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Background: Body water measured by bioelectrical impedance analysis (BIA) predicts the outcomes of many diseases. This study aimed to evaluate the relationship between body water and the prognosis of cancer patients with sarcopenia. Methods: This study employed 287 cancer patients with sarcopenia underwent BIA from a prospective multicenter study of patients with cancer in China from 2013 to 2020. The primary outcome of interest was all-cause mortality presented as the longest time to follow-up available. Eight indicators of body water [total body water, extracellular water, intracellular water, free fat mass, active cell mass, extracellular water/intracellular water, extracellular water/total body water (ECW/TBW), and intracellular water/total body water] were included in the research. Neutrophil–lymphocyte ratio (NLR) = neutrophil (× 109)/lymphocyte (× 109). The discriminatory ability and prediction accuracy of each factor were assessed using the C-index. The hazard ratios (HR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazard model. Results: The median age was 65 years old, and 138 (48%) patients were men. During a mean follow-up of 46 months, 140 deaths were recorded, resulting in a rate of 204.6 events per 1000 patient-years. ECW/TBW showed the best predictive accuracy (C-index = 0.619) compared to the other indicators [p = 0.004, adjusted HR (95% CI) 1.70 (1.18,2.44)]. In the middle tertile (0.385–0.405), ECW/TBW had a strong independent negative association with patient survival [adjusted HR (95% CI) 2.88 (1.39–5.97), p = 0.004]. Patients who had a high ECW/TBW (ECW/TBW ≥ 0.395) combined with a high NLR had 3.84-fold risk of mortality (p < 0.001, 95% CI 1.99,7.38). Conclusions: ECW/TBW was better than other indicators in predicting survival of cancer patients with sarcopenia. High ECW/TBW combined with high NLR would further increase the risk of mortality. Trial registration: The Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) (Chinese Clinical Trial Registry: ChiCTR1800020329, URL of registration: http://www.chictr.org.cn/showprojen.aspx?proj=31813). [ABSTRACT FROM AUTHOR]

Background: A large number (n = 460) of A(H7N9) human infections have been reported in China from March 2013 through December 2014, and H7N9 outbreaks in humans became an emerging issue for China health, which have caused numerous disease outbreaks in domestic poultry and wild bird populations, and threatened human health severely. The aims of this study were to investigate the directional trend of the epidemic and to identify the significant presence of spatial-temporal clustering of influenza A(H7N9) human cases between March 2013 and December 2014.Methods: Three distinct epidemic phases of A(H7N9) human infections were identified in this study. In each phase, standard deviational ellipse analysis was conducted to examine the directional trend of disease spreading, and retrospective space-time permutation scan statistic was then used to identify the spatio-temporal cluster patterns of H7N9 outbreaks in humans.Results: The ever-changing location and the increasing size of the three identified standard deviational ellipses showed that the epidemic moved from east to southeast coast, and hence to some central regions, with a future epidemiological trend of continue dispersing to more central regions of China, and a few new human cases might also appear in parts of the western China. Furthermore, A(H7N9) human infections were clustering in space and time in the first two phases with five significant spatio-temporal clusters (p < 0.05), but there was no significant cluster identified in phase III.Conclusions: There was a new epidemiologic pattern that the decrease in significant spatio-temporal cluster of A(H7N9) human infections was accompanied with an obvious spatial expansion of the outbreaks during the study period, and identification of the spatio-temporal patterns of the epidemic can provide valuable insights for better understanding the spreading dynamics of the disease in China. [ABSTRACT FROM AUTHOR]

Background: On average, 570 million users, 93% in China's first-tier cities, log on to WeChat every day. WeChat has become the most widely and frequently used social media in China, and has been profoundly integrated into the daily life of many Chinese people. A variety of health-related information may be found on WeChat. The objective of this study is to understand how the general public views the impact of the rapidly emerging social media on health information acquisition.Methods: A self-administered questionnaire was designed, distributed, collected, and analyzed utilizing the online survey tool Sojump. WeChat was adopted to randomly release the questionnaires using convenience sampling and collect the results after a certain amount of time.Results: (1) A total of 1636 questionnaires (WeChat customers) were collected from 32 provinces. (2) The primary means by which respondents received health education was via the Internet (71.79%). Baidu and WeChat were the top 2 search tools utilized (90.71% and 28.30%, respectively). Only 12.41% of respondents were satisfied with their online health information search. (3) Almost all had seen (98.35%) or read (97.68%) health information; however, only 14.43% believed that WeChat health information could improve health. Nearly one-third frequently received and read health information through WeChat. WeChat was selected (63.26%) as the most expected means for obtaining health information. (4) The major concerns regarding health information through WeChat included the following: excessively homogeneous information, the lack of a guarantee of professionalism, and the presence of advertisements. (5) Finally, the general public was most interested in individualized and interactive health information by managing clinicians, they will highly benefit from using social media rather than Internet search tools.Conclusions: The current state of health acquisition proves worrisome. The public has a high chance to access health information via WeChat. The growing popularity of interactive social platforms (e.g. WeChat) presents a variety of challenges and opportunities with respect to public health acquisition. [ABSTRACT FROM AUTHOR]

Background: To explore the current situation, existing problems and possible causes of said problems with regards to physician-nurse communication under an environment of increasingly widespread usage of Hospital Information Systems and to seek out new potential strategies in information technology to improve physician-nurse communication.Methods: Semi-structured interviews were conducted with 20 physicians and nurses in five leading tertiary grade A hospitals in Beijing, China (two physicians and two nurses in each hospital). The interviews primarily included three aspects comprising the current situation and problems of clinical physician-nurse communication, the application and problems of Hospital Information Systems, and assessments on the improvement of physician-nurse communication through the usage of information technology. The inductive conventional content analysis approach was employed.Results: (1) Physicians and nurses are generally quite satisfied with the current situation of communication. However, the information needs of nurses are prone to being overlooked, and the communication methods are primarily synchronous communication such as face-to-face and phone communication. (2) Hospital Information Systems are gradually being used for physician-nurse communication; in the meantime, physicians and nurses face challenges with regards to the improvement of physician-nurse communication through the usage of information technology. Challenges differ based on the different stages of using the system and the different levels of understanding of physicians and nurses towards information technology. Their dissatisfaction mainly deals with system errors and the level of convenience in using the system. (3) In-depth interviews found that in general, physicians and nurses have a strong interest and trust in improving physician-nurse communication through appropriate information technology, e.g., communication methods such as information reminders for physicians and nurses through mobile devices and instant voice-to-text conversion methods.Conclusions: There are objective risks in physician-nurse communication in Chinese hospitals, and clinical information systems lack solutions to the relevant problems. Developing a dedicated, mobile, quick and convenient module for physician-nurse communication within existing hospital information system with automatic reminders for important information that segregates between synchronous and asynchronous communication according to the different types of information could help improve physician-nurse communication. [ABSTRACT FROM AUTHOR]

Background: The incidence and radiological patterns of eosinophilic granuloma (EG) in China is not clear. We described the incidence, presentation, and imaging characteristics of Chinese EG patients in a tertiary hospital. Methods: A retrospective chart review was performed from January 2004 to October 2017 at a single tertiary general hospital. Seventy-six patients were pathologically identified as EG. Besides, 60 patients with preoperative imaging diagnosis of "EG" were analyzed to reveal the radiological patterns and their diagnostic power. Results: Fifty-three male and 23 female EG patients with a mean age of 18.1 ± 16.7 years (range 1–58 years) were retrospectively included. Significant differences were observed in gender (male to female = 2.3:1) and age (the highest incidence at the age of 0~5 years) for EG. EG predominantly involved the skeletal system: flat bones (31.43%) > irregular bones (24.76%) > long bones (22.86%) > other organs (20.95%). No obvious relationships between season, biochemical markers, and EG incidence were observed. The common presenting symptoms were pain followed with local mass, and most patients underwent surgical resection. Among 60 imagingly diagnosed "EG" patients from April 2009 to October 2017, only 22 were with histological confirmation. The correct diagnosis rates were 37.1% (13 out of 35), 16.7% (5 out of 30), and 22.2% (8 out of 36) for plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI), respectively. Conclusions: Chinese EG has a varied presentation, age distribution, and gender difference. EG diagnosis is still based on biopsy or histopathology instead of imaging techniques. [ABSTRACT FROM AUTHOR]

Background: Severe neonatal hyperbilirubinemia could lead to kernicterus and neonatal death. This study aimed to analyze the association between single nucleotide polymorphisms in genes involved in bilirubin metabolism and the incidence of severe hyperbilirubinemia., Methods: A total of 144 neonates with severe hyperbilirubinemia and 50 neonates without or mild hyperbilirubinemia were enrolled in 3 institutions between 2019 and 2020. Twelve polymorphisms of 5 genes (UGT1A1, SLCO1B1, SLCO1B3, BLVRA, and HMOX1) were analyzed by PCR amplification of genomic DNA. Genotyping was performed using an improved multiplex ligation detection reaction technique based on ligase detection reaction., Results: The frequencies of the A allele in UGT1A1-rs4148323 and the C allele in SLCO1B3-rs2417940 in the severe hyperbilirubinemia group (30.2% and 90.6%, respectively) were significantly higher than those in the controls (30.2% vs.13.0%, 90.6% vs. 78.0%, respectively, both p < 0.05). Haplotype analysis showed the ACG haplotype of UGT1A1 were associated with an increased hyperbilirubinemia risk (OR 3.122, p = 0.001), whereas the GCG haplotype was related to a reduced risk (OR 0.523, p = 0.018)., Conclusion: The frequencies of the A allele in rs4148323 and the C allele in rs2417940 are highly associated with the incidence of severe hyperbilirubinemia in Chinese Han neonates., Trial Registration: Trial registration number:ChiCTR1800020424; Date of registration:2018-12-29., (© 2024. The Author(s).)

Background: Gastric cancer is the fourth most common malignant disease worldwide, with lower one-third gastric cancer the most common type. Distal gastrectomy with D2 lymph node dissection was recommended as a standard surgery for distal gastric cancer patients. However, some controversy remains about the anastomosis of the residual stomach and the intestine. The objectives of this trial are to test the hypothesis that uncut Roux-en-Y anastomosis can reduce postoperative complications and improve nutritional status more effectively than Billroth II anastomosis in gastric cancer patients after D2 gastrectomy., Methods/design: This multi-center, prospective, phase III, randomized controlled trial will compare the efficacy of uncut Roux-en-Y anastomosis versus Billroth II anastomosis in phase I-III patients with initial treatment of radical distal gastrectomy. Patients will be randomized to undergo either the intervention (uncut Roux-en-Y anastomosis) or the control (Billroth II anastomosis). We will recruit 832 patients who meet the trial eligibility criteria and will follow the patients after surgery to observe postoperative complications and nutrition status for 5 years. The primary assessment indices of the study are reflux gastritis, esophagitis, bile regurgitation, and anastomotic ulcer. The secondary assessment indices are nutritional status, quality of life, perioperative complications, overall survival rate, and others. When the number of cases reaches 400, an interim analysis will be performed to identify any evidence of definite superiority of the experimental intervention., Discussion: We aim to test the hypothesis that uncut Roux-en-Y anastomosis can reduce postoperative complications and improve nutritional status more than Billroth II anastomosis in gastric cancer patients after D2 gastrectomy. The results of the trial will contribute to the best evidence on which to base the reconstruction of distal gastrectomy., Trial Registration: Chinese Southern Gastric Cancer Conference CSGC002 Trial. ClinicalTrials.gov, NCT02763878 . Registered on 5 May 2016.

Background: Self-rated health (SRH) and health-related quality of life (HRQOL) are two outcome measures used to assess health status. However, little is known about population-based SRH and HRQOL in China., Methods: Data from the 2010 China Chronic Disease and Risk Factor Surveillance, a nationally representative sample of 98,658 adults (≥18-year-old) residing in China, were analyzed. SRH was assessed by asking "Would you say that, in general, your health is very good, good, general, poor, or very poor?" HRQOL was assessed by asking "For about how many days during the past 30 days was your health not good due to physical illnesses, injuries, or mental unhealthy?"., Results: Overall, 6.3 % of participants rated their health as poor or very poor. The prevalence of poor/very poor health increased with advancing age ranging from 2.0 % in the 18-24 year-olds to 14.9 % in those ≥75 years-old, while it decreased with education levels from 13.0 % in illiterates/those with some primary school education to 2.2 % in college graduates or above. Additionally, women were more likely than men to rate their health as poor or very poor (7.2 % vs. 5.4 %). The reported rate of poor/very poor health was higher in western region residents compared to those in the east (7.4 % vs. 5.3 %). The mean numbers of self-reported physically unhealthy days, injury-caused unhealthy days, or mentally unhealthy days during the past 30 days were 1.48, 0.20, and 0.54, respectively. Older adults had more physically unhealthy days than the younger ones ranging from 2.92 days in those ≥ 75 year-old to 0.95 days in 18-24 year-olds. Women had more physically unhealthy days and mentally unhealthy days than men (1.72 vs. 1.23; 0.62 vs. 0.46, respectively). The highest mean number of physically unhealthy days (2.32) was reported by illiterates or those with some primary school education. The highest mean number of mentally unhealthy days (0.86) reported by college graduates or above., Conclusions: Substantial variations existed in SRH and HRQOL among age groups, gender groups, education groups, and across regions in China. Considering these disparities will be important when developing health policies and allocating resources.