1990-2015年天津市滨海新区甲状腺癌流行特征及长期发病趋势分析

目的 分析1990-2015年天津市滨海新区甲状腺癌流行趋势及特征。方法 利用天津市滨海新区肿瘤监测数据,计算1990-2015年滨海新区甲状腺癌发病率、标化发病率、累积率(0~74岁)以及截缩率(35~64岁);采用Joinpoint回归分析26年间甲状腺癌发病趋势;采用χ2检验比较不同地区甲状腺癌发病率情况。结果 天津市滨海新区1990-2015年甲状腺癌新发病例共3 178例,粗发病率为12.36/10万,标化发病率为9.97/10万,男、女标化发病率比例为1∶3.09。26年间滨海新区甲状腺癌发病率及标化发病率均呈明显上升趋势,其中以2010-2013年甲状腺癌发病率上升最为迅速[年度变化百分比(APC)=53.62%,P<0.05];滨海新区3个不同地区甲状腺癌发病率南高北低(χ2=115.270,P<0.001),且甲状腺癌发病增长速度南快北慢(南部地区APC=18.95%,中部地区APC=13.30%,北部地区APC=9.61%)。结论 1990-2015年滨海新区甲状腺癌发病率增长迅速,且滨海新区南部地区甲状腺癌发病率较北部地区升高。     

2010—2018年陕西省成年居民血脂异常现状调查分析

目的 分析2010—2018年陕西省成年居民血脂异常流行现状和变化趋势。方法 2010年、2013年、2015年和2018年共开展四次慢性病及其危险因素监测，抽取调查对象静脉血，检测总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯（TG）。对四次调查的数据均采用复杂加权进行调整，计算血脂异常患病率，运用趋势〖XC小五号.EPS;P〗检验分析四次调查中患病率的变化趋势。结果 2010—2018年陕西省成年居民血脂异常患病率从49.47%下降到31.71%，高TC血症患病率从1.50%上升至5.38%，低HDL-C血症患病率从43.96%下降到19.14%，高TG血症患病率从12.92%上升至21.03%，高LDL-C血症患病率从2010年的1.20%上升到2015年的5.28%，2018年又下降至4.72%。结论 陕西省成年居民血脂异常患病率呈下降趋势，但是总患病率仍较高，低HDL-C血症和高TG血症是该地区血脂异常的主要形式。     

Modelling the optimal target age group for seasonal influenza vaccination in Japan

BackgroundIn Japan, the current influenza vaccination programme is targeting older individuals. On the other hand, epidemics of influenza are likely to be mainly driven by children. In this study, we consider the most cost-effective target age group for a seasonal influenza vaccination programme in Japan.MethodsWe constructed a deterministic compartmental Susceptible-Exposed-Infectious-Recovered (SEIR) model with data from the 2012/13 to 2014/15 influenza seasons in Japan. Bayesian inference with Markov Chain Monte Carlo method was used for parameter estimation. Cost-effectiveness analyses were conducted from public health care payer’s perspective.ResultsA scenario targeting children under 15 was expected to reduce the number of cases 6,382,345 compared to the current strategy. A scenario targeting elderly population (age over 49 years) was expected to reduce the number of cases 693,206. The children targeted scenario demonstrated negative ICER (incremental cost-effectiveness ratio) value. On the other hand, elderly targeted scenario demonstrated higher ICER value than the willingness to pay (50,000 USD/QALY).ConclusionsA vaccination programme which targets children under 15 is predicted to have much larger epidemiological impact than those targeting elderly.     

Delay of adjuvant radiotherapy due to postoperative complications after oncoplastic breast conserving surgery

BackgroundIn the past a mastectomy was the first approach of treating breast cancer. Oncoplastic techniques combined with breast conserving surgery (BCS) and radiotherapy has become an alternative to mastectomy in patients with non-metastasized breast cancer. The aim of this study was to analyse the amount and types of complications occurring after oncoplastic BCS before and after adjuvant radiotherapy and the delay of adjuvant therapy due to the complications.MethodA retrospective study based on all patients who received immediate oncoplastic BCS by a plastic surgeon at two medical hospitals in The Netherlands between 2013 and 2015. (n = 150). The performed oncoplastic BCS techniques were the primary outcome measures. In particular major complications with the need for antibiotics or surgical intervention. A one-year follow-up was achieved for all patients.Results52% of the 150 included patients received an oncoplastic BCS through the reduction pattern, 35% with a LICAP and 10% with an AICAP. Complications occurred in 37.5% of the patients, 10% of the patients needed treatment with antibiotics and in 6.6% of the patients a revision operation was indicated. 79.6% of all postoperative complications occurred before the start of adjuvant radiotherapy. In 8.2% of the patients the adjuvant radiotherapy had to be delayed due to a complication.ConclusionThis study provides a detailed overview of the used techniques of oncoplastic BCS and their postoperative complications. Most complications occurred before the start of the adjuvant radiotherapy. Just a small amount caused a delay for the radiotherapy to start.     

1,5 Anhydroglucitol in gestational diabetes mellitus

Objective

1,5 Anhydroglucitol (1,5 AG) is reported to be a more sensitive marker of glucose variability and short-term glycemic control (1–2?weeks) in patients with type1 and type 2 diabetes. However, the role of 1,5 AG in gestational diabetes mellitus (GDM) is not clear. We estimated the serum levels of 1,5 AG in pregnant women with and without GDM.

Independent and joint associations of non-exercise cardiorespiratory fitness and obesity with risk of type 2 diabetes mellitus in the Rural Chinese Cohort Study

Background and aimsAn association between cardiorespiratory fitness (CRF) and type 2 diabetes mellitus (T2DM) has not been established in the Chinese population. This study aimed to estimate the independent and joint associations of CRF and obesity with T2DM incidence in the rural Chinese population.Methods and resultsWe conducted a prospective study of 11,825 non-T2DM subjects among rural Chinese adults. Cox regression models were used to estimate the independent and joint associations between CRF and obesity exposure on T2DM. Restricted cubic splines were used to model the dose–response association. During a median follow-up of 6.01 years, 835 participants developed T2DM. In comparison to quartile 1 of CRF, the multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) of quartiles 2, 3, 4 were 0.75 (0.61–0.91), 0.54 (0.43–0.68), and 0.42 (0.32–0.55), respectively. When stratified by sex, the results were similar. Joint analyses showed that overweight/obesity-unfit individuals had a 2.28 times higher risk of developing T2DM than the normal weight-fit referent (HR 2.28, 95% CI 1.84–2.83; P_interaction <0.001). The risk for the overweight/obesity-fit category (HR 1.61, 95% CI 1.21–2.15) was larger than for the normal weight-unfit category (HR 1.38, 95% CI 0.97–1.95) versus the normal weight-fit referent. Similar joint associations for waist circumference and CRF with T2DM were also observed.ConclusionA negative association was observed between CRF and risk of T2DM. Overweight/obese or abdominal obesity and unfit participants showed the highest risks of T2DM. It is therefore strongly recommended that fitness-enhancing be encouraged for the prevention of T2DM, especially among obesity participants.     

Toward a conceptual model for national policy and practice considerations

Chronic diseases and conditions are serious threats to the population's health. Chronic diseases represent seven of the top ten causes of mortality in the U.S. and are major economic drivers underlying burgeoning national health costs. People with disabilities experience dramatically higher rates of some chronic conditions, but only recently has this problem been recognized. We propose a set of contributing factors and a model to help better understand the relationship of disability with chronic disease. The paper summarizes current CDC initiatives to include disability status and considerations in public health surveys and programs, exemplifying a strategy to promote inclusion of people with disabilities in mainstream programs wherever possible; use cross-disability strategies for conditions unique to people with disabilities where necessary; and implement condition-specific approaches where essential. This initial model is intended to invite dialog on a conceptual framework for preventing chronic conditions and additional functional limitations among people with disabilities.     

中国淮安地区2009年至2011年食管癌流行病学特征分析

Objective

The aim of our study was to investigate the epidemiological characteristics of esophageal cancer from 2009 to 2011 in Huai’an area, China.

Methods

The data about the incidence and mortality of esophageal cancer were provided by Huai’an Cancer Registry, and the epidemiological characteristics of the disease were analyzed.

Results

Esophageal cancer was not only the first most common cancer, but also the leading cause of cancer death in Huai’an area. The crude and standardized incidence rates were 62.91/10⁵ and 49.92/10⁵, and the crude and standardized mortality rates were 46.75/10⁵ and 36.87/10⁵, respectively. The sex ratio (male-female) was 1.69:1 in incidence, and the incidence increased in people aged 40 years and over, reaching the peak at the ages of 70–75 years. The mortality rate was at low level under the age of 50 years, but increased after the age of 50 years, reaching the peak at the age of 75–85 years. Incidence and mortality rates varied regionally with the highest rate found in Chuzhou district (90.76/10⁵ and 67.17/10⁵) and lowest rate observed in Qinghe district (32.41/10⁵ and 8.75/10⁵).

Conclusion

Esophageal cancer is the major burden of cancer in Huai’an area, and has marked geographic distribution difference. The key period of age for screening and prevention of the disease is 55–85 years old.     

环境碘过量地区居民亚临床甲状腺功能减退症调查

[目的]研究长期重度环境碘过量地区居民亚临床甲状腺功能减退症患病情况及其与环境碘水平的可能关系。[方法]调查现场选择高碘地区徐州市沛县孟庄乡，对照地区为环境碘水平正常的邳州市新集乡。普查两乡所有居民甲状腺疾病情况，根据既往病史、B超及血清促甲状腺激素（TSH）、游离甲状腺素（FT4）、血清游离三碘甲状腺原氨酸（FT3）诊断亚临床甲状腺功能减退症，并抽取部分无症状、无既往病史者测定血清TSH、FT4、FT3。[结果]亚临床甲状腺功能减退症患病率在过量组及对照组分别为55．52／万和11．75／万。调整年龄因素后，过量组亚临床甲状腺功能减退症较对照组的RR为4．6（95％CI：2．7～7．9）；按性别分组后，男性组年龄调整RR为2．9（95％CI：1．0～8．6）。女性组年龄调整RR为5．2（95％CI：2．8～9．8）。[结论]环境重度碘过量可能与亚临床甲状腺功能减退症患病有关，需进一步进行危险度评估。