Background: To estimate incubation period in patients infected with hepatitis C virus (HCV) and to predict patients’ risk of developing hepatocellular carcinoma (HCC) for indicating health policymaking. Methods: An o...Background: To estimate incubation period in patients infected with hepatitis C virus (HCV) and to predict patients’ risk of developing hepatocellular carcinoma (HCC) for indicating health policymaking. Methods: An outbreak of HCV infection from a clinic was occurred due to the injection treatment of varicose veins called minimally invasive thrombolysis and meridian activating therapy (MITMT) in a county-level city of China. Conventional method and bootstrapping approach were used to estimate HCV incubation period. Risk assessment model generated from the previous study was applied to predict the risk of developing HCC in the coming 5-, 10-, and 15-year for HCV infected patients from the above outbreak. Results: A total of 120 subjects were underwent MITMT between October 22, 2012 and January 28, 2013;of those, 99 subjects were diagnosed with HCV infection. Mean age of the subjects was 54.42 years old, and females were accounted for 51.5% in contracted subjects. Mean incubation period of hepatitis C (HC) was 45.76 days using first MITMT as infected date and 30.68 days using bootstrapping approach, their standard deviations were 23.01 and 15.05 days, respectively. A total of 1.3, 4.7, and 10.6 persons will be developed into HCC in the coming 5, 10, and 15 years in infected subjects based on a risk prediction model. Conclusion: Some patients with HCV infection from a nosocomial clinic in a county-level city will be suffered from more severe HCC in the coming decade;effective measures and controls were urgently needed to manage these patients with high risk of developing into end-stage liver disease.展开更多
Objective： To investigate the existence of pericryptal fibroblasts sheath （PCFS） in normal gastric mucosa, intestinal metaplasia （IM）, indefinite for dysplasia （I-Dys）, low grade dysplasia （L-Dys）, high grade...Objective： To investigate the existence of pericryptal fibroblasts sheath （PCFS） in normal gastric mucosa, intestinal metaplasia （IM）, indefinite for dysplasia （I-Dys）, low grade dysplasia （L-Dys）, high grade dysplasia （H-Dys） and gastric cancer （GC）, and its association with gastric carcinogenesis. Methods： In this study, we examined the existence of PCFS in normal gastric mucosa （N=10）, IM （N=26）, I-Dys （N=16）, L-Dys （N=13）, H-Dys （N=21） and GC （N=145） using immunohistochemical staining for two smooth muscle markers, alpha smooth muscle actin（α-SMA） and high molecular weight caldesmon （h-CD）. The significance of PCFS was discussed, especially in association with gastric carcinogenesis. Results： The PCFS was recognized in 65.4%（17/26） of IM, 62.5%（10/16） of I-Dys and 23.1% （3/13） of L-Dys respectively. No PCFS was detected in H-Dys and GC. The PCFS was gradually reduced in IM, Dys and GC in sequence （P〈0.0001）. Conclusion： The PCFS is associated with the differentiation of epithelium and involved in gastric carcinogenesis via epithelial-mesenchymal interaction.展开更多
Statistical analysis is critical in medical research.The objective of this article is to summarize the appropriate use and reporting of commonly used statistical methods in medical research,on the basis of existing st...Statistical analysis is critical in medical research.The objective of this article is to summarize the appropriate use and reporting of commonly used statistical methods in medical research,on the basis of existing statistical guidelines and the authors’experience in reviewing manuscripts,to provide recommendations for statistical applications and reporting.展开更多
Background:The stage at diagnosis is a major factor in making treatment strategies and cancer control policies.However,the stage distribution for liver cancer in China was not well studied.In this multi-center hospita...Background:The stage at diagnosis is a major factor in making treatment strategies and cancer control policies.However,the stage distribution for liver cancer in China was not well studied.In this multi-center hospital-based study,we aimed to identify the distribution and factors associated with stage at diagnosis for liver cancer in China.Methods:We included patients diagnosed with primary liver cancer in 13 hospitals of 10 provinces covering various geographic and socioeconomic populations during 2016-2017 in China.The stage distribution overall,and by sex and age at diagnosis were analyzed.We used logistic regression to identify the factors associated with stage Ⅲ-Ⅳ disease.We further compared these estimates with data from the USA.Results:We included 2,991 patients with known stage at diagnosis in China.The proportion of patients diagnosed with stageⅠ,Ⅱ,Ⅲ,and Ⅳ was 17.5%,25.6%,29.3%,and 27.6%,respectively.The proportion of stage Ⅲ-Ⅳ cases was higher in women[65.1%vs 54.9%,adjusted odds ratio(OR)=1.5,95%CI:1.2,1.8]and those≥60 years(61.6%vs 52.8%,OR=1.4,95%CI:1.2,1.6).We found an increased risk of stage Ⅲ-Ⅳ among drinkers and those without a family history of cancer.Compared to the USA,our study population had a substantially higher proportion of stage Ⅲ-Ⅳ cases(56.9%vs 45.6%).Conclusion:The disparities in liver cancer stage at diagnosis among different populations within China,and between China and the USA,imply the necessity for improving cancer awareness and early detection for liver cancer in China.展开更多
Background:This study aimed to provide a detailed analysis of the temporal trends of cancer incidence rates for individuals aged 0-19 years in selected regions globally from 1978 to 2012.Methods:Data were obtained fro...Background:This study aimed to provide a detailed analysis of the temporal trends of cancer incidence rates for individuals aged 0-19 years in selected regions globally from 1978 to 2012.Methods:Data were obtained from Volumes V-XI of Cancer Incidence in Five Continents(CI5),published by the International Agency for Research on Cancer.A total of 53 registries in 23 regions from the Americas,Asia,Europe,and Oceania that contained information on cancer incidence throughout 1978-2012(35 years)were included in this study.Joinpoint regression was used for the analysis of trends.Results:Most regions showed increasing trends in overall childhood cancer among children(aged 0-14 years)and adolescents(aged 15-19 years).Nearly all regions showed rising trends in childhood and adolescent leukemia incidence rates,whereas the incidence of lymphoma among children generally decreased.Only France,Australia,and New Zealand showed decreasing trends for malignant central nervous system(CNS)tumors among adoles-cents.Kidney cancer and bone cancer incidence rates remained stable for most regions.The incidence of thyroid cancer among adolescents increased in most regions and that of testicular cancer decreased in approximately one-half of the regions studied.Conclusion:The international temporal trends of cancer incidents among children and adolescents are varied by region,cancer type,age group,and gender,and have changed over time.展开更多
Objective:Cardiovascular disease(CVD)is one of the leading causes of death worldwide,and answers are urgently needed regarding many aspects,particularly risk identification and prognosis prediction.Real-world studies ...Objective:Cardiovascular disease(CVD)is one of the leading causes of death worldwide,and answers are urgently needed regarding many aspects,particularly risk identification and prognosis prediction.Real-world studies with large numbers of observations provide an important basis for CVD research but are constrained by high dimensionality,and missing or unstructured data.Machine learning(ML)methods,including a variety of supervised and unsupervised algorithms,are useful for data governance,and are effective for high dimensional data analysis and imputation in real-world studies.This article reviews the theory,strengths and limitations,and applications of several commonly used ML methods in the CVD field,to provide a reference for further application.Methods:This article introduces the origin,purpose,theory,advantages and limitations,and applications of multiple commonly used ML algorithms,including hierarchical and k-means clustering,principal component analysis,random forest,support vector machine,and neural networks.An example uses a random forest on the Systolic Blood Pressure Intervention Trial(SPRINT)data to demonstrate the process and main results of ML application in CVD.Conclusion:ML methods are effective tools for producing real-world evidence to support clinical decisions and meet clinical needs.This review explains the principles of multiple ML methods in plain language,to provide a reference for further application.Future research is warranted to develop accurate ensemble learning methods for wide application in the medical field.展开更多
Epstein-Barr virus(EBV)is very common,with the infection rate in adults over 90%worldwide.Infectious mononucleosis(IM)is caused by primary infection with EBV.Most IM patients are generally considered to have a favorab...Epstein-Barr virus(EBV)is very common,with the infection rate in adults over 90%worldwide.Infectious mononucleosis(IM)is caused by primary infection with EBV.Most IM patients are generally considered to have a favorable prognosis,but a few patients will also develop complications.Children with severe symptoms will require hospitalization.However,the disease burden of children hospitalized with IM in China has been rarely described.In this study,we included the Face sheets of discharge medical records from 27 member children's hospitals of Futang Research Center of Pediatric Development from Jan 1st,2016 to Dec 31st,2020,and medical information such as gender,age,region,time of admission,length of stay and expenditure were extracted.There were 24,120 IM cases,which accounted for 0.42%(24,120/5,693,262)of all hospitalized cases during this period.The ratio of male to female was 1.48:1.Hospitalization for IM in the 4-6 years age group was the highest among inpatients of all age groups.Case numbers increased year by year between 2016 and 2020,and the monthly hospitalization was generally high from Jul to Sep but reduced from Jan to Feb per year.Bronchitis/pneumonia and hepatic dysfunction were two common complications in hospitalized IM patients.The median length of stay was 8 days,and the median cost of hospitalization was 970.59 US dollars.This study will help understand the epidemiological characteristics and disease burden of hospitalized children with IM in China.展开更多
Introduction Futang Research Center of Pediatric Development(FRCPD),the first nonprofit social service organization engaging in pediatric research in China,was founded in May 2013.Until August 2021,FRCPD has 40 tertia...Introduction Futang Research Center of Pediatric Development(FRCPD),the first nonprofit social service organization engaging in pediatric research in China,was founded in May 2013.Until August 2021,FRCPD has 40 tertiary children’s hospitals,accounting for about 65.6%of all national public children’s hospitals,which was reported to be 61 in China Health Statistical Yearbook(2020).The hospitals are distributed in 30 provinces,autonomous regions,and municipalities(except for Tibet autonomous region),and most of them are in the capital of the province,forming a broad frontline representing the best quality of health care for the diagnosis and treatment of children’s disease in China.Based on the idea of sharing,FRCPD realized the exchange of experts,medical resources,research findings,educational events,preventive strategies,and management experiences among members.In the long run,FRCPD aims to continuously promote the quality of healthcare and medical service capability for children in China.展开更多
To the Editor:It is difficult to capture the exact time of initiation of puberty in normal children,such as when breasts in girls and testicles in boys begin to grow,especially in boys.As a result,research on the deta...To the Editor:It is difficult to capture the exact time of initiation of puberty in normal children,such as when breasts in girls and testicles in boys begin to grow,especially in boys.As a result,research on the detailed patterns of physical development during puberty and the cut-off values and changes of hormones at the initiation of puberty and developmental maturation is rare.It is generally believed that hormonal changes during puberty are a direct result of the stimulating effect of luteinizing hormone(LH)on initiation of puberty;[1]thus,LH is widely accepted as an indicator to evaluate initiation of puberty.However,researchers have not yet reached an agreement on the cut-off value of LH,especially in boys.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
Importance:The incidence of obstructive sleep apnea syndrome(OSAS)in children has increased year by year recently.Blood pressure research of OSAS children can help understand the occurrence of OSAS related complicatio...Importance:The incidence of obstructive sleep apnea syndrome(OSAS)in children has increased year by year recently.Blood pressure research of OSAS children can help understand the occurrence of OSAS related complications.Early detection and intervention of blood pressure changes in children with OSAS can reduce the incidence of cardiovascular disease in later adulthood.Objective:To investigate the differences in blood pressure among different groups of snoring children and different sleep stages.Methods:Habitually snoring children(snoring frequency of≥3 nights per week)aged3 to 11 years were recruited from Beijing Children's Hospital from 1 January 2017 to 30 June 2018.All children underwent polysomnography,and their blood pressure was monitored and calculated by the pulse transit time.The children were divided into those with primary snoring(PS),mild OSAS,and moderate to severe OSAS according to their obstructive apnea-hypopnea index(OAHI).Results:In total,140 children were included.Ninety-seven had PS,24 had mild OSAS,and 19 had moderate to severe OSAS.There were no differences in age,sex,or body mass index z-score among the groups.Statistieally significant differences were found in the OAHI,oxygen desaturation index 3%,respiratory arousal index,and lowest oxygen saturation among the three groups.Children with moderate to severe OSAS had higher systolic and diastolic blood pressure than those with mild OSAS andPS(P<0.001).In all children,systolic and diastolic blood pressure was higher in the rapid eye movement(REM)sleep stage than in the non-REM sleep stage(P<0.05).Interpretation:Children with moderate to severe OSAS had higher blood pressure than those with PS and mild OSAS in all sleep stages.Blood pressure in the REM sleep stage was higher than that in other sleep stages in all groups of children.展开更多
Importance:As the most common subtype of pediatric rhabdomyosarcoma(RMS),the prognosis of embryonal RMS has rarely been investigated solely.Objective:To perform a population-based study to characterize the prognosis o...Importance:As the most common subtype of pediatric rhabdomyosarcoma(RMS),the prognosis of embryonal RMS has rarely been investigated solely.Objective:To perform a population-based study to characterize the prognosis of embryonal RMS in children and adolescents.Methods:Demographic and clinical features were retrospectively evaluated in selected patients with embryonal RMS registered in the Surveillance,Epidemiology,and End Results(SEER)program from 1988 to 2016.Survival curves were compared using the log-rank test.A multivariate Cox proportional hazards model was developed to assess the impact of each factor on the overall survival.A nomogram was constructed based on the results of Cox regression model.Results:A total of 464 patients were included in the analysis,among which 64.6%were male and 70.2%were white patients.About 38.6%and 26.3%of the patients were at 1-4 years and 5-9 years,respectively.Cox analysis showed that patients at age group 5-9 years had the lowest risk of mortality(hazard ratio[HR],0.277;95%confidential interval[CI],0.123-0.620),compared with patients diagnosed at less than 1-year-old,and age group 1-4 years had the second-best prognosis.Patients having distant tumors had significantly higher mortality risk(HR,4.842;95%CI,2.804-8.362)than the patients with localized tumor.Compared with receiving no surgery or radiotherapy,receiving any combination of surgery and radiotherapy would lower the risk of mortality significantly(for surgery without radiotherapy:HR,0.418;for radiotherapy without surgery:HR,0.405;and for surgery plus radiotherapy:HR,0.410).Interpretation:Age,stage at diagnosis,and treatment received were found to be the most important predictors of the overall survival of pediatric embryonal RMS.展开更多
Background In recent years,increasing numbers of families have been affected by childhood cancer.According to data from the International Agency for Research on Cancer(IARC)of the World Health Organization,approximate...Background In recent years,increasing numbers of families have been affected by childhood cancer.According to data from the International Agency for Research on Cancer(IARC)of the World Health Organization,approximately 279000 new cases of cancer were predicted in children and adolescents aged 0–19 years worldwide in 2020.The global incidence of childhood cancer is 10.9 per 100000(global standard rate)and the mortality rate is 4.2 per 100000.1 According to data from the China National Cancer Center,the incidences of cancer in 2017 were 9.9 per 100000 in children aged 0–14 years and 11.5 per 100000 in adolescents aged 15–19 years.2 There are estimated to be approximately 22000 new cases of childhood cancer in China each year,and the incidence of malignant tumors in children aged 0–14 years has increased by 2.5%annually in the past decade.展开更多
Individualized controlled ovarian stimulation(COS)is a milestone for treatment of infertility.^(1)The two acknowledged time points for individualized ovarian stim-ulation are,one,the beginning of each new treatment cy...Individualized controlled ovarian stimulation(COS)is a milestone for treatment of infertility.^(1)The two acknowledged time points for individualized ovarian stim-ulation are,one,the beginning of each new treatment cycle when the starting dose is selected and,two,during a given COS cycle when dose adjustment is performed.A few algorithms for directing the follicle-stimulating hormone(FSH)dose have been developed.The number of oocytes retrieved(NOR)during ovarian stimulation was used as the outcome variable,and then the outcome variable and independent variables are stratified and a dose suggested by considering their experience.展开更多
Besides upper tract urothelial cell carcinoma(UTUCs),a recent study published in Science Translational Medicine has indicated that liver cancer may be associated with the exposure of aristolochic acids and similar der...Besides upper tract urothelial cell carcinoma(UTUCs),a recent study published in Science Translational Medicine has indicated that liver cancer may be associated with the exposure of aristolochic acids and similar derivatives(collectively,AA).However,according to our research,this study needs more number of samples for further verification which should be sampled from a wider range of people.展开更多
Ovarian reserve is the quantity of primordial follicles present in the ovarian cortex that have the potential to mature into healthy oocytes.A high ovarian reserve typically results in a high chance of a successful pr...Ovarian reserve is the quantity of primordial follicles present in the ovarian cortex that have the potential to mature into healthy oocytes.A high ovarian reserve typically results in a high chance of a successful pregnancy for couples.Fertility declines as women age because of changes in the ovarian reserve,and this decline is called ovarian aging.Diminished ovarian reserve(DOR)can impact fertility regardless of chronological age and can lead to embryonic aneuploidy,fertilization failure,and high pregnancy loss rates.Therefore,it is important to consider ovarian reserve when evaluating the potential effect of aging on fertility,rather than relying solely on chronological age.Many women are unaware of the heterogeneity in ovarian reserve and ovarian aging.Whereas irregular cycles and menopause are easily identifiable,these signs often indicate extremely low fertility,leaving limited available interventions.展开更多
Dear Editor,Polycystic ovary syndrome(PCOS)affects more than 1 in 10 women worldwide.^(1)Despite its high prevalence,PCOS and its accompanying morbidities are likely underdiagnosed.^(2)To induce a PCOS-like phenotype ...Dear Editor,Polycystic ovary syndrome(PCOS)affects more than 1 in 10 women worldwide.^(1)Despite its high prevalence,PCOS and its accompanying morbidities are likely underdiagnosed.^(2)To induce a PCOS-like phenotype in animals,testosterone and dihydrotestosterone are usually used,indicating that androgen excess is a major contributor to PCOS.^(3)Anti-M€ullerian hormone(AMH)is an upstream regulator of androgen and is well correlated with the androgens.展开更多
Importance:Adenovirus encephalitis is a significant infectious disease of the central nervous system that commonly affects children under the age of 5 and has a profound impact on the health of infants and young child...Importance:Adenovirus encephalitis is a significant infectious disease of the central nervous system that commonly affects children under the age of 5 and has a profound impact on the health of infants and young children throughout China.National multicenter epidemiological studies have significant public health implications.Objective:This study aims to report the epidemiology of adenovirus encephalitis in hospitalized children in China,providing valuable guidance for clinicians.Methods:The data utilized in this study were extracted from the comprehensive Futang Update Medical Records database,which comprises discharge medical records collected by 27 tertiary children’s hospitals between January 2016 and December 2018 in China.Specifically,the face sheet of discharge medical records encompassed critical sociodemographic variables and basic medical care details.Results:In this database,a total of 544 children were hospitalized due to adenoviral encephalitis.The male-to-female ratio was 1.62:1,with more boys being affected across different age groups and places of residence.Of the children hospitalized,the highest number of hospitalizations occurred in the 1–3-year age group and the number of hospitalizations decreased each year from 2016 to 2018.The disease exhibits seasonal characteristics with a pronounced peak in the summer months of June and July.While most children(58%)did not have any significant complications,one-third of them developed respiratory complications,including pneumonia and acute bronchitis.The median length of stay for adenoviral encephalitis was 7 days,and the median cost of hospitalization was 2145.56 US dollars.Interpretation:This study highlights the prevalence of adenovirus encephalitis in hospitalized children in China.Children aged 1–3 years were found to be the main demographic hospitalized due to this condition,with boys being significantly more affected than girls.The seasonal variations of adenovirus encephalitis were also found to be significant.Fortunately,the fatality rate associated with this condition was low,and the prognosis was generally favorable.展开更多
To the Editor:Incidence of type 1 diabetes(T1D)in young children has been increasing over time in China.[1]There are challenges in achieving metabolic control without leading to severe hypoglycemia or adverse effect o...To the Editor:Incidence of type 1 diabetes(T1D)in young children has been increasing over time in China.[1]There are challenges in achieving metabolic control without leading to severe hypoglycemia or adverse effect on the quality of life in toddlers,as they showed marked sensitivity to insulin and higher variability in insulin requirements.展开更多
What is already known on this topic?The incidence of diabetes is on the rise in the world,and it is increasingly affecting young people.The American Diabetes Association(ADA)has published the 2020 Diabetes Medical Sta...What is already known on this topic?The incidence of diabetes is on the rise in the world,and it is increasingly affecting young people.The American Diabetes Association(ADA)has published the 2020 Diabetes Medical Standard,but there is no blood glucose standard for teenagers by age and sex.What is added by this report?In this study,quantile regression was used to analyze the data of National Health and Nutrition Examination Survey(NHANES)and found that blood glucose varied significantly based on demographics.What are the implications for public health practice?This study provides reference for formulating the normal ranges of adolescent blood glucose and helping to screen out high-risk groups at an early stage for key interventions.The quantile regression method can give a set of curves,which could better describe the situation.展开更多
文摘Background: To estimate incubation period in patients infected with hepatitis C virus (HCV) and to predict patients’ risk of developing hepatocellular carcinoma (HCC) for indicating health policymaking. Methods: An outbreak of HCV infection from a clinic was occurred due to the injection treatment of varicose veins called minimally invasive thrombolysis and meridian activating therapy (MITMT) in a county-level city of China. Conventional method and bootstrapping approach were used to estimate HCV incubation period. Risk assessment model generated from the previous study was applied to predict the risk of developing HCC in the coming 5-, 10-, and 15-year for HCV infected patients from the above outbreak. Results: A total of 120 subjects were underwent MITMT between October 22, 2012 and January 28, 2013;of those, 99 subjects were diagnosed with HCV infection. Mean age of the subjects was 54.42 years old, and females were accounted for 51.5% in contracted subjects. Mean incubation period of hepatitis C (HC) was 45.76 days using first MITMT as infected date and 30.68 days using bootstrapping approach, their standard deviations were 23.01 and 15.05 days, respectively. A total of 1.3, 4.7, and 10.6 persons will be developed into HCC in the coming 5, 10, and 15 years in infected subjects based on a risk prediction model. Conclusion: Some patients with HCV infection from a nosocomial clinic in a county-level city will be suffered from more severe HCC in the coming decade;effective measures and controls were urgently needed to manage these patients with high risk of developing into end-stage liver disease.
基金supported in part by the grants from Beijing Municipal Science & Technology commission NOVA program (No.2005B-44)the National"863"High-Tech Res & Dev program of China(No.2006AA02A402)the Major State Basic Research Program of china(No.2004CB518702)
文摘Objective： To investigate the existence of pericryptal fibroblasts sheath （PCFS） in normal gastric mucosa, intestinal metaplasia （IM）, indefinite for dysplasia （I-Dys）, low grade dysplasia （L-Dys）, high grade dysplasia （H-Dys） and gastric cancer （GC）, and its association with gastric carcinogenesis. Methods： In this study, we examined the existence of PCFS in normal gastric mucosa （N=10）, IM （N=26）, I-Dys （N=16）, L-Dys （N=13）, H-Dys （N=21） and GC （N=145） using immunohistochemical staining for two smooth muscle markers, alpha smooth muscle actin（α-SMA） and high molecular weight caldesmon （h-CD）. The significance of PCFS was discussed, especially in association with gastric carcinogenesis. Results： The PCFS was recognized in 65.4%（17/26） of IM, 62.5%（10/16） of I-Dys and 23.1% （3/13） of L-Dys respectively. No PCFS was detected in H-Dys and GC. The PCFS was gradually reduced in IM, Dys and GC in sequence （P〈0.0001）. Conclusion： The PCFS is associated with the differentiation of epithelium and involved in gastric carcinogenesis via epithelial-mesenchymal interaction.
文摘Statistical analysis is critical in medical research.The objective of this article is to summarize the appropriate use and reporting of commonly used statistical methods in medical research,on the basis of existing statistical guidelines and the authors’experience in reviewing manuscripts,to provide recommendations for statistical applications and reporting.
基金supported by the National Key R&D Program of China(grant numbers:2022YFC3600805,2016YFC1302502).
文摘Background:The stage at diagnosis is a major factor in making treatment strategies and cancer control policies.However,the stage distribution for liver cancer in China was not well studied.In this multi-center hospital-based study,we aimed to identify the distribution and factors associated with stage at diagnosis for liver cancer in China.Methods:We included patients diagnosed with primary liver cancer in 13 hospitals of 10 provinces covering various geographic and socioeconomic populations during 2016-2017 in China.The stage distribution overall,and by sex and age at diagnosis were analyzed.We used logistic regression to identify the factors associated with stage Ⅲ-Ⅳ disease.We further compared these estimates with data from the USA.Results:We included 2,991 patients with known stage at diagnosis in China.The proportion of patients diagnosed with stageⅠ,Ⅱ,Ⅲ,and Ⅳ was 17.5%,25.6%,29.3%,and 27.6%,respectively.The proportion of stage Ⅲ-Ⅳ cases was higher in women[65.1%vs 54.9%,adjusted odds ratio(OR)=1.5,95%CI:1.2,1.8]and those≥60 years(61.6%vs 52.8%,OR=1.4,95%CI:1.2,1.6).We found an increased risk of stage Ⅲ-Ⅳ among drinkers and those without a family history of cancer.Compared to the USA,our study population had a substantially higher proportion of stage Ⅲ-Ⅳ cases(56.9%vs 45.6%).Conclusion:The disparities in liver cancer stage at diagnosis among different populations within China,and between China and the USA,imply the necessity for improving cancer awareness and early detection for liver cancer in China.
基金sponsored by the National Ma-jor Science and Technology Projects of China(2018ZX09721003).
文摘Background:This study aimed to provide a detailed analysis of the temporal trends of cancer incidence rates for individuals aged 0-19 years in selected regions globally from 1978 to 2012.Methods:Data were obtained from Volumes V-XI of Cancer Incidence in Five Continents(CI5),published by the International Agency for Research on Cancer.A total of 53 registries in 23 regions from the Americas,Asia,Europe,and Oceania that contained information on cancer incidence throughout 1978-2012(35 years)were included in this study.Joinpoint regression was used for the analysis of trends.Results:Most regions showed increasing trends in overall childhood cancer among children(aged 0-14 years)and adolescents(aged 15-19 years).Nearly all regions showed rising trends in childhood and adolescent leukemia incidence rates,whereas the incidence of lymphoma among children generally decreased.Only France,Australia,and New Zealand showed decreasing trends for malignant central nervous system(CNS)tumors among adoles-cents.Kidney cancer and bone cancer incidence rates remained stable for most regions.The incidence of thyroid cancer among adolescents increased in most regions and that of testicular cancer decreased in approximately one-half of the regions studied.Conclusion:The international temporal trends of cancer incidents among children and adolescents are varied by region,cancer type,age group,and gender,and have changed over time.
基金This study was funded by the National Natural Science Foundation of China(project No.82173620 to Y.Z.,82204156 to D.Y.)This study was also funded by the Priority Academic Program Development of Jiangsu Higher Education Institution(PAPD).
文摘Objective:Cardiovascular disease(CVD)is one of the leading causes of death worldwide,and answers are urgently needed regarding many aspects,particularly risk identification and prognosis prediction.Real-world studies with large numbers of observations provide an important basis for CVD research but are constrained by high dimensionality,and missing or unstructured data.Machine learning(ML)methods,including a variety of supervised and unsupervised algorithms,are useful for data governance,and are effective for high dimensional data analysis and imputation in real-world studies.This article reviews the theory,strengths and limitations,and applications of several commonly used ML methods in the CVD field,to provide a reference for further application.Methods:This article introduces the origin,purpose,theory,advantages and limitations,and applications of multiple commonly used ML algorithms,including hierarchical and k-means clustering,principal component analysis,random forest,support vector machine,and neural networks.An example uses a random forest on the Systolic Blood Pressure Intervention Trial(SPRINT)data to demonstrate the process and main results of ML application in CVD.Conclusion:ML methods are effective tools for producing real-world evidence to support clinical decisions and meet clinical needs.This review explains the principles of multiple ML methods in plain language,to provide a reference for further application.Future research is warranted to develop accurate ensemble learning methods for wide application in the medical field.
基金supported by the National Natural Science Foundation of China (82002130)supported by the CAMS Innovation Fund for Medical Sciences (2019-I2M-5-026)
文摘Epstein-Barr virus(EBV)is very common,with the infection rate in adults over 90%worldwide.Infectious mononucleosis(IM)is caused by primary infection with EBV.Most IM patients are generally considered to have a favorable prognosis,but a few patients will also develop complications.Children with severe symptoms will require hospitalization.However,the disease burden of children hospitalized with IM in China has been rarely described.In this study,we included the Face sheets of discharge medical records from 27 member children's hospitals of Futang Research Center of Pediatric Development from Jan 1st,2016 to Dec 31st,2020,and medical information such as gender,age,region,time of admission,length of stay and expenditure were extracted.There were 24,120 IM cases,which accounted for 0.42%(24,120/5,693,262)of all hospitalized cases during this period.The ratio of male to female was 1.48:1.Hospitalization for IM in the 4-6 years age group was the highest among inpatients of all age groups.Case numbers increased year by year between 2016 and 2020,and the monthly hospitalization was generally high from Jul to Sep but reduced from Jan to Feb per year.Bronchitis/pneumonia and hepatic dysfunction were two common complications in hospitalized IM patients.The median length of stay was 8 days,and the median cost of hospitalization was 970.59 US dollars.This study will help understand the epidemiological characteristics and disease burden of hospitalized children with IM in China.
文摘Introduction Futang Research Center of Pediatric Development(FRCPD),the first nonprofit social service organization engaging in pediatric research in China,was founded in May 2013.Until August 2021,FRCPD has 40 tertiary children’s hospitals,accounting for about 65.6%of all national public children’s hospitals,which was reported to be 61 in China Health Statistical Yearbook(2020).The hospitals are distributed in 30 provinces,autonomous regions,and municipalities(except for Tibet autonomous region),and most of them are in the capital of the province,forming a broad frontline representing the best quality of health care for the diagnosis and treatment of children’s disease in China.Based on the idea of sharing,FRCPD realized the exchange of experts,medical resources,research findings,educational events,preventive strategies,and management experiences among members.In the long run,FRCPD aims to continuously promote the quality of healthcare and medical service capability for children in China.
基金The research was supported by grants from the Beijing Municipal Science and Technology Funding(No.Z151100003915103)the Beijing Municipal Administration of Hospital Clinical Medicine Development of Special Funding Support(No.ZYLX201821)。
文摘To the Editor:It is difficult to capture the exact time of initiation of puberty in normal children,such as when breasts in girls and testicles in boys begin to grow,especially in boys.As a result,research on the detailed patterns of physical development during puberty and the cut-off values and changes of hormones at the initiation of puberty and developmental maturation is rare.It is generally believed that hormonal changes during puberty are a direct result of the stimulating effect of luteinizing hormone(LH)on initiation of puberty;[1]thus,LH is widely accepted as an indicator to evaluate initiation of puberty.However,researchers have not yet reached an agreement on the cut-off value of LH,especially in boys.
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The Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority(XTYB201807)Capital Health Research and Development of Special Funding(2018-1-2091)National Key Research and Development Plan(2017YFC0112502).
文摘Importance:The incidence of obstructive sleep apnea syndrome(OSAS)in children has increased year by year recently.Blood pressure research of OSAS children can help understand the occurrence of OSAS related complications.Early detection and intervention of blood pressure changes in children with OSAS can reduce the incidence of cardiovascular disease in later adulthood.Objective:To investigate the differences in blood pressure among different groups of snoring children and different sleep stages.Methods:Habitually snoring children(snoring frequency of≥3 nights per week)aged3 to 11 years were recruited from Beijing Children's Hospital from 1 January 2017 to 30 June 2018.All children underwent polysomnography,and their blood pressure was monitored and calculated by the pulse transit time.The children were divided into those with primary snoring(PS),mild OSAS,and moderate to severe OSAS according to their obstructive apnea-hypopnea index(OAHI).Results:In total,140 children were included.Ninety-seven had PS,24 had mild OSAS,and 19 had moderate to severe OSAS.There were no differences in age,sex,or body mass index z-score among the groups.Statistieally significant differences were found in the OAHI,oxygen desaturation index 3%,respiratory arousal index,and lowest oxygen saturation among the three groups.Children with moderate to severe OSAS had higher systolic and diastolic blood pressure than those with mild OSAS andPS(P<0.001).In all children,systolic and diastolic blood pressure was higher in the rapid eye movement(REM)sleep stage than in the non-REM sleep stage(P<0.05).Interpretation:Children with moderate to severe OSAS had higher blood pressure than those with PS and mild OSAS in all sleep stages.Blood pressure in the REM sleep stage was higher than that in other sleep stages in all groups of children.
基金Beihang University&Capital Medical University Advanced Innovation Center for Big Data-Based Precision Medicine Plan(BHME-201801)。
文摘Importance:As the most common subtype of pediatric rhabdomyosarcoma(RMS),the prognosis of embryonal RMS has rarely been investigated solely.Objective:To perform a population-based study to characterize the prognosis of embryonal RMS in children and adolescents.Methods:Demographic and clinical features were retrospectively evaluated in selected patients with embryonal RMS registered in the Surveillance,Epidemiology,and End Results(SEER)program from 1988 to 2016.Survival curves were compared using the log-rank test.A multivariate Cox proportional hazards model was developed to assess the impact of each factor on the overall survival.A nomogram was constructed based on the results of Cox regression model.Results:A total of 464 patients were included in the analysis,among which 64.6%were male and 70.2%were white patients.About 38.6%and 26.3%of the patients were at 1-4 years and 5-9 years,respectively.Cox analysis showed that patients at age group 5-9 years had the lowest risk of mortality(hazard ratio[HR],0.277;95%confidential interval[CI],0.123-0.620),compared with patients diagnosed at less than 1-year-old,and age group 1-4 years had the second-best prognosis.Patients having distant tumors had significantly higher mortality risk(HR,4.842;95%CI,2.804-8.362)than the patients with localized tumor.Compared with receiving no surgery or radiotherapy,receiving any combination of surgery and radiotherapy would lower the risk of mortality significantly(for surgery without radiotherapy:HR,0.418;for radiotherapy without surgery:HR,0.405;and for surgery plus radiotherapy:HR,0.410).Interpretation:Age,stage at diagnosis,and treatment received were found to be the most important predictors of the overall survival of pediatric embryonal RMS.
基金This research was funded by Research Platform Project of Beijing Children’s Hospital,Capital Medical University(grant number YPT202001)The author is grateful to all those who supported the National Pediatric Cancer Surveillance Work.
文摘Background In recent years,increasing numbers of families have been affected by childhood cancer.According to data from the International Agency for Research on Cancer(IARC)of the World Health Organization,approximately 279000 new cases of cancer were predicted in children and adolescents aged 0–19 years worldwide in 2020.The global incidence of childhood cancer is 10.9 per 100000(global standard rate)and the mortality rate is 4.2 per 100000.1 According to data from the China National Cancer Center,the incidences of cancer in 2017 were 9.9 per 100000 in children aged 0–14 years and 11.5 per 100000 in adolescents aged 15–19 years.2 There are estimated to be approximately 22000 new cases of childhood cancer in China each year,and the incidence of malignant tumors in children aged 0–14 years has increased by 2.5%annually in the past decade.
文摘Individualized controlled ovarian stimulation(COS)is a milestone for treatment of infertility.^(1)The two acknowledged time points for individualized ovarian stim-ulation are,one,the beginning of each new treatment cycle when the starting dose is selected and,two,during a given COS cycle when dose adjustment is performed.A few algorithms for directing the follicle-stimulating hormone(FSH)dose have been developed.The number of oocytes retrieved(NOR)during ovarian stimulation was used as the outcome variable,and then the outcome variable and independent variables are stratified and a dose suggested by considering their experience.
基金supported by National Key Research and Development Program of China(2015AA020108)National Natural Science Foundation of China(31671377,31771460)Shanghai 111Project(B14019)
文摘Besides upper tract urothelial cell carcinoma(UTUCs),a recent study published in Science Translational Medicine has indicated that liver cancer may be associated with the exposure of aristolochic acids and similar derivatives(collectively,AA).However,according to our research,this study needs more number of samples for further verification which should be sampled from a wider range of people.
基金We thank Margaret Biswas,PhD,from Liwen Bianji(Edanz)(www.liwenbianji.cn/)for editing the English text of a draft of this manuscript.
文摘Ovarian reserve is the quantity of primordial follicles present in the ovarian cortex that have the potential to mature into healthy oocytes.A high ovarian reserve typically results in a high chance of a successful pregnancy for couples.Fertility declines as women age because of changes in the ovarian reserve,and this decline is called ovarian aging.Diminished ovarian reserve(DOR)can impact fertility regardless of chronological age and can lead to embryonic aneuploidy,fertilization failure,and high pregnancy loss rates.Therefore,it is important to consider ovarian reserve when evaluating the potential effect of aging on fertility,rather than relying solely on chronological age.Many women are unaware of the heterogeneity in ovarian reserve and ovarian aging.Whereas irregular cycles and menopause are easily identifiable,these signs often indicate extremely low fertility,leaving limited available interventions.
基金supported by the National Natural Science Foundation of China for Distinguished Young Scholars(Grant No.81925013)the National Natural Science Foundation of China(Grant Nos.82172368 and 81771650)+4 种基金the Key Clinical Project of the Peking University Third Hospital(Grant No.BYSY2018022)the Innovation&Transfer Fund of Peking University Third Hospital(Grant Nos.BYSYZHZB2020102 and BYSYZHKC2021104)Major National R&D Projects of China(Grant No.2017ZX09304012012)the Capital Health Research and Development of Special Project(Grant No.2018-1-4091)the Beijing-Tianjin-Hebei Basic Research Cooperation Project(Grant No.19JCZDJC65000).
文摘Dear Editor,Polycystic ovary syndrome(PCOS)affects more than 1 in 10 women worldwide.^(1)Despite its high prevalence,PCOS and its accompanying morbidities are likely underdiagnosed.^(2)To induce a PCOS-like phenotype in animals,testosterone and dihydrotestosterone are usually used,indicating that androgen excess is a major contributor to PCOS.^(3)Anti-M€ullerian hormone(AMH)is an upstream regulator of androgen and is well correlated with the androgens.
基金CAMS Innovation Fund for Medical Sciences,Grant/Award Number:2019-I2M-5-026。
文摘Importance:Adenovirus encephalitis is a significant infectious disease of the central nervous system that commonly affects children under the age of 5 and has a profound impact on the health of infants and young children throughout China.National multicenter epidemiological studies have significant public health implications.Objective:This study aims to report the epidemiology of adenovirus encephalitis in hospitalized children in China,providing valuable guidance for clinicians.Methods:The data utilized in this study were extracted from the comprehensive Futang Update Medical Records database,which comprises discharge medical records collected by 27 tertiary children’s hospitals between January 2016 and December 2018 in China.Specifically,the face sheet of discharge medical records encompassed critical sociodemographic variables and basic medical care details.Results:In this database,a total of 544 children were hospitalized due to adenoviral encephalitis.The male-to-female ratio was 1.62:1,with more boys being affected across different age groups and places of residence.Of the children hospitalized,the highest number of hospitalizations occurred in the 1–3-year age group and the number of hospitalizations decreased each year from 2016 to 2018.The disease exhibits seasonal characteristics with a pronounced peak in the summer months of June and July.While most children(58%)did not have any significant complications,one-third of them developed respiratory complications,including pneumonia and acute bronchitis.The median length of stay for adenoviral encephalitis was 7 days,and the median cost of hospitalization was 2145.56 US dollars.Interpretation:This study highlights the prevalence of adenovirus encephalitis in hospitalized children in China.Children aged 1–3 years were found to be the main demographic hospitalized due to this condition,with boys being significantly more affected than girls.The seasonal variations of adenovirus encephalitis were also found to be significant.Fortunately,the fatality rate associated with this condition was low,and the prognosis was generally favorable.
基金Beijing Municipal Science&Technology Commission(No.Z201100005520061)
文摘To the Editor:Incidence of type 1 diabetes(T1D)in young children has been increasing over time in China.[1]There are challenges in achieving metabolic control without leading to severe hypoglycemia or adverse effect on the quality of life in toddlers,as they showed marked sensitivity to insulin and higher variability in insulin requirements.
基金Study on the current situation,change trend,nutrition and related factors of diabetes in children and adolescents,National Key R&D Program of China(2016YFC1305201)Beihang University&Capital Medical University Advanced Innovation Center for Big Data-Based Precision Medicine Plan(BHME-201801)Study on the influencing factors of herpes zoster,Chinese Center for Disease Control and Prevention surplus project(59911917).
文摘What is already known on this topic?The incidence of diabetes is on the rise in the world,and it is increasingly affecting young people.The American Diabetes Association(ADA)has published the 2020 Diabetes Medical Standard,but there is no blood glucose standard for teenagers by age and sex.What is added by this report?In this study,quantile regression was used to analyze the data of National Health and Nutrition Examination Survey(NHANES)and found that blood glucose varied significantly based on demographics.What are the implications for public health practice?This study provides reference for formulating the normal ranges of adolescent blood glucose and helping to screen out high-risk groups at an early stage for key interventions.The quantile regression method can give a set of curves,which could better describe the situation.
