OBJECTIVE To investigate the role of family aggregation and genetic factors of esophageal cancer （EC）, including carcinoma of gastric cardia （CGC）, in Cixian county, and to calculate the segregation ratio and heri...OBJECTIVE To investigate the role of family aggregation and genetic factors of esophageal cancer （EC）, including carcinoma of gastric cardia （CGC）, in Cixian county, and to calculate the segregation ratio and heritability of first-degree relatives （FDR） in EC cases.METHODS A case control study was conducted, and each of 285 esophageal cancer cases and FDR＇s case history and family medical history of EC in 1415 controls was carried by home visits to compare the incidence of EC in the crowds. The family aggregation of EC was found by X2 test for goodness of fit test according to binomial distribution. Li-Mantel-Gart method was used to calculate the segregation ratio and Falconer method was employed to compute the heritability （h2）.RESULTS The incidence rate of the FDR in the index case of EC （12.80%） was higher than that in the controls （7.52%）. There were significant differences between the 2 groups （X2= 44.34, P = 0.000）. The distribution of EC in the family did not agree with the binomial distribution, which presented a conspicuous familial aggregation （X2= 288.19, P 〈 0.0001）. The heritability of EC was （29.67 ±4.32）%, and segregation ratio was 0.1814 （95%CI = 0.1574-0.2054）, which is lower than 0.25, and can be regarded as a disease of multi-factorial inheritance.CONCLUSION The occurrence of EC in the Cixian County is the outcome of the mutual effect of genetic and environmental factors. The family history of upper gastrointestinal cancers increases the risk of EC in late generations.展开更多
Severe trauma has the characteristics of complicated condition, multiple organs involved, limitq auxiliary examinations, and difficulty in treatment. Most of the trauma patients were sent to prima hospitals to receive...Severe trauma has the characteristics of complicated condition, multiple organs involved, limitq auxiliary examinations, and difficulty in treatment. Most of the trauma patients were sent to prima hospitals to receive treatments. But the traditional mode of separate discipline management can easi lead to delayed treatment, missed or wrong diagnosis and high disability, which causes a high mc tality in severe trauma patients. Therefore, if the primary hospitals, especially county-level hospit~ （usually the top general hospital within the administrative region of a county）, can establish a sc entific and comprehensive trauma care system, the success rate of trauma rescue in this region can ] greatly improved. On March 1st, 2013, Tiantai People＇s Hospital of Zhejiang Province, China set up trauma care center, which integrated the pre-hospital and in-hospital trauma treatment procedur~ and has achieved good economic and social benefits. Till March 1st, 2017, 1265 severe trauma patier （injury severity score 〉16） have been treated in this trauma center. The rescue success rate reach~ 95~ and the delayed and]or missed diagnosis rate was less than 5%. Totally 86 severe cases of peK fractures with unstable hemodynamics were treated, and the success rate was 92%. The in-hospil emergency rescue response time is less than 3 min, and the time from definite diagnosis to surge is within 35 min.展开更多
文摘OBJECTIVE To investigate the role of family aggregation and genetic factors of esophageal cancer （EC）, including carcinoma of gastric cardia （CGC）, in Cixian county, and to calculate the segregation ratio and heritability of first-degree relatives （FDR） in EC cases.METHODS A case control study was conducted, and each of 285 esophageal cancer cases and FDR＇s case history and family medical history of EC in 1415 controls was carried by home visits to compare the incidence of EC in the crowds. The family aggregation of EC was found by X2 test for goodness of fit test according to binomial distribution. Li-Mantel-Gart method was used to calculate the segregation ratio and Falconer method was employed to compute the heritability （h2）.RESULTS The incidence rate of the FDR in the index case of EC （12.80%） was higher than that in the controls （7.52%）. There were significant differences between the 2 groups （X2= 44.34, P = 0.000）. The distribution of EC in the family did not agree with the binomial distribution, which presented a conspicuous familial aggregation （X2= 288.19, P 〈 0.0001）. The heritability of EC was （29.67 ±4.32）%, and segregation ratio was 0.1814 （95%CI = 0.1574-0.2054）, which is lower than 0.25, and can be regarded as a disease of multi-factorial inheritance.CONCLUSION The occurrence of EC in the Cixian County is the outcome of the mutual effect of genetic and environmental factors. The family history of upper gastrointestinal cancers increases the risk of EC in late generations.
文摘Severe trauma has the characteristics of complicated condition, multiple organs involved, limitq auxiliary examinations, and difficulty in treatment. Most of the trauma patients were sent to prima hospitals to receive treatments. But the traditional mode of separate discipline management can easi lead to delayed treatment, missed or wrong diagnosis and high disability, which causes a high mc tality in severe trauma patients. Therefore, if the primary hospitals, especially county-level hospit~ （usually the top general hospital within the administrative region of a county）, can establish a sc entific and comprehensive trauma care system, the success rate of trauma rescue in this region can ] greatly improved. On March 1st, 2013, Tiantai People＇s Hospital of Zhejiang Province, China set up trauma care center, which integrated the pre-hospital and in-hospital trauma treatment procedur~ and has achieved good economic and social benefits. Till March 1st, 2017, 1265 severe trauma patier （injury severity score 〉16） have been treated in this trauma center. The rescue success rate reach~ 95~ and the delayed and]or missed diagnosis rate was less than 5%. Totally 86 severe cases of peK fractures with unstable hemodynamics were treated, and the success rate was 92%. The in-hospil emergency rescue response time is less than 3 min, and the time from definite diagnosis to surge is within 35 min.
