Objective To explore the clinical epidemiologic characteristics and tendency of gastric cancer during recently ten years in northern Henan province. Methods The clinical data of 1 090 patients with gastric cancer in our department were collected from January 1998 to May 2008. The ten-year period was divided into two groups: previous 5 years group (n=433) and post 5 years group (n=657). The age, gender, pathologic characteristics and the relationship between age and pathologic features were analyzed retrospectively. Results ①The patient’s age was 15-83 years old 〔mean （57.60±10.84） years old〕 and men-momen ratio was 3.71∶1 in previous 5-year group. The patient’s age was 18-82 years old 〔mean （58.95±10.81）years old〕 and men-momen ratio was 2.84∶1 in post 5-year group. There was no significant difference in age or gender between two groups （Pgt;0.05）. ②Gastric cancer arised in cardia and gastric fundus more common and for the incidence of the site no change was found in two groups. The incidence of gastric antrum cancer descended but that of gastric body arised. ③The mean age of patients with gastrocardiac cancer was significantly different (Plt;0.05) between two groups. No significant difference occurred on the mean age of patients with gastric antrum (Pgt;0.05) or gastric body cancer (Pgt;0.05). The mean age of patients with highly malignant tumor (signet ring cell cancer, poorly differentiated adenocarcinoma and undifferentiated carcinoma) was significantly different compared with that of patients with lowly malignant tumor (well differentiated and moderately differentiated adenocarcinoma) (Plt;0.05). ④The proportion of patients with highly and lowly malignant tumor presented significantly different between the previous 5 years and the post 5 years (Plt;0.05). ⑤The proportion of early gastric cancer was very low and no correlation was found between infiltrating depth and age in all patients (Pgt;0.05). Conclusion Cardia and gastric fundus is the most common site of gastric cancer in northern Henan province. The patients with gastrocardiac cancer are often older but gastric antrum and gastric body cancer patients are younger. Highly malignant gastric cancer is often found in youths, however, lowly malignant gastric cancer occurred predominantly in elderly. The proportion of gastric cancer found early is very low in northern Henan province.
Objective To study the risk factors for contralateral breast cancer (CBC) in women after regular treatment of the primary breast cancer. Methods Between January 1997 to December 2002, the clinical data of 340 breast cancer patients at our institution were retrospectively analyzed. In all the patients a detailed analysis was carried out with respect to age, operation type, radiation therapy technique and dose, the use of chemotherapy or hormone therapy, and other clinicopathologic characteristics. The KaplanMeier method was used to estimate the actuarial rate of CBC. The Cox proportional hazard regression model was used to estimate the relative risk factors of CBC. Results Fourteen cases were diagnosed to be CBC, thus overall incidence of CBC was 4.1%. Ten-year CBC incidence (2.7%) was higher than 5-year incidence of CBC (1.4%). Univariate analysis showed that the risk factors of CBC at 5-year and 10-year included: ≤45 years old, medullary carcinoma, family history of breast cancer and being taken without endocrine therapy (P＜0.05), while chemotherapy and radiotherapy were not risk factors of CBC (P＞0.05). Mutivariate analysis showed that ≤ 45 years old and being internal breast radiotherapy were independent risk factors of CBC at 5-year and 10-year (P＜0.05). Conclusions CBC may occur in these primary breast cancer patients with age ≤45 years old, medullary carcinoma, family history of breast cancer. In order to reduce the incidence of CBC, endocrine therapy rather than internal breast radiotherapy should be performed in early breast cancer patients.
In recent years, clinical research in traditional Chinese medicine (TCM) has witnessed vigorous development, with increasingly close integration with clinical epidemiological methodologies. However, certain controversies persist, such as the difficulty in aligning epidemiology’s population-based perspective with TCM’s principle of syndrome differentiation and treatment and the characteristics of individualized diagnosis and treatment. This paper reviews the development and current status of TCM clinical research, integrating the practice rules of TCM, and analyzes the manifestations and applicability of the basic characteristics of epidemiology in TCM clinical research. The study shows that epidemiological concepts and characteristics are fully compatible with the practical features of TCM clinical practice and its research needs. Moreover, epidemiological techniques can effectively uncover and elucidate the scientific basis of TCM clinical practice. Building on these analyses, we propose future directions for TCM clinical research, aiming to promote the integration of epidemiology and TCM clinical research and advance TCM clinical research to a higher level.
ObjectiveTo investigate the epidemiological characteristics of patients in the emergency observation room of Beijing Shijitan Hospital during the last 5 years, to enhance the local and regional construction of education discipline and improve the quality of medical services.MethodsA retrospective study was carried out on selected patients admitted to the emergency observation room of the Capital Medical University Affiliated Beijing Shijitan Hospital between January 1st 2014 and December 31st 2018. Statistical analysis was performed to identify associated epidemiological features in these patients.ResultsAmong the 19 518 patients admitted to the emergency observation room, 49.08% were males and 50.92% were females, with a male to female ratio of 1:1.04. The 46-65 age group had the lowest proportion of females of 47.28%, while this proportion reached to 55.38% in the over-80 age group, which was higher than that in the 46-65 and 66-80 age groups, showing statistical significance (P<0.05). During the last 5 years, 59.66% of the patients were aged above 65; the proportion of over 65 years old patients admitted to the emergency observation room of the hospital each year was 53.86%, 53.19%, 57.00%, 65.40%, and 68.79%, respectively, showing an increasing trend (P=0.011). Among the patients diagnosed, 24.20% had respiratory system diseases, 23.67% had circulation system diseases, 14.47% had digestive system diseases, 12.75% had neurological system diseases, and 7.08% had endocrine system diseases. According to the primary diagnosis, the top 10 most predominant diseases were bacterial pneumonia (14.72%), acute and chronic heart failure (7.86%), hypertension (5.00%), arrhythmia (4.02%), coronary atherosclerotic heart disease (3.92%), chronic obstructive pulmonary disease (3.01%), cerebrovascular disease (2.68%), gastrointestinal hemorrhage (2.66%), acute diabetes (2.43%), and celiac infection (1.73%), which accounted for 48.02% of the total patients admitted. In the winters (December to February) of these 5 years, the total number of patients admitted was 6 145, which contributed to 31.48% of the total admission number, and hence making winter the season with the highest number of patients seeking for medical services.ConclusionsAccording to the spectrum of the disease features, there is a need to enhance the training of specialty and emergency clinics associated with respiratory, circulation, neurological, digestive, and endocrine diseases. Special attention should be paid for treatment and health care targeted at old-aged patients. During winter, the peak hospital visiting time, appropriate medical care service, which addresses the plan of working time, should be provided in order to optimize diagnosis and treatment processes.
Objectives To systematically review the prevalence of sleep disorders in Chinese elderly population. Methods CNKI, Wanfang, VIP, PubMed and Web of Science were searched to collect studies on the prevalence of sleep disorders the Chinese elderly from January 2000 to November 2017. Two reviewers independently screened literatures, extracted data and evaluated risk of bias of the included studies, then meta-analysis was performed by Stata 14.0 software. Results A total of 19 cross-sectional studies were included. The results of the meta-analysis showed that, the overall prevalence of sleep disorders was 41.2% (95% CI 36.2% to 46.2%). Male and female prevalence rates were 35.7% and 45.0%, respectively. For individuals aged between 60 to 70, 70 to 80 and above 80, the prevalence rates were 29.9%, 42.0%, 44.2%, respectively. For individuals with primary school education and below, junior/high school education, college degree or above, the prevalence rates were 29.0%, 23.1%, 22.4%, respectively. The prevalence rate of individuals with normal marital status was 31.5%, and those with abnormal marital status (widowed, divorced, single, etc.) was 41.0%. The prevalence rate in individuals with in people with physical illness was 45.7%, and those without physical illness was 32.4%. For the urban population, the prevalence rate was 36.4%, while for the rural population, the prevalence rate was 42%. Conclusions The overall prevalence of sleep disorders in the Chinese elderly is high. The prevalence rate of sleep disorders among gender, age, educational level, marital status, physical illness, and living space is different.
Objective
Establishing Nomogram to predict the overall survival (OS) rate of patients with gastric adenocarcinoma by utilizing the database of the Surveillance, Epidemiology, and End Results (SEER) Program.
Methods
Obtained the data of 3 272 gastric adenocarcinoma patients who were diagnosed between 2004 and 2014 from the SEER database. These patients were randomly divided into training (n=2 182) and validation (n=1 090) cohorts. The Cox proportional hazards regression model was performed to evaluate the prognostic effects of multiple clinicopathologic factors on OS. Significant prognostic factors were combined to build Nomogram. The predictive performance of Nomogram was evaluated via internal (training cohort data) and external validation (validation cohort data) by calculating index of concordance (C-index) and plotting calibration curves.
Results
In the training cohort, the results of Cox proportional hazards regression model showed that, age at diagnosis, race, grade, 6th American Joint Committee on Cancer (AJCC) stage, histologic type, and surgery were significantly associated with the survival prognosis (P<0.05). These factors were used to establish Nomogram. The Nomograms showed good accuracy in predicting OS rate, with C-index of 0.751 ［95%CI was (0.738, 0.764)］ in internal validation and C-index of 0.753 ［95% CI was (0.734, 0.772)］ in external validation. All calibration curves showed excellent consistency between prediction by Nomogram and actual observation.
Conclusion
Novel Nomogram for patients with gastric adenocarcinoma was established to predict OS in our study has good prognostic significance, it can provide clinicians with more accurate and practical predictive tools which can quickly and accurately assess the patients’ survival prognosis individually, and can better guiding clinicians in the follow-up treatment of patients.
Objective To analyze the epidemiological features of clavicle fractures.Methods A total of 363 cases of clavicle fractures were treated from February 1993 to November 2002, their case history data were reviewed and evaluated by epidemiological method.Results Out of 363 cases, there were 269 males and 94 females, aged from new born to 96 years. The locations of fractures were on left side in 159 cases and on right side in 204 cases. Neonatal clavicle fracture occurred in the case of delivery (0.28%). The causes of disease for adult clavicle fractures were traffic injury (52.1%) and daily falling injury(31.1%). There were232 cases of simple fractures and 131 cases of comminuted fractures. The fracture positions included inner(6 cases), middle(328 cases) and outer parts(29 cases). Multiinjuries occurred in 78 cases, the rib fractures concomitant with clavicle fractures were the commonest(31 cases).Conclusion The clavicle fractures are the common injury. Of them, traffic injury and daily falling injury arethe most common. The rib fractures are always accompanied with clavicle fractures.The main position of fracture is on the middle part.
Cytomegalovirus (CMV) retinitis (CMVR) is a common opportunistic infection of the eye after allogeneic hematopoietic stem cell transplantation in patients with hematological diseases. It often occurs within 3 months after the operation, with CMV activation and high blood CMV peaks. It often occurs on patients with long-term CMV viremia, human leukocyte antigen incompatible transplantation, unrelated donor transplantation, haploid transplantation, childhood hematopoietic stem cell transplantation, delayed lymphocyte engraftment, acute and chronic graft-versus-host disease after surgery. The visual prognosis of patients is related to the area of CMVR lesions on the retina, the number of quadrants involved, whether the macula is involved, and the CMV load of the vitreous body is involved, and it is not related to whether the Epstein-Barr virus infection is combined with blood and vitreous humor. The incidence of CMVR is increasing year by year. It is helpful that paying attention to systemic risk factors and epidemiology can provide more effective guidance for ophthalmologists during diagnosis and treatment, help patients improve the prognosis of vision, and reduce or even avoid the occurrence of blindness caused by CMVR.
ObjectivesTo systematically review the epidemiological characteristics of post-stroke shoulder pain (PSSP).MethodsPubMed, WanFang Data, CNKI, EMbase, The Cochrane Library and SinoMed databases were electronically searched to collect studies on the morbidity of PSSP from inception to November 30th, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using Stata 15.0 software.ResultsA total of 13 studies were included. The total sample size was 3 514, including 1 357 patients with PSSP. The results of meta-analysis showed that the total morbidity of PSSP was 45.0% with 95%CI 32.0% to 58.0%. The results of subgroup analysis showed that the morbidity of PSSP was 55.5% (95%CI 48.1% to 63.0%) prior to 2010 and 40.6% (95%CI 28.3% to 52.9%) after 2010, respectively. The morbidity of PSSP in Asia was 61.2% (95%CI 51.3% to 71.1%), and in Europe and America was 18.4% (95%CI 9.9% to 26.9%), respectively.ConclusionsCurrent evidence suggests that PSSP has high morbidity, and it may be affected by regional factors. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Acute kidney injury (AKI) is characterized by a rapid decrease in renal function caused by different etiologies and can involve multiple organs and systems. AKI is a potentially reversible disease. However, it can also progress to chronic kidney disease (CKD) without proper treatment. The concept of acute kidney disease (AKD) is recently recommended as a derivative between AKI and CKD. At present, AKI still lacks specific drug treatment; therefore prevention and early diagnosis are crucial in AKI management. Due to the heterogeneity of the pathogenesis, the epidemiological features of AKI vary across nations and regions, so the strategies for prevention and control are different. This papers reports new progress of epidemiological features of AKI in different countries, so as to provide reference for assessing the disease burden and formulating public health policies.
