Objective: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and preve...Objective: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and prevention. However, studies on economic burden of cancers in China are scant and the results are inconsistent. Methods: The Chinese hospital information database and nearly 350 million inpatient medical record data were used. As the ratios of cancer inpatient payments to total inpatient payments were mainly influenced by the grades and sites of hospitals, the estimates of payments of cancer inpatients in this study were stratified by hospital grades and provinces. Only the payments of cancer inpatients happened in grade 2, grade 3 and specialized cancer hospitals were included in the analyses. The total medical payments of cancers in China were estimated based on the ratios of outpatient payments to inpatient payments in specialized cancer hospitals. Results: From 2011 to 2015, the payments of cancer inpatients in China have increased by 84.1% and the total inpatient payments reached 177.1 billion RMB in 2015, accounting for 4.3% of the total health expenditure in China. Based on the ratio of outpatient payments to inpatient payments, the total payments on cancer treatments in China were estimated to be 221.4 billion RMB in 2015. Among different cancer types, the highest payments were the treatment of trachea, bronchus and lung cancer. The major cancer inpatient payments (67.1% in 2015) spent in grade 3 general hospitals and this ratio increased continually from 2011 to 2015. The expenditure of cancer treatments also varies by region with the major expenditure in the eastern region of China. Conclusions: This study estimated the total payments of cancer treatments in China and analyzed how the money was spent on cancer treatments in the recent 5 years, which would provide information for decision makings on the allocation of resources to service provisioning, prevention strategies, research funding, and 展开更多
Background: The increasing prevalence of colorectal cancer(CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC...Background: The increasing prevalence of colorectal cancer(CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.Methods: We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan(CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup(hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure.Results: A total of 2356 patients with a mean age of 57.4 years were included, 57.1 % of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY.The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3%of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups(P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spen展开更多
AIM： To evaluate the risk factors for primary liver carcinoma （PLC） in Chinese population.METHODS： Chinese Biomedical Literature Database, China Hospital Knowledge Database and MEDLINE were searched. All the relat...AIM： To evaluate the risk factors for primary liver carcinoma （PLC） in Chinese population.METHODS： Chinese Biomedical Literature Database, China Hospital Knowledge Database and MEDLINE were searched. All the related literatures were screened, and the risk factors for PLC in Chinese population were studied. Heterogeneity was evaluated by odds ratio （OR） q test. Combined OR and its 95% confidence interval （95%CI）were calculated, the association between the investigated risk factors and PLC was determined. Validity and bias of the findings were evaluated by sensitivity analysis and funnel plot analysis respectively.RESULTS： Fifty-five of one hundred and ninety identified studies were accepted according to the inclusive criteria. Ten factors related to PLC were demonstrated by sensitive analysis and funnel plot analysis. They were cirrhosis （OR = 11.97, P= 0.000）, HBV infection （OR = 11.34, P= 0.000）,HCV infection （OR = 4.28, P = 0.000）, family history of liver cancer （OR = 3.49, P = 0.000）, unstable emotion （OR = 2.20, P = 0.000）, depressed characters （OR = 3.07,P = 0.000）, aflatoxin （OR = 1.80, P = 0.000）, alcoholic （OR = 1.88, P = 0.000）, intake of musty food （OR =1.87,P = 0.000） and drinking contaminated water from pond （OR = 1.77, P = 0.003）.CONCLUSION： The main risk factors for PLC in China are liver diseases, family history of liver carcinoma, poor psychic status, aflatoxin, and some unhealthy behaviors.展开更多
In June 2013,the fi rst human H6N1 infl uenza virus infec-tion was confirmed in Taiwan.However,the origin and molecular characterization of this virus,A/Taiwan/2/2013(H6N1),have not been well studied thus far.In the p...In June 2013,the fi rst human H6N1 infl uenza virus infec-tion was confirmed in Taiwan.However,the origin and molecular characterization of this virus,A/Taiwan/2/2013(H6N1),have not been well studied thus far.In the present report,we performed phylogenetic and coalescent analy-ses of this virus and compared its molecular profi le/char-acteristics with other closely related strains.Molecular characterization of H6N1 revealed that it is a typical avian infl uenza virus of low pathogenicity,which might not rep-licate and propagate well in the upper airway in mammals.Phylogenetic analysis revealed that the virus clusters with A/chicken/Taiwan/A2837/2013(H6N1)in seven genes,except PB1.For the PB1 gene,A/Taiwan/2/2013 was clus-tered with a different H6N1 lineage from A/chicken/Taiwan/A2837/2013.Although a previous study demonstrated that the PB2,PA,and M genes of A/Taiwan/2/2013 might be derived from the H5N2 viruses,coalescent analyses revealed that these H5N2 viruses were derived from more recent strains than that of the ancestor of A/Taiwan/2/2013.Therefore,we propose that A/Taiwan/2/2013 is a reassor-tant from different H6N1 lineages circulating in chickens in Taiwan.Furthermore,compared to avian isolates,a sin-gle P186L(H3 numbering)substitution in the hemaggluti-nin H6 of the human isolate might increase the mammali-an receptor binding and,hence,this strain’s pathogenicity in humans.Overall,human infection with this virus seems an accidental event and is unlikely to cause an infl uenza pandemic.However,its co-circulation and potential reas-sortment with other infl uenza subtypes are still worthy of attention.展开更多
Ultrasonic imaging is becoming the most popular medical imaging modality,owing to the low price per examination and its safety.However,blood is a poor scatterer of ultrasound waves at clinical diagnostic transmit freq...Ultrasonic imaging is becoming the most popular medical imaging modality,owing to the low price per examination and its safety.However,blood is a poor scatterer of ultrasound waves at clinical diagnostic transmit frequencies.For perfusion imaging,markers have been designed to enhance the contrast in B-mode imaging.These so-called ultrasound contrast agents consist of microscopically small gas bubbles encapsulated in biodegradable shells.In this review,the physical principles of ultrasound contrast agent microbubble behavior and their adjustment for drug delivery including sonoporation are described.Furthermore,an outline of clinical imaging applications of contrast-enhanced ultrasound is given.It is a challenging task to quantify and predict which bubble phenomenon occurs under which acoustic condition,and how these phenomena may be utilized in ultrasonic imaging.Aided by high-speed photography,our improved understanding of encapsulated microbubble behavior will lead to more sophisticated detection and delivery techniques.More sophisticated methods use quantitative approaches to measure the amount and the time course of bolus or reperfusion curves,and have shown great promise in revealing effective tumor responses to anti-angiogenic drugs in humans before tumor shrinkage occurs.These are beginning to be accepted into clinical practice.In the long term,targeted microbubbles for molecular imaging and eventually for directed anti-tumor therapy are expected to be tested.展开更多
More than half of stroke patients live with different levels of motor dysfunction after receiving routine rehabilitation treatments.Therefore,new rehabilitation technologies are urgently needed as auxiliary treatments...More than half of stroke patients live with different levels of motor dysfunction after receiving routine rehabilitation treatments.Therefore,new rehabilitation technologies are urgently needed as auxiliary treatments for motor rehabilitation.Based on routine rehabilitation treatments,a new intelligent rehabilitation platform has been developed for accurate evaluation of function and rehabilitation training.The emerging intelligent rehabilitation techniques can promote the development of motor function rehabilitation in terms of informatization,standardization,and intelligence.Traditional assessment methods are mostly subjective,depending on the experience and expertise of clinicians,and lack standardization and precision.It is therefore difficult to track functional changes during the rehabilitation process.Emerging intelligent rehabilitation techniques provide objective and accurate functional assessment for stroke patients that can promote improvement of clinical guidance for treatment.Artificial intelligence and neural networks play a critical role in intelligent rehabilitation.Multiple novel techniques,such as braincomputer interfaces,virtual reality,neural circuit-magnetic stimulation,and robot-assisted therapy,have been widely used in the clinic.This review summarizes the emerging intelligent rehabilitation techniques for the evaluation and treatment of motor dysfunction caused by nervous system diseases.展开更多
OBJECTIVE: To help researchers selecting appropriate data mining models to provide better evidence for the clinical practice of Traditional Chinese Medicine(TCM) diagnosis and therapy.METHODS: Clinical issues based on...OBJECTIVE: To help researchers selecting appropriate data mining models to provide better evidence for the clinical practice of Traditional Chinese Medicine(TCM) diagnosis and therapy.METHODS: Clinical issues based on data mining models were comprehensively summarized from four significant elements of the clinical studies:symptoms, symptom patterns, herbs, and efficacy.Existing problems were further generalized to determine the relevant factors of the performance of data mining models, e.g. data type, samples, parameters, variable labels. Combining these relevant factors, the TCM clinical data features were compared with regards to statistical characters and informatics properties. Data models were compared simultaneously from the view of applied conditions and suitable scopes.RESULTS: The main application problems were the inconsistent data type and the small samples for the used data mining models, which caused the inappropriate results, even the mistake results. These features, i.e. advantages, disadvantages, satisfied data types, tasks of data mining, and the TCM issues, were summarized and compared.CONCLUSION: By aiming at the special features of different data mining models, the clinical doctors could select the suitable data mining models to resolve the TCM problem.展开更多
Hippocampal morphological change is one of the main hallmarks of Alzheimer’s disease(AD).However,whether hippocampal radiomic features are robust as predictors of progression from mild cognitive impairment(MCI)to AD ...Hippocampal morphological change is one of the main hallmarks of Alzheimer’s disease(AD).However,whether hippocampal radiomic features are robust as predictors of progression from mild cognitive impairment(MCI)to AD dementia and whether these features provide any neurobiological foundation remains unclear.The primary aim of this study was to verify whether hippocampal radiomic features can serve as robust magnetic resonance imaging(MRI)markers for AD.Multivariate classifier-based support vector machine(SVM)analysis provided individual-level predictions for distinguishing AD patients(n=261)from normal controls(NCs;n=231)with an accuracy of 88.21%and intersite crossvalidation.Further analyses of a large,independent the Alzheimer’s Disease Neuroimaging Initiative(ADNI)dataset(n=1228)reinforced these findings.In MCI groups,a systemic analysis demonstrated that the identified features were significantly associated with clinical features(e.g.,apolipoprotein E(APOE)genotype,polygenic risk scores,cerebrospinal fluid(CSF)Ab,CSF Tau),and longitudinal changes in cognition ability;more importantly,the radiomic features had a consistently altered pattern with changes in the MMSE scores over 5 years of follow-up.These comprehensive results suggest that hippocampal radiomic features can serve as robust biomarkers for clinical application in AD/MCI,and further provide evidence for predicting whether an MCI subject would convert to AD based on the radiomics of the hippocampus.The results of this study are expected to have a substantial impact on the early diagnosis of AD/MCI.展开更多
Objective： This study was designed to explore the time trends in geographical variations of cervical cancer mortality in China's Mainland over the period 1973 to 2013, to provide subnational spatio-temporal patte...Objective： This study was designed to explore the time trends in geographical variations of cervical cancer mortality in China's Mainland over the period 1973 to 2013, to provide subnational spatio-temporal patterns for targeted promotion of human papillomavirus vaccine in China. Methods： Data were extracted from three national retrospective death surveys and cancer registry. The rate ratio （RR） was estimated for the aggregated data for seven geographical regions using generalized linear models to evaluate time trends in geographical disparities of cervical cancer mortality. Results： There was a significant decrease in cervical cancer mortality in China from 1973-1975 to 2004-2005, but leveled off thereafter to 2011-2013. Compared to the period 1973-1975 the RR for the three last time periods were 0.33 [95% confidence interval （95% CI）： 0.30-0.37] for 1990-1992, 0.21 （95% CI： 0.19-0.24） for 2004-2005 and 0.24 （95% CI： 0.22-0.26） for 2011-2013. Females living in the Northwest China and Central China have a high risk of mortality from cervical cancer compared to the nationwide, with the RR being 2.09 （95% CI： 1.83-2.38） and 1.26 （95% CI： t.11-1.44） respectively, while the RRs for South China, Northeast China and Southwest China were below 1.00, indicating the lower death risk. Despite the mortality rate had increased slightly from 2004 to 2013, there was an encouraging sign that the geographical disparities in cervical cancer mortality had gradually narrowed over time across China. Conclusions： Although cervical cancer mortality in China has reduced to very low levels, the high risk of cervical cancer in Northwest China and Central China is still noteworthy. Public health policies including the promotion of vaccine should be targeted to further reduction of geographical disparities in cervical cancer mortality.展开更多
The SARS-CoV-2-caused COVID-19 pandemic has resulted in a devastating threat to human society in terms of health,economy,and lifestyle.Although the virus usually first invades and infects the lung and respiratory trac...The SARS-CoV-2-caused COVID-19 pandemic has resulted in a devastating threat to human society in terms of health,economy,and lifestyle.Although the virus usually first invades and infects the lung and respiratory track tissue,in extreme cases,almost all major organs in the body are now known to be negatively impacted often leading to severe systemic failure in some people.Unfortunately,there is currently no effective treatment for this disease.Pre-existing pathological conditions or comorbidities such as age are a major reason for premature death and increased morbidity and mortality.The immobilization due to hospitalization and bed rest and the physical inactivity due to sustained quarantine and social distancing can downregulate the ability of organs systems to resist to viral infection and increase the risk of damage to the immune,respiratory,cardiovascular,musculoskeletal systems and the brain.The cellular mechanisms and danger of this“second wave”effect of COVID-19 to the human body,along with the effects of aging,proper nutrition,and regular physical activity,are reviewed in this article.展开更多
Objective Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the ris...Objective Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.Methods A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients’ medical records. Multivariable logistic regression models were used to estimate the odds ratio(OR) and 95% confidence interval(95% CI) of the associations between comorbidities(cardiometabolic or non-cardiometabolic diseases), clinical severity, and treatment outcomes of COVID-19.Results Overall, 158(13.6%) patients were diagnosed with severe illness and 32(2.7%) had unfavorable outcomes. Hypertension(2.87, 1.30–6.32), type 2 diabetes(T2 DM)(3.57, 2.32–5.49),cardiovascular disease(CVD)(3.78, 1.81–7.89), fatty liver disease(7.53, 1.96–28.96), hyperlipidemia(2.15, 1.26–3.67), other lung diseases(6.00, 3.01–11.96), and electrolyte imbalance(10.40, 3.00–26.10)were independently linked to increased odds of being severely ill. T2 DM(6.07, 2.89–12.75), CVD(8.47,6.03–11.89), and electrolyte imbalance(19.44, 11.47–32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission(5.46,3.25–9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes(6.58, 1.46–29.64) within two weeks.Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.展开更多
Objective: Colorectal cancer(CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expen...Objective: Colorectal cancer(CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expenditures and the time trends for CRC diagnosis and treatment in China.Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 13 provinces across China. For each eligible CRC patient diagnosed from 2002 to 2011, clinical information and expenditure data were extracted using a uniform questionnaire. All expenditure data were reported in Chinese Yuan(CNY)using 2011 values.Results: Of the 14,536 CRC patients included, the average age at diagnosis was 58.2 years and 15.8% were stageI cases. The average medical expenditure per patient was estimated at 37,902 CNY [95 % confidence interval(95%CI): 37,282-38,522], and the annual average increase rate was 9.2% from 2002 to 2011(P for trend <0.001), with a cumulative increase of 2.4 times(from 23,275 CNY to 56,010 CNY). The expenditure per patient in stages Ⅰ, Ⅱ, Ⅲ and Ⅳ were 31,698 CNY, 37,067 CNY, 38,918 CNY and 42,614 CNY, respectively(P<0.001). Expenditure significantly differed within various subgroups. Expenses for drugs contributed the largest proportion(52.6%).Conclusions: These conservative estimates illustrated that medical expenditures for CRC diagnosis and treatment in tertiary hospitals in China were substantial and increased rapidly over the 10 years, with drugs continually being the main expense by 2011. Relatively, medical expenditures are lower for CRC in the earlier stages. These findings will facilitate the economic evaluation of CRC prevention and control in China.展开更多
In this review,we summarize the recent microbiome studies related to diabetes disease and discuss the key findings that show the early emerging potential causal roles for diabetes.On a global scale,diabetes causes a s...In this review,we summarize the recent microbiome studies related to diabetes disease and discuss the key findings that show the early emerging potential causal roles for diabetes.On a global scale,diabetes causes a significant negative impact to the health status of human populations.This review covers type 1 diabetes and type 2 diabetes.We examine promising studies which lead to a better understanding of the potential mechanism of microbiota in diabetes diseases.It appears that the human oral and gut microbiota are deeply interdigitated with diabetes.It is that simple.Recent studies of the human microbiome are capturing the attention of scientists and healthcare practitioners worldwide by focusing on the interplay of gut microbiome and diabetes.These studies focus on the role and the potential impact of intestinal microflora in diabetes.We paint a clear picture of how strongly microbes are linked and associated,both positively and negatively,with the fundamental and essential parts of diabetes in humans.The microflora seems to have an endless capacity to impact and transform diabetes.We conclude that there is clear and growing evidence of a close relationship between the microbiota and diabetes and this is worthy of future investments and research efforts.展开更多
BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy viaendoscopic observation is subject to sampling error and interobserver variability.The Kimura-Takemoto classification system was ...BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy viaendoscopic observation is subject to sampling error and interobserver variability.The Kimura-Takemoto classification system was developed to overcome theselimitations.AIMTo compare the morphological classification of atrophic gastritis between theKimura-Takemoto system and the Updated Sydney system.METHODSA total of 169 patients with atrophic gastritis were selected according to diagnosisby the visual endoscopic Kimura-Takemoto method. Following the UpdatedKimura-Takemoto classification system, one antrum biopsy and five gastriccorpus biopsies were taken according to the visual stages of the Kimura-Takemoto system. The Updated Kimura-Takemoto classification system was thenapplied to each and showed 165 to have histological mucosal atrophy;theremaining 4 patients had no histological evidence of atrophy in any biopsy. The Updated Kimura-Takemoto classification was verified as a referencemorphological method and applied for the diagnosis of atrophic gastritis. Addingone more biopsy from the antrum to the six biopsies according to the Updated Kimura-Takemoto classification, constitutes the updated combined Kimura-Takemoto classification and Sydney system.RESULTSThe sensitivity for degree of mucosal atrophy assessed by the Updated Sydneysystem was 25% for mild, 36% for moderate, and 42% for severe, when comparedwith the Updated Kimura-Takemoto classification of atrophic gastritis formorphological diagnosis. Four types of multifocal atrophic gastritis wereidentified: sequential uniform (type 1;in 28%), sequential non-uniform (type 2;in7%), diffuse uniform (type 3;in 23%), diffuse non-uniform (type 4;in 24%), and"alternating atrophic – non-atrophic" (type 5;in 18%). The pattern of the spread ofatrophy, sequentially from the antrum to the cardiac segment of the stomach,which was described by the Updated Kimura-Takemoto system, washistologically confirmed in 82% of cases evaluated.CONCLUSIONThe Updated Sydney system is significantly展开更多
Importance: Morbidity and mortality of children are important indicators of the performance of the public health system in any country. In China, the children's disease spectrum has gradually changed in recent yea...Importance: Morbidity and mortality of children are important indicators of the performance of the public health system in any country. In China, the children's disease spectrum has gradually changed in recent years. However, the gender- and age-specific disease spectrum for hospitalized children under 15 years old is still unclear. Objective: To explore the gender- and age-based distribution of diseases in hospitalized children under 15 years in China. Methods: Medical records home page data for 2016 to 2018 were collected from 18 tertiary children's hospitals in China. The gender- and age-specific disease spectrum was analyzed, using the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Results: The most common diseases were those of the respiratory system (25.7% of all 2232142 hospitalized children). The top three diseases for boys were diseases of the respiratory system (25.6%), diseases of the digestive system (11.4%) and certain conditions originating in the perinatal period (8.6%). The top three diseases for girls were diseases of the respiratory system (25.9%), certain conditions originating in the perinatal period (10.1%), and factors influencing health status and contact with health services (9.4%).The most common diseases for children under 1 year old were certain conditions originating in the perinatal period (38.1%). For all other age groups, the most common conditions were respiratory diseases (33.8% for those aged 1–3 years, 25.2% for those aged 4–6 years, and 12.2% for those aged 7–14 years). Interpretation: This study analyzed the medical records home pages of 18 children's hospitals to provide the first overview of the disease spectrum and its gender- and age-specific distribution among children in China.展开更多
Dear editor,Lung carcinoma is responsible for the highest fatal-ity rate among cancer-related deaths globally,with lung adenocarcinoma(LADC)emerging as the prevailing sub-type.
Thousands of resting state functional magnetic resonance imaging(RS-f MRI)articles have been published on brain disorders.For precise localization of abnormal brain activity,a voxel-level comparison is needed.Because ...Thousands of resting state functional magnetic resonance imaging(RS-f MRI)articles have been published on brain disorders.For precise localization of abnormal brain activity,a voxel-level comparison is needed.Because of the large number of voxels in the brain,multiple comparison correction(MCC)must be performed to reduce false positive rates,and a smaller P value(usually including either liberal or stringent MCC)is widely recommended[1].展开更多
Background: Esophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions. The medical expenditure for the dia...Background: Esophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions. The medical expenditure for the diagnosis and treatment of esophageal cancer in China has not been fully quantified. This study aimed to examine the medical expenditure of Chinese patients with esophageal cancer and the associated trends.Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 37 hospitals in 13 provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. For each esophageal cancer patient diagnosed between 2002 and 2011, clinical information and expense data were extracted by using structured questionnaires. All expense data were reported in Chinese Yuan(CNY; 1 CNY = 0.155 USD) based on the2011 value and inflated using the year-specific health care consumer price index for China.Results: A total of 14,967 esophageal cancer patients were included in the analysis. It was estimated that the overall average expenditure per patient was 38,666 CNY, and an average annual increase of 6.27% was observed from 2002(25,111 CNY) to 2011(46,124 CNY). The average expenditures were 34,460 CNY for stage Ⅰ,39,302 CNY for stage Ⅱ,40,353 CNY for stage Ⅲ, and 37,432 CNY for stage IV diseases(P < 0.01). The expenditure also differed by the therapy type, which was 38,492 CNY for surgery, 27,933 CNY for radiotherapy, and 27,805 CNY for chemotherapy(P < 0.05).Drugs contributed to 45.02% of the overall expenditure.Conclusions: These conservative estimates suggested that medical expenditures for esophageal cancer in China substantially increased in the last 10 years, treatment for early-stage esophageal cancer costs less than that for advanced cases, and spending on drugs continued to account for a considerable proportion of the overall expenditure.展开更多
Cancer is an abnormal state of cells where they undergo uncontrolled proliferation and produce aggressive malignancies that causes millions of deaths every year.With the new understanding of the molecular mechanism(s)...Cancer is an abnormal state of cells where they undergo uncontrolled proliferation and produce aggressive malignancies that causes millions of deaths every year.With the new understanding of the molecular mechanism(s)of disease progression,our knowledge about the disease is snowballing,leading to the evolution of many new therapeutic regimes and their successive trials.In the past few decades,various combinations of therapies have been pro-posed and are presently employed in the treatment of diverse cancers.Targeted drug therapy,immunotherapy,and personalized medicines are now largely being employed,which were not common a few years back.The field of cancer discoveries and therapeutics are evolving fast as cancer type-specific biomarkers are progressively being identified and several types of cancers are nowadays undergoing systematic therapies,extending patients’disease-free survival thereafter.Although growing evidence shows that a systematic and targeted approach could be the future of cancer medicine,chemotherapy remains a largely opted therapeutic option despite its known side effects on the patient’s physical and psychological health.Chemother-apeutic agents/pharmaceuticals served a great purpose over the past few decades and have remained the frontline choice for advanced-stage malignancies where surgery and/or radiation therapy cannot be prescribed due to specific reasons.The present report succinctly reviews the existing and contemporary advancements in chemotherapy and assesses the status of the enrolled drugs/pharmaceuticals;it also comprehensively discusses the emerging role of specific/targeted therapeutic strategies that are presently being employed to achieve better clinical success/survival rate in cancer patients.展开更多
基金supported by National Natural Science Foundation of China (No.71403189)
文摘Objective: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and prevention. However, studies on economic burden of cancers in China are scant and the results are inconsistent. Methods: The Chinese hospital information database and nearly 350 million inpatient medical record data were used. As the ratios of cancer inpatient payments to total inpatient payments were mainly influenced by the grades and sites of hospitals, the estimates of payments of cancer inpatients in this study were stratified by hospital grades and provinces. Only the payments of cancer inpatients happened in grade 2, grade 3 and specialized cancer hospitals were included in the analyses. The total medical payments of cancers in China were estimated based on the ratios of outpatient payments to inpatient payments in specialized cancer hospitals. Results: From 2011 to 2015, the payments of cancer inpatients in China have increased by 84.1% and the total inpatient payments reached 177.1 billion RMB in 2015, accounting for 4.3% of the total health expenditure in China. Based on the ratio of outpatient payments to inpatient payments, the total payments on cancer treatments in China were estimated to be 221.4 billion RMB in 2015. Among different cancer types, the highest payments were the treatment of trachea, bronchus and lung cancer. The major cancer inpatient payments (67.1% in 2015) spent in grade 3 general hospitals and this ratio increased continually from 2011 to 2015. The expenditure of cancer treatments also varies by region with the major expenditure in the eastern region of China. Conclusions: This study estimated the total payments of cancer treatments in China and analyzed how the money was spent on cancer treatments in the recent 5 years, which would provide information for decision makings on the allocation of resources to service provisioning, prevention strategies, research funding, and
基金supported by the grants from the Beijing Hope Run Special Fund(#LC2012YF44)National Natural Science Foundation of China(No.81402740)+1 种基金Specialized Research Fund for the Doctoral Program of Higher Education(No.20131106120014)The National Health and Family Planning Committee of P.R.China
文摘Background: The increasing prevalence of colorectal cancer(CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.Methods: We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan(CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup(hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure.Results: A total of 2356 patients with a mean age of 57.4 years were included, 57.1 % of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY.The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3%of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups(P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spen
文摘AIM： To evaluate the risk factors for primary liver carcinoma （PLC） in Chinese population.METHODS： Chinese Biomedical Literature Database, China Hospital Knowledge Database and MEDLINE were searched. All the related literatures were screened, and the risk factors for PLC in Chinese population were studied. Heterogeneity was evaluated by odds ratio （OR） q test. Combined OR and its 95% confidence interval （95%CI）were calculated, the association between the investigated risk factors and PLC was determined. Validity and bias of the findings were evaluated by sensitivity analysis and funnel plot analysis respectively.RESULTS： Fifty-five of one hundred and ninety identified studies were accepted according to the inclusive criteria. Ten factors related to PLC were demonstrated by sensitive analysis and funnel plot analysis. They were cirrhosis （OR = 11.97, P= 0.000）, HBV infection （OR = 11.34, P= 0.000）,HCV infection （OR = 4.28, P = 0.000）, family history of liver cancer （OR = 3.49, P = 0.000）, unstable emotion （OR = 2.20, P = 0.000）, depressed characters （OR = 3.07,P = 0.000）, aflatoxin （OR = 1.80, P = 0.000）, alcoholic （OR = 1.88, P = 0.000）, intake of musty food （OR =1.87,P = 0.000） and drinking contaminated water from pond （OR = 1.77, P = 0.003）.CONCLUSION： The main risk factors for PLC in China are liver diseases, family history of liver carcinoma, poor psychic status, aflatoxin, and some unhealthy behaviors.
基金the National Basic Research Pro-gram(973 Program)(Nos.2010CB530303,2011CB504703,and 2012CB955501an intramural special grant for influenza virus research from the Chinese Academy of Sciences(KSZD-EW-Z-002)the Doctoral Starting up Foundation of Taishan Medical College.GFG is a leading principal investigator of the Innova-tive Research Group of the National Natural Science Foundation of China(Grant No.81021003)。
文摘In June 2013,the fi rst human H6N1 infl uenza virus infec-tion was confirmed in Taiwan.However,the origin and molecular characterization of this virus,A/Taiwan/2/2013(H6N1),have not been well studied thus far.In the present report,we performed phylogenetic and coalescent analy-ses of this virus and compared its molecular profi le/char-acteristics with other closely related strains.Molecular characterization of H6N1 revealed that it is a typical avian infl uenza virus of low pathogenicity,which might not rep-licate and propagate well in the upper airway in mammals.Phylogenetic analysis revealed that the virus clusters with A/chicken/Taiwan/A2837/2013(H6N1)in seven genes,except PB1.For the PB1 gene,A/Taiwan/2/2013 was clus-tered with a different H6N1 lineage from A/chicken/Taiwan/A2837/2013.Although a previous study demonstrated that the PB2,PA,and M genes of A/Taiwan/2/2013 might be derived from the H5N2 viruses,coalescent analyses revealed that these H5N2 viruses were derived from more recent strains than that of the ancestor of A/Taiwan/2/2013.Therefore,we propose that A/Taiwan/2/2013 is a reassor-tant from different H6N1 lineages circulating in chickens in Taiwan.Furthermore,compared to avian isolates,a sin-gle P186L(H3 numbering)substitution in the hemaggluti-nin H6 of the human isolate might increase the mammali-an receptor binding and,hence,this strain’s pathogenicity in humans.Overall,human infection with this virus seems an accidental event and is unlikely to cause an infl uenza pandemic.However,its co-circulation and potential reas-sortment with other infl uenza subtypes are still worthy of attention.
文摘Ultrasonic imaging is becoming the most popular medical imaging modality,owing to the low price per examination and its safety.However,blood is a poor scatterer of ultrasound waves at clinical diagnostic transmit frequencies.For perfusion imaging,markers have been designed to enhance the contrast in B-mode imaging.These so-called ultrasound contrast agents consist of microscopically small gas bubbles encapsulated in biodegradable shells.In this review,the physical principles of ultrasound contrast agent microbubble behavior and their adjustment for drug delivery including sonoporation are described.Furthermore,an outline of clinical imaging applications of contrast-enhanced ultrasound is given.It is a challenging task to quantify and predict which bubble phenomenon occurs under which acoustic condition,and how these phenomena may be utilized in ultrasonic imaging.Aided by high-speed photography,our improved understanding of encapsulated microbubble behavior will lead to more sophisticated detection and delivery techniques.More sophisticated methods use quantitative approaches to measure the amount and the time course of bolus or reperfusion curves,and have shown great promise in revealing effective tumor responses to anti-angiogenic drugs in humans before tumor shrinkage occurs.These are beginning to be accepted into clinical practice.In the long term,targeted microbubbles for molecular imaging and eventually for directed anti-tumor therapy are expected to be tested.
基金the National Key Research and Development Project of China,No.2020YFC2004200(to ZYL)the National Natural Science Foundation of China,Nos.61761166007(to ZYL),81772453(to DSX),81974358(to DSX),31771071(to ZYL)Fundamental Research Funds for Central Public Welfare Research Institutes,No.118009001000160001(to ZYL)。
文摘More than half of stroke patients live with different levels of motor dysfunction after receiving routine rehabilitation treatments.Therefore,new rehabilitation technologies are urgently needed as auxiliary treatments for motor rehabilitation.Based on routine rehabilitation treatments,a new intelligent rehabilitation platform has been developed for accurate evaluation of function and rehabilitation training.The emerging intelligent rehabilitation techniques can promote the development of motor function rehabilitation in terms of informatization,standardization,and intelligence.Traditional assessment methods are mostly subjective,depending on the experience and expertise of clinicians,and lack standardization and precision.It is therefore difficult to track functional changes during the rehabilitation process.Emerging intelligent rehabilitation techniques provide objective and accurate functional assessment for stroke patients that can promote improvement of clinical guidance for treatment.Artificial intelligence and neural networks play a critical role in intelligent rehabilitation.Multiple novel techniques,such as braincomputer interfaces,virtual reality,neural circuit-magnetic stimulation,and robot-assisted therapy,have been widely used in the clinic.This review summarizes the emerging intelligent rehabilitation techniques for the evaluation and treatment of motor dysfunction caused by nervous system diseases.
基金Supported by Research on Pattern differentiation of AIDS based on Graph Theroy of National Natural Science Foundation of China(No.81202858)Research on Intervention Evaluation of TCM Health Differentiation of National Key Technology Support Program(No.2012BAI25B02)+3 种基金Research and Development in Digital Information System of Traditional Chinese Medicine of National 863 Program of China(No.2012AA02A609)Acupuncture Efficacy of Gastrointestinal Dysfunction(No.ZZ05003)Acupuncture-point Specialty Analysis based on Image Processing Technology(No.ZZ03090)of Self-selected subject of China Academy of Chinese Medical SciencesSemantic Recognition of Tongue and Pulse based on Image Content of the Beijing Key Laboratory of Advanced Information Science and Network Technology(No.XDXX1306)
文摘OBJECTIVE: To help researchers selecting appropriate data mining models to provide better evidence for the clinical practice of Traditional Chinese Medicine(TCM) diagnosis and therapy.METHODS: Clinical issues based on data mining models were comprehensively summarized from four significant elements of the clinical studies:symptoms, symptom patterns, herbs, and efficacy.Existing problems were further generalized to determine the relevant factors of the performance of data mining models, e.g. data type, samples, parameters, variable labels. Combining these relevant factors, the TCM clinical data features were compared with regards to statistical characters and informatics properties. Data models were compared simultaneously from the view of applied conditions and suitable scopes.RESULTS: The main application problems were the inconsistent data type and the small samples for the used data mining models, which caused the inappropriate results, even the mistake results. These features, i.e. advantages, disadvantages, satisfied data types, tasks of data mining, and the TCM issues, were summarized and compared.CONCLUSION: By aiming at the special features of different data mining models, the clinical doctors could select the suitable data mining models to resolve the TCM problem.
基金partially supported by the National Key Research and Development Program of China (2016YFC1305904)the National Natural Science Foundation of China (81871438, 81901101, 61633018, 81571062, 81400890, 81871398)+10 种基金the Strategic Priority Research Program (B) of the Chinese Academy of Sciences (XDB32020200)the Beijing Municipal Science & Technology Commission (Z171100000117001, Z171100000117002)the Primary Research & Development Plan of Shandong Province (2017GGX10112)the Open Project Program of the National Laboratory of Pattern Recognition (NLPR) (201900021)Data collection and sharing for this project was funded by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904)DOD ADNI (Department of Defense award number W81XWH-12-2-0012)funded by the National Institute on Agingthe National Institute of Biomedical Imaging and Bioengineeringgenerous contributions from Abb Vie, Alzheimer’s AssociationAlzheimer’s Drug Discovery FoundationThe Canadian Institutes of Health Research provide funds to support ADNI clinical sites in Canada。
文摘Hippocampal morphological change is one of the main hallmarks of Alzheimer’s disease(AD).However,whether hippocampal radiomic features are robust as predictors of progression from mild cognitive impairment(MCI)to AD dementia and whether these features provide any neurobiological foundation remains unclear.The primary aim of this study was to verify whether hippocampal radiomic features can serve as robust magnetic resonance imaging(MRI)markers for AD.Multivariate classifier-based support vector machine(SVM)analysis provided individual-level predictions for distinguishing AD patients(n=261)from normal controls(NCs;n=231)with an accuracy of 88.21%and intersite crossvalidation.Further analyses of a large,independent the Alzheimer’s Disease Neuroimaging Initiative(ADNI)dataset(n=1228)reinforced these findings.In MCI groups,a systemic analysis demonstrated that the identified features were significantly associated with clinical features(e.g.,apolipoprotein E(APOE)genotype,polygenic risk scores,cerebrospinal fluid(CSF)Ab,CSF Tau),and longitudinal changes in cognition ability;more importantly,the radiomic features had a consistently altered pattern with changes in the MMSE scores over 5 years of follow-up.These comprehensive results suggest that hippocampal radiomic features can serve as robust biomarkers for clinical application in AD/MCI,and further provide evidence for predicting whether an MCI subject would convert to AD based on the radiomics of the hippocampus.The results of this study are expected to have a substantial impact on the early diagnosis of AD/MCI.
基金supported by Ministry of Science and Technology of China (Grant No.2014FY121100)
文摘Objective： This study was designed to explore the time trends in geographical variations of cervical cancer mortality in China's Mainland over the period 1973 to 2013, to provide subnational spatio-temporal patterns for targeted promotion of human papillomavirus vaccine in China. Methods： Data were extracted from three national retrospective death surveys and cancer registry. The rate ratio （RR） was estimated for the aggregated data for seven geographical regions using generalized linear models to evaluate time trends in geographical disparities of cervical cancer mortality. Results： There was a significant decrease in cervical cancer mortality in China from 1973-1975 to 2004-2005, but leveled off thereafter to 2011-2013. Compared to the period 1973-1975 the RR for the three last time periods were 0.33 [95% confidence interval （95% CI）： 0.30-0.37] for 1990-1992, 0.21 （95% CI： 0.19-0.24） for 2004-2005 and 0.24 （95% CI： 0.22-0.26） for 2011-2013. Females living in the Northwest China and Central China have a high risk of mortality from cervical cancer compared to the nationwide, with the RR being 2.09 （95% CI： 1.83-2.38） and 1.26 （95% CI： t.11-1.44） respectively, while the RRs for South China, Northeast China and Southwest China were below 1.00, indicating the lower death risk. Despite the mortality rate had increased slightly from 2004 to 2013, there was an encouraging sign that the geographical disparities in cervical cancer mortality had gradually narrowed over time across China. Conclusions： Although cervical cancer mortality in China has reduced to very low levels, the high risk of cervical cancer in Northwest China and Central China is still noteworthy. Public health policies including the promotion of vaccine should be targeted to further reduction of geographical disparities in cervical cancer mortality.
文摘The SARS-CoV-2-caused COVID-19 pandemic has resulted in a devastating threat to human society in terms of health,economy,and lifestyle.Although the virus usually first invades and infects the lung and respiratory track tissue,in extreme cases,almost all major organs in the body are now known to be negatively impacted often leading to severe systemic failure in some people.Unfortunately,there is currently no effective treatment for this disease.Pre-existing pathological conditions or comorbidities such as age are a major reason for premature death and increased morbidity and mortality.The immobilization due to hospitalization and bed rest and the physical inactivity due to sustained quarantine and social distancing can downregulate the ability of organs systems to resist to viral infection and increase the risk of damage to the immune,respiratory,cardiovascular,musculoskeletal systems and the brain.The cellular mechanisms and danger of this“second wave”effect of COVID-19 to the human body,along with the effects of aging,proper nutrition,and regular physical activity,are reviewed in this article.
基金This study was supported by the‘National Major Science and Technology Projects of China'[2018ZX10101001-005-003,2018ZX10101001-005-004]
文摘Objective Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.Methods A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients’ medical records. Multivariable logistic regression models were used to estimate the odds ratio(OR) and 95% confidence interval(95% CI) of the associations between comorbidities(cardiometabolic or non-cardiometabolic diseases), clinical severity, and treatment outcomes of COVID-19.Results Overall, 158(13.6%) patients were diagnosed with severe illness and 32(2.7%) had unfavorable outcomes. Hypertension(2.87, 1.30–6.32), type 2 diabetes(T2 DM)(3.57, 2.32–5.49),cardiovascular disease(CVD)(3.78, 1.81–7.89), fatty liver disease(7.53, 1.96–28.96), hyperlipidemia(2.15, 1.26–3.67), other lung diseases(6.00, 3.01–11.96), and electrolyte imbalance(10.40, 3.00–26.10)were independently linked to increased odds of being severely ill. T2 DM(6.07, 2.89–12.75), CVD(8.47,6.03–11.89), and electrolyte imbalance(19.44, 11.47–32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission(5.46,3.25–9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes(6.58, 1.46–29.64) within two weeks.Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
基金co-supported by the National Natural Science Foundation of China (No. 81773521)CAMS Innovation Fund for Medical Sciences (No. 2017-I2M-1006, No. 2016-12M-2-004)+4 种基金the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (No. 2018RC330001)the National Key Projects of Research and Development of China (No. 2018 YFC1315000)China Scholarship Council (No. 201908110180)the Sanming Project of Medicine in Shenzhen (No. SZSM201911015)the Cancer Screening Program in Urban China funded by National Health Commission of People’s Republic of China
文摘Objective: Colorectal cancer(CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expenditures and the time trends for CRC diagnosis and treatment in China.Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 13 provinces across China. For each eligible CRC patient diagnosed from 2002 to 2011, clinical information and expenditure data were extracted using a uniform questionnaire. All expenditure data were reported in Chinese Yuan(CNY)using 2011 values.Results: Of the 14,536 CRC patients included, the average age at diagnosis was 58.2 years and 15.8% were stageI cases. The average medical expenditure per patient was estimated at 37,902 CNY [95 % confidence interval(95%CI): 37,282-38,522], and the annual average increase rate was 9.2% from 2002 to 2011(P for trend <0.001), with a cumulative increase of 2.4 times(from 23,275 CNY to 56,010 CNY). The expenditure per patient in stages Ⅰ, Ⅱ, Ⅲ and Ⅳ were 31,698 CNY, 37,067 CNY, 38,918 CNY and 42,614 CNY, respectively(P<0.001). Expenditure significantly differed within various subgroups. Expenses for drugs contributed the largest proportion(52.6%).Conclusions: These conservative estimates illustrated that medical expenditures for CRC diagnosis and treatment in tertiary hospitals in China were substantial and increased rapidly over the 10 years, with drugs continually being the main expense by 2011. Relatively, medical expenditures are lower for CRC in the earlier stages. These findings will facilitate the economic evaluation of CRC prevention and control in China.
基金Supported by Shandong Provincial Key Research and Development Program,No.2018CXGC1219City of Weihai Technique Extension Project,No.2016GNS023+1 种基金TaiShan Scholars Program of Shandong Province,No.tshw20120206TaiShan Industrial Experts Program,No.tscy20190612.
文摘In this review,we summarize the recent microbiome studies related to diabetes disease and discuss the key findings that show the early emerging potential causal roles for diabetes.On a global scale,diabetes causes a significant negative impact to the health status of human populations.This review covers type 1 diabetes and type 2 diabetes.We examine promising studies which lead to a better understanding of the potential mechanism of microbiota in diabetes diseases.It appears that the human oral and gut microbiota are deeply interdigitated with diabetes.It is that simple.Recent studies of the human microbiome are capturing the attention of scientists and healthcare practitioners worldwide by focusing on the interplay of gut microbiome and diabetes.These studies focus on the role and the potential impact of intestinal microflora in diabetes.We paint a clear picture of how strongly microbes are linked and associated,both positively and negatively,with the fundamental and essential parts of diabetes in humans.The microflora seems to have an endless capacity to impact and transform diabetes.We conclude that there is clear and growing evidence of a close relationship between the microbiota and diabetes and this is worthy of future investments and research efforts.
文摘BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy viaendoscopic observation is subject to sampling error and interobserver variability.The Kimura-Takemoto classification system was developed to overcome theselimitations.AIMTo compare the morphological classification of atrophic gastritis between theKimura-Takemoto system and the Updated Sydney system.METHODSA total of 169 patients with atrophic gastritis were selected according to diagnosisby the visual endoscopic Kimura-Takemoto method. Following the UpdatedKimura-Takemoto classification system, one antrum biopsy and five gastriccorpus biopsies were taken according to the visual stages of the Kimura-Takemoto system. The Updated Kimura-Takemoto classification system was thenapplied to each and showed 165 to have histological mucosal atrophy;theremaining 4 patients had no histological evidence of atrophy in any biopsy. The Updated Kimura-Takemoto classification was verified as a referencemorphological method and applied for the diagnosis of atrophic gastritis. Addingone more biopsy from the antrum to the six biopsies according to the Updated Kimura-Takemoto classification, constitutes the updated combined Kimura-Takemoto classification and Sydney system.RESULTSThe sensitivity for degree of mucosal atrophy assessed by the Updated Sydneysystem was 25% for mild, 36% for moderate, and 42% for severe, when comparedwith the Updated Kimura-Takemoto classification of atrophic gastritis formorphological diagnosis. Four types of multifocal atrophic gastritis wereidentified: sequential uniform (type 1;in 28%), sequential non-uniform (type 2;in7%), diffuse uniform (type 3;in 23%), diffuse non-uniform (type 4;in 24%), and"alternating atrophic – non-atrophic" (type 5;in 18%). The pattern of the spread ofatrophy, sequentially from the antrum to the cardiac segment of the stomach,which was described by the Updated Kimura-Takemoto system, washistologically confirmed in 82% of cases evaluated.CONCLUSIONThe Updated Sydney system is significantly
文摘Importance: Morbidity and mortality of children are important indicators of the performance of the public health system in any country. In China, the children's disease spectrum has gradually changed in recent years. However, the gender- and age-specific disease spectrum for hospitalized children under 15 years old is still unclear. Objective: To explore the gender- and age-based distribution of diseases in hospitalized children under 15 years in China. Methods: Medical records home page data for 2016 to 2018 were collected from 18 tertiary children's hospitals in China. The gender- and age-specific disease spectrum was analyzed, using the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Results: The most common diseases were those of the respiratory system (25.7% of all 2232142 hospitalized children). The top three diseases for boys were diseases of the respiratory system (25.6%), diseases of the digestive system (11.4%) and certain conditions originating in the perinatal period (8.6%). The top three diseases for girls were diseases of the respiratory system (25.9%), certain conditions originating in the perinatal period (10.1%), and factors influencing health status and contact with health services (9.4%).The most common diseases for children under 1 year old were certain conditions originating in the perinatal period (38.1%). For all other age groups, the most common conditions were respiratory diseases (33.8% for those aged 1–3 years, 25.2% for those aged 4–6 years, and 12.2% for those aged 7–14 years). Interpretation: This study analyzed the medical records home pages of 18 children's hospitals to provide the first overview of the disease spectrum and its gender- and age-specific distribution among children in China.
基金This research was supported in part by the Japan Agency for Medical Research and Development(AMED)(JP15ck0106096 to TK)Japan Science and Tech-nology Agency(JST)Core Research for Evolutionary Science and Technology(JPMJCR1689 to RH)+5 种基金Artifi-cial Intelligence,Big Data,IoT,Cyber Security Integration Project of the Public/Private R&D Investment Strategic Expansion Program(JPMJCR18Y4 to RH)the Japan Soci-ety for the Promotion of Science(JSPS)Grant-in-Aid for Scientific Research(S)(17H06162 to HN),Grant-in-Aid for Scientific Research(B)(20H03695 to KS),Grants-in-Aid for the Tailor-Made Medical Treatment Program(BioBank Japan Project)from the Japanese Ministry of Education,Culture,Sports,ScienceandTechnology(MEXT),Princess Takamatsu Cancer Research Fund,and National Cancer Center Research and Development Fund(NCC Biobank and NCC Core Facility).The J-MICC study was supported by Grants-in-Aid for Scientific Research for Priority Areas of Cancer(No.17015018 to KW)Innovative Areas(No.221S0001 to KW)from MEXTby JSPS Grant-in-Aid for Scientific Research Grant(No.16H06277[CoBiA])The JPHC Study was supported by National Cancer Center Research and Development Fund since 2011(latest grant number:2020-J4)and a Grant-in-Aid for Cancer Research from the Ministry of Health,Labor and Welfare of Japan(1989-2010).ToMMoissupportedinpartbyMEXT-JSTand AMED(most recent grant numbers:JP20km0105001 and JP20km0105002)Iwate Tohoku Medical Megabank Orga-nization(Iwate Medical University)is supported in part by MEXT-JST and AMED(most recent grant numbers:JP20km0105003 and JP20km0105004).
文摘Dear editor,Lung carcinoma is responsible for the highest fatal-ity rate among cancer-related deaths globally,with lung adenocarcinoma(LADC)emerging as the prevailing sub-type.
基金the National Natural Science Foundation of China(81520108016,81661148045,and 31471084 to Yu-Feng Zang81671774 and 81630031 to Chao-Gan Yan+11 种基金81571228 to Tao Wu61571047 to Xia Wu81701664 to Jian Wang,81471654 to Biao Huang81701671 to Wei-Guo Liu82001898 to Xi-Ze Jia81771820,81371519 and 81571654 to Wei Luo)Henry G Leong Endowed Professorship in Neurology to Shu-Leong Ho and Shirley YY Pang,BRC for Mental Health at South London and Maudsley NHS Foundation Trust and by the Sackler Institute to Grainne McAlonan,NIH(2R01AG006457 to Fay B.Horak1RC4NS073008-01 and P50NS062684 to Tara Madhyastha)NINDS Intramural Research Program to Mark HallettStart-up Funds for Leading Talents at Beijing Normal UniversityNational Basic Science Data Center‘‘Chinese Data-sharing Warehouse for In-vivo Imaging Brain”(NBSDC-DB-15)to Xi-Nian ZuoGrant NU20-04-00294 of the Agency for Health Research,Czech Republic to Lenka Krajcovicova and Irena Rektorova。
文摘Thousands of resting state functional magnetic resonance imaging(RS-f MRI)articles have been published on brain disorders.For precise localization of abnormal brain activity,a voxel-level comparison is needed.Because of the large number of voxels in the brain,multiple comparison correction(MCC)must be performed to reduce false positive rates,and a smaller P value(usually including either liberal or stringent MCC)is widely recommended[1].
基金supported by the National Health and Family Plan Commission of P. R. China
文摘Background: Esophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions. The medical expenditure for the diagnosis and treatment of esophageal cancer in China has not been fully quantified. This study aimed to examine the medical expenditure of Chinese patients with esophageal cancer and the associated trends.Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 37 hospitals in 13 provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. For each esophageal cancer patient diagnosed between 2002 and 2011, clinical information and expense data were extracted by using structured questionnaires. All expense data were reported in Chinese Yuan(CNY; 1 CNY = 0.155 USD) based on the2011 value and inflated using the year-specific health care consumer price index for China.Results: A total of 14,967 esophageal cancer patients were included in the analysis. It was estimated that the overall average expenditure per patient was 38,666 CNY, and an average annual increase of 6.27% was observed from 2002(25,111 CNY) to 2011(46,124 CNY). The average expenditures were 34,460 CNY for stage Ⅰ,39,302 CNY for stage Ⅱ,40,353 CNY for stage Ⅲ, and 37,432 CNY for stage IV diseases(P < 0.01). The expenditure also differed by the therapy type, which was 38,492 CNY for surgery, 27,933 CNY for radiotherapy, and 27,805 CNY for chemotherapy(P < 0.05).Drugs contributed to 45.02% of the overall expenditure.Conclusions: These conservative estimates suggested that medical expenditures for esophageal cancer in China substantially increased in the last 10 years, treatment for early-stage esophageal cancer costs less than that for advanced cases, and spending on drugs continued to account for a considerable proportion of the overall expenditure.
基金funded by"Agencia Canaria de Inves-tigación,Innovación y Sociedad de la Información(ACIISI)del Gobierno de Canarias"(No.ProID2020010134),óCaja Canarias(Project No.2019SP43).
文摘Cancer is an abnormal state of cells where they undergo uncontrolled proliferation and produce aggressive malignancies that causes millions of deaths every year.With the new understanding of the molecular mechanism(s)of disease progression,our knowledge about the disease is snowballing,leading to the evolution of many new therapeutic regimes and their successive trials.In the past few decades,various combinations of therapies have been pro-posed and are presently employed in the treatment of diverse cancers.Targeted drug therapy,immunotherapy,and personalized medicines are now largely being employed,which were not common a few years back.The field of cancer discoveries and therapeutics are evolving fast as cancer type-specific biomarkers are progressively being identified and several types of cancers are nowadays undergoing systematic therapies,extending patients’disease-free survival thereafter.Although growing evidence shows that a systematic and targeted approach could be the future of cancer medicine,chemotherapy remains a largely opted therapeutic option despite its known side effects on the patient’s physical and psychological health.Chemother-apeutic agents/pharmaceuticals served a great purpose over the past few decades and have remained the frontline choice for advanced-stage malignancies where surgery and/or radiation therapy cannot be prescribed due to specific reasons.The present report succinctly reviews the existing and contemporary advancements in chemotherapy and assesses the status of the enrolled drugs/pharmaceuticals;it also comprehensively discusses the emerging role of specific/targeted therapeutic strategies that are presently being employed to achieve better clinical success/survival rate in cancer patients.
