among adult owners of land-based telephones in ...AIM:To determine the prevalences of symptoms consistent with gastroesophageal reflux disease(GERD)and dyspepsia in South America.METHODS:A telephone survey was conducted among adult owners of land-based telephones in S?o Paulo,Brazil,using previously validated computer-assisted sampling and survey protocols.The Portugueselanguage survey included(1)sociodemographic characteristics(e.g.,weight,height,smoking)and comorbidities;(2)dietary habits;(3)presence of symptoms consistent with GERD or dyspepsia within the prior 3mo;and(4)use of medications and other therapies to manage symptoms.Data were stratified post-hoc into three homogeneous geographical regions of S?o Paulo according to the Social Exclusion Indices of the districts and postal codes.Survey response data from each respondent were weighted by the numbers of adults and landline telephones in each household.The analyses were weighted to account for sampling design and to be representative of the S?o Paulo population according to city census data.RESULTS:Among 4570 households contacted,an adult from 3050(66.7%)agreed to participate.The nonresponse rate was 33.3%.The mean(SE)respondent age was 42.6(16.0)years.More than half of all respondents were women(53.1%),aged 18 through 49 years(66.7%),married or cohabitating(52.5%),and/or above normal-weight standards(i.e.,35.3%overweight and 16.3%obese).A total of 26.5%of women were perimenopausal.More than 20%of respondents reported highly frequent symptoms consistent with GERD(e.g.,gastric burning sensation=20.8%)or dyspepsia(e.g.,abdominal swelling/distension=20.9%)at least once per month.Prevalences of these symptoms were significantly(approximately 1.5-to 2.0-fold)higher among women than men but did not vary significantly as a function of advancing age.For instance,14.1%of women reported that they experienced stomach burning(symptom of GERD)at least twice per week,compared to 8.4%of men(P=0.012 byχ2 test).A total of 15.7%of women reported that they experienced abdominal swelling(symptom of dyspepsia)at least twice per week,compared to 6.4%of men(P<0.001byχ2 test).Despite frequent manifestations of GERD or dyspepsia,most(≥90%)respondents reported that they neither received prescription medications fromphysicians,nor took behavioral measures(e.g.,dietary modifications),to manage symptoms.CONCLUSION:Symptoms consistent with dyspepsia and GERD are prevalent in Brazil and represent major public-health and clinical challenges.展开更多
We used nationally reported cases (NCAIDS/China CDC,2016) and published literature to summarize up-to the end of 2015 epidemiologic trends in the HIV/AIDS epidemic in China.HIV-positive cases are distributed unevenly ...We used nationally reported cases (NCAIDS/China CDC,2016) and published literature to summarize up-to the end of 2015 epidemiologic trends in the HIV/AIDS epidemic in China.HIV-positive cases are distributed unevenly with most infections found in southwest China and the most affected population being men who have sex with men.Transmission mode of HIV infection has shifted from drug injection to sexual contact,which accounts for 95% of total reported cases.Two thirds of cases are from heterosexual transmission.Transmission pattern varies greatly throughout China.Some provinces in China reported heterosexual transmission accounted for over 90% of cases while other provinces reported homosexual transmission accounted for over 80% of cases.Patterns of heterosexually acquired HIV also vary widely,with 80% of cases attributed to commercial sex in some provinces,while in other provinces non-commercial extramarital sex accounted for over 70% of cases.Significant increase in HIV infection was observed among young students aged 15-24.China has successfully controlled blood transfusion-and injecting drug-related transmissions of HIV.Homosexual and non-commercial extramarital heterosexual transmissions have become new challenges for China's HIV/AIDS program.Urgent adoption of the UNAIDS/WHO 90-90-90 target will help overcome these new challenges.展开更多
We analyzed prevalence, risk factors and hepatitis C virus(HCV) genotype distribution in different population groups in Croatia in the context of HCV epidemiology in Europe, with the aim to gather all existing informa...We analyzed prevalence, risk factors and hepatitis C virus(HCV) genotype distribution in different population groups in Croatia in the context of HCV epidemiology in Europe, with the aim to gather all existing information on HCV infection in Croatia which will be used to advise upon preventive measures. It is estimated that 35000-45000 of the Croatian population is chronically infected with HCV. Like in other European countries, there have been changes in the HCV epidemiology in Croatia over the past few decades. In some risk groups(polytransfused and hemodialysis patients), a significant decrease in the HCV prevalence was observed after the introduction of routine HCV screening of blood/blood products in 1992. Injecting drug users(IDUs) still represent a group with the highest risk for HCV infection with prevalence ranging from 29% to 65%. Compared to the prevalence in theCroatian general population(0.9%), higher prevalence rates were found in prison populations(8.3%-44%), human immunodeficiency virus-infected patients(15%), persons with high-risk sexual behavior(4.6%) and alcohol abusers(2.4%). Low/very low prevalence was reported in children and adolescents(0.3%) as well as in blood donors(0%-0.009%). In addition, distribution of HCV genotypes has changed due to different routes of transmission. In the general population, genotypes 1 and 3 are most widely distributed(60.4%-79.8% and 12.9%-47.9%, respectively). The similar genotype distribution is found in groups with high-risk sexual behavior. Genotype 3 is predominant in Croatian IDUs(60.5%-83.9%) while in the prison population genotypes 3 and 1 are equally distributed(52.4% and 47.6%). Data on HCV prevalence and risk factors for transmission are useful for implementation of preventive measures and HCV screening.展开更多
文摘BACKGROUND Mucosa-associated lymphoid tissue(MALT)lymphoma is a subtype of extranodal marginal zone lymphoma,typically occurring in mucosal sites such as the stomach,salivary glands,and lungs.This study aims to analyze the demographic and clinicopathologic characteristics of patients with gastric MALT lymphoma in the United States and evaluate the interaction between age and gender on survival outcomes.AIM To analyze the demographic and clinicopathologic characteristics of patients with gastric MALT lymphoma in the United States and evaluate the interaction between age and gender on survival outcomes.METHODS A retrospective cohort study was conducted using the Surveillance,Epidemiology,and End Results(SEER)database,which included 2453 patients diagnosed with MALT lymphoma from 2010 to 2021.Data were analyzed for demographic factors,tumor characteristics,treatment modalities,and survival outcomes.A Cox proportional hazards regression model was used to identify predictors of overall mortality and cancer-specific mortality.RESULTS The study predominantly included Non-Hispanic White patients(62.78%),with nearly equal gender distribution(50.31%females,49.69%males),and most diagnoses occurring in individuals aged 60-79 years.The majority of tumors were localized(80.07%).Multivariate analysis identified older age,male gender,advanced tumor stage,and socioeconomic factors—such as annual income and marital status—as independent predictors of mortality.No significant interaction between age and gender on mortality outcomes was observed.CONCLUSION Sociodemographic factors,including advanced age,male gender,annual income,and marital status,as well as advanced tumor stage,significantly impacted survival outcomes in patients with MALT lymphoma.Radiotherapy was associated with a reduction in overall mortality.Early detection is crucial for optimizing outcomes,as localized disease responds well to available treatment modalities.
基金supported by the National Natural Science Foundation of China(No.82404365)the Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2023ZD0513200)+7 种基金China Medical Board(No.15-230)China Postdoctoral Science Foundation(Nos.2023M730317and 2023T160066)the Fundamental Research Funds for the Central Universities(No.3332023042)the Open Project of Hebei Key Laboratory of Environment and Human Health(No.202301)the National Key Research and Development Program of China(No.2022YFC3703000)the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2022-JKCS-11)the CAMS Innovation Fund for Medical Sciences(No.2022-I2M-JB-003)the Programs of the National Natural Science Foundation of China(No.21976050).
文摘Associations of per-and polyfluoroalkyl substances(PFAS)on lipid metabolism have been documented but research remains scarce regarding effect of PFAS on lipid variability.To deeply understand their relationship,a step-forward in causal inference is expected.To address these,we conducted a longitudinal study with three repeated measurements involving 201 participants in Beijing,among which 100 eligible participants were included for the present study.Twenty-three PFAS and four lipid indicators were assessed at each visit.We used linear mixed models and quantile g-computation models to investigate associations between PFAS and blood lipid levels.A latent class growth model described PFAS serum exposure patterns,and a generalized linear model demonstrated associations between these patterns and lipid variability.Our study found that PFDA was associated with increased TC(β=0.083,95%CI:0.011,0.155)and HDL-C(β=0.106,95%CI:0.034,0.178).The PFAS mixture also showed a positive relationship with TC(β=0.06,95%CI:0.02,0.10),with PFDA contributing most positively.Compared to the low trajectory group,the middle trajectory group for PFDA was associated with VIM of TC(β=0.756,95%CI:0.153,1.359).Furthermore,PFDA showed biological gradientswith lipid metabolism.This is the first repeated-measures study to identify the impact of PFAS serum exposure pattern on the lipid metabolism and the first to estimate the association between PFAS and blood lipid levels in middle-aged and elderly Chinese and reinforce the evidence of their causal relationship through epidemiological studies.
文摘BACKGROUND The prevalence of negative emotional states,such as anxiety and depression,has increased annually.Although personal habits are known to influence emotional regulation,the precise mechanisms underlying this relationship remain unclear.AIM To investigate emotion regulation habits impact on students negative emotions during lockdown,using the coronavirus disease 2019 pandemic as a case example.METHODS During the coronavirus disease 2019 lockdown,an online cross-sectional survey was conducted at a Chinese university.Emotional states were assessed using the Depression,Anxiety,and Stress Scale-21(DASS-21),while demographic data and emotion regulation habits were collected concurrently.Data analysis was performed using SPSS version 27.0 and includedχ^(2)-tests for intergroup comparisons,Spearman’s rank-order correlation coefficient analysis to examine associations,and stepwise linear regression modeling to explore the relationships between emotion regulation habits and emotional states.Statistical significance was set atα=0.05.RESULTS Among the 494 valid questionnaires analyzed,the prevalence rates of negative emotional states were as follows:Depression(65.0%),anxiety(69.4%),and stress(50.8%).DASS-21 scores(mean±SD)demonstrated significant symptomatology:Total(48.77±34.88),depression(16.21±12.18),anxiety(14.90±11.91),and stress(17.64±12.07).Significant positive intercorrelations were observed among all DASS-21 subscales(P<0.01).Regression analysis identified key predictors of negative emotions(P<0.05):Risk factors included late-night frequency and academic pressure,while protective factors were the frequency of parental contact and the number of same-gender friends.Additionally,compensatory spending and binge eating positively predicted all negative emotion scores(β>0,P<0.01),whereas appropriate recreational activities negatively predicted these scores(β<0,P<0.01).CONCLUSION High negative emotion prevalence occurred among confined students.Recreational activities were protective,while compensatory spending and binge eating were risk factors,necessitating guided emotion regulation.
基金supported by the National Science and Technology Major Program for Noncommunicable Chronic Diseases(2023ZD0503500)the National Natural Science Foundation of China(82030102,12126602,91857118)+1 种基金the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-010,2019-I2M-2-003)the National High Level Hospital Clinical Research Funding(2022-GSP-GG-1,2022-GSP-GG-2)。
文摘Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabolites mediating the associations ofα-diversity with blood pressure(BP)and BP variability(BPV).Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study.The 24-hour,daytime,and nighttime BP and BPV were calculated based on ambulatory BP measurements.Linear mixed models were used to characterize the relationships betweenα-diversity(Shannon and Chao1 index)and BP indices.Mediation analyses were performed to assess the contribution of metabolites to the observed associations.The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants.Results Gut microbial richness(Chao1)was negatively associated with 24-hour systolic BP,daytime systolic BP,daytime diastolic BP,24-hour systolic BPV,and nighttime systolic BPV(P<0.05).Moreover,26 metabolites were strongly associated with richness(Bonferroni P<0.05).Among them,four key metabolites(imidazole propionate,2-hydroxy-3-methylbutyric acid,homovanillic acid,and hydrocinnamic acid)mediated the associations between richness and BP indices(proportions of mediating effects:14.1%–67.4%).These key metabolites were also associated with hypertension in the prospective cohort.For example,each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent(OR[95%CI]=0.90[0.82,0.99];P=0.03)and incident hypertension(HR[95%CI]=0.83[0.71,0.96];P=0.01).Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV,and that certain metabolites mediate these associations.These findings provide novel insights into the pathogenesis and prevention of hypertension.
基金supported by grants from the National Key Research and Development Program of China(No.2023YFC3606300,No.2022YFC3600300)the National Natural Science Foundation of China(No.82325043)the National Key Research and Development Program of Hubei Province(2022BCA036)。
文摘Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank,sarcopenia was diagnosed according to European and Asian Working Groups for Sarcopenia criteria.Social isolation was assessed using standardized questionnaires,including questions on solitude,frequency of social activities,contact with others,and marital status(for the CLHLS only).Results During the follow-up period,8,249 deaths occurred in the CLHLS and 26,670 deaths in the UK Biobank groups.While no significant interaction was observed between sarcopenia and social isolation in predicting all-cause mortality in the CLHLS cohort,the association between social isolation and mortality was stronger among individuals with sarcopenia in the UK Biobank(P-interaction=0.03,relative risk due to interaction:0.23,95%confidence interval[CI]:0.06–0.41).Further joint analyses showed that participants with sarcopenia and high levels of social isolation had the highest mortality risk(hazard ration[HR]:1.99;95%CI:[1.74–2.28]in the CLHLS and 1.69[1.55–1.85]in the UK Biobank)compared to those without either condition.Conclusion The combination of social isolation and sarcopenia synergistically increases the risk of mortality in middle-aged and older adults across diverse populations.
基金supported by the National Natural Science Foundation of China(82341245,82371491)the Chinese Central Government(Key Project of Public Health Program)the National Key Research and Development Program of China(2018YFC1311706,2018YFC1311702)。
文摘Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Factors Surveillance)conducted between 2010 and 2018,a total of 645,420 adult participants(97,741 in 2010;175,749 in 2013;187,777 in 2015;and 184,153 in 2018)were included in the trend analysis.Linear and logistic regression models were utilized to assess trends in sleep duration.Results In 2018,the estimated overall mean sleep duration among the Chinese adult population was7.58(SD,1.45)hours per day,with no significant trend from 2010.A significant increase in short sleep duration(≤6 hours)was observed in the total population,from 15.3%(95%CI:14.1%–16.5%)in 2010 to18.5%(95%CI:17.7%–19.3%)in 2018(P<0.001).Similarly,the trend in long sleep duration(>9 hours)was also significant,increasing in weighted prevalence from 7.2%(95%CI:6.3%–8.1%)in 2010 to 9.0%(95%CI:8.2%–9.9%)in 2018(P<0.001).Conclusion The prevalence of both short and long sleep durations significantly increased among Chinese adults from 2010 to 2018,highlighting the urgency of health initiatives to promote optimal sleep duration in China.
基金supported by the Research Funds of the Center for Big Data and Population Health of IHM(grant number JKS2022015)the Key Scientific Research Fund of the Anhui Provincial Education Department(grant number2023AH050610)the Anhui Natural Science Foundation(grant number 1808085QH252)。
文摘In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.
基金supported by grants from the National Natural Science Foundation of China(G.F.Wang,grant number 82204071)(P.Y.Su,grant numbers 81874268 and 82473655)the Research Funds of the Center for Big Data and Population Health of IHM(P.Y.Su,No.JKS2023016)Anhui Provincial Health Commission Scientific Research Project(Y.Zhou,No.AHWJ2023A30027)。
文摘Vitamin D deficiency(VDD)represents a significant nutritional concern among children and adolescents.The estimated prevalence of VDD in China is 46.8%in this population^([1]).VDD during childhood and adolescence has been associated with the onset of various conditions,including acute respiratory infections,asthma,atopic dermatitis,and food allergies^([2]).Multiple factors,including age,sun exposure,adiposity,and genetics,influence vitamin D levels^([2,3]).Increasing attention has been directed toward understanding the environmental determinants that may influence vitamin D status.Given the potential of metallic pollutants to disrupt endocrine function and their ubiquity in the environment,investigating the effects of metal exposure on human vitamin D status,particularly in vulnerable populations,is imperative.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82192900,82192901,82192904,81390540,and 91846303 to L.L.)the National Key Research and Development Program of China(Grant No.2016YFC0900500 to Y.G.)the Kadoorie Charitable Foundation in Hong Kong,and the Wellcome Trust in the UK(Grant/Award Nos.088158/Z/09/Z,104085/Z/14/Z,and 202922/Z/16/Z to Z.C.).
文摘While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the association between combined lifestyle factors and stroke incidence.Using data from 51929 participants free of major cardiovascular diseases or cancer at baseline,we employed structural equation modeling to assess the mediating effects of systolic(SBP)and diastolic(DBP)blood pressure.During the follow-up,2811 incident stroke cases were identified.A healthy lifestyle was significantly associated with a reduced risk of stroke,with SBP mediating 44.70%(β=-0.0014,95%confidence interval[CI]:-0.0016 to-0.0012)and DBP mediating 37.81%(β=-0.0012,95%CI:-0.0015 to-0.0009)of this association.The mediating effects were attenuated but remained significant for ischemic stroke(SBP:33.21%;DBP:27.24%).In conclusion,approximately two-fifths of the protective association between a healthy lifestyle and stroke may be mediated by BP.These findings suggest that BP control may serve as an important early indicator for evaluating the effectiveness of lifestyle interventions in reducing stroke risk.
文摘Despite a decline in incidence and mortality during the last decades,stomach cancer is one of the main health challenges worldwide.According to the GLOBOCAN 2020 estimates,stomach cancer caused approximately 800000 deaths(accounting for 7.7%of all cancer deaths),and ranks as the fourth leading cause of cancer deaths in both genders combined.About 1.1 million new cases of stomach cancer were diagnosed in 2020(accounting for 5.6%of all cancer cases).About 75%of all new cases and all deaths from stomach cancer are reported in Asia.Stomach cancer is one of the most lethal malignant tumors,with a five-year survival rate of around 20%.There are some well-established risk factors for stomach cancer:Helicobacter pylori infection,dietary factors,tobacco,obesity,and radiation.To date,the most important way of preventing stomach cancer is reduced exposure to risk factors,as well as screening and early detection.Further research on risk factors can help identify various opportunities for more effective prevention.Screening programs for stomach cancer have been implemented in a few countries,either as a national or opportunistic screening of high-risk individuals only.Generally,due to its high aggressiveness and heterogeneity,stomach cancer still remains a severe global health problem.
文摘Lung cancer is the leading cause of cancer death worldwide,with large variation of the incidence and mortality across regions.Although the mortality of lung cancer has been decreasing,or steady in the US,it has been increasing in Asia for the past two decades.Smoking is the leading cause of lung cancer,and other risk factors such as indoor coal burning,cooking fumes,and infections may play important roles in the development of lung cancer among Asian never smoking women.The median age of diagnosis in Asian patients with lung cancer is generally younger than Caucasian patients,particularly among never-smokers.Asians and Caucasians may have different genetic susceptibilities to lung cancer,as evidenced from candidate polymorphisms and genome-wide association studies.Recent epidemiologic studies and clinical trials have shown consistently that Asian ethnicity is a favorable prognostic factor for overall survival in non-small cell lung cancer(NSCLC),independent of smoking status.Compared with Caucasian patients with NSCLC,East Asian patients have a much higher prevalence of epidermal growth factor receptor(EGFR) mutation(approximately 30% vs.7%,predominantly among patients with adenocarcinoma and never-smokers),a lower prevalence of K-Ras mutation(less than 10% vs.18%,predominantly among patients with adenocarcinoma and smokers),and higher proportion of patients who are responsive to EGFR tyrosine kinase inhibitors.The ethnic differences in epidemiology and clinical behaviors should be taken into account when conducting global clinical trials that include different ethnic populations.
文摘The incidence and mortality of gastric cancer have fallen dramatically in US and elsewhere over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cancer and the second leading cause of cancer death worldwide. Demographic trends differ by tumor location and histology. While there has been a marked decline in distal, intestinal type gastric cancers, the incidence of proximal, diffuse type adenocarcinomas of the gastric cardia has been increasing, particularly in the Western countries. Incidence by tumor sub-site also varies widely based on geographic location, race, and socioeconomic status. Distal gastric cancer predominates in developing countries, among blacks, and in lower socioeconomic groups, whereas proximal tumors are more common in developed countries, among whites, and in higher socio-economic classes. Diverging trends in the incidence of gastric cancer by tumor location suggest that they may represent two diseases with different etiologies. The main risk factors for distal gastric cancer include Helicobacter pylori （H pylori） infection and dietary factors, whereas gastroesophageal reflux disease and obesity play important roles in the development of proximal stomach cancer. The purpose of this review is to examine the epidemiology and risk factors of gastric cancer, and to discuss strategies for primary prevention.
基金Supported by National S and T Major Project Foundation of China,No.2011ZX10004-902Priority Academic Program Development of Jiangsu Higher Education Institutions,Jiangsu Province Health Development Project with Science and Education,No.ZX201109Research and Innovation Project for College Graduates of Jiangsu Province of China,No.KYZZ_0265
文摘AIM: To investigate hepatitis B virus(HBV) prevalence in the general population in China.METHODS: A total of 148931 individuals were investigated by multistage random sampling in Eastern China. Data were collected on demographics and hepatitis B vaccination history, and serum was tested for hepatitis B surface antigen(HBs Ag) by ELISA. RESULTS: A total of 11469 participants(7.70%, 95%CI: 7.57%-7.84%) were positive for HBs Ag. HBs Ag prevalence was 0.77% among children < 5 years old but increased progressively from adolescents(1.40%-2.55%) to adults(5.69%-11.22%). A decrease in HBs Ag prevalence was strongly associated with vaccination and familial history of HBV among both children and adult groups. Meanwhile, HBs Ag risk in adults was associated with invasive testing and sharing needles. The HBV immunization rate among participants aged < 20 years was 93.30%(95%CI: 93.01%-93.58%). Significant difference in HBs Ag prevalence appeared between vaccinated and unvaccinated participants(3.59% vs 10.22%). CONCLUSION: Although the national goal of HBs Ag prevalence < 1% among children < 5 years old has been reached, immunization programs should be maintained to prevent resurgence.
基金supported by the Projects of Zhejiang Province Non-profit Technology Research(No.2013C33180),China
文摘In many traditional Chinese medicine （TCM） hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections （nBSIs） are an important cause of morbidity and mortality. A retrospective sur- veillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions Escherichia coli （25.5%） was the most common Gram-negative and coagulase-negative staphylococcus （CONS） （14.1%） was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsie/la pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7% were resistant to methicillin. Carbapenems and glyco- peptide were the most frequently used for nBSI therapy. Only about one-third of patients （157/482） received appro- priate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score 〉4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs.
文摘Objectives Quality of life(QoL) is a priority outcome in older adults suffering from cardiovascular diseases. Frailty and poor nutritional status may affect the QoL through mobility disorders and exhaustion. The objective of this study was to determine if physical frailty and nutritional status were associated with QoL, in older cardiology patients. Methods Cross sectional, observational study conducted in a cardiology department from a university hospital. Participants(n = 100) were aged 70 and older. Collected data included age, sex, cardiac diseases, New York Heart Association(NYHA) classification, comorbidities(Charlson Index) and disability. A Short Physical Performance Battery(SPPB), including walking speed assessment was performed;handgrip strength were measured as well as Fried’s frailty phenotype. Nutritional status was assessed using the Mini Nutritional Assessment(MNA) and Body Mass Index(BMI), inflammation by C-reactive protein(CRP). QoL was assessed using the EORTC–QLQ questionnaire. Univariate and multivariate analyses were performed to study the associations between all recorded parameters and QoL. Results In participants(mean age: 79.3 ± 6.7 years;male: 59%), Charlson index, arrhythmia, heart failure, NYHA class III-IV, MNA, disability, walking speed, SPPB score, frailty and CRP were significantly associated with QoL in univariate analysis. Multivariate analysis showed that NYHA class III-IV(P < 0.001), lower MNA score(P = 0.03), frailty(P < 0.0001), and higher CRP(P < 0.001) were independently associated with decreased QoL. Conclusions Frailty, nutritional status and inflammation were independently associated with poor QoL. Further studies are needed to assess the efficacy of nutritional and physical interventions on QoL in this population.
文摘In Iran,the prevalence of hepatitis C virus(HCV) infection is relatively low according to the populationbased epidemiological studies. However,the epidemiology of HCV is changing and the rate of HCV infection is increasing due to the growth in the number of injecting drug users in the society. In addition,a shift has occurred in the distribution pattern of HCV genotypes among HCV-infected patients in Iran. Genotype 1a is the most prevalent genotype in Iran,but in recent years,an increase in the frequency of 3a and a decrease in 1a and 1b have been reported. These variations in the epidemiology of HCV reflect differences in the routes of transmission,status of public health,lifestyles,and risk factors in different groups and geographic regions of Iran. Health policy makers should consider these differences to establish better strategies for control and prevention of HCV infection. Therefore,this review was conducted to present a clear view regarding the current epidemiology of HCV infection in Iran.
文摘Dear editor,Patients with supraventricular tachycardia(SVT)commonly present to the emergency department(ED).Current guidelines[1,2]do not recommend routine pathology testing and a report on the topic has questioned their role.A systematic review concluded that troponin testing is commonly performed with a high proportion of positive fi ndings,but these results were not associated with major adverse cardiac events.[3]The conclusions of this review were limited by paucity of data and heterogeneity among studies.
基金Supported by Janssen-Cilag Farmacêutica Ltda.,S?o Paulo,Brazil
文摘AIM:To determine the prevalences of symptoms consistent with gastroesophageal reflux disease(GERD)and dyspepsia in South America.METHODS:A telephone survey was conducted among adult owners of land-based telephones in S?o Paulo,Brazil,using previously validated computer-assisted sampling and survey protocols.The Portugueselanguage survey included(1)sociodemographic characteristics(e.g.,weight,height,smoking)and comorbidities;(2)dietary habits;(3)presence of symptoms consistent with GERD or dyspepsia within the prior 3mo;and(4)use of medications and other therapies to manage symptoms.Data were stratified post-hoc into three homogeneous geographical regions of S?o Paulo according to the Social Exclusion Indices of the districts and postal codes.Survey response data from each respondent were weighted by the numbers of adults and landline telephones in each household.The analyses were weighted to account for sampling design and to be representative of the S?o Paulo population according to city census data.RESULTS:Among 4570 households contacted,an adult from 3050(66.7%)agreed to participate.The nonresponse rate was 33.3%.The mean(SE)respondent age was 42.6(16.0)years.More than half of all respondents were women(53.1%),aged 18 through 49 years(66.7%),married or cohabitating(52.5%),and/or above normal-weight standards(i.e.,35.3%overweight and 16.3%obese).A total of 26.5%of women were perimenopausal.More than 20%of respondents reported highly frequent symptoms consistent with GERD(e.g.,gastric burning sensation=20.8%)or dyspepsia(e.g.,abdominal swelling/distension=20.9%)at least once per month.Prevalences of these symptoms were significantly(approximately 1.5-to 2.0-fold)higher among women than men but did not vary significantly as a function of advancing age.For instance,14.1%of women reported that they experienced stomach burning(symptom of GERD)at least twice per week,compared to 8.4%of men(P=0.012 byχ2 test).A total of 15.7%of women reported that they experienced abdominal swelling(symptom of dyspepsia)at least twice per week,compared to 6.4%of men(P<0.001byχ2 test).Despite frequent manifestations of GERD or dyspepsia,most(≥90%)respondents reported that they neither received prescription medications fromphysicians,nor took behavioral measures(e.g.,dietary modifications),to manage symptoms.CONCLUSION:Symptoms consistent with dyspepsia and GERD are prevalent in Brazil and represent major public-health and clinical challenges.
文摘We used nationally reported cases (NCAIDS/China CDC,2016) and published literature to summarize up-to the end of 2015 epidemiologic trends in the HIV/AIDS epidemic in China.HIV-positive cases are distributed unevenly with most infections found in southwest China and the most affected population being men who have sex with men.Transmission mode of HIV infection has shifted from drug injection to sexual contact,which accounts for 95% of total reported cases.Two thirds of cases are from heterosexual transmission.Transmission pattern varies greatly throughout China.Some provinces in China reported heterosexual transmission accounted for over 90% of cases while other provinces reported homosexual transmission accounted for over 80% of cases.Patterns of heterosexually acquired HIV also vary widely,with 80% of cases attributed to commercial sex in some provinces,while in other provinces non-commercial extramarital sex accounted for over 70% of cases.Significant increase in HIV infection was observed among young students aged 15-24.China has successfully controlled blood transfusion-and injecting drug-related transmissions of HIV.Homosexual and non-commercial extramarital heterosexual transmissions have become new challenges for China's HIV/AIDS program.Urgent adoption of the UNAIDS/WHO 90-90-90 target will help overcome these new challenges.
文摘We analyzed prevalence, risk factors and hepatitis C virus(HCV) genotype distribution in different population groups in Croatia in the context of HCV epidemiology in Europe, with the aim to gather all existing information on HCV infection in Croatia which will be used to advise upon preventive measures. It is estimated that 35000-45000 of the Croatian population is chronically infected with HCV. Like in other European countries, there have been changes in the HCV epidemiology in Croatia over the past few decades. In some risk groups(polytransfused and hemodialysis patients), a significant decrease in the HCV prevalence was observed after the introduction of routine HCV screening of blood/blood products in 1992. Injecting drug users(IDUs) still represent a group with the highest risk for HCV infection with prevalence ranging from 29% to 65%. Compared to the prevalence in theCroatian general population(0.9%), higher prevalence rates were found in prison populations(8.3%-44%), human immunodeficiency virus-infected patients(15%), persons with high-risk sexual behavior(4.6%) and alcohol abusers(2.4%). Low/very low prevalence was reported in children and adolescents(0.3%) as well as in blood donors(0%-0.009%). In addition, distribution of HCV genotypes has changed due to different routes of transmission. In the general population, genotypes 1 and 3 are most widely distributed(60.4%-79.8% and 12.9%-47.9%, respectively). The similar genotype distribution is found in groups with high-risk sexual behavior. Genotype 3 is predominant in Croatian IDUs(60.5%-83.9%) while in the prison population genotypes 3 and 1 are equally distributed(52.4% and 47.6%). Data on HCV prevalence and risk factors for transmission are useful for implementation of preventive measures and HCV screening.
