Background:More efficacious,noninvasive screening methods are needed for advanced colorectal neoplasia.miR-92a is a reliable and reproducible biomarker for early colorectal cancer detection in stool samples.We compare...Background:More efficacious,noninvasive screening methods are needed for advanced colorectal neoplasia.miR-92a is a reliable and reproducible biomarker for early colorectal cancer detection in stool samples.We compared the diagnostic efficacies of miR-92a,immunochemical fecal occult blood testing(FIT),and their combination(FIT+miR-92a)in a prospective multicenter screening trial.Methods:Overall,16,240 participants aged 30-75 years were enrolled between April 1,2021,and December 31,2023.A total of 15,586 participants returned samples available for both FIT and miR-92a tests.All those with positive,and a random selection of those with negative screening tests were recommended to undergo colonoscopy.Follow-ups were performed until participants completed the colonoscopic examination.A total of 1401 screen-positive and 2079 randomly selected screen-negative individuals completed colonoscopies.Primary outcomes included sensitivity,number needed to screen(NNS),Youden index and receiver operating characteristic area under the curve(AUC)for advanced adenomas and colorectal cancer[advanced neoplasia(AN)]for each screening modality in the diagnostic performance analysis.Results:Colonoscopy was performed in 3480 individuals.The colonoscopy compliance rate was 47.8%for screen-positive individuals.The sensitivity of miR-92a vs.FIT for AN was 70.9%vs.54.3%(P<0.001),NNS was 24.7 vs.32.2(P=0.001),Youden index was 47.9%vs.35.0%(P<0.001),AUC was 0.74 vs.0.67(P=0.010).FIT+miR-92a had a sensitivity of 85.4%,an NNS of 20.5,a Youden index of 47.9%and an AUC of 0.74 for AN.Conclusions:For AN screening,miR-92a demonstrated better sensitivity,NNS,Youden index and AUC as compared with FIT.Compared with FIT,using miR-92a appears to be more efficient for population-based screening programs.Screening sensitivity for AN can be further enhanced if conditionally used in combination with FIT.Trial registration Chinese Clinical Trial Registration Number:ChiCTR2200065415.展开更多
Introduction:Breast cancer is a leading tumor with a high mortality in women.This study examined the spatio-temporal distribution of the incidence of female breast cancer in Shenzhen between 2007 and 2012.Methods:The ...Introduction:Breast cancer is a leading tumor with a high mortality in women.This study examined the spatio-temporal distribution of the incidence of female breast cancer in Shenzhen between 2007 and 2012.Methods:The data on breast cancer incidence were obtained from the Shenzhen Cancer Registry System.To describe the temporal trend,the average annual percentage change(AAPC) was analyzed using a pinpoint regression model.Spatial autocorrelation and a retrospective spatio-temporal scan approach were used to detect the spatio-temporal cluster distribution of breast cancer cases.Results:Breast cancer ranked first among different types of cancer in women in Shenzhen between 2007 and 2012 with a crude incidence of 20.0/100,000 population.The age-standardized rate according to the world standard population was 21.1/100,000 in 2012,with an AAPC of 11.3%.The spatial autocorrelation analysis showed a spatial correlation characterized by the presence of a hotspot in south-central Shenzhen,which included the eastern part of Luohu District(Donghu and Liantang Streets) and Yantian District(Shatoujiao,Haishan,and Yantian Streets).Five spatio-temporal cluster areas were detected between 2010 and 2012,one of which was a Class 1 cluster located in southwestern Shenzhen in 2010,which included Yuehai,Nantou,Shahe,Shekou,and Nanshan Streets in Nanshan District with an incidence of 54.1/100,000 and a relative risk of 2.41;the other four were Class 2 clusters located in Yantian,Luohu,Futian,and Longhua Districts with a relative risk ranging from 1.70 to 3.25.Conclusions:This study revealed the spatio-temporal cluster pattern for the incidence of female breast cancer in Shenzhen,which will be useful for a better allocation of health resources in Shenzhen.展开更多
Objective This study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction(AMI)and stroke in Shenzhen.Methods Data on ischemic(n=72,945)and hemorrhagic(n=18,659)stroke and...Objective This study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction(AMI)and stroke in Shenzhen.Methods Data on ischemic(n=72,945)and hemorrhagic(n=18,659)stroke and AMI(n=17,431)incidence covering about 12 million people in Shenzhen from 2012 to 2016 were used.Immediate and gradual changes in incidence rates were analyzed using segmented Poisson regression.Results Following the smoke-free legislation,a 9%(95%CI:3%-15%)immediate reduction was observed in AMI incidence,especially in men(8%,95%CI:1%-14%)and in those aged 65 years and older(17%,95%CI:9%-25%).The gradual annual benefits were observed only in hemorrhagic and ischemic stroke incidence,with a 7%(95%CI:2%-11%)and 6%(95%CI:4%-8%)decrease per year,respectively.This health effect extended gradually to the 50-64 age group.In addition,neither the immediate nor gradual decrease in stroke and AMI incidence rates did not show statistical significance among the 35-49 age group(P>0.05).Conclusion Smoke-free legislation was enforced well in Shenzhen,which would generate good experiences for other cities to enact and enforce smoke-free laws.This study also provided more evidence of the health benefits of smoke-free laws on stroke and AMI.展开更多
We assessed the prevalence of non‐ communicable diseases（NCDs） risk factors with a focus on their clustering among healthy adults in Shenzhen, China. Data from the 2011 China Health and Nutrition Survey, comprising...We assessed the prevalence of non‐ communicable diseases（NCDs） risk factors with a focus on their clustering among healthy adults in Shenzhen, China. Data from the 2011 China Health and Nutrition Survey, comprising a regionally representative sample of 806 healthy adults aged 35 years or older, were obtained to determine the prevalence of five risk factors for NCDs. The prevalence of current smoking, central obesity, impaired fasting glucose, borderline hypertension, and borderline high total cholesterol was 19.97%, 28.29%, 4.47%, 10.55%, and 36.10%, respectively. A total 63.77% of participants had at least one risk factor. Upon examination of risk factor clustering, we observed that 7.57% of participants had at least three risk factors. Using this threshold as a cutoff, clustering of risk factors was associated with sex [odds ratio（OR） = 3.336, 95% confidence interval（CI）： 1.782 to 6.246], physical activity（OR = 1.913, 95% CI： 1.009 to 3.628）, and BMI（OR = 7.376, 95% CI： 3.812 to 14.270）. The prevalence of risk factors for NCDs is fairly high among healthy adults in Shenzhen, with a clustering tendency.展开更多
Nontuberculous mycobacteria(NTM)are opportunistic pathogens of environmental origin that can cause human infections in a wide variety of tissues[1].Lung involvement is the most common manifestation of NTM infection[1]...Nontuberculous mycobacteria(NTM)are opportunistic pathogens of environmental origin that can cause human infections in a wide variety of tissues[1].Lung involvement is the most common manifestation of NTM infection[1].The symptoms and radiographic signs are similar to those of patients with pulmonary tuberculosis(TB)who are infected with Mycobacterium tuberculosis complex(MTBC)[1].Most NTM species are naturally resistant to first-line anti-TB drugs and have different resistance profiles,thus misdiagnosis leads to inappropriate treatment and increases the risk of poor prognosis for patients with an NTM infection,and even wider spread through person-to-person contact[2].展开更多
Objective:The number of liver cancer patients in China accounts for more than half of the world.However,China currently lacks national,multicenter economic burden data,and meanwhile,measuring the differences among dif...Objective:The number of liver cancer patients in China accounts for more than half of the world.However,China currently lacks national,multicenter economic burden data,and meanwhile,measuring the differences among different subgroups will be informative to formulate corresponding policies in liver cancer control.Thus,the aim of the study was to measure the economic burden of liver cancer by various subgroups.Methods:A hospital-based,multicenter and cross-sectional survey was conducted during 2012・2014,covering 39 hospitals and 21 project sites in 13 provinces across China.The questionnaire covers clinical information,sociology,expenditure,and related variables.All expenditure data were reported in Chinese Yuan(CNY)using 2014 values.Results:A total of 2,223 liver cancer patients were enrolled,of whom 59.61%were late-stage cases(III-IV),and 53.8%were hepatocellular carcinoma.The average total expenditure per liver cancer patient was estimated as 53,220 CNY,including 48,612 CNY of medical expenditures(91.3%)and 4,608 CNY of non-medical expenditures(8.7%).The average total expenditures in stage I,H,m and stage IV were 52,817 CNY,50,877 CNY,50,678 CNY and 54,089 CNY(P>0.05),respectively.Non-medical expenditures including additional meals,additional nutrition care,transportation,accommodation and hired informal nursing were 1,453 CNY,839 CNY,946 CNY,679 CNY and 200 CNY,respectively.The one-year out-of-pocket expenditure of a newly diagnosed patient was 24,953 CNY,and 77.2%of the patients suffered an unmanageable financial burden.Multivariate analysis showed that overall expenditure differed in almost all subgroups(P<0.05),except for sex,clinical stage,and pathologic type.Conclusions:There was no difference in treatment expenditure for liver cancer patients at different clinical stages,which suggests that maintaining efforts on treatment efficacy improvement is important but not enough.To fiirtherly reduce the overall economic burden from liver cancer,more effort should be given to primary and secondary prevention strategies.展开更多
In this study, we analyse the relationship between the occurrences of influenza in Shenzhen, a rapid developing city in subtropic regions of southern China with over 10 million populations, and the vapor pressure (VP)...In this study, we analyse the relationship between the occurrences of influenza in Shenzhen, a rapid developing city in subtropic regions of southern China with over 10 million populations, and the vapor pressure (VP), the concentrations of atmospheric pollutants (SO2, NO2, PM10) for the period of 2003 - 2008. Using the data such as the rate of Influ- en-za-Like-Illness (ILI (%)), the concentrations of pollutants and vapor pressure, we show quite different results from pre-vious research conducted in other regions in China which are dominated by temperate climate and with influenza out-break in Winter and Autumn. Our results show that the rate of ILI in Shenzhen reaches its maximum in Summer and minimum in Winter and the concentrations of pollutants were significantly correlated with ILI (%), there are significant positive correlations between ILI (%) and VP which can explain over 25% the variance of ILI (%) variations. Quite surprisingly, both atmospheric SO2 and PM10 concentrations are negatively correlated with ILI (%), this is because acid deposition may limit the spread of disease, the seasonal variations of acid rain in Shenzhen could contribute to the sea-sonality of its influenza. Furthermore, there are some significant correlations between preceding VP and SO2 and PM10 concentrations to ILI occurrence and such connections can be used for ILI predictions.展开更多
Objectives: To conduct health risk assessment of drinking water pesticide residues and its annual trend analysis in Shenzhen City. Methods: The samples of product water, pipe water and secondary supply water from 2011...Objectives: To conduct health risk assessment of drinking water pesticide residues and its annual trend analysis in Shenzhen City. Methods: The samples of product water, pipe water and secondary supply water from 2011 to 2013 were collected and analyzed. The evaluation models of health risk assessments for children and adults on the 12 non-carcinogenic materials (namely heptachlor, pentachlorophenol, hexachlorocyclohexane, hexachlorobenzene, DDT, malathion, glyphosate, dimethoate, bentazone, atrazine, chlorothalonil, furadan) were recommended by the U.S. Environmental Protection Agency (US EPA). Results: The results showed that the maximums of the measured indicators in the above were controlled in accordance with the National Health Standards (GB5749-2006) published by Ministry of Health in China. The adults and children’s health indices (HIs) of the 12 non-carcinogenic materials were greater than 1 (2.323 - 6.312). Dimethoate residue in factory and peripheral water was the largest risks of harm among the non-carcinogenic pollutants measured. And its HIi (Its Hli) was also greater than 1 (1.995 - 5.094) and followed by hexachlorobenzene and heptachlor. Annual rising trend on health risk of the 12 pesticide residues indicated that their HIT on adults was 2323. 18 × 10-3 in 2011, 2340. 18 × 10-3 in 2012 and 2431. 97 × 10-3 in 2013, and HIT on children was 2965. 07 × 10-3 in 2011, 2986. 77 × 10-3 in 2012 and 3103. 93 × 10-3 in 2013, respectively. This study also suggested that the average risk of peripheral water samples (HIT was equal to 2619. 64 × 10-3) was greater than the factory samples’ (HIT was the same as 2366. 92 × 10-3), and the children’s health risk was greater than the adults’. Conclusions: Health risks of drinking water pesticide residues in Shenzhen have exceeded the threshold values. The dimethoate was the main hazard and had been rising annually, and the children’s health risk was greater than the adults’.展开更多
Objectives: To conduct health risk assessment on drinking water in 2012 in Shenzhen of China. Methods: The water quality monitoring data on product water and pipe water in 2012 were collected and analyzed, and the ris...Objectives: To conduct health risk assessment on drinking water in 2012 in Shenzhen of China. Methods: The water quality monitoring data on product water and pipe water in 2012 were collected and analyzed, and the risk evaluation models recommended by the U.S. environmental protection agency (US EPA) were employed, to perform adults and children’s health risk assessments on the three kinds of genetic toxic substances such as hexavalent chromium, cadmium and arsenic and the 12 non-carcinogenic materials such as iron, manganese, lead, fluoride, volatile phenol, cyanide, mercury, ammonia nitrogen, nitrate, copper, zinc and selenium. Results: The results about water quality from the 150 factory samples and 207 peripheral water samples showed that the measured indicators in other water samples were accord with the National Health Standards (GB5749-2006) released by Ministry of Health of the People’s Republic of China, except manganese level in one factory sample and the same index in one peripheral sample, and nitrate concentration in another water sample were out of limit, respectively. Namely, the total of 3 samples was disqualification. The adults and children’s health risks (HI) on the 12 non-carcinogenic materials were 178.04 × 10-8 and 249.96 × 10-8 in the factor water samples, and 363.02 × 10-8 and 509.66 × 10-8 in the pipe samples, respectively. Lead in factory water and fluoride in peripheral water samples were the most serious harm in the all measured non-carcinogenic indicators. The adults and children’s cancer risks (R) on the 3 genetic toxic substances were 25.60 × 10-6 and 28.51 × 10-6 in the factor water samples, and 23.47 × 10-6 and 26.08 × 10-6 in the pipe samples, respectively. Hexavalent chromium was the most damage among the three detected carcinogenic indicators. Therefore, the total adults and children’s health hazard risks including the 3 carcinogenic and 12 non-carcinogenic substances were 27.38 × 10-6 and 31.00 × 10-6 in the factor water samples, and 27.10 × 10-6 and 31.17 × 10-6 in the pipe samples, respectively. Genetic toxic matters in drinking water are the main hazard and more children’s health risk than adults’ risk. Conclusions: The health risk (R) on the 15 kinds of chemicals in Shenzhen’s municipal water supply was in the range of maximum acceptable risk levels (5.0 × 10-5/a) recommended by the International Commission of Radiation Protection (ICRP). The results in this study indicate that the carcinogenic substances are greater risk comparing with the non-carcinogenic substances, and hexavalent chromium is the biggest carcinogenic risk, and lead and fluoride are the most non-carcinogenic risk, and the rather risk of children than adults.展开更多
Neurological disorders,including headaches(tension-type headaches,medication-overuse headaches,and migraines)and dementias that include Alzheimer’s disease,are among the most prevalent and debilitating global conditi...Neurological disorders,including headaches(tension-type headaches,medication-overuse headaches,and migraines)and dementias that include Alzheimer’s disease,are among the most prevalent and debilitating global conditions.In 2016,these disorders affected 276 million people worldwide and were the second leading cause of death that year[1].This highlights the urgent need for effective prevention,treatment,and support strategies.The etiology of neurological disorders is multifaceted and involves genetic,environmental,physiological,and social factors[2].展开更多
基金supported by the Capital’s Funds for Health Improvement and Research(2024-1G-4023)the National Natural Science Foundation of China(82273721).
文摘Background:More efficacious,noninvasive screening methods are needed for advanced colorectal neoplasia.miR-92a is a reliable and reproducible biomarker for early colorectal cancer detection in stool samples.We compared the diagnostic efficacies of miR-92a,immunochemical fecal occult blood testing(FIT),and their combination(FIT+miR-92a)in a prospective multicenter screening trial.Methods:Overall,16,240 participants aged 30-75 years were enrolled between April 1,2021,and December 31,2023.A total of 15,586 participants returned samples available for both FIT and miR-92a tests.All those with positive,and a random selection of those with negative screening tests were recommended to undergo colonoscopy.Follow-ups were performed until participants completed the colonoscopic examination.A total of 1401 screen-positive and 2079 randomly selected screen-negative individuals completed colonoscopies.Primary outcomes included sensitivity,number needed to screen(NNS),Youden index and receiver operating characteristic area under the curve(AUC)for advanced adenomas and colorectal cancer[advanced neoplasia(AN)]for each screening modality in the diagnostic performance analysis.Results:Colonoscopy was performed in 3480 individuals.The colonoscopy compliance rate was 47.8%for screen-positive individuals.The sensitivity of miR-92a vs.FIT for AN was 70.9%vs.54.3%(P<0.001),NNS was 24.7 vs.32.2(P=0.001),Youden index was 47.9%vs.35.0%(P<0.001),AUC was 0.74 vs.0.67(P=0.010).FIT+miR-92a had a sensitivity of 85.4%,an NNS of 20.5,a Youden index of 47.9%and an AUC of 0.74 for AN.Conclusions:For AN screening,miR-92a demonstrated better sensitivity,NNS,Youden index and AUC as compared with FIT.Compared with FIT,using miR-92a appears to be more efficient for population-based screening programs.Screening sensitivity for AN can be further enhanced if conditionally used in combination with FIT.Trial registration Chinese Clinical Trial Registration Number:ChiCTR2200065415.
文摘Introduction:Breast cancer is a leading tumor with a high mortality in women.This study examined the spatio-temporal distribution of the incidence of female breast cancer in Shenzhen between 2007 and 2012.Methods:The data on breast cancer incidence were obtained from the Shenzhen Cancer Registry System.To describe the temporal trend,the average annual percentage change(AAPC) was analyzed using a pinpoint regression model.Spatial autocorrelation and a retrospective spatio-temporal scan approach were used to detect the spatio-temporal cluster distribution of breast cancer cases.Results:Breast cancer ranked first among different types of cancer in women in Shenzhen between 2007 and 2012 with a crude incidence of 20.0/100,000 population.The age-standardized rate according to the world standard population was 21.1/100,000 in 2012,with an AAPC of 11.3%.The spatial autocorrelation analysis showed a spatial correlation characterized by the presence of a hotspot in south-central Shenzhen,which included the eastern part of Luohu District(Donghu and Liantang Streets) and Yantian District(Shatoujiao,Haishan,and Yantian Streets).Five spatio-temporal cluster areas were detected between 2010 and 2012,one of which was a Class 1 cluster located in southwestern Shenzhen in 2010,which included Yuehai,Nantou,Shahe,Shekou,and Nanshan Streets in Nanshan District with an incidence of 54.1/100,000 and a relative risk of 2.41;the other four were Class 2 clusters located in Yantian,Luohu,Futian,and Longhua Districts with a relative risk ranging from 1.70 to 3.25.Conclusions:This study revealed the spatio-temporal cluster pattern for the incidence of female breast cancer in Shenzhen,which will be useful for a better allocation of health resources in Shenzhen.
基金supported by the CAMS Innovation Fund for Medical Sciences[CIFMS2016-12M-3-001]the China Medical Board Strengthen Capacity of Study and Application on Burden of Disease in Health Care System of China-Establishment and Development of Chinese Burden of Disease Research and Dissemination Center[15-208]。
文摘Objective This study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction(AMI)and stroke in Shenzhen.Methods Data on ischemic(n=72,945)and hemorrhagic(n=18,659)stroke and AMI(n=17,431)incidence covering about 12 million people in Shenzhen from 2012 to 2016 were used.Immediate and gradual changes in incidence rates were analyzed using segmented Poisson regression.Results Following the smoke-free legislation,a 9%(95%CI:3%-15%)immediate reduction was observed in AMI incidence,especially in men(8%,95%CI:1%-14%)and in those aged 65 years and older(17%,95%CI:9%-25%).The gradual annual benefits were observed only in hemorrhagic and ischemic stroke incidence,with a 7%(95%CI:2%-11%)and 6%(95%CI:4%-8%)decrease per year,respectively.This health effect extended gradually to the 50-64 age group.In addition,neither the immediate nor gradual decrease in stroke and AMI incidence rates did not show statistical significance among the 35-49 age group(P>0.05).Conclusion Smoke-free legislation was enforced well in Shenzhen,which would generate good experiences for other cities to enact and enforce smoke-free laws.This study also provided more evidence of the health benefits of smoke-free laws on stroke and AMI.
基金supported by National Project of NCDs High‐risk Population Health Management,Center for Chronic and Non‐communicable Diseases Control and Prevention,China CDC(Grant No.2013085)The Science and Technology Planning Project of Shenzhen City,Guangdong Province,China(Grant No.201602005)
文摘We assessed the prevalence of non‐ communicable diseases（NCDs） risk factors with a focus on their clustering among healthy adults in Shenzhen, China. Data from the 2011 China Health and Nutrition Survey, comprising a regionally representative sample of 806 healthy adults aged 35 years or older, were obtained to determine the prevalence of five risk factors for NCDs. The prevalence of current smoking, central obesity, impaired fasting glucose, borderline hypertension, and borderline high total cholesterol was 19.97%, 28.29%, 4.47%, 10.55%, and 36.10%, respectively. A total 63.77% of participants had at least one risk factor. Upon examination of risk factor clustering, we observed that 7.57% of participants had at least three risk factors. Using this threshold as a cutoff, clustering of risk factors was associated with sex [odds ratio（OR） = 3.336, 95% confidence interval（CI）： 1.782 to 6.246], physical activity（OR = 1.913, 95% CI： 1.009 to 3.628）, and BMI（OR = 7.376, 95% CI： 3.812 to 14.270）. The prevalence of risk factors for NCDs is fairly high among healthy adults in Shenzhen, with a clustering tendency.
基金funded in part by the Sanming Project of Medicine in Shenzhen[SZSM201611030]the Fundamental Research Funds for the Central Universities[2042021kf0041]Guangdong Medical Science and Technology Research Fund[B2021075].
文摘Nontuberculous mycobacteria(NTM)are opportunistic pathogens of environmental origin that can cause human infections in a wide variety of tissues[1].Lung involvement is the most common manifestation of NTM infection[1].The symptoms and radiographic signs are similar to those of patients with pulmonary tuberculosis(TB)who are infected with Mycobacterium tuberculosis complex(MTBC)[1].Most NTM species are naturally resistant to first-line anti-TB drugs and have different resistance profiles,thus misdiagnosis leads to inappropriate treatment and increases the risk of poor prognosis for patients with an NTM infection,and even wider spread through person-to-person contact[2].
基金This study was supported by the State Key Projects Specialized on Infectious Diseases(No.2O17ZX1O2O12O1-008-002,No.2O17ZX1O2O12O1-OO6-OO3)Sanming Project of Medicine in Shenzhen(No.SZSM201911015)+2 种基金the National Natural Science Foundation of China(No.81974492,No.81773521)Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(No.2019-I2M-2-004)the Natural Science Foundation of Guangdong Province(No.2020A151501478).
文摘Objective:The number of liver cancer patients in China accounts for more than half of the world.However,China currently lacks national,multicenter economic burden data,and meanwhile,measuring the differences among different subgroups will be informative to formulate corresponding policies in liver cancer control.Thus,the aim of the study was to measure the economic burden of liver cancer by various subgroups.Methods:A hospital-based,multicenter and cross-sectional survey was conducted during 2012・2014,covering 39 hospitals and 21 project sites in 13 provinces across China.The questionnaire covers clinical information,sociology,expenditure,and related variables.All expenditure data were reported in Chinese Yuan(CNY)using 2014 values.Results:A total of 2,223 liver cancer patients were enrolled,of whom 59.61%were late-stage cases(III-IV),and 53.8%were hepatocellular carcinoma.The average total expenditure per liver cancer patient was estimated as 53,220 CNY,including 48,612 CNY of medical expenditures(91.3%)and 4,608 CNY of non-medical expenditures(8.7%).The average total expenditures in stage I,H,m and stage IV were 52,817 CNY,50,877 CNY,50,678 CNY and 54,089 CNY(P>0.05),respectively.Non-medical expenditures including additional meals,additional nutrition care,transportation,accommodation and hired informal nursing were 1,453 CNY,839 CNY,946 CNY,679 CNY and 200 CNY,respectively.The one-year out-of-pocket expenditure of a newly diagnosed patient was 24,953 CNY,and 77.2%of the patients suffered an unmanageable financial burden.Multivariate analysis showed that overall expenditure differed in almost all subgroups(P<0.05),except for sex,clinical stage,and pathologic type.Conclusions:There was no difference in treatment expenditure for liver cancer patients at different clinical stages,which suggests that maintaining efforts on treatment efficacy improvement is important but not enough.To fiirtherly reduce the overall economic burden from liver cancer,more effort should be given to primary and secondary prevention strategies.
文摘In this study, we analyse the relationship between the occurrences of influenza in Shenzhen, a rapid developing city in subtropic regions of southern China with over 10 million populations, and the vapor pressure (VP), the concentrations of atmospheric pollutants (SO2, NO2, PM10) for the period of 2003 - 2008. Using the data such as the rate of Influ- en-za-Like-Illness (ILI (%)), the concentrations of pollutants and vapor pressure, we show quite different results from pre-vious research conducted in other regions in China which are dominated by temperate climate and with influenza out-break in Winter and Autumn. Our results show that the rate of ILI in Shenzhen reaches its maximum in Summer and minimum in Winter and the concentrations of pollutants were significantly correlated with ILI (%), there are significant positive correlations between ILI (%) and VP which can explain over 25% the variance of ILI (%) variations. Quite surprisingly, both atmospheric SO2 and PM10 concentrations are negatively correlated with ILI (%), this is because acid deposition may limit the spread of disease, the seasonal variations of acid rain in Shenzhen could contribute to the sea-sonality of its influenza. Furthermore, there are some significant correlations between preceding VP and SO2 and PM10 concentrations to ILI occurrence and such connections can be used for ILI predictions.
文摘Objectives: To conduct health risk assessment of drinking water pesticide residues and its annual trend analysis in Shenzhen City. Methods: The samples of product water, pipe water and secondary supply water from 2011 to 2013 were collected and analyzed. The evaluation models of health risk assessments for children and adults on the 12 non-carcinogenic materials (namely heptachlor, pentachlorophenol, hexachlorocyclohexane, hexachlorobenzene, DDT, malathion, glyphosate, dimethoate, bentazone, atrazine, chlorothalonil, furadan) were recommended by the U.S. Environmental Protection Agency (US EPA). Results: The results showed that the maximums of the measured indicators in the above were controlled in accordance with the National Health Standards (GB5749-2006) published by Ministry of Health in China. The adults and children’s health indices (HIs) of the 12 non-carcinogenic materials were greater than 1 (2.323 - 6.312). Dimethoate residue in factory and peripheral water was the largest risks of harm among the non-carcinogenic pollutants measured. And its HIi (Its Hli) was also greater than 1 (1.995 - 5.094) and followed by hexachlorobenzene and heptachlor. Annual rising trend on health risk of the 12 pesticide residues indicated that their HIT on adults was 2323. 18 × 10-3 in 2011, 2340. 18 × 10-3 in 2012 and 2431. 97 × 10-3 in 2013, and HIT on children was 2965. 07 × 10-3 in 2011, 2986. 77 × 10-3 in 2012 and 3103. 93 × 10-3 in 2013, respectively. This study also suggested that the average risk of peripheral water samples (HIT was equal to 2619. 64 × 10-3) was greater than the factory samples’ (HIT was the same as 2366. 92 × 10-3), and the children’s health risk was greater than the adults’. Conclusions: Health risks of drinking water pesticide residues in Shenzhen have exceeded the threshold values. The dimethoate was the main hazard and had been rising annually, and the children’s health risk was greater than the adults’.
文摘Objectives: To conduct health risk assessment on drinking water in 2012 in Shenzhen of China. Methods: The water quality monitoring data on product water and pipe water in 2012 were collected and analyzed, and the risk evaluation models recommended by the U.S. environmental protection agency (US EPA) were employed, to perform adults and children’s health risk assessments on the three kinds of genetic toxic substances such as hexavalent chromium, cadmium and arsenic and the 12 non-carcinogenic materials such as iron, manganese, lead, fluoride, volatile phenol, cyanide, mercury, ammonia nitrogen, nitrate, copper, zinc and selenium. Results: The results about water quality from the 150 factory samples and 207 peripheral water samples showed that the measured indicators in other water samples were accord with the National Health Standards (GB5749-2006) released by Ministry of Health of the People’s Republic of China, except manganese level in one factory sample and the same index in one peripheral sample, and nitrate concentration in another water sample were out of limit, respectively. Namely, the total of 3 samples was disqualification. The adults and children’s health risks (HI) on the 12 non-carcinogenic materials were 178.04 × 10-8 and 249.96 × 10-8 in the factor water samples, and 363.02 × 10-8 and 509.66 × 10-8 in the pipe samples, respectively. Lead in factory water and fluoride in peripheral water samples were the most serious harm in the all measured non-carcinogenic indicators. The adults and children’s cancer risks (R) on the 3 genetic toxic substances were 25.60 × 10-6 and 28.51 × 10-6 in the factor water samples, and 23.47 × 10-6 and 26.08 × 10-6 in the pipe samples, respectively. Hexavalent chromium was the most damage among the three detected carcinogenic indicators. Therefore, the total adults and children’s health hazard risks including the 3 carcinogenic and 12 non-carcinogenic substances were 27.38 × 10-6 and 31.00 × 10-6 in the factor water samples, and 27.10 × 10-6 and 31.17 × 10-6 in the pipe samples, respectively. Genetic toxic matters in drinking water are the main hazard and more children’s health risk than adults’ risk. Conclusions: The health risk (R) on the 15 kinds of chemicals in Shenzhen’s municipal water supply was in the range of maximum acceptable risk levels (5.0 × 10-5/a) recommended by the International Commission of Radiation Protection (ICRP). The results in this study indicate that the carcinogenic substances are greater risk comparing with the non-carcinogenic substances, and hexavalent chromium is the biggest carcinogenic risk, and lead and fluoride are the most non-carcinogenic risk, and the rather risk of children than adults.
基金supported by the National Key Research and Development Program of China[2018YFE0206900].
文摘Neurological disorders,including headaches(tension-type headaches,medication-overuse headaches,and migraines)and dementias that include Alzheimer’s disease,are among the most prevalent and debilitating global conditions.In 2016,these disorders affected 276 million people worldwide and were the second leading cause of death that year[1].This highlights the urgent need for effective prevention,treatment,and support strategies.The etiology of neurological disorders is multifaceted and involves genetic,environmental,physiological,and social factors[2].
