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BACKGROUND: Orbital blowout fracture is common in ocular trauma. Accurate measurement of orbital volume after fracture is key in improving intraocular correction. OBJECTIVE: This study aims to explore the impact of 3D reconstruction technology in restoring normal exophthalmos in patients with old orbital wall fractures. METHODS: A total of 31 patients were randomly divided into an experimental group (n= 15) and a control group (n= 16). For orbital wall repair and reconstruction, the conventional group used the conventional surgical scheme, and the 3D group used 3D printing technology. RESULTS: There was no statistical difference between the preoperative mean extraocular muscle volume of the healthy eye and the affected eye. However, the mean orbital volume (24.76 vs 27.11, P= 0.005) and mean retrobulbar fat volume (17.53 vs 16.42, P= 0.006) were significantly different between the healthy eye and the affected eye. After an average follow-up of 16 weeks, the differences in pre- and post-surgery exophthalmos in the two groups were 0.42 ± 0.08 mm and 1.63 ± 0.51 mm, respectively. The difference between the two groups was statistically significant (t= 4.42, P= 0.003). The complications were not statistically different. CONCLUSION: Using 3D reconstruction technology preoperatively can significantly improve exophthalmos in patients with old orbital wall fractures.

Legal English courses for international students in pre-LLM (Pre-Master of Laws) programs in the U.S. are important and require careful design to meet the needs of the students. This paper, taking the legal English course design of pre-LL.M. program in a Midwestern university in the U.S. as a case, discusses a theoretically informed, research-based approach to the design of a pre-LL.M. program emphasizing legal English based on a needs analysis. In the paper, a target situation analysis, present situation analysis, and teaching context analysis are carried out to understand the needs of the law school and needs of the students. According to these multifaceted needs analysis, goals and objectives of the course are established and teaching material are developed by following effective guidelines. These materials guide the suggested development of classroom activities in the lesson plan which integrates the SIOP® model. It is hoped that the analysis of pre-LL.M. legal English courses, its subsequent design in a U.S. context, and application of related theories and practice in this paper can be broadly applied in other institutions or ESP course design settings in global contexts.

Pengfei Ren,1,2,* Keyan Wang,3,* Jie Ma,1,2 Xiaoqin Cao,4 Jiuzhou Zhao,1,2 Chengzhi Zhao,1,2 Yongjun Guo,1,2 Hua Ye5,6 1Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China; 2Henan Key Laboratory of Molecular Pathology, Zhengzhou, People’s Republic of China; 3Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, People’s Republic of China; 4Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China; 5College of Public Health, Zhengzhou University, Zhengzhou, People’s Republic of China; 6Henan Key Laboratory of Tumor Epidemiology and State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongjun Guo, Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University, 127 Dongming Road, Zhengzhou, 450008, People’s Republic of China, Fax +86 371 65587506 Email guoyongjun@zzu.edu.cn Hua Ye, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001, People’s Republic of China, Fax +86 371 67781248, Email yehua@zzu.edu.cnPurpose: Ferritin is a protein that plays an important role in iron metabolism, it consists of two subunits: heavy chain (FTH) and light chain (FTL). Elevated expression of FTL is observed in multiple malignancies. Recent studies have found that the frequency of circulating autoantibody against FTL (anti-FTL) increased significantly in hepatocellular carcinoma (HCC). The aim of this study is to verify circulating anti-FTL as a biomarker for the early detection of HCC.Patients and Methods: A total of 1565 participants were enrolled and assigned to two independent validation cohorts, including 393 HCC patients, 379 liver cirrhosis (LC) patients, 400 chronic hepatitis (CH) patients, and 393 healthy subjects. The concentration of serum anti-FTL was measured by indirect Enzyme-Linked Immunosorbent Assay (ELISA). Kruskal–Wallis test was used to compare anti-FTL concentrations between HCC group and three control groups. Percentile 95 of anti-FTL absorbance value of healthy group was selected as the cut-off value to calculate the positive rate in each group. The area under receiver operating characteristic curve (AUC) was used to quantitatively describe its diagnostic value.Results: The median concentration of anti-FTL in HCC patients was higher than that in CH patients and healthy subjects, but there was no difference between HCC patients and LC patients. Further analysis showed that there was no difference between early stage LC, advanced stage LC, Child-Pugh A HCC, Child-Pugh B HCC and Child-Pugh C HCC. The positive rate of anti-FTL was 12.2% (48/393) in HCC, 13.5% (51/379) in LC, 6.3% (25/400) in CH and 5.1% (20/393) in healthy subjects, respectively. The AUC of anti-FTL to distinguish LC from CH or healthy subjects were 0.654 (95% CI: 0.615– 0.692) and 0.642 (95% CI: 0.602– 0.681), respectively.Conclusion: Anti-FTL is not a biomarker for the early diagnosis of HCC due to specificity deficiency, but may be helpful for the early detection of LC.Keywords: biomarker, ferritin light chain, hepatocellular carcinoma, liver cirrhosis, tumor-associated antigen

Two large randomized controlled trials (RCTs) have demonstrated that low dose computed tomography (LDCT) screening reduces lung cancer mortality. Risk-prediction models have been proved to select individuals for lung cancer screening effectively. With the focus on established risk factors for lung cancer routinely available in general cancer screening settings, we aimed to develop and internally validated a risk prediction model for lung cancer.Using data from the Cancer Screening Program in Urban China (CanSPUC) in Henan province, China between 2013 and 2019, we conducted a prospective cohort study consisting of 282,254 participants including 126,445 males and 155,809 females. Detailed questionnaire, physical assessment and follow-up were completed for all participants. Using Cox proportional risk regression analysis, we developed the Henan Lung Cancer Risk Models based on simplified questionnaire. Model discrimination was evaluated by concordance statistics (C-statistics), and model calibration was evaluated by the bootstrap sampling, respectively.By 2020, a total of 589 lung cancer cases occurred in the follow-up yielding an incident density of 64.91/100,000 person-years (pyrs). Age, gender, smoking, history of tuberculosis and history of emphysema were included into the model. The C-index of the model for 1-year lung cancer risk was 0.766 and 0.741 in the training set and validation set, respectively. In stratified analysis, the model showed better predictive power in males, younger participants, and former or current smoking participants. The model calibrated well across the deciles of predicted risk in both the overall population and all subgroups.We developed and internally validated a simple risk prediction model for lung cancer, which may be useful to identify high-risk individuals for more intensive screening for cancer prevention.

The increasing energy demand has prompted engineers to explore deeper wells where rich oil and gas reserves exist. However, the high-temperature and high-salt conditions have impeded the further application of traditional water-based fracturing fluids in such reservoirs. Therefore, it is urgent to develop fracturing fluids that are suitable for such geographic characteristics. In this study, for the first time, a novel synthetic polymer, poly-(acrylamide-co-acrylic acid-co-2-acrylamido-2-methyl-1-propanesulfonic acid) (P3A), was investigated as a rheological modifier for water-based fracturing fluids in high-temperature and high-salt conditions and compared with a guar gum system. Results showed that the apparent viscosity increased with increasing P3A and guar gum concentrations, and the thickening ability of P3A was much better than that of guar gum. Despite the better shear and temperature resistance and proppant suspension ability of guar gum fluids in high-temperature and saturated salt conditions, plentiful solid residues after gel-breaking have prevented their progress in the petroleum industry. P3A fluids have no residues, but the unsatisfying proppant suspension capability and high dosage encourage us to promote their rheological performance via interaction with an organic zirconium crosslinker. Infrared spectroscopy and scanning electron microscopy were applied to guarantee the successful reaction of P3A with the crosslinker. The subsequent investigation indicated that the transformed fracturing fluid exhibited remarkably improved thickening capability and satisfying rheological performance in terms of temperature and shear resistance and proppant-carrying ability as well as gel-breaking results in a high-temperature and saturated salt environment. All of the above results suggest the potential application of crosslinked P3A in hydraulic fracturing for the reservoirs with hostile conditions, and this article also provides a new orientation for synthetic polymers utilized in the oil and gas industry.

Atopic dermatitis (AD) is a multifactorial chronic inflammatory skin disease characterized by skin barrier dysfunction, eczematous lesions, pruritus, and abnormal immune responses. In this study, we assessed the therapeutic effect of topical applied conjugated linoleic acid (CLA) on a murine AD model that was developed by repetitive applications of 2, 4-dinitrofluorobenzene (DNFB). 2% or 5% CLA could markedly ameliorate AD-like skin lesions, scratching behaviour and skin inflammation as evidenced by the reduced inflammatory blood cells, IgE and Th2-related cytokine levels, and the infiltration of mast cells and inflammatory cells to the dermal tissues. Moreover, topical application with CLA modulated skin barrier repair including maintaining a balanced skin pH and increasing skin hydration, partially mediated by upregulating skin barrier-related protein, filaggrin (FLG). In addition, topical CLA significantly dose-dependently inhibited pro-inflammatory cytokines including interleukin (IL)-6, IL-1β, tumour necrosis factor (TNF)-α and pro-inflammatory enzyme expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in inflamed mice skin. Its anti-inflammatory effect was associated with the inhibition of DNFB-stimulated IκBα and NF-κB p65 phosphorylation in mouse skin. Taken together, our results suggest that locally applied CLA exerts potentially protective effects against AD lesional skin at least in part, due to regulation of skin barrier function and inflammatory response.

BACKGROUND Premature birth is an unsolved social and public problem. We aimed to explore the independent association and interaction effect between gestational hypertension (GH) and the history of preterm birth (HPB) on the risk of preterm birth. MATERIAL AND METHODS A case-control study involving participants with complete birth data was conducted using the United States National Vital Statistics System in 2019. Logistic regression analysis of 3 models were performed with odds ratio (OR) and 95% confidence interval (CI). Relative excess risk of interaction (RERI), attributable proportion of interaction (AP), and synergy index (S) were used to evaluate the interaction between GH and HPB on the risk of preterm birth. RESULTS A total of 2 822 624 participants were examined, with 10.83% in the known preterm birth group and 89.17% in the control group. Following adjustments for covariates, the association between GH and HPB and preterm birth was significant with ORs of 2.604 (95% CI: 2.573-2.635) and 3.047 (95% CI: 2.997-3.097), respectively. Moreover, there was a significant interaction between GH and HPB on preterm birth risk, with an OR of 6.095 (95% CI: 5.847-6.352), RERI of 1.222 (95% CI: 0.965-1.479), AP of 0.201 (95% CI: 0.167-0.235), and S of 1.317 (95% CI: 1.250-1.387), especially in participants with maternal age 20 to 29, 30 to 34, ≥35 years, and single birth. CONCLUSIONS GH and HPB might be positively associated with preterm birth, and there was an additive interaction between GH and HPB on preterm birth, indicating that obstetricians should pay more attention to prevention in this population.

BACKGROUND Evidence of the effects of cancer prevention knowledge on the risk of developing cancer remains scarce. The objective of this study was to prospectively examine the association of cancer prevention awareness levels with cancer risk in a population-based cancer screening cohort in China. METHODS This prospective cohort study included 164,341 participants aged 40 to 69 years with no history of cancer and with available information on cancer prevention core knowledge in the Esophageal, Stomach, and Liver Cancer Screening Program. Participants were recruited from 18 rural regions across 4 provinces in China from 2007 to 2014 and were followed until December 31, 2015. The core knowledge of cancer prevention content included 9 items, with a total score ranging from 0 to 100. Cox proportional hazards regression models and restricted cubic spline analysis were used to estimate hazard ratios and 95% CIs. RESULTS High cancer prevention knowledge scores were inversely associated with the overall risk of cancer (group 4 vs group 1: hazard ratio, 0.669; 95% CI, 0.576-0.776). Subgroup analysis showed that this inverse association could be observed in women, participants with lower educational or income levels, and those without a family history of cancer. Restricted cubic spline analysis exhibited a nonlinear (L-shaped) relation between cancer knowledge scores and cancer risk (overall P

The mortality benefit of esophageal squamous cell carcinoma (ESCC) screening has been reported in several studies; however, the results of ESCC screening programs in China are suboptimal. Our study aimed to develop an ESCC risk prediction model to identify high-risk individuals for population-based esophageal cancer screening. In total, 86 745 participants enrolled in a population-based esophageal cancer screening program in rural China between 2007 and 2012 were included in the present study and followed up until December 31, 2015. Models for identifying individuals at risk of ESCC within 3 years were created using logistic regressions. The area under the receiver operating curve (AUC) was determined to estimate the model's overall performance. A total of 298 individuals were diagnosed with ESCC within 3 years after baseline. The model of ESCC included the predictors of age, sex, family history of upper gastrointestinal cancer, smoking status, alarming symptoms of retrosternal pain, back pain or neck pain, consumption of salted food and fresh fruits and disease history of peptic ulcer or esophagitis (AUC of 0.81; 95% confidence interval: 0.78-0.83). Compared to the current prescreening strategy in our program, the cut-off value of 10 in the score-based model could result in 3.11% fewer individuals subjected to endoscopies and present higher sensitivity, slightly higher specificity and lower number needed to screen. This score-based risk prediction model of ESCC based on eight epidemiological risk factors could increase the efficiency of the esophageal cancer screening program in rural China.

Ischemic cardiovascular disease (ICVD) has high incidence and high mortality worldwide. The studies of its risk factors were mostly concentrated on an individual level, and there are scarce studies on the two levels of risk factors which include individual and regional levels.The data were obtained from a community-based study in 4 cities and 6 counties of Henan, China. Risk factors were initially screened by one-way analysis of variance or chi-square test. Then, they were re-analyzed using a two-level logistic regression model to construct a personal disease risk prediction model.A two-level ICVD risk prediction model comprised 11 variables: age, body mass index (BMI), family history of hypertension, marital status, salt intake, smoking, moderate recreational physical activities, alcohol intake, and education at the individual level. Among the unalterable risk factors, for each additional unit of age and family history of hypertension, the risk of ICVD increased by 1.08 and 1.07 units [β95% confidence interval (95%CI): 0.99-1.16, 0.97-1.17, both p 0.0001], respectively. Among the modifiable risk factors, the ICVD risk increases by 0.67, 0.27, and 0.28 units for each additional unit of BMI, marital status, and education (β95%CI: 0.60-0.74, p 0.0001; β95%CI: 0.14-0.40, p = 0.0012, 0.18-0.37, p = 0.0001).The two-level ICVD risk model can predict that the risk of one person for ICVD will be lower if one is younger, thinner, and well-educated without a family history of hypertension. Overall, the two-level ICVD risk prediction model gets a better fitting effect than the single-level model.

Purpose The proportion of cured gastric cancer patients has drawn the attention of patients, physicians, and healthcare providers after comprehensive prevention and control measures were carried out for several years. Therefore, the relative survival and cure fraction were estimated in our study. Methods Population‐based cancer registration data were used to estimate survival and cure fraction. A total of 7585 gastric cancer cases (ICD10:C16.0 ~ C16.9) were extracted and included in the final analysis. Cases were diagnosed in 2003‐2012 and followed until the end of 2017. Relative survival was calculated as the ratio between the observed survival through the life‐table method. The expected survival was estimated by the Ederer II method. The cure fraction was estimated using flexible parametric cure models stratified by age and calendar period when the cases were diagnosed. Results The 5‐year relative survival of cardia gastric cancer increased with the calendar period of 2003‐2004, 2005‐2006, 2007‐2008, 2009‐2010, and 2011‐2012 (27.5%, 28.3%, 33.5%, 38.2%, and 46.8%, respectively). The increasing trend along with the calendar periods was also observed in cure proportion of cardia gastric cancer (24.8%, 25.2%, 31.7%, 36.0%, and 43.1%, respectively). Notable improvement of cure proportion was observed in the period of 2011‐2012, compared with the initial period of 2003‐2004. There was an improvement of 79.8% among all gastric cancer subjects, and it was 74.1% and 55.7% in cardia gastric and noncardia gastric cancer subjects, respectively. The median survival of “uncured” patients showed no significant improvement along with the calendar periods in all age groups. Conclusions Notable improvement of gastric cancer relative survival and cure proportion was observed in Linzhou during 2003‐2012., Notable improvement of cure proportion was observed in the period of 2011‐2012, compared with the initial period of 2003‐2004. There was an improvement of 79.8% among all gastric cancer subjects, and it was 74.1% and 55.7% in cardia gastric and noncardia gastric cancer subjects, respectively.

In chronic pruritic diseases such as atopic dermatitis (AD), pruritus and skin lesions are exacerbated by scratching in clinical and experimental settings. TRPV1 is known to mediate itch and neurogenic inflammation, but the role of TRPV1 in itch-associated scratching in AD is poorly understood. In this study, we examined the efficacy of cutting off nails and TRPV1 antagonist, ruthenium red (RR) in a murine model of AD induced by DNFB and further investigated the underlying mechanism. Nail clipping or RR could markedly ameliorate the general AD-like symptoms as manifested by the reduced clinical severity of dermatitis, IgE and Th2-related cytokine levels, and mast cell degranulation. Moreover, scratching behaviour, the levels of pruritogenic mediators, including HIS, TSLP, IL-31 and SP, and skin pH and TEWL were all significantly decreased in nail clipping or RR-treated mice, suggesting a reduction in itch-associated scratching and skin barrier defects. Immunofluorescence staining and Western blot results revealed that antipruritic effect of nail clipping or RR in AD may be explained, at least in part, by the suppression of TRPV1 activation. In summary, these data show that TRPV1 mediates itch-associated scratching and subsequent skin barrier defects, suggesting its potential as a therapeutic target in AD.

Upper gastrointestinal cancer (UGC) screening has been widely implemented in many Asian countries. However, there is little evidence of participation and diagnostic yields in population‐based UGC screening in China. The participation rate and detection of upper gastrointestinal lesions in this program were reported and related factors were explored. The analysis was conducted in the context of the Cancer Screening Program in Urban China, which recruited 179 002 eligible participants aged 40‐74 years from three cities in Henan province from 2013 to 2017. A total of 43 423 participants were evaluated to be high risk for esophageal cancer or gastric cancer by an established risk score system and were subsequently recommended for endoscopy. Of 43 423 with high risk for UGC, 7996 subjects undertook endoscopy (participation rate of 18.4%). We found that male sex, high level of education, marriage, smoking, current alcohol drinking, lack of physical activity, history of upper gastrointestinal system disease, and family history of UGC were associated with increased participation of endoscopy screening. Overall, 15 UGC (0.19%), 275 squamous epithelial dysplasia (3.44%), and 33 intraepithelial neoplasm (0.41%) cases were detected. Several factors including age, sex, smoking, current alcohol drinking, lack of physical activity, and dietary intake of processed meat were identified to be associated with the presence of upper gastrointestinal lesions. Health promotion campaigns targeting the specific group of individuals identified in our study will be helpful for improvement of the adherence of UGC screening in population‐based cancer screening programs. Participant rate and yield of UGC screening will provide important references for evaluating the effectiveness and cost‐effectiveness of cancer screening in China., Endoscopy is effective in terms of detecting esophageal cancer, gastric cancer, and precursors. The adherence to screening endoscopy in this high‐risk population is relatively low and factors associated with the willingness to accept endoscopy screening were identified. Risk factors associated with upper gastrointestinal lesion in Chinese population were identified.

Objective: Liver cancer is one of the most common types of cancer. We aimed to use the cancer registration data in 2015 to estimate the incidence and mortality of liver cancer in Henan province. Methods: The data from 37 population-based cancer registries in Henan province were collected for this study. The pooled data were stratified by area, sex, and age group. New cases of liver cancer and deaths due to the disease were estimated using age-specific rates and provincial population in 2015. All incidence and death rates were age standardized to the 2000 Chinese standard population and Segi's population, which were expressed per 100,000 populations. Results: After clearance and assessment, data from 30 population-based cancer registries (5 in urban and 25 in rural areas) were included in the analysis. All 30 cancer registries encompassed a total population of 23,421,609 (3,507,984 in urban and 19,913,625 in rural areas), accounting for 21.84% of the provincial population. The proportion of morphological verification (MV%), percentage of cancer cases identified with death certification only (DCO%), and mortality-to-incidence ratio (M/I) were 38.55%, 2.34%, and 0.81, respectively. Approximately 31,639 new cases of liver cancer were diagnosed and 26,057 deaths from liver cancer occurred in Henan in 2015. The crude incidence rate of liver cancer was 27.05/100,000 (36.24/100,000 in men and 17.35/100,000 in women). Age-standardized incidence rates by Chinese standard population and world standard population were 21.10/100,000 and 20.95/100,000, respectively. Liver cancer was more common in men than in women. The incidence rates in urban (26.31/100,000) and rural (27.18/100,000) areas were similar. The crude mortality rate of liver cancer was 21.98/100,000 (29.33/100,000 in males and 14.22/100,000 in females). Age-standardized mortality rates by Chinese standard population and world standard population were 16.93/100,000 and 16.90/100,000, respectively. There was no distinct difference in mortality rates of liver cancer between urban (22.55/100,000) and rural (21.87/100,000) areas. Conclusions: Liver cancer has posed a heavy burden on people in Henan province. Comprehensive measures should be conducted to prevent the increase in the incidence of liver cancer. Key words: Liver cancer; Cancer registry; Incidence; Mortality; Henan province

Objective The cancer etiology in children and adolescents is largely different with that in adults, and the description in epidemiology still remains deficiency. Therefore, we described the cancer incidence and related epidemiological features in children and adolescents to provide clues for etiological studies. Methods Cancer incidence stratified by age, gender, and areas was calculated using data extracted from population‐based cancer registries in Henan Province, China. All cancer among children aged 0‐19 years were reclassified according to category criteria of the International Classification of Childhood Cancer, 3rd Edition (ICCC‐3). Age‐standardized rate (WSR) was calculated using Segi's world standardized population by the direct method, and it was expressed per million person‐years. Results The crude cancer incidence and mortality were 87.56 and 36.32 per million person‐years among children aged 0‐19 years, and the WSRs slightly changed compared with crude incidence and mortality, and they were 87.36 and 35.46 per million person‐years. Leukemia and central nervous system neoplasms (CNS) were the most common cancer categories both in children aged 0‐14 years and in adolescents aged 15‐19 years in regardless of gender and areas. Tiny difference of incidence and mortality existed in different age groups across 0‐14 years; however, they were higher in adolescents aged 15‐19 years than that in children aged 0‐14 years. Among children aged 0‐19 years, the cancer incidence and mortality were predominant in boys, and the sex ratio was 1.19; however, it was varied by diagnostic categories. Conclusion This is the first study that described the cancer incidence and mortality among children aged 0‐19 in Henan Province, and it would help researchers to understand the burden and epidemiological characteristics of childhood cancer, and hence suggested clues for the etiological studies.

This cross-sectional study assesses the participation and detection rates of a lung cancer screening program in China and the factors associated with participation and detection among individuals at high risk for lung cancer., Key Points Question What were the participation rate and detection rate of lung cancer and the factors associated with participation in a population-based screening program in China? Findings In this cross-sectional study of 282 377 participants including 55 428 with high risk for lung cancer, adherence to low-dose computed tomography screening was 40.16%, and factors associated with the willingness to accept low-dose computed tomography screening included female sex, former smoking, lack of physical activity, and family history of lung cancer. Meaning These findings may inform future evaluations of the effectiveness and cost-effectiveness of cancer screening programs in China., Importance Lung cancer screening has been widely implemented in Europe and the US. However, there is little evidence on participation and diagnostic yields in population-based lung cancer screening in China. Objective To assess the participation rate and detection rate of lung cancer in a population-based screening program and the factors associated with participation. Design, Setting, and Participants This cross-sectional study used data from the Cancer Screening Program in Urban China from October 2013 to October 2019, with follow-up until March 10, 2020. The program is conducted at centers in 8 cities in Henan Province, China. Eligible participants were aged 40 to 74 and were evaluated for a high risk for lung cancer using an established risk score system. Main Outcomes and Measures Overall and group-specific participation rates by common factors, such as age, sex, and educational level, were calculated. Differences in participation rates between those groups were compared. The diagnostic yield of both screening and nonscreening groups was calculated. Results The study recruited 282 377 eligible participants and included 55 428 with high risk for lung cancer; the mean (SD) age was 55.3 (8.1) years, and 34 966 participants (63.1%) were men. A total of 22 260 participants underwent LDCT (participation rate, 40.16%; 95% CI, 39.82%-40.50%). The multivariable logistic regression model showed that female sex (odds ratio [OR], 1.64; 95% CI, 1.52-1.78), former smoking (OR, 1.26; 95% CI, 1.13-1.41), lack of physical activity (OR, 1.19; 95% CI, 1.14-1.24), family history of lung cancer (OR, 1.73; 95% CI, 1.66-1.79), and 7 other factors were associated with increased participation of LDCT screening. Overall, at 6-year follow-up, 78 participants in the screening group (0.35%; 95% CI, 0.29%-0.42%) and 125 in the nonscreening group (0.38%; 95% CI, 0.33%-0.44%) had lung cancer detected, which resulted in an odds ratio of 0.93 (95% CI, 0.70-1.23; P = .61). Conclusions and Relevance The low participations rate in the program studied suggests that an improved strategy is needed. These findings may provide useful information for designing effective population-based lung cancer screening strategies in the future.

This study aims to evaluate the clinical performance of the HPV E6/E7 mRNA test in cervical cancer screening in China. A hospital-based study was conducted with mRNA, DNA, and liquid-based cytology (LBC) as primary screening tests. Each woman with a positive result received colposcopy with lesion-targeted-biopsy. Histopathological diagnosis was used as the gold standard. The total agreement of HPV DNA and mRNA was 90.7% (95%CI: 87.9, 92.9) with a kappa value of 0.81. The positive rates of HPV DNA, mRNA, and LBC increased with the severity of histopathology diagnosis, from 25.5%, 19.1%, and 11.4% in normal to 100.0% in SCC, respectively. The sensitivities for mRNA to detect CIN2+ and CIN3+ were 93.8% (95%CI: 89.7-96.4) and 95.7% (95%CI: 91.3-97.9), respectively, which were not different from HPV DNA testing (95.7% [95%CI: 92.0-97.7], 96.3% [95%CI: 92.1-98.3]), but higher than LBC (80.4% [95%CI: 74.5-85.2] and 88.8% [95%CI: 83.0-92.8]). The specificities for mRNA to detect CIN2+ (79.0% [95%CI: 74.2-83.0]) and CIN3+ (70.5% [95%CI: 65.7-74.9]) were higher than HPV DNA testing (71.0% [95%CI: 65.9-75.7], 62.8% [95%CI: 57.8-67.5]), but lower than LBC (84.5% [95%CI: 80.1-88.0] 79.8% [95%CI: 75.4-83.6]). All tests were more effective in women older than 30 years. HPV mRNA test showed excellent agreement with the DNA test, with similar sensitivity and a higher specificity in detecting high-grade cervical lesions. It is promising that mRNA test could be used for the national cervical cancer screening to reduce false positive without losing sensitivity.

Background The COVID-19 pandemic has threatened the health systems of many countries worldwide. Several studies have suggested that the pandemic affects not only physical health but also all aspects of society. A lot of information has been reported about the disease since the beginning of the outbreak. For that reason, it is essential to investigate the attitudes and level of knowledge and awareness that different populations had regarding COVID-19 during the critical period of the outbreak. Objective This study aimed to assess the knowledge and awareness of and attitudes toward the COVID-19 pandemic among different populations in Central China during the critical period of the outbreak. Methods A cross-sectional web-based survey was conducted in Central China from February to March 2020. The study participants included three different populations: medical workers, students, and those with other occupations. In this study, a questionnaire was designed to collect information on the following four aspects: sociodemographic information, knowledge related to COVID-19, awareness of COVID-19, and attitude toward COVID-19. The chi-square test and Fisher test were used for comparison among groups. The level of significance was set at P Results This study enrolled a total of 508 participants. Among them, there were 380 students (74.8%), 39 medical workers (7.7%), and 89 people with other occupations (17.5%). Most of the participants were female (n=272, 53.5%), lived in rural areas (n=258, 50.8%), and were single (n=423, 86.9%). The majority of the respondents had attended college (n=454, 89.4%). Most of the participants said they had heard about COVID-19 by January, and most of them looked for information on social media (Sina Weibo, 84.7%), and WeChat and QQ groups (74.2%). The participants showed an adequate level of knowledge about COVID-19 with no significant differences among the groups. However, medical workers demonstrated a slightly advanced knowledge in their responses to professional questions such as the potential susceptible population, possible host, treatment of COVID-19, and disease category. A higher proportion of medical workers (71.8%) and those in the other occupations group (52.8%) were highly concerned about the COVID-19 pandemic. More than 43% of the participants stated that the lockdown of their village/city had a significant impact on their lives. Nevertheless, the majority of respondents had an overall optimistic attitude toward the control of the disease (92.1% of students [n=350], 94.9% of medical workers [n=37], and 92.3% of those in other occupations [n=83]). Conclusions All three groups reported an adequate background knowledge about COVID-19 but medical workers showed a slightly advanced knowledge in their responses to professional questions. Most of the participants were highly concerned about COVID-19 during the critical period of the outbreak. The majority of respondents declared that the village/city lockdown policy had a significant impact on their daily life but most of them held an optimistic attitude toward the control of COVID-19.

BACKGROUND The COVID-19 pandemic has threatened the health systems of many countries worldwide. Several studies have suggested that the pandemic affects not only physical health but also all aspects of society. A lot of information has been reported about the disease since the beginning of the outbreak. For that reason, it is essential to investigate the attitudes and level of knowledge and awareness that different populations had regarding COVID-19 during the critical period of the outbreak. OBJECTIVE This study aimed to assess the knowledge and awareness of and attitudes toward the COVID-19 pandemic among different populations in Central China during the critical period of the outbreak. METHODS A cross-sectional web-based survey was conducted in Central China from February to March 2020. The study participants included three different populations: medical workers, students, and those with other occupations. In this study, a questionnaire was designed to collect information on the following four aspects: sociodemographic information, knowledge related to COVID-19, awareness of COVID-19, and attitude toward COVID-19. The chi-square test and Fisher test were used for comparison among groups. The level of significance was set at P RESULTS This study enrolled a total of 508 participants. Among them, there were 380 students (74.8%), 39 medical workers (7.7%), and 89 people with other occupations (17.5%). Most of the participants were female (n=272, 53.5%), lived in rural areas (n=258, 50.8%), and were single (n=423, 86.9%). The majority of the respondents had attended college (n=454, 89.4%). Most of the participants said they had heard about COVID-19 by January, and most of them looked for information on social media (Sina Weibo, 84.7%), and WeChat and QQ groups (74.2%). The participants showed an adequate level of knowledge about COVID-19 with no significant differences among the groups. However, medical workers demonstrated a slightly advanced knowledge in their responses to professional questions such as the potential susceptible population, possible host, treatment of COVID-19, and disease category. A higher proportion of medical workers (71.8%) and those in the other occupations group (52.8%) were highly concerned about the COVID-19 pandemic. More than 43% of the participants stated that the lockdown of their village/city had a significant impact on their lives. Nevertheless, the majority of respondents had an overall optimistic attitude toward the control of the disease (92.1% of students [n=350], 94.9% of medical workers [n=37], and 92.3% of those in other occupations [n=83]). CONCLUSIONS All three groups reported an adequate background knowledge about COVID-19 but medical workers showed a slightly advanced knowledge in their responses to professional questions. Most of the participants were highly concerned about COVID-19 during the critical period of the outbreak. The majority of respondents declared that the village/city lockdown policy had a significant impact on their daily life but most of them held an optimistic attitude toward the control of COVID-19.

It is of significant importance for the design of electrodes to construct enhanced electrochemical sensing platforms, and a nanoarray offers an ideal architecture for the detection of molecules. In this communication, we demonstrate that cobalt phosphide nanowire array grown in situ on titanium mesh (CoP NA/TM) exhibits high catalytic activity towards electrooxidation of glucose. As a non-enzymatic electrochemical glucose sensor, this CoP NA/TM catalytic electrode possesses superior analytical performance with a short response time of less than 5 s, a wide linear range of 0.0005–1.5 mM, a low detection limit of 0.1 μM (S/N = 3), a high sensitivity of 5168.6 μA mM−1 cm−2, and a remarkable selectivity and long-term stability for glucose detection. We further demonstrate the successful use of such glucose biosensors in human blood serum and fruit juice.

In this communication, we demonstrate that a nickel cobalt sulfide nanosheet film electrodeposited on a titanium mesh (Ni–Co–S/TM) exhibits high catalytic activity toward electrooxidation of glucose. As a nonenzymatic glucose sensor, this Ni–Co–S/TM catalyst electrode shows a wide linear response range of 0.001–3 mM, a low limit of detection of 0.12 μM with a signal-to-noise ratio of 3, a sensitivity of 3291.5 μA mM−1 cm−2, and a fast response time of less than 5 s. Moreover, it also demonstrates high selectivity, good reproducibility and long-term stability for glucose detection.

Background and Aims In China, regional organized esophageal cancer screening programs have been implemented since 2005. However, the implementation of these screening programs is still facing some urgent challenges, especially concerning identifying high-risk individuals. This study aimed to evaluate the risk stratification potential of the current initial assessment strategy used in a mass esophageal squamous cell carcinoma (ESCC) screening program in China. Methods A total of 43,875 participants without a previous cancer history enrolled in a mass ESCC screening program in China from 2007 to 2010 who had initial assessment results were included in this study and were followed until December 31, 2015. Eight potential risk factors for ESCC were evaluated in the initial assessment strategy. A comprehensive evaluation of the association of the initial assessment results with ESCC risk was performed by propensity score matching and Cox regression analysis. Results During a median follow-up of 5.5 years, 272 individuals developed ESCC. The high-risk population assessed at baseline had a higher risk of ESCC than the non-high-risk population, with a hazard ratio (HR) of 3.11 (95% confidence interval (CI), 2.33-4.14) after adjustment for sex, age, education level, income level, and body mass index. In addition, the initial assessment results of the high-risk population were significantly associated with the risk of all esophageal cancers (HR, 3.30; 95% CI, 2.51-4.33) and upper gastrointestinal cancers (HR, 3.03; 95% CI, 2.43-3.76). Conclusions The initial screening tool in a mass ESCC screening program in China, consisting of 8 accessible variables in epidemiologic surveys, could be helpful for the selection of asymptomatic individuals for priority ESCC screening.

Background Survival of esophageal cancer in Linzhou was seen to increase over the past few decades and is higher than the average level of China due to the implementation of comprehensive prevention and control measures. In population-based studies, relative survival is a common index to approximate disease-specific survival. However, the cure fraction maybe great interest to patients and physicians. This study aimed to investigate the cure fraction of esophageal cancer in Linzou city during 2003–2012 with a cure model. Methods We carried out a population-based study of 8067 esophageal cancer patients in the Linzhou city during 2003–2012. Flexible parametric cure models were used to estimate cure proportions and median survival times of uncured by year of diagnosed and age. In each model, an interaction between calendar year and age were included. All variables in the model were included both as constant and time-varying effects. Results The 5-year relative survival rate was increased in every age group from 2003 to 2012. The huge increase in the cure proportion was observed in each age group. At the year of 2011–2012, 79.8%, 58.0%, 123.4% and 162.7% improvements of cure proportion were seen in age group 19–49, 50–59, 60–69 and 70–99 years compared with year of 2003–2004. Meanwhile, survival of ‘uncured’ patients changed little in all age group. Conclusions The improvement of survival in Linzhou city during 2003–2012 was mainly due to an increasing cure proportion. Huge improvement of cure fraction within short period is likely due to the organized screening of esophageal cancer in Linzhou city.

It is highly attractive to develop non-noble-metal nanoarray architecture as a high-active catalyst electrode for molecular detection due to its large specific surface area and easy accessibility to target molecules. In this paper, we demonstrate the development of cobalt nitride nanowire array on Ti mesh (Co 3 N NW/TM) as an efficient catalyst electrode for glucose oxidation in alkaline solutions and H 2 O 2 reduction in neutral solutions. Electrochemical tests suggest that such Co 3 N NW/TM possesses superior non-enzymatic sensing ability toward rapid glucose and H 2 O 2 detection. As a glucose sensor, this fabricated electrode offers a high sensitivity of 3325.6 μA mM −1 cm −2 , with a wide linear range from 0.1 μM to 2.5 mM, a low detection limit of 50 nM (S/N = 3), and satisfactory stability and reproducibility. Its application in determining glucose in human blood serum is also successful. Amperometric H 2 O 2 sensing can also been realized with a sensitivity of 139.9 μA mM −1 cm −2 , a linear range from 2 μM to 28 mM, and a detection limit of 1 μM (S / N = 3). This nanoarray architecture holds great promise as an attractive sensing platform toward electrochemical small molecules detection.

Objective To analyze the incidence and mortality rates of lung cancer in China from 2008 to 2012. Methods Incident and death cases of lung cancer were retrieved from the National Central Cancer Registry (NCCR) database collecting from 135 cancer registries in China during 2008-2012. The crude incidence and mortality rates of lung cancer were calculated by area (urban/rural), region (eastern, middle, western), gender and age group (0, 1-4, 5-9, …, 85+). China census in 2000 and Segi's world population were applied for age-standardized rates. JoinPoint (Version 4.5.0.1) model was used for time trend analysis. Results The crude incidence rate of lung cancer was 54.66/100,000 which ranked the first in overall cancers. The age-standardized incidence rates by China population (ASIRC) and by World population (ASIRW) were 35.13/100,000 and 34.86/100,000, respectively. The crude mortality of lung cancer in China was 45.60/100,000 and it was the first cause of cancer-related death in overall cancers. The age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 28.57/100,000 and 28.22/100,000, respectively. Incidence and mortality rates of lung cancer were higher in males than in females and higher in urban areas than in rural areas. Eastern areas had the highest incidence and mortality rates followed by middle and western areas. Incidence and mortality rates of lung cancer retained low level in age groups before 40 years old but increased greatly after and peaked in age group of 80-84. During 2003-2012, the temporal trend of the incidence rate of lung cancer in both sexes in China was general stable (P 0.05). In urban areas, it declined by 0.76% per year (P

Among reported electrode materials, a nanoarray is an attractive architecture for molecular detection because of its large specific surface area and easy accessibility for target molecules. Here, a new Fe3 N-Co2 N nanowires array grown on carbon cloth (Fe3 N-Co2 N/CC) is reported as a non-noble-metal bifunctional catalyst electrode for high-performance glucose oxidation and H2 O2 reduction. As an electrochemical non-enzymatic sensor for glucose detection, Fe3 N-Co2 N/CC shows a fast response time of 8 s, a low detection limit (LOD) of 77 nm (signal/noise=3), and a high sensitivity of 4333.7 μA mm-1 cm-2 . As an H2 O2 sensor, it shows a LOD of 59 nm (signal/noise=3) and a sensitivity of 2273.8 μA mm-1 cm-2 with a response time of 2 s. In addition, the proposed sensor is stable with high selectivity, specificity, and reproducibility, and its application for real sample analysis has been successfully demonstrated.

It is highly attractive to develop non-noble-metal nanoarray architecture as a 3D-catalyst electrode for molecular detection due to its large specific surface area and easy accessibility to target molecules. Here, we report the development of a copper-nitride nanowires array on copper foam (Cu3N NA/CF) as a dual-functional catalyst electrode for efficient glucose oxidation in alkaline solutions and hydrogen peroxide (H2O2) reduction in neutral solutions. Electrochemical tests indicate that such Cu3N NA/CF possesses superior non-enzymatic sensing ability toward rapid glucose and H2O2 detection with high selectivity. At 0.40 V, this sensor offers a high sensitivity of 14 180 μA mm cm−2 for glucose detection, with a wide linear range from 1 μm to 2 mm, a low detection limit of 13 nm (S/N=3), and satisfactory stability and reproducibility. Its application in determining glucose in human blood serum is also demonstrated. Amperometric H2O2 sensing can also been realized with a sensitivity of 7600 μA mm cm−2, a linear range from 0.1 μm to 10 mm, and a detection limit of 8.9 nm (S/N=3). This 3D-nanoarray architecture holds great promise as an attractive sensing platform toward electrochemical small molecules detection.

Context. Human papillomavirus (HPV) testing is widely used in cervical cancer screening in women; however, its efficiency in triaging women with atypical squamous cells of undetermined significance (ASC-US) needs to be validated. Objective. To evaluate the performance of HPV16/18 in the triage of women with ASC-US. Methods. Women presenting for routine cervical cancer screening had cervical specimens collected, with which both liquid-based cytology (LBC) and hrHPVs were examined; those with ASC-US cytology underwent colposcopy. HPV16/18 and 12 other types were tested with domestic hybridization capture and chemiluminescence signal amplification (DH3). Performance characteristics of HPV test (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for identification of cervical intraepithelium neoplasma (CIN) grade 2 or worse (CIN2+), and CIN grade 3 or worse (CIN3+)) were determined using standard statistical tests. Results. 317 women with ASC-US were eligible for the study. HrHPV prevalence was 15.77% (50/317); HPV16/18 prevalence was 3.61% (20/317). Sensitivity and specificity of HPV16/18 for detection of CIN 2+ were 64.71% and 97% and 64.29% and 96.37% for detection of CIN 3+, respectively. The positive predictive values (PPVs) and negative predictive values (NPVs) of HPV16/18 were 55.00% and 97.98% for CIN2+ and 45.00% and 98.32% for CIN3+, respectively. Conclusion. HPV16/18 can be considered as an effective method to triage women with ASC-US as its good clinical performance. Trial Registration. This trial is registered with Henan Cancer Hospital Medical Ethics Committee on July 5, 2016 (http://www.anti-cancer.com.cn), with registry no.: 2016037.

Objective To analyze the incidence and mortality rates of lung cancer in China from 2008 to 2012. Methods Incident and death cases of lung cancer were retrieved from the National Central Cancer Registry (NCCR) database collecting from 135 cancer registries in China during 2008−2012. The crude incidence and mortality rates of lung cancer were calculated by area (urban/rural), region (eastern, middle, western), gender and age group (0, 1−4, 5−9, …, 85+). China census in 2000 and Segi’s world population were applied for age-standardized rates. JoinPoint (Version 4.5.0.1) model was used for time trend analysis. Results The crude incidence rate of lung cancer was 54.66/100,000 which ranked the first in overall cancers. The age-standardized incidence rates by China population (ASIRC) and by World population (ASIRW) were 35.13/100,000 and 34.86/100,000, respectively. The crude mortality of lung cancer in China was 45.60/100,000 and it was the first cause of cancer-related death in overall cancers. The age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 28.57/100,000 and 28.22/100,000, respectively. Incidence and mortality rates of lung cancer were higher in males than in females and higher in urban areas than in rural areas. Eastern areas had the highest incidence and mortality rates followed by middle and western areas. Incidence and mortality rates of lung cancer retained low level in age groups before 40 years old but increased greatly after and peaked in age group of 80−84. During 2003−2012, the temporal trend of the incidence rate of lung cancer in both sexes in China was general stable (P0.05). In urban areas, it declined by 0.76% per year (P

The aim of the study was to compare the efficiency of bioelectrical indices (percentage body fat, PBF; visceral fat index, VFI) and various anthropometric measures (body mass index, BMI; waist circumference, WC; waist-to-height ratio, WHtR) on determining hypertension in Chinese.We conducted the community-based cross-sectional survey during August of 2013 to August of 2015 in 66 sample sites selected by multistage random sampling method from Henan province. 14,364 residents were included in the study.In both genders, VFI and PBF tended to rise with age. However, for each age-specific group, men consistently had significantly greater VFI than women (all P0.0001) and women had considerably higher PBF (all P0.0001). The odds ratios and area under the ROC curves (AUCs) for hypertension associated with adiposity indices decreased with age. In younger (15~34year) men and women, VFI had the highest crude (2.43-7.95) and adjusted (2.40-11.63) odds ratio for hypertension. The AUCs for PBF, VFI and WHtR were significantly larger than those for BMI and WC (all P0.01). Whereas no statistically significant difference were found in AUCs among PBF, VFI and WHtR (all P0.10). Additionally, VFI and PBF yielded the greatest Youden index in identifying hypertension in men (0.27) and women (0.34), respectively. Optimal cutoffs for VFI/PBF were 11.70/24.45 and 7.55/33.65 in men and women, respectively.VFI and PBF could be better candidates for identifying hypertension in men and women, respectively. Adolescents and young adults should be highlighted in preventing hypertension by control of excess body and visceral fat.

Background This study aimed to evaluate the clinical performance of p16/Ki-67 dual staining in the detection of cervical intraepithelial neoplasia grade 2 or 3 or worse (CIN2+/CIN3+) in Chinese women. Methods Cervical exfoliated cells were collected from 537 eligible women and were used for liquid-based cytology (LBC), p16/Ki-67 dual staining, and human papillomavirus (HPV) DNA testing. All women received colposcopy with biopsies taken at abnormal sites. Histopathological diagnoses were used as the gold standard. Results p16/Ki-67 staining had a positivity rate of 43.58% overall; the rate increased significantly with histological severity (p0.001). The sensitivities of p16/ki-67 for detecting CIN2+ and CIN3+ were 88.10% and 91.30%, respectively. Compared with high-risk HPV (HR-HPV), sensitivity of p16/Ki-67 was lower for detecting CIN2+ (88.10% versus 95.71%), but similar for detecting CIN3+ (91.30% versus 96.27%). Specificities of p16/Ki-67 were 85.02% for detecting CIN2+ and 76.86% for detecting CIN3+, values similar to those for LBC (84.71% for CIN2+, 80.05% for CIN3+) but higher than those for HR-HPV (62.77% for CIN2+, 71.25% for CIN3+). All the tests performed better in women30 years. With respect to the performance of triage for women with ASC-US, sensitivities of p16/Ki-67 were 86.36% for detecting CIN2+ and 83.33% for detecting CIN3+, values similar to those of HR-HPV. However, specificities of p16/Ki-67 were both higher than those of HR-HPV (85.96% versus 67.54% for CIN2+, 79.84% versus 62.90% for CIN3+). Conclusion P16/Ki-67 dual staining could probably provide an optional method for China's national cervical cancer screening, and could also be considered as an efficient method of triage for managing women with ASC-US.

Among reported electrode materials, a nanoarray is an attractive architecture for molecular detection because of its large specific surface area and easy accessibility for target molecules. Here, a new Fe