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Aim This study investigated the cost-effectiveness of a community-based colorectal cancer-screening program (C-CRCSP) in Shanghai, China, with a comparison of urban, suburban, and rural areas. Methods A Markov model was constructed to evaluate the cost-effectiveness of a 25-year-long annual C-CRCSP with 100,000 samples. Cost-effectiveness was determined by the incremental cost-effectiveness ratio (ICER) referring to either life-years gained, or quality-adjusted life-years (QALYs) gained. The threshold was gross domestic product per capita. Univariate and multivariate sensitivity analyses were performed to investigate the influence of compliance, prevalence, technological performance, price, and an annual cost discount rate (3.5%) on ICERs. A probabilistic sensitivity analysis evaluated the probability of cost-effectiveness of C-CRCSP at different maximum acceptable ceiling ratios. Results Compared with no screening, the C-CRCSP could result in total gains of 7840 QALYs and 2210 life-years, at a total cost of CNY 58.54 million; that is, the ICERs were CNY 7460/QALY and CNY 26,650/life-year. Stratifying by residency, the highest cumulative gains in QALYs and life-years were estimated for the rural population, followed by the suburban and urban. The cost for the urban population was 3- and 6-fold that of the suburban and rural populations. The ICERS for QALYs ranged from 2180 (rural) to 16,840 (urban). Conclusion The cost-effectiveness of a C-CRCSP in Shanghai was most favorable for the rural population, while the urban population would realize lesser benefit in terms of QALYs. ICERs could be enhanced by measures that increase compliance. This article is protected by copyright. All rights reserved.

Background There have been few studies on children hospitalized with respiratory syncytial virus (RSV) published from mainland China. We performed a retrospective review of medical charts to describe the epidemiology, clinical features and direct medical cost of laboratory-proven RSV children hospitalized in Suzhou, China. Methods Testing is routine for RSV for children admitted to the respiratory ward at Suzhou University Children's Hospital. We performed a retrospective study on children with documented RSV infection hospitalized at Suzhou University Children Hospital during 2005-2009 using a structured chart review instrument. Results A total of 2721 hospitalized children (15.0% of those tested) were positive by immunofluorescent assay for RSV during 2005-2009, and 64.0% of them were male. Eighty-seven percentage of the RSV-infected children were 2 years old and younger, and 56.6% were ≤ 6 months of age. The median length of hospital stay was 8 days. Of the RSV-infected children, 92.5% developed pneumonia and 21.8% experienced wheezing. In total, 49 (5.1%) of RSV-positive children were transferred to the ICU. Children ≤ 6 months old and who had congenital heart disease had higher risk of severe RSV disease. The mean cost of each RSV-related hospitalization was US$571.8 (US$909.6 for children referred to ICU and US$565.4 for those cared for on the wards). Multivariable logistic regression showed that compared with the ≤ 6 months children, those aged >6 months old had higher hospitalization cost; children with respiratory distress or with chronic lung diseases tended to have higher hospitalization costs than others. Conclusions RSV infections and severe RSV diseases mostly occurred in early infancy. The direct medical cost was high relative to family income. Effective strategies of RSV immunization of young children in China may be beneficial in addressing this disease burden.

Background Very little is known about the effect of modifiable lifestyle factors on outcomes of triple-negative breast cancer. We examined this association in a population-based prospective cohort study of patients with triple-negative breast cancer. Methods A total of 518 women with confirmed triple-negative breast cancer, recruited by the Shanghai Breast Cancer Survival Study, completed 6-, 18-, 36-, and 60-month postdiagnosis surveys. We applied Cox proportional hazard models to evaluate the associations. Results The mean age at diagnosis was 53.4 (standard deviation = 10.6) years old. After a median follow-up of 9.1 years (range: 0.6-11.8), 128 deaths and 112 recurrences were documented. Exercise during the first 60 months postdiagnosis was inversely associated with total mortality and recurrence/disease-specific mortality with adjusted hazard ratios (HRs) of 0.67 (95% confidence interval [CI] = 0.46, 0.96) and 0.58 (95% CI = 0.39, 0.86), respectively. Women with higher exercise-metabolic equivalent scores (≥7.6 metabolic equivalent-hours/week) and longer duration of exercise (≥2.5 hours/week) had lower risk of total and recurrence/disease-specific mortality than did nonexercisers. Compared with nontea drinkers, survival was better among women who were regular tea drinkers during the first 60 months for all cause (HR = 0.57, 95% CI = 0.34, 0.93) and recurrence/disease-specific mortality (HR = 0.54, 95% CI = 0.31, 0.96). There was no dose-response pattern for tea consumption. No interactions were observed for body mass index, menopausal status, and comorbidity. Conclusions These findings show that postdiagnosis exercise and tea intake were associated with improved survival among women with triple-negative breast cancer.

A prospective study was performed to determine serotype distribution and antimicrobial resistance in Streptococcus pneumoniae (S. pneumoniae) from Chinese children

Insight into the spatial and temporal contamination of the environment by bovine faeces in China can provide important information on the significance of bovines in the transmission of human schistosomiasis. This insight will be useful for the new evidence-based strategy of the Chinese national schistosomiasis control programme. To enhance our understanding of the spatio-temporal relationship between the prevalence of human and bovine schistosomiasis, we performed correlation and regression analyses using data from three national sampling surveys on schistosomiasis, carried out in 1989, 1995 and 2004. In addition, we established a geographical information system and performed spatial analyses to identify the high-risk areas of the disease. We found that schistosomiasis is mainly concentrated in the marshlands along the Yangtze River. It was also noted that, although the human prevalence and force of transmission in highly endemic areas has been reduced since 1989, the relative importance of bovine schistosomiasis has increased. This is seen in a declining Spearman correlation coefficient between the infection prevalence in humans and in bovines over time (0.812 in 1989, 0.754 in 1995 and 0.376 in 2004). In parallel, the slope of the linear regression decreased from 0.395 in 1989 to 0.215 in 2004. Our data therefore suggest that future schistosomiasis control efforts in China should more vigorously address the important role of bovines in the transmission of human schistosomiasis, and to reduce the environmental contamination of Schistosoma japonicum eggs by bovines.

Although the number of human infections decreased, human prevalence increased from 4.9% in 1995 to 5.1% in 2004., Results from the third nationwide cluster sampling survey on the epidemiology of schistosomiasis in the People’s Republic of China, conducted by the Ministry of Health in 2004, are presented. A stratified cluster random sampling technique was used, and 239 villages were selected in 7 provinces where Schistosoma japonicum remains endemic. A total of 250,987 residents 6–65 years of age were included in the survey. Estimated prevalence rates in the provinces of Hunan, Hubei, Jiangxi, Anhui, Yunnan, Sichuan, and Jiangsu were 4.2%, 3.8%, 3.1%, 2.2%, 1.7%, 0.9%, and 0.3%, respectively. The highest prevalence rates were in the lake and marshland region (3.8%) and the lowest rates were in the plain region with waterway networks (0.06%). Extrapolation to all residents in schistosome-endemic areas indicated 726,112 infections. This indicates a reduction of 16.1% compared with a nationwide survey conducted in 1995. However, human infection rates increased by 3.9% in settings where transmission is ongoing.

Summary Objectives To understand the association between the outbreak of severe acute respiratory syndrome (SARS) and meteorological factors and air pollution. Study design An ecological study was conducted. Methods Three hundred and fifty primary probable SARS cases diagnosed in mainland China between 1 January and 31 May 2003, and their 6727 close contacts during the period of their clinical symptoms before admission, were included in this study. Of the 6727 close contacts, 135 (2.0%) later developed clinical symptoms and were diagnosed as probable SARS cases. The daily meteorological data and daily air pollution data during the same SARS outbreak period in mainland China were used in the data analysis. Logistic regression analyses were conducted to explore the association between the secondary attack rate of SARS and meteorological factors and air pollution. Results In univariate analyses, daily average temperature (DAT), daily average air pressure (DAAP), and daily average relative humidity (DARH) were inversely associated with secondary attack rate (P

Background. Surveillance for pneumococcal respiratory illness was conducted in children hospitalized at Affiliated Pediatric Hospital of Fudan University in Shanghai from August 2000 to August 2001. Methods. Sputum cultures were obtained from pediatric patients admitted with pneumonia or respiratory distress by tracheal aspirate. Blood cultures were also performed on a subset of patients. All pneumococcal isolates were serotyped and tested for antibiotic susceptibility. In addition clinical information on the patients including prior antibiotic history was abstracted. Streptococcus pneumoniae tracheal isolations were attempted in a total of 1013 pediatric patients hospitalized during this period. Among these samples 112 specimens were S. pneumoniae-positive. These positive isolates underwent serotyping and antibiotic susceptibility testing. Results. Five serotypes (19F, 23F, 6A, 14, 6B) of S. pneumonia accounted for 81% (91 of 112 cases). Other serotypes accounted only for 12% (13 of 112 cases), and 7% (8 of 112 cases) of isolates could not be typed by quelling test. Only one blood culture isolate was positive, probably reflecting the frequent use of antibiotic treatment before hospitalization. Fifty-one and 8.0% of isolates had intermediate and high level penicillin resistance, respectively. Fifty-eight percent were resistant to ampicillin, 6.6% to cefazolin, 25.0% to cefaclor, 6.6% to ceftriaxone, 85.7% to erythromycin, 66.7% to clindamycin and 28.2% to chloramphenicol. Among 66 isolates that were not susceptible to penicillin, serotype 19F was the most common, followed by 23F and 14. Conclusion. S. pneumoniae is a common cause of respiratory illness requiring hospitalization in young children in Shanghai, with antibiotic resistance increasingly common. Five serotypes account for most disease.

OBJECTIVE Our objective was to determine the secular trend in prevalence of type 2 diabetes in Shanghai, China. RESEARCH DESIGN AND METHODS Two consecutive population-based surveys for type 2 diabetes were conducted in randomly selected adults aged 35–74 years in Shanghai in 2002–2003 (n = 12,329) and in 2009 (n = 7,423). Diagnosed type 2 diabetes was determined based on self-report, whereas those undiagnosed were identified by measured fasting and postload glucose according to 2009 American Diabetes Association criteria. RESULTS Age-standardized prevalence of diagnosed and undiagnosed type 2 diabetes increased from 5.1 and 4.6% in 2002–2003 to 7.4 and 5.2% in 2009. The prevalence of type 2 diabetes increased with age and was higher among men and in urban residents in both surveys (P < 0.001). Between the two surveys, the increase in the prevalence was more evident in the rural population (P < 0.001) and appeared more rapid in younger birth cohorts (P < 0.05). CONCLUSIONS Our results suggest that Shanghai has experienced an increasing burden of type 2 diabetes.

To understand the distribution of univalvia molluscs in Eastern Dongting lake area where the Oncomelania hupensis is extinct, so as to explore the causes of extinction and to provide the evidence for formulating schistosomiasis control strategy.The univalvia molluscs of the Qianliang Lake district, Jianxin District and Junshan Park were investigated in August of 2013. All the collected snails were classified and identified. The data were analyzed by using the method of Shapiro-Wilk normality test and non-parametric test. The ecological biodiversity differences from each district were compared by the biodiversity indexes.The univalvia molluscs collected were from 6 species in 3 families in Gastropoda class, namely Oncomelania hupensis Gredler in Pomatiopsidae family, Parafossarulus striatulus, Alocinma longicornis, Parafossarulus sineasis, Bithynia fuchsisana in Bithyniidae family, and one genus provisioy nally named Radix in Lymaneidae family. In Junshan Park, a total of 4553 snails were collected, among which 1264 were Oncomelania snails. In Jianxin District, 336 univalvia molluscs were collected, and no Oncomelania snails were found. In Qianliang Lake district, there were only 7 Alocinma longicornis snails, 2 Parafossarulus sinensis snails and 1 Parafossarulus striatulus snail collected. There were significant differences among the distributions of the samples from the three districts (chi2 = 166.225, P0.01) .The Simpson's diversity indexes in Qianliang Lake area, Jianxin Dis- trict and Junshan Park were 0.4028, 0.7186 and 0.6788, respectively, and the Shannon-Wiener indexes of the 3 areas were 0.7215, 1.4313 and 1.1999, respectively.With the extinction of Oncomelania snails, the species and quantities of other snails become rare in Qianliang Lake area. Whether their causes are relevant is worth further studying.

To understand the change trend of Oncomelania hupensis snails in the bottomland areas of Qian Liang Lake district in Eastern Dongting Lake area so as to provide the evidence for formulating a schistosomiasis control strategy.The monitoring data of snails of Qianliang Lake district from 1988 to 2011 were collected retrospectively and analyzed by using the method of the trend Chi-square test. The correlations among the snail density indicators were analyzed.1988 to 2011, the area of snails surveyed did not change and was 433.2 hm(2). The monitoring data showed that the change trend of the density of living snails and the schistosome infection rates of snails were not obvious (P0.05), but the mortality of snails showed a falling trend (P0.05); There were positive correlations between the average density of infected snails and the mortality of snails (r = 0.640, P0.05) , the infection rate of snails (r = 0.639, P0.05) , and the average density of living snails (r = 0.646, P0.05) , respectively. There was no correlation among other snail indicators. In 1999, only 7 snails were found, of them, only one snail was alive. The alive snails were not found after 2000.In the bottomland areas of Qianliang Lake district, the change trend of the density of alive snails were not obvious from 1988 to 1998, but the number of snails underwent a sharp drop in 1999 and snails have been not found till now.

To investigate the relationships between hyperuricaemia, serum uric acid (SUA) level and the chronic kidney disease (CKD) in adult residents of Pudong New Area, Shanghai.3326 residents aged 20 - 80 years were randomly selected from Pudong New Area, Shanghai through multistage sampling and interviewed between April and July of 2008. Fasting blood sample and morning ovid urine sample were collected for each participant for testing of SUA, serum creatinine, urinary albumin and creatinine. Both urine albumin to creatinine ratio (ACR) and glomerular filtration rate (GFR) were calculated to estimate the renal function.The overall prevalence of CKD was 16.0% (age standardized 13.2%). The mean values of estimated GFR in participants with CKD and without CKD were (89.19±27.25) and (105.88±98.37) ml×min(-1)×(1.73 m2)(-1), respectively. The prevalence rates of CKD in serum uric acid quartiles: first quartile, less than 4.2 mg/dl; second quartile, 4.2-5.0 mg/dl; third quartile, 5.0-6.0 mg/dl; and fourth quartile, 6.0 mg/dl or more were 13.9%, 15.0%, 15.8%and 19.4% (P0.05) respectively, increasing along with the increase of SUA among both sexes. Compared to the serum uric acid first quartile, the multivariate-adjusted odds for CKD of the second, third and fourth quartiles were 1.19 [95% confidence interval (CI): 0.90-1.58], 1.27 (95%CI: 1.02-1.70), 1.28 (95%CI: 1.10-1.68), respectively.Hyperuricaemia was independently associated with the increased prevalence of CKD among population living in the Pudong New Area, Shanghai.

To observe the compliance of film-coated praziquantel tablets in the schistosomiasis transmission controlled areas, so as to provide the evidence for the establishment of chemotherapy intervention measures in these areas.In the areas of schistosomiasis transmission controlled in Sichuan Province, 234 people were selected as film-coated praziquantel group (FCPG), and 203 people were selected as praziquantel group (PG). A questionnaire survey was implemented and the compliance of chemotherapy of the 2 groups was compared.In PG, all the people indicated that the praziquantel tablets has bad smell, 98.0% of the people had side-effects, such as nausea, headache, 69.5% thought the medicine was harmful to health subjectively, and 99.5% thought that it was too much dose of tablets for taking one time. In FCPG, all the people indicated that the film-coated praziquantel tablets had no bad smell, 18.8% of the people had side-effects, and 74.4% would like to choose film-coated praziquantel tablets. The rates of knowledge of praziquantel of PG and FCPG were 50.7% and 29.1%, respectively ( chi2 = 21.449, P = 0.01).The film-coated praziquantel tablets have no bad smell and lighter side-effects. The compliance of the film-coated praziquantel tablets is high in the areas of schistosomiasis transmission controlled, so the film-coated praziquantel tablets are worth to popularize and apply.

To evaluate the cost-benefit for the Influenza Type A H1N1 Virus (Influenzae H1N1) vaccination in Shanghai primary and junior schools.A semi-experiment study was selected to evaluate the cost-benefit for Influenza H1N1 vaccination in primary and junior schools in 6 districts of Shanghai, including 414 636 students in total. According to the voluntary principle, the students were divided into the vaccinated group (233 445 students) and control group (181 191 students). The information of vaccine cost was collected from CDC in 19 districts in Shanghai by questionnaire; and the information of medical treatment cost was collected from questionnaire and abstracts of retrospective medical records, which included 31 mild cases and 15 severe cases. The cost-benefit analysis was conducted by health economic evaluation.In total, there were 414 636 students enrolled in this study; while 233 445 (56.3%) students were in the vaccinated group and 181 191 in the control group. The attack rate in vaccinated group and control group was 0.61% (1433/233 445) and 1.76% (3166/181 191) respectively. The protection ratio was 65.34% ((1.76 - 0.61)/1.76) in the vaccinated group. The average cost of Influenza H1N1 was 36.81 yuan/person; and the average cost of medical treatment was (358.3 ± 243.6) yuan/mild case and (49 188.4 ± 99 917.3) yuan/severe case. The total benefit of vaccination in schools was 19 155 566.3 yuan, and the net benefit was 10 560 673.7 yuan. Therefore, the benefit-cost ratio was 2.24:1.Influenza H1N1 vaccine could protect the students from Influenza H1N1 infection, and the cost-benefit analysis showed that the intervention strategy was worth trying.

To detect the schistosomiasis clusters in marshland and lake areas in 2008, so as to provide the reference for schistosomiasis control and the methodology for detection of cluster areas of related diseases.SaTScan was used to detect the schistosomiasis clusters based on the spatial database from GIS and related variables, including the number of current patients and population in endemic areas.A total of 5 clusters including 39 counties (districts) were detected by SaTScan, the RRs and the Log-likelihood ratios of 3 clusters among them were over 3 and 1 000 (P0.05), respectively. The one with the highest RR and Log-likelihood ratio was located in the boundary of Hubei and Hunan provinces, and the cluster range there was the biggest. From there to the downstream of the Yangtze River, the area and RRs of the 5 clusters became smaller and smaller.The 5 provinces in the marshland and lake areas are still the key spatial clusters of schistosomiasis, especially near the boundary of Hubei and Hunan provinces.

The surveillance network of schistosomiasis in China can be roughly divided into three parts, namely repetitive cross-sectional sample survey, regional surveillance, and fixed longitudinal surveillance. The result of the network provides an important basis for decision-making to realize the endemic situation of schistosomiasis, to develop and evaluate the control planning and its effects in various stages. However, there still exist some problems in the surveillance network of schistosomiasis, such as relatively backward of the surveillance technology, low utilization of data, lack of an effective monitoring network evaluation system and so on. With the advances in socio-economic and technology, the surveillance network of schistosomiasis will develop from a single integrated disease surveillance towards a multi-disciplines surveillance, and gradually establish an efficient and timely surveillance system integrating early warning and multi-disciplines surveillance after the establishment and improvement of real-time reports and other basic information platform.

To explore the spatial pattern of the distribution of Oncomelania hupensis population in marshland and lake region.Four bottomlands were selected randomly for the investigation along the Qiupu River in Guichi District, Anhui Province. The quadrats were placed randomly for snail survey, and the mean crowding, mean density, aggregation indices (diffusion coefficient (C), morisita index (Idelta), index of patchiness (m*/m) ), Taylor's power law and Iwao's m*-m regression index were analyzed.For 4 bottomlands in different time, the diffusion coefficients, Morisita indices, and m*/m indices were all more than one. There was a close linear relationship between the logarithm of the snail density and its variance (P0.01), and the correlation coefficient was 0.972. In Taylor's power law, the lg a was 0.602 and b was 1.427. There was a close linear relationship between the mean crowding (m*) and the snail density (m) (P0.01), and the correlation coefficient, alpha and beta was 0.984, 2.367 and 1.617 respectively.The spatial pattern of Oncomelania hupensis population shows an aggregation distribution in marshland and lake region, and the basic components of snail distribution are in colonies.

A total of 1,811 individuals from two villages located in the areas of China endemic for Schistosoma japonicum were analyzed by the Kato-Katz parasitologic examination, indirect hemagglutination assay (IHA), and enzyme-linked immunosorbent assay (ELISA). Statistical analysis of the results showed the kappa indices ranged from 0.106 to 0.234 between IHA and the stool examination and ranged from 0.037 to 0.134 between ELISA and the fecal examination. The sensitivity value of the IHA was 83.7% in Village A and 92.3% in Village B; the specificity value of the IHA was 55.8% in Village A and 67.3% in Village B. The sensitivity value of the ELISA was 88.4% in Village A and 96.2% in Village B; the specificity value of the ELISA was 38.4% in both Village A and Village B. A search for a good diagnostic test that can be applied in field situations in China should be given high priority.

To explore the genetic diversity among populations of Oncomelania hupensis.Amplified fragment length polymorphism method was used to amplify the genomic DNA pools of twenty five snail populations from ten provinces, and the genetic diversities among these snail populations were analyzed.The coefficient rates of similarity (GS(DICE)) among twenty five snail populations were ranged was from 0.694 to 0.831 while Nei's unbiased genetic identity was from 0.635 to 0.799. Genetic distance D from 0.169 to 0.306, and Nei's unbiased genetic distance from 0.225 to 0.452. Genetic variation among smooth-shell snail populations was higher than that of ribbed shell snail populations. Twenty five snail populations were divided into three groups: group A including smooth-shell snail from Fuqing of Fujian province and Yizhou of Guangxi province while group B consisted of smooth-shell snail from Dali of Yunnan province and Xichang, Puge, Danleng, Pujiang, Guanghan of Sichuan. Group C was composed of other seventeen snail populations from the Yangtze River drainage below the Three Gorges.Big genetic variation was found among these populations of Oncomelania hupensis. The clustering result of snail populations in genomic level was consistent basically with geographical distribution.

To specify the trends of endemic situation among twenty one national surveillance sites for schistosomiasis from 2000 to 2004.According to the national surveillance protocol, longitudinal surveillance on endemic situation of schistosomiasis was carried out at twenty-one sites since 2000.The infection rate of Schistosoma japonicum declined in six of the twenty-one surveillance sites. The density of living snails and of infected snails decreased in two sites but not well controlled in most other sites. The prevalence in cattle fluctuated yearly in most sites and maintained at a relatively high level. During the surveillance period, acute cases were found annually and the number of advanced patients did not increase significantly. No new case and infected snails were found in Jinshan, Shanghai, since 2000, where transmission of schistosomiasis was interrupted two decades ago.Routine control strategies such as selective chemotherapy combined with livestock chemotherapy, snail control in risk areas have a positive impact on the control of schistosomiasis. However, these strategies should be lasted for longer time and the surveillance on snails and cattle should be continued.

Many epidemiologists have agreed that a refined estimate of the incubation period of severe acute respiratory syndrome (SARS) would need a sample size of about 200 cases and appropriate statistical methods enabling the inclusion of cases with defined periods of exposure. However, no such studies have been reported so far. Besides, determinants of the SARS incubation period remain unclear. In this study, 209 probable SARS cases with documented episodes of exposure between March 1 and May 31, 2003, in mainland China were included. A nonparametric method was used to analyze these data with defined periods of exposure to obtain the refined estimate of the SARS incubation period. Furthermore, the authors also explored the influence of various factors on the SARS incubation period by analysis of variance, linear regression analysis, and analysis of covariance. The estimates of mean and variance of the SARS incubation period were 5.29 days and 12.33 days2, respectively; 90% of patients would have an incubation period of less than 11.58 days with a probability of 0.8, and 99% of patients would have an incubation of less than 22.22 days with a probability of 0.9. The affected area showed a highly significant effect on the incubation period (p < 0.001), but the contact pattern, occupation, gender, and age did not.

To build an epidemic model of severe acute respiratory syndrome (SARS) to be used to quantitatively evaluate the effectiveness of intervention measures.Following the nature of SARS epidemics, an epidemic model of SARS based on SEIR model of infectious disease was built, in which case management group was set up and some parameters related to control measures were included. As an example, data gathered from Beijing was fitted to illustrate its application to quantitatively evaluate the intervention measures.In the newly developed model of epidemics, parameters related to control measures could easily be modified. When scenario assumption was used, a model on SARS outbreak under various circumstances of intervention measures could be set. Thus, quantitative evaluation of intervention measures could perfectly be caried out. Pilot study revealed that the fitness existed in modeling the outbreak of SARS in Beijing and the intervention measures implemented around April 20, 2003, had major contribution to the control of SARS.The model of SARS epidemics seemed to be stable and reliable to be used to evaluate the effectiveness of intervention measures implemented during the SARS outbreak in a quantitative way.

This paper presents a statistical method of familial correlation on family data from case-control studies.Marginal mean models of the probands and the relatives conditional on the proband's disease status, as well as the marginal association model of the relatives were modeled integrately. Conditional odds-ratio and marginal odds-ratio were used to measure the familial correlation.The parameter's interpretation in the model was in accordance with sample characteristics. This method is more efficient due to making fully use of information of the probands and relatives. In addition, the method has all advantages of GEE2.The method in this paper efficiently and conveniently analyzes the family data from case-control studies to estimate the familial correlation on disease.

To study the effect of infection control on schistosomasis Japonicum based on selective chemotherapy.Data were derived from national surveillance of schistosomiasis from 2000 to 2002, and random effect model of Meta-analysis was used to analyze the effect of chemotherapy on controlling schistosomiasis infection.One year after chemotherapy was started in the pilot villages where infection rate of schistosomiasis was more than 10%, the infection rates among residents and eggs per gram (EPG) of patients as well as population (geometric mean, GM) significantly reduced by 20.15%, 22.91% and 33.93% with 95% confidence interval (CI) 6.95 - 31.48, 14.69 - 30.34 and 11.69 - 50.68 respectively. In the pilot villages where infection rates were between 6% and 10%, the control measures largely base on chemotherapy significantly reduced the infection rate, by 24.50 (95% CI: 5.35 - 39.83). However the infection rates were no longer reduced in the pilot villages where the infection rate was less than 6%; EPG of patients and residents were maintained at the original level in the pilot villages where infection rate was 10% or less.In China, the rates of schistosomiasis Japonicum infection could be effectively reduced through the control measures largely based on chemotherapy, and they were kept at a relatively low level. However, it was very difficult to interrupt the transmission of schistosomiasis.

To identify the trends of endemic situation at the twenty-one national surveillance sites from 2000 to 2002.According to the protocol of the national surveillance system, longitudinal surveillance of endemic situation of schistosomiasis was carried out at the twenty-one surveillance sites since 2000.Relative indexes of endemic situation of schistosomiasis decreased in two surveillance sites annually. The infection rate of Schistosoma japonicum in human population decreased in most surveillance sites. The infection rate of cattle decreased in eight surveillance sites. However, acute cases were found in two sites each year. The density of live snails and infected snails was higher compared with that in 2000 among eight sites and infected snails were found in inner embankment in Junshan surveillance sites. Hunan Province, in 2002 at first time. The snail ridden areas increased significantly in Fengjin sites, Shanghai, where schistosomiasis was eliminated years ago.Current control strategies have some impact on the morbidity of schistosomiasis. However, these strategies should be lasted for longer time and surveillance on snails should be enhanced.

To explore the synthetical index for diagnosing schistosomiasis with ultrasound and to assess the prevalence rate with the index.Ultrasound indexes of schistosomiasis Japonicum were analyzed by principal component analysis, and the synthetical indexes were assessed by ROC curve.Among the abnormal rates of the 6 indexes, the lowest was 1.6% comparing with the highest of 59.5%. Significant difference was noficed among the abnormal rates (chi(2) = 631.1, P0.01). The individual correlation of the six indexes to each other as will as with age distribution was significant (P0.05). The three principal components reflected the degree of pathological changes on liver and spleen. The first principal component was the factor reflecting the degree of liver pathological changes, and the second and third principal components reflected the degree of pathological changes on spleen. The synthetical index D(1) = 0.047X(1) + 0.428X(2) + 1.247X(3) + 0.095X(4) + 0.002X(5) + 0.213X(6) - 12.837 was found by adding the three weight principal components, and it's area under the ROC curve was 0.957. When -1.70 was taken as the critical value, the abnormal rate of population was 66.3%, close to the resident's actual prevalence rate 66.9%.Ultrasonography was considered as a method which could rapidly assessing the resident's prevalence rate in the endemic areas of schisitosomiasis Japonicum, and could also provide powerful information for development of strategy on chemotherapy.

Background Few population-based studies have examined the relationship between glycemic status and chronic kidney disease (CKD) in China. We examined the prevalence of CKD across categories of glycemia [diagnosed diabetes, undiagnosed diabetes (fasting plasma glucose [FPG] ≥ 126 mg/dL), prediabetes (FPG 100–126 mg/dL) and normal glycemia (FPG Methods 5,584 Chinese adults aged 20–79 years were selected from the Pudong New Area of Shanghai through a multistage random sampling. Demographic and lifestyle characteristics, anthropometry and blood pressure were measured. Biochemical assays included FPG, serum creatinine and lipids, urinary creatinine and albumin. Prevalence of albuminuria [urine albumin-to-creatinine ratio (ACR) ≥ 30 mg/g], decreased kidney function and CKD (either decreased kidney function or albuminuria) across levels of glycemia were estimated. Results The prevalence of albuminuria, decreased kidney function and CKD each increased with higher glycemic levels (P Conclusions As much as 30% of the CKD burden may be associated with dysglycemia among Chinese adults, independent of age, gender and hypertension status. Prevention and control of diabetes and prediabetes should be a high priority in reducing the CKD burden in China.