Association and potential mediators between socioeconomic status and childhood obesity in China:findings from a national cohort study

Objective:Socioeconomic status(SES)is associated with childhood obesity,but the underlying factors remain unknown.This study aimed to identify mediators that may explain SES disparities in childhood obesity in China.Methods:Nationally representative longitudinal data from the China Education Panel Survey of 11 o019 children(13.03±0.79)collected from 2013-2014 to 2016-2017 academic years.Overweight/obesity was defined using Chinese national body mass index cut-points.Principal component analysis was used to convert the four SES indicators(maternal and paternal education,and occupation)into one comprehensive variable.Mediation analysis for SES disparities in childhood obesity was conducted using structure equation models.Results:The prevalence of overweight/obesity was 12.8%,and was higher in boys than in girls(17.8%vs.7.6%,P<0.001)at baseline.Among boys,relative risk(RR)of obesity was 1.23(95%CI:1.09 to 1.40,P<O.001)for per unit change in SES.There was no significant association between obesity and SES among girls.Mediation analyses showed that among boys,birth weight,being the only child in the family and children's selfperceived weight status mediated 70.0%of the effects of SES on obesity.No mediation effect was detected in girls.Conclusions:Chinese boys are more likely to be overweight or obese than girls.SES may impact childhood obesity through birth weight,being the only child in the family and children's self-perceived body weight status in boys,but not in girls.More attention should be made to address childhood obesity in high SES families among boys.Interventions targeting at these mediators are needed.

Incidence and mortality of oral and oropharyngeal cancer in China, 2015

Objective: To report the incidence and mortality rates of oral and oropharyngeal cancer in Chinese population.Methods: Data were taken from a population-based cancer registry collected by the National Central Cancer Registry of China(NCCRC) in 2015. The data collected from 501 local cancer registries in China were assessed using NCCRC screening methods and criteria. Incidence and mortality rates of oral and oropharyngeal cancer were stratified by age group, gender, and area. Age-standardized incidence and mortality rates were adjusted using the Chinese standard population in 2000 and Segi’s world population.Results: In 2015, it was estimated that there were 51,765 oral and oropharyngeal cancer incident cases and 23,830 deaths in China. The crude incidence rate of oral and oropharyngeal cancer was 3.77/100,000, and the agestandardized incidence rate by Chinese standard population and by Segi’s world standard population were 2.55/100,000 and 2.49/100,000, respectively. The crude mortality rate and the age-standardized mortality rates by Chinese standard population and by Segi’s world standard population were 1.73/100,000, 1.09/100,000 and1.08/100,000, respectively. Both incidence and mortality rates of oral and oropharyngeal cancer were higher in males and in urban areas. Residents in eastern areas had the highest incidence and mortality rates, followed by those from middle areas and western areas. The rates of oral and oropharyngeal cancer increased greatly with age,especially after the age of 40 years.Conclusions: This study reports the latest incidence and mortality rates of oral and oropharyngeal cancer in China. Prevention intervention including early detection, treatment, and regular follow-ups is encouraged to be set up to reduce incidence and mortality rates of oral and oropharyngeal cancer in the future.

Willingness to pay for colorectal cancer screening in Guangzhou

AIM To measure the willingness to pay for colorectal cancer screening in Guangzhou, and to identify those factors associated with it. METHODS A face-to-face questionnaire survey for pre-screening population from free and non-free colonoscopy districts was used to collect information on demographic characteristics, health behaviours, the intention of the cancer screenings and willingness to pay for colorectal cancer screening. A total of 1243 participants who took part in the pre-screening for colorectal cancer in Guangzhou were collected in the study. Categorical data were compared using the χ~2 test to analyse significant differences. Non-conditional logistic regression and multi-class logistic regression were also performed for multivariate analysis and to estimate the odds ratios.RESULTS The percentage of participants willing to pay for colorectal cancer screening was 91.7%. "Unnecessary" was the dominant reason that participants gave for their unwillingness, accounting for 63.1%. Of those who were willing to pay, 29.2%, 20.7%, 14.8%, 13.0% and 22.4% of participants were willing to pay less than $100, $100-$199, $200-299, $300-$399 and more than $400, respectively. Non-logistic regression analysis showed that respondents who were male, had a high level of education, were from the family with more children/older to raise, and accepted colorectal cancer screening were willing to pay for this screening. Multi-class logistic regression analysis showed that respondents with higher annual household income per capita, from government and private enterprises, government agency/institution and peasants, and less family medical expenditure were willing to pay more.CONCLUSION Willingness to pay for colorectal cancer screening in Guangzhou is high, but the amount of willing to pay is not much.

The Ability of Baseline Triglycerides and Total Cholesterol Concentrations to Predict Incidence of Type 2 Diabetes Mellitus in Chinese Men and Women:A Longitudinal Study in Qingdao, China

Objectives The purpose of this study was to assess the association between triglycerides(TG),total cholesterol(TC)at baseline,and type 2 diabetes mellitus(T2DM)incidence in a general Chinese population.Further,it aimed to evaluate the ability of TG and TC to predict T2DM incidence.Methods Qingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012–2015.TG,TC,and T2DM status were measured.Cox proportional hazards models were used to estimate the association between TG,TC,and T2DM incidence.The receiver operating characteristic(ROC)curve was used to evaluate the ability of TG and TC to identify T2DM participants.Results The incidence of T2DM significantly increased with TG in women and TC in both men and women(Ptrend<0.05).Univariate Cox regression indicated that higher TG{borderline high TG[hazards ratio(HR):2.05;95%confidence interval(CI):1.40,3.00]and hypertriglyceridemia[HR:2.64;95%CI:1.68,4.15]}and TC[hypercholesterolemia(HR:2.05;95%CI:1.43,2.95)]were significantly associated with increased risk of T2DM incidence in women but not in men.Multivariate Cox regression showed that hypertriglyceridemia in women(HR:1.78,95%CI:1.07,2.97),borderline high TC in men(HR:1.61,95%CI:1.04,2.48),and hypercholesterolemia in women(HR:1.68,95%CI:1.81,2.61)had a higher significant risk of T2DM incidence.The optimal cutoff values of TG were>1.15 and>1.23 mmol/L in men and women,respectively.For TC,they were>5.17 and>5.77 mmol/L in men and women,respectively.The area under the ROCs of TG and TC were 0.54(0.51–0.57)and 0.55(0.52–0.58),respectively,in men,and 0.60(0.58–0.62)and 0.59(0.56–0.61),respectively,in women.Conclusion Elevated TG and TC were risk factors for T2DM incidence.However,no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women.Hence,TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.

Oral microbiome and risk of malignant esophageal lesions in a high-risk area of China:A nested case-control study

Objective:We aimed to prospectively evaluate the association of oral microbiome with malignant esophageal lesions and its predictive potential as a biomarker of risk.Methods:We conducted a case-control study nested within a population-based cohort with up to 8 visits of oral swab collection for each subject over an 11-year period in a high-risk area for esophageal cancer in China.The oral microbiome was evaluated with 16 S ribosomal RNA(rRNA)gene sequencing in 428 pre-diagnostic oral specimens from 84 cases with esophageal lesions of severe squamous dysplasia and above(SDA)and 168 matched healthy controls.DESeq analysis was performed to identify taxa of differential abundance.Differential oral species together with subject characteristics were evaluated for their potential in predicting SDA risk by constructing conditional logistic regression models.Results:A total of 125 taxa including 37 named species showed significantly different abundance between SDA cases and controls(all P<0.05&false discovery rate-adjusted Q<0.10).A multivariate logistic model including 11 SDA lesion-related species and family history of esophageal cancer provided an area under the receiver operating characteristic curve(AUC)of 0.89(95%CI,0.84-0.93).Cross-validation and sensitivity analysis,excluding cases diagnosed within 1 year of collection of the baseline specimen and their matched controls,or restriction to screenendoscopic-detected or clinically diagnosed case-control triads,or using only bacterial data measured at the baseline,yielded AUCs>0.84.Conclusions:The oral microbiome may play an etiological and predictive role in esophageal cancer,and it holds promise as a non-invasive early warning biomarker for risk stratification for esophageal cancer screening programs.

Analyses on cancer incidence and mortality in Huai’an area,China,from 2009 to 2011

Objective： The aim of the study was to investigate the cancer incidence and mortality in Huai＇an area, China, from 2009 to 2011. Methods： The data about cancer incidence and mortality were provided by Huai＇an Cancer Registry, China. Incidence and mortality rates, and standardized rates were calculated by age, gender, areas （urban and rural areas of Huai＇an） and cancer sites. Results： The crude incidence rate for all cancer sites was 205.60/105 and the standardized incidence rate was 166.22/10. Both the crude and standardized rates were higher in urban area than in rural area for both sexes. The inci- dence rates increased in people aged 40 and over, and the peak ages of incidence were between 70-75 in both males and females. The crude mortality rate for all cancer sites was 153.88/105 and the standardized mortality rate was 122.14/105. Both the crude and standardized rates were similar in urban and rural areas for both men and women. The mortality rates were at low level under the age 50 in both sexes, but increased after the age 50, reaching the peak at the ages of 80-85 in both males and females. The top 10 most common cancer sites in rank were esophagus, stomach, lung, liver, colon-rectum, breast, pancreas, cervix uteri, brain and central nervous system, and leukemia, accounting for 87.56% of all cancers. The top 10 most leading causes of cancer death in order were cancers of esophagus, lung, liver, stomach, colon-rectum, pancreas, brain and central nervous system, leukemia, breast and lymphoma, accounting for 90.53% of all cancer deaths. Conclusion： Cancer is one kind of major diseases threatening people＇s health in Huai＇an area, China. Cancer prevention and control should be enhanced, especially for esophageal cancer.

Relationship between Short-term Exposure to PM2.5 and Daily Lung Cancer Mortality in Nanjing

Lung cancer is one of the most common types of cancer worldwide in terms of incidence,and it is the leading cause of cancer death.Many etiologic factors for lung cancer tumorigenesis have been identified to date,such as smoking and exposure to radon,cooking fumes,and asbestos[1].

Hospital contacts with alcohol problems prior to liver cirrhosis or pancreatitis diagnosis

AIM To evaluate prior hospital contacts with alcohol problems in patients with alcoholic liver cirrhosis and pancreatitis. METHODS This was a register-based study of all patients diagnosed with alcoholic liver cirrhosis or pancreatitis during 2008-2012 in Denmark. Hospital contacts with alcohol problems(intoxication, harmful use, or dependence) in the 10-year period preceding the diagnosis of alcoholic liver cirrhosis and pancreatitis were identified.RESULTS In the 10 years prior to diagnosis, 40% of the 7719 alcoholic liver cirrhosis patients and 40% of the 1811 alcoholic pancreatitis patients had at least one prior hospital contact with alcohol problems. Every sixth patient(15%-16%) had more than five contacts. A similar pattern of prior hospital contacts was observed for alcoholic liver cirrhosis and pancreatitis. Around 30% were diagnosed with alcohol dependence and 10% with less severe alcohol diagnoses. For the majority, admission to somatic wards was the most common type of hospital care with alcohol problems. Most had their first contact with alcohol problems more than five years prior to diagnosis.CONCLUSION There may be opportunities to reach some of the patients who later develop alcoholic liver cirrhosis or pancreatitis with preventive interventions in the hospital setting.

Association of obesity with hypertension and type 2 diabetes mellitus in India:A meta-analysis of observational studies

AIM To perform a meta-analysis of the association of obesity with hypertension and type 2 diabetes mellitus(T2DM) in India among adults. METHODS To conduct meta-analysis, we performed comprehensive, electronic literature search in the PubM ed, CINAHL Plus, and Google Scholar. We restricted the analysis to studies with documentation of some measure of obesity namely; body mass index, waist-hip ratio, waist circumference and diagnosis of hypertension or diagnosis of T2DM. By obtaining summary estimates of all included studies, the meta-analysis was performed using both RevM an version 5 and "metan" command STATA version 11. Heterogeneity was measured by I^2 statistic. Funnel plot analysis has been done to assess the study publication bias.RESULTS Of the 956 studies screened, 18 met the eligibility criteria. The pooled odds ratio between obesity and hypertension was 3.82(95%CI: 3.39 to 4.25). The heterogeneity around this estimate(I^2 statistic) was 0%, indicating low variability. The pooled odds ratio from the included studies showed a statistically significant association between obesity and T2DM(OR = 1.14, 95%CI: 1.04 to 1.24) with a high degree of variability.CONCLUSION Despite methodological differences, obesity showed significant, potentially plausible association with hypertension and T2DM in studies conducted in India. Being a modifiable risk factor, our study informs setting policy priority and intervention efforts to prevent debilitating complications.

Intravenous drug abuse and tricuspid valve endocarditis: Growing trends in the Middle East Gulf region

Traditionally, tricuspid valve endocarditis is uncommon in the Middle East region. However, recent global data indicate growing trends in the use of illicit drug abuse, specifically injectable heroin, in the Middle East Gulf region. The presence of many transit port services in the Middle East Gulf States has led to smuggling of substance abuse drugs in the region. The Middle East Gulf States, currently a transit market, are also becoming a growing consumer market in view of the increased substance abuse in the youth. However, there is a paucity of data with respect to the prevalence or incidence of tricuspid valve endocarditis in the region, probably due to underdiagnosis or underreporting. A high index of suspicion of tricuspid valve endocarditis is essential in patients with a history of intravenous drug abuse. This article reviews the epidemiology of illicit drug abuse in the Middle East Gulf region, as well as the diagnosis and treatment of tricuspid valve endocarditis, and calls for all physicians in the region to be vigilant while dealing with intravenous drug abuse.

Child disciplinary actions and women exposure to marital violence in Egypt

Objective: To investigate the association of women's exposure to marital violence with their child disciplinary actions in the 2005 EDHS.Methods: A sub-sample of 5249 currently-married women were investigated for ever and the 12 months prior to survey exposure to physical and sexual violence by their current husbands,and its association with their child disciplinary actions specifically hitting or slapping the child on the body and/or the face to address child behavior problem adjusting for the effect of respondents' age,education,work,residence,wealth index,number of children ever borne,and empowerment in household decisions.Results: Around 29.4% and 5.2% of the studied women have been ever exposed to physical and sexual violence by their current husbands;of them 60% and 65.7% have been subjected to it the 12 months prior to the survey respectively.Around 70% of women were slapping or hitting their children aged 3-17 years on their body or face as an action to address behavior problems the month prior to the survey.Around 40 % of women were slapping their children on face,head,or ears.Logistic regression models showed that exposure to marital violence predicted hitting or slapping the child on the body and/or the face to address behavior problems the month prior to the survey adjusted to other confounders.Conclusion: Marital Violence is significantly associated with child maltreatment.The study highlights the need for effective screening and identification of marital violence in families in which child maltreatment has occurred and vice versa.

Analysis on the epidemiological characteristics of esophageal cancer in Huai’an area,China from 2009 to 2011

Objective: The aim of our study was to investigate the epidemiological characteristics of esophageal cancer from 2009 to 2011 in Huai'an area, China. Methods: The data about the incidence and mortality of esophageal cancer were provid- ed by Huai'an Cancer Registry, and the epidemiological characteristics of the disease were analyzed. Results: Esophageal cancer was not only the first most common cancer, but also the leading cause of cancer death in Huai'an area. The crude and standardized incidence rates were 62.91/10 5 and 49.92/10 5 , and the crude and standardized mortality rates were 46.75/10 5 and 36.87/10 5 , respectively. The sex ratio (male-female) was 1.69:1 in incidence, and the incidence increased in people aged 40 years and over, reaching the peak at the ages of 70-75 years. The mortality rate was at low level under the age of 50 years, but increased after the age of 50 years, reaching the peak at the age of 75-85 years. Incidence and mortality rates varied regionally with the highest rate found in Chuzhou district (90.76/10 5 and 67.17/10 5 ) and lowest rate observed in Qinghe district (32.41/10 5 and 8.75/10 5 ). Conclusion: Esophageal cancer is the major burden of cancer in Huai'an area, and has marked geographic distribution difference. The key period of age for screening and prevention of the disease is 55-85 years old.

Noncommunicable chronic disease prevention should start from childhood

Noncommunicable chronic diseases(NCDs),such as cardiovascular disease(CVD),diabetes,cancers,and osteoporosis,are the leading causes of death and health costs.According to the 2020 Report on Chinese Resident’s Chronic Disease and Nutrition,NCDs account for 88.5%of China’s disease burden in 2019,more than all other causes combined.

一个Liddle综合征新SCNN1B基因移码突变的鉴定

Liddle综合征是一种由编码肾小管上皮细胞钠离子通道(ENa Cs)的SCNN1A、SCNN1B及SCNN1G基因突变引起的罕见单基因遗传性高血压,基于基因检测技术进行确诊并及时给予对应治疗可显著改善患者预后.由于发病率低,相关突变位点报道少,目前Liddle综合征突变位点谱仍不完善.本研究通过对野生型及突变型ENa Cs重组非洲爪蟾卵母细胞进行膜片钳检测,首次确定了SCNN1B基因中一个移码突变c.1691_1693delins G对Liddle综合征的致病性.进一步研究结果表明,突变型非洲爪蟾卵母细胞ENa Cs电流显著增加,这与已知的Liddle综合征发病机制一致.此外,本研究通过对该家系中接受阿米洛利/氢氯噻嗪复方制剂治疗的7名患者进行为期12个月的观察研究,发现所有患者血压控制理想,血清钾离子、血浆肾素及醛固酮水平正常,无心血管事件及严重药物不良反应发生.本研究有助于扩大Liddle综合征的基因诊断谱,并为该病的治疗方案提供参考.

Worldwide trends in esophageal cancer survival,by sub-site,morphology,and sex:an analysis of 696,974 adults diagnosed in 60 countries during 2000-2014(CONCORD-3)

Background Esophageal cancer survival is poor worldwide,though there is some variation.Differences in the distribution of anatomical sub-site and morphological sub-type may help explain international differences in survival for all esophageal cancers combined.We estimated survival by anatomic sub-site and morphological sub-type to understand further the impact of topography and morphology on international comparisons of esophageal cancer survival.Methods We estimated age-standardized one-year and five-year net survival among adults(15-99 years)diagnosed with esophageal cancer in each of 60 participating countries to monitor survival trends by calendar period of diagnosis(2000-2004,2005-2009,2010-2014),sub-site,morphology,and sex.Results For adults diagnosed during 2010-2014,tumors in the lower third of the esophagus were the most common,followed by tumors of overlapping sub-site and sub-site not otherwise specified.The proportion of squamous cell carcinomas diagnosed during 2010-2014 was generally higher in Asian countries(50%-90%),while adenocarcinomas were more common in Europe,North America and Oceania(50%-60%).From 2000-2004 to 2010-2014,the proportion of squamous cell carcinoma generally decreased,and the proportion of adenocarcinoma increased.Over time,there were few improvements in age-standardized five-year survival for each sub-site.Age-standardized one-year survival was highest in Japan for both squamous cell carcinoma(67.7%)and adenocarcinoma(69.0%),ranging between 20%-60%in most other countries.Age-standardized five-year survival from squamous cell carcinoma and adenocarcinoma was similar for most countries included,around 15%-20%for adults diagnosed during 2010-2014,though international variation was wider for squamous cell carcinoma.In most countries,survival for both squamous cell carcinoma and adenocarcinoma increased by less than 5%between 2000-2004 and 2010-2014.Conclusions Esophageal cancer survival remains poor in many countries.The distributions of sub-site and morphological sub-type vary between countries,but these differences do not fully explain international variation in esophageal cancer survival.

Sleep Status Among Children and Adolescents Aged 6-17 Years—China,2016-2017

Summary What is already known about this topic?There has been little to no description of sleep status among children and adolescents nationwide in recent years.What is added by this report?This report assesses the sleep duration and sleep patterns of children and adolescents in China.Approximately half of the adolescents did not get the recommended amount of sleep on school days,and more than half overslept on weekends.

中国人群伤残权重测量:聚焦癌症,量化评估伤残权重对癌症疾病负担估计的影响

伤残权重对于量化评估非死亡相关健康损失至关重要.全球范围看,目前仅有少数国家或地区对伤残权重进行了评估,且极少有肿瘤特异性的伤残权重结果报道.本研究基于大样本人群估计中国人群肿瘤特异性伤残权重,并比较不同伤残权重对量化评估肿瘤疾病负担的影响.基于开放式网络调查,采用配对比较的方法进行伤残权重的测量.伤残寿命损失年(YLDs)估计为不同瘤种各时期肿瘤的患病人数与其对应时期的伤残权重乘积之和.研究共收集到44,069份有效调查问卷,估计了包含18类恶性肿瘤在内的254个健康状态的残疾权重.其中,诊断和初始治疗阶段的肿瘤特异性伤残权差异较大,脑瘤的伤残权重最高为0.619(95%不确定性区间(UI):0.606~0.632),口咽癌伤残权重最低,为0.167(95%UI:0.158~0.176).不同肿瘤伤残权重对YLDs估计影响较大,所有肿瘤合计的YLDs差异超过30%.本研究提供的肿瘤特异性伤残权重可以为精确估计肿瘤疾病负担提供重要的数据支持.

单基因遗传性高血压:一类可“治愈”的高血压

Hypertension is a global problem that affects more than 1 billion people worldwide with the increased prevalence year by year[1,2].It contributes to major impacts on health including morbidity and all-cause mortality,as well as consumption of substantial health care expenses.Understanding the complex pathophysiology and risk factors involved in the development of elevated blood pressure can help treat the disease to better prevent life-threatening conditions and alleviate the socio-economic burden.The hereditary nature of hypertension relies on that up to 30%of blood pressure variation is due to genetics and an individual’s genetic predisposition to hypertensive disease ranges from 15%to 35%[3].

Pancreatic cancer survival trends in the US from 2001 to 2014:a CONCORD-3 study

Background:Survival from pancreatic cancer is low worldwide.In the US,the 5-year relative survival has been slightly higher for women,whites and younger patients than for their counterparts,and differences in age and stage at diagnosis[Corrections added Nov 16,2022,after first online publication:a new affiliation is added to Maja Nikšić]may contribute to this pattern.We aimed to examine trends in survival by race,stage,age and sex for adults(15-99 years)diagnosed with pancreatic cancer in the US.Methods:This population-based study included 399,427 adults registered with pancreatic cancer in 41 US state cancer registries during 2001-2014,with followup to December 31,2014.We estimated age-specific and age-standardized net survival at 1 and 5 years.Results:Overall,12.3%of patients were blacks,and 84.2%were whites.About 9.5%of patients were diagnosed with localized disease,but 50.5%were diagnosed at an advanced stage;slightly more among blacks,mainly among men.No substantial changes were seen over time(2001-2003,2004-2008,2009-2014).In general,1-year net survival was higher in whites than in blacks(26.1%vs.22.1%during 2001-2003,35.1%vs.31.4%during 2009-2014).This difference was particularly evident among patients with localized disease(49.6%in whites vs.44.6%in blacks during 2001-2003,60.1%vs.55.3%during 2009-2014).The survival gap between blacks and whites with localized disease was persistent at 5 years after diagnosis,and it widened over time(from 24.0%vs.21.3%during 2001-2003 to 39.7%vs.31.0%during 2009-2014).The survival gap was wider among men than among women.Conclusions:Gaps in 1-and 5-year survival between blacks and whites were persistent throughout 2001-2014,especially for patients diagnosed with a localized tumor,for which surgery is currently the only treatment modality with the potential for cure.

Emerging roles of podoplanin in vascular development and homeostasis

Podoplanin （PDPN） is a mucin-type O-glycoprotein expressed in diverse cell types, such as lymphatic endothelial cells （LECs） in the vascular system and fibroblastic reticular cells （FRCs） in lymph nodes. PDPN on LECs or FRCs activates CLEC-2 in platelets, triggering platelet activation and/or aggregation through downstream signaling events, including activation of Syk kinase. This mechanism is required to initiate and maintain separation of blood and lymphatic vessels and to stabilize high endothelial venule integrity within lymph nodes. In the vascular system, normal expression of PDPN at the LEC surface requires transcriptional activation of Pdpn by Proxl and modification of PDPN with core 1-derived O-glycans. This review provides a comprehensive overview of the roles of PDPN in vascular development and lymphoid organ maintenance and discusses the mechanisms that regulate PDPN expression related to its function.