This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Sample...This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Samples with screening results showing atypical squamous cells of undetermined significance （ASC-US） or worse were referred for colposcopy, and some samples were tested for high-risk HPV types with the Hybrid Capture II system （HC II）. Data on LCT （n=61,193） and HC II （n=1056） results were analysed. Overall test positivity for LCT was 2.53% using an ASC-US threshold, 3.11% using a low-grade squamous intraepithelial lesion （LSIL） threshold, and 0.67% using a high-grade squamous intraepithelial lesion （HSIL） threshold. A total of 1839 women （84% of the 3893 patients with abnormal cytology） underwent colposcopy-directed biopsy. HPV was positive in 80.3% of women with cervical intraepithelial neoplasia 1 （CIN1）, 88.3% of those with CIN2, 79.2% of women with CIN3 and 50% （2 of 4） of women with invasive cancer. There was a significant increase in the detection of CIN2 or worse with adjunct HPV testing of women with ASC-US and LSIL However, there were detection of CIN2＋ cases no differences in the with adjunct HPV testing of women with HSlI.. The results indicate that HPV testing for HSlL triage should not be recommended in cervical cancer screening.展开更多
BACKGROUND Transforming growth factor-β(TGF-β)superfamily plays an important role in tumor progression and metastasis.Activin A receptor type 1C(ACVR1C)is a TGF-βtype I receptor that is involved in tumorigenesis th...BACKGROUND Transforming growth factor-β(TGF-β)superfamily plays an important role in tumor progression and metastasis.Activin A receptor type 1C(ACVR1C)is a TGF-βtype I receptor that is involved in tumorigenesis through binding to dif-ferent ligands.AIM To evaluate the correlation between single nucleotide polymorphisms(SNPs)of ACVR1C and susceptibility to esophageal squamous cell carcinoma(ESCC)in Chinese Han population.METHODS In this hospital-based cohort study,1043 ESCC patients and 1143 healthy controls were enrolled.Five SNPs(rs4664229,rs4556933,rs77886248,rs77263459,rs6734630)of ACVR1C were assessed by the ligation detection reaction method.Hardy-Weinberg equilibrium test,genetic model analysis,stratified analysis,linkage disequi-librium test,and haplotype analysis were conducted.RESULTS Participants carrying ACVR1C rs4556933 GA mutant had significantly decreased risk of ESCC,and those with rs77886248 TA mutant were related with higher risk,especially in older male smokers.In the haplotype analysis,ACVR1C Trs4664229Ars4556933Trs77886248Crs77263459Ars6734630 increased risk of ESCC,while Trs4664229Grs4556933Trs77886248Crs77263459Ars6734630 was associated with lower susceptibility to ESCC.CONCLUSION ACVR1C rs4556933 and rs77886248 SNPs were associated with the susceptibility to ESCC,which could provide a potential target for early diagnosis and treatment of ESCC in Chinese Han population.展开更多
Background:Esophageal cancer(EC)remains a global health challenge due to its poor prognosis.China and the United States of America(USA)represent two distinct epicenters of EC burden.Understanding the EC disparities in...Background:Esophageal cancer(EC)remains a global health challenge due to its poor prognosis.China and the United States of America(USA)represent two distinct epicenters of EC burden.Understanding the EC disparities in these two countries is vital for tailoring prevention strategies,optimizing treatment,and enhancing outcomes in both countries.Yet,there lacks a comprehensive comparison of EC characteristics between the two countries.Methods:In this multicenter,retrospective hospital-based study,we enrolled primary EC patients who received their initial treatment at one of 23 hospitals in China during 2016-2017.Using electronic medical records and cancer registration records,information on demographics,lifestyle,and clinicopathological characteristics(in-cluding tumor site,pathology,stage,metastases,differentiation,and treatment)were collected.Additionally,we compared these data with the clinicopathological information of invasive EC patients diagnosed in 2016-2017 from the Surveillance,Epidemiology,and End Results(SEER)database in the USA.Results:A total of 6,658 EC patients in China and 8,555 EC patients in the USA were included finally.85.5%(n=5,694)of EC were esophageal squamous cell carcinoma(ESCC)in China,while esophageal adenocarcinoma(EAC)was prominent in the USA(58.9%,n=5,041).Among EC patients with known staging,the proportion of early stage was higher in China compared to the USA(48.3%vs.30.5%).Among ESCC patients,early-stage cases were higher in China than in the USA(49.8%vs.31.8%),while among EAC patients,late-stage cases were higher in China than in the USA(77.3%vs.68.5%)(all P<0.001).In China,EC mainly occurred in the middle third(60.2%)of the esophagus,whereas in the USA,it was more common in the lower third(59.9%)of the organ.Compared with EC patients with known metastatic status in the USA,China had fewer cases of lymph node metastases(51.4%vs.57.7%)and distant metastases(7.9%vs.33.8%).Regarding treatment,China had more surgical therapy(53.7%vs.22.6%),less radiotherapy(35.6%vs.53.3%),and less chem展开更多
Background and Aims:Recently,the World Health Organization adopted the first-ever global hepatitis strategy with the dream of eliminating viral hepatitis as a public health threat by 2030.However,the epidemiology and ...Background and Aims:Recently,the World Health Organization adopted the first-ever global hepatitis strategy with the dream of eliminating viral hepatitis as a public health threat by 2030.However,the epidemiology and treatment rates of hepatitis C virus(HCV)infection in Western China are still unknown.Methods:A total of 111,916 adult individuals(15-96 years)who underwent the HCV-antibody(HCV-Ab)test in the Second Affiliated Hospital of Chongqing Medical University between 2013 and 2015 were included in this study.We retrospectively analyzed the electronic medical records'data for each,and the positivity of HCV-Ab and the treatment of HCV RNA-positive patients were evaluated.Results:During 2013-2015,the crude prevalence of HCVAb was 1.4%(95%CI:1.4-1.5;1,611/111,916)and the adjusted prevalence of HCV-Ab was 1.7%(95%CI:1.6-1.8),which was higher than in the 2006 national study(0.43%).The prevalence was 2-times higher in males than females(2.0%vs.1.1%,p<0.01).Notably,only 46%(434/951)of the HCV RNA-positive patients received standard peginterferon plus ribavirin treatment,with 370(82%)that completed treatment,of whom 272(74%)achieved sustained virologic response(SVR).Particularly,11%(32/292)of HCV RNA-positive patients were HBsAg-positive,and the SVR rate for them was lower than for the HBsAg-negative patients,but no significant difference was observed.Conclusions:HCV infection may have increased since 2006 in Western China.The SVR rate of peg-interferon plus ribavirin treatment was high,but the proportion of untreated HCV patients was large.Thus,more efforts need to be made by the government to create a scientific-based policy for HCV treatment and prevention.展开更多
Hospital-based health technology assessment(HB-HTA)is highly valuable in the application of hospital medical technology,cost control,improvement of medical quality,and protection of medical safety,and its use is incre...Hospital-based health technology assessment(HB-HTA)is highly valuable in the application of hospital medical technology,cost control,improvement of medical quality,and protection of medical safety,and its use is increasing daily globally.However,in China,HB-HTA is still in its infancy,and it is yet to be adopted in traditional Chinese medicine(TCM).Therefore,this article introduces the application and development of HB-HTA,as well as discusses the current situation of TCM and related future development strategies to provide ideas and references for the development of HB-HTA in TCM.We conclude and recommend that all major stakeholders,including the state,health departments,and hospital leaders,support and promote the exploration and development of HB-HTA in TCM hospitals and integrative medicine hospitals.We also suggest the utilization of existing talents and introduction of other necessary talents to promote better and faster organizational development,as well as suggest the formation of a national and internationally recognized HB-HTA guidance manual and toolkit for TCM hospitals based on both the national HTA guidelines and the evaluation of TCM hospitals pilot projects.Moreover,we recommend that HB-HTA pilot study should be executed with Chinese patent medicine as the starting point to form the implementation process and framework in the TCM arena.展开更多
基金funded by Beijing Municipal Science & Technology Commission(No.Y0905001000091)
文摘This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Samples with screening results showing atypical squamous cells of undetermined significance （ASC-US） or worse were referred for colposcopy, and some samples were tested for high-risk HPV types with the Hybrid Capture II system （HC II）. Data on LCT （n=61,193） and HC II （n=1056） results were analysed. Overall test positivity for LCT was 2.53% using an ASC-US threshold, 3.11% using a low-grade squamous intraepithelial lesion （LSIL） threshold, and 0.67% using a high-grade squamous intraepithelial lesion （HSIL） threshold. A total of 1839 women （84% of the 3893 patients with abnormal cytology） underwent colposcopy-directed biopsy. HPV was positive in 80.3% of women with cervical intraepithelial neoplasia 1 （CIN1）, 88.3% of those with CIN2, 79.2% of women with CIN3 and 50% （2 of 4） of women with invasive cancer. There was a significant increase in the detection of CIN2 or worse with adjunct HPV testing of women with ASC-US and LSIL However, there were detection of CIN2＋ cases no differences in the with adjunct HPV testing of women with HSlI.. The results indicate that HPV testing for HSlL triage should not be recommended in cervical cancer screening.
基金Supported by The National Natural Science Foundation of China,No.82350127 and No.82241013the Shanghai Natural Science Foundation,No.20ZR1411600+2 种基金the Shanghai Shenkang Hospital Development Center,No.SHDC2020CR4039the Bethune Ethicon Excellent Surgery Foundation,No.CESS2021TC04Xuhui District Medical Research Project of Shanghai,No.SHXH201805.
文摘BACKGROUND Transforming growth factor-β(TGF-β)superfamily plays an important role in tumor progression and metastasis.Activin A receptor type 1C(ACVR1C)is a TGF-βtype I receptor that is involved in tumorigenesis through binding to dif-ferent ligands.AIM To evaluate the correlation between single nucleotide polymorphisms(SNPs)of ACVR1C and susceptibility to esophageal squamous cell carcinoma(ESCC)in Chinese Han population.METHODS In this hospital-based cohort study,1043 ESCC patients and 1143 healthy controls were enrolled.Five SNPs(rs4664229,rs4556933,rs77886248,rs77263459,rs6734630)of ACVR1C were assessed by the ligation detection reaction method.Hardy-Weinberg equilibrium test,genetic model analysis,stratified analysis,linkage disequi-librium test,and haplotype analysis were conducted.RESULTS Participants carrying ACVR1C rs4556933 GA mutant had significantly decreased risk of ESCC,and those with rs77886248 TA mutant were related with higher risk,especially in older male smokers.In the haplotype analysis,ACVR1C Trs4664229Ars4556933Trs77886248Crs77263459Ars6734630 increased risk of ESCC,while Trs4664229Grs4556933Trs77886248Crs77263459Ars6734630 was associated with lower susceptibility to ESCC.CONCLUSION ACVR1C rs4556933 and rs77886248 SNPs were associated with the susceptibility to ESCC,which could provide a potential target for early diagnosis and treatment of ESCC in Chinese Han population.
基金supported by the National Key R&D Program of China(grant number:2022YFC3600805,2016YFC1302502).
文摘Background:Esophageal cancer(EC)remains a global health challenge due to its poor prognosis.China and the United States of America(USA)represent two distinct epicenters of EC burden.Understanding the EC disparities in these two countries is vital for tailoring prevention strategies,optimizing treatment,and enhancing outcomes in both countries.Yet,there lacks a comprehensive comparison of EC characteristics between the two countries.Methods:In this multicenter,retrospective hospital-based study,we enrolled primary EC patients who received their initial treatment at one of 23 hospitals in China during 2016-2017.Using electronic medical records and cancer registration records,information on demographics,lifestyle,and clinicopathological characteristics(in-cluding tumor site,pathology,stage,metastases,differentiation,and treatment)were collected.Additionally,we compared these data with the clinicopathological information of invasive EC patients diagnosed in 2016-2017 from the Surveillance,Epidemiology,and End Results(SEER)database in the USA.Results:A total of 6,658 EC patients in China and 8,555 EC patients in the USA were included finally.85.5%(n=5,694)of EC were esophageal squamous cell carcinoma(ESCC)in China,while esophageal adenocarcinoma(EAC)was prominent in the USA(58.9%,n=5,041).Among EC patients with known staging,the proportion of early stage was higher in China compared to the USA(48.3%vs.30.5%).Among ESCC patients,early-stage cases were higher in China than in the USA(49.8%vs.31.8%),while among EAC patients,late-stage cases were higher in China than in the USA(77.3%vs.68.5%)(all P<0.001).In China,EC mainly occurred in the middle third(60.2%)of the esophagus,whereas in the USA,it was more common in the lower third(59.9%)of the organ.Compared with EC patients with known metastatic status in the USA,China had fewer cases of lymph node metastases(51.4%vs.57.7%)and distant metastases(7.9%vs.33.8%).Regarding treatment,China had more surgical therapy(53.7%vs.22.6%),less radiotherapy(35.6%vs.53.3%),and less chem
基金supported in part by the National Natural Science Foundation of China(30930082,81171561 and 30972584)the National Science and Technology Major Project of China(2008ZX10002-006,2012ZX10002007001,2017ZX10202203-007 and 2017ZX10202203-008)
文摘Background and Aims:Recently,the World Health Organization adopted the first-ever global hepatitis strategy with the dream of eliminating viral hepatitis as a public health threat by 2030.However,the epidemiology and treatment rates of hepatitis C virus(HCV)infection in Western China are still unknown.Methods:A total of 111,916 adult individuals(15-96 years)who underwent the HCV-antibody(HCV-Ab)test in the Second Affiliated Hospital of Chongqing Medical University between 2013 and 2015 were included in this study.We retrospectively analyzed the electronic medical records'data for each,and the positivity of HCV-Ab and the treatment of HCV RNA-positive patients were evaluated.Results:During 2013-2015,the crude prevalence of HCVAb was 1.4%(95%CI:1.4-1.5;1,611/111,916)and the adjusted prevalence of HCV-Ab was 1.7%(95%CI:1.6-1.8),which was higher than in the 2006 national study(0.43%).The prevalence was 2-times higher in males than females(2.0%vs.1.1%,p<0.01).Notably,only 46%(434/951)of the HCV RNA-positive patients received standard peginterferon plus ribavirin treatment,with 370(82%)that completed treatment,of whom 272(74%)achieved sustained virologic response(SVR).Particularly,11%(32/292)of HCV RNA-positive patients were HBsAg-positive,and the SVR rate for them was lower than for the HBsAg-negative patients,but no significant difference was observed.Conclusions:HCV infection may have increased since 2006 in Western China.The SVR rate of peg-interferon plus ribavirin treatment was high,but the proportion of untreated HCV patients was large.Thus,more efforts need to be made by the government to create a scientific-based policy for HCV treatment and prevention.
基金This study was supported by China Center for Evidence Based Traditional Chinese Medicine,CCEBTCM(2020YJSZX-2).
文摘Hospital-based health technology assessment(HB-HTA)is highly valuable in the application of hospital medical technology,cost control,improvement of medical quality,and protection of medical safety,and its use is increasing daily globally.However,in China,HB-HTA is still in its infancy,and it is yet to be adopted in traditional Chinese medicine(TCM).Therefore,this article introduces the application and development of HB-HTA,as well as discusses the current situation of TCM and related future development strategies to provide ideas and references for the development of HB-HTA in TCM.We conclude and recommend that all major stakeholders,including the state,health departments,and hospital leaders,support and promote the exploration and development of HB-HTA in TCM hospitals and integrative medicine hospitals.We also suggest the utilization of existing talents and introduction of other necessary talents to promote better and faster organizational development,as well as suggest the formation of a national and internationally recognized HB-HTA guidance manual and toolkit for TCM hospitals based on both the national HTA guidelines and the evaluation of TCM hospitals pilot projects.Moreover,we recommend that HB-HTA pilot study should be executed with Chinese patent medicine as the starting point to form the implementation process and framework in the TCM arena.
