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Traditional publications for Chinese children were based on core value and belief systems in Confucianism. After the First Opium War, foreign missionaries began to disseminate Western knowledge and religious beliefs within the Chinese society on a wider scale, reaching children through the avenue of education. At this time, however, most Chinese intellectuals held fast to their belief in traditional Chinese methods of education which emphasised the Confucian principles. The loss of the Sino-Japanese War brought a realization within China that its society and education system were relatively backward when compared with those of Western powers. Chinese intellectuals became more aware of the necessity for an entire education reform which should start from the younger generations in an attempt to revitalize China. As a result of this realization, Chinese educators began to adopt the missionaries’ practice of using publications targeted specifically at children. From the mid-19th century onwards, these publications underwent a period of vigorous development in China. Missionaries and Chinese intellectuals in the late Qing period had thus, between them, helped to prepare the ground for the modernization of China by educating the future generations to employ new ideas and values. This historical survey aims to investigate the development of Chinese publications for children from the mid-19th to the early 20th centuries, and offering a closer look at childhood education in China during this period. Some basic clarifications on the definition of children and the nature of books for children is given in the Introductory Chapter, and a brief account of the previous works and articles related to the study is also included. The main part of this thesis starts with a critical examination of the changes of the traditional Chinese primers for children education like Three Character Classic (《三字經》) under the influence of western ideas. Then it proceeds to an exploration of the emergence of modernized textbooks in Chapter Three with a critical appraisal of noted writers and publishers such as Wang Hengtong (Wang Hang-T’ong 王亨統) and the Commercial Press (商務印書館). Chapters Four to Seven present case studies of four children’s periodicals representing different parties of interest in the reform of children education, they are respectively the missionary publication The Child’s Paper (Xiaohai yuebao 《小孩月報》), The Children’s Educator (Mengxue bao《蒙學報》) published by the Chinese reformist, Enlightenment Pictorial (Qimeng huabao《啟蒙畫報》) published by enlightened Chinese intellectuals, and The Children’s World (Tongzi shijie 《童子世界》) published by the Chinese revolutionist. Chapter Eight attempts to reveal the nature of leisure readings and the development of children’s literature in late Qing China while the final Chapter provides conclusions and suggestions for further investigation. By writing this thesis, I am committed to provide readers with a comprehensive and solid historical sketch of the development of children’s publication in a critical period of pre-modern China.

Background Numerous studies have examined catastrophic health expenditures (CHE) worldwide, mostly focusing on general or common chronic populations, rather than particularly vulnerable groups. This study assessed the medical expenditure and compensation of lung cancer, and explored the extent and influencing factors of CHE among households with lung cancer patients in China. Methods During 2018–2019, a hospital-based multicenter retrospective survey was conducted in seven provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. CHE was measured according to the proportion of out-of-pocket (OOP) health payments of households on non-food expenditures. Chi-square tests and logistic regression analysis was adjusted to determine the factors that significantly influenced the likelihood of a household with lung cancer patient to incur in CHE. Results In total, 470 households with lung cancer patients were included in the analysis. Health insurance was shown to protect some households from the impact of CHE. Nonetheless, CHE incidence (78.1%) and intensity (14.02% for average distance and 22.56% for relative distance) were still relatively high among households with lung cancer patients. The incidence was lower in households covered by the Urban Employee Basic Medical Insurance (UEMBI) insurance, with higher income level and shorter disease course. Conclusion More attention is needed for CHE incidence among vulnerable populations in China. Households with lung cancer patients were shown to be more likely to develop CHE. Therefore, policy makers should focus on improving the financial protection and reducing the economic burden of this disease.

Background and Purpose: Aceruloplasminemia (ACP) is a rare disorder of iron overload resulting from ceruloplasmin (CP) variants. Because of its rarity and heterogeneity, the diagnosis of ACP is often missed or misdiagnosed. Here, we aim to present a clinical spectrum of ACP and raise more attention to the early diagnosis. Methods: Whole exome sequencing (WES) was performed in a Chinese female patient suspected with ACP and her clinical data were collected in detail. The PubMed databases was searched for published ACP patients within the last decade, and we present a systematic review of their clinical features with data extracted from these researches. Results: A novel pathogenic variant (c.2689delC) and a known pathogenic variant (c.606dupA) within ceruloplasmin gene were identified in our patient and confirmed the diagnosis of ACP. Then we reviewed 50 ACP patients including the case we reported here. A possible timeline of symptoms was discovered, anemia appears first (29.7 years old on average), followed by diabetes (37.3 years old) and finally neurological symptoms (52.2 years old). The delay in diagnosis was significantly shortened in patients without neurological symptoms. Biochemical triad including anemia, low to undetectable serum ceruloplasmin, low serum iron and/or hyperferritinemia, showed better sensitivity in diagnosis than clinical triad including diabetes, neurological symptoms and retinal degeneration. Conclusions: Due to the variable symptom spectrum, patients with ACP often visit different departments, which can lead to misdiagnosis. Clinical attention needs to be paid to symptoms and tests that have a warning effect. Prompt diagnosis in the early stage of the disease can be beneficial.

Summary Background & aims Maternal depression has been reported to be harmful to maternal and child health, and nutrition-mental health interactions may play a key role, but evidence from longitudinal studies throughout pregnancy remains insufficient. This study aimed to investigate the association of maternal dietary patterns with depressive symptoms throughout pregnancy. Methods This study was based in the Born in Guangzhou Cohort Study. Dietary patterns were defined by cluster analysis based on validated food frequency questionnaires in mid-pregnancy. A healthy diet score was also developed based on predefined criteria of existing dietary guidelines. Depressive symptoms were measured by Self-rating Depression Scale (SDS) in both early and late pregnancy, with SDS scores ≥53 defined as having depressive symptoms. Associations of dietary patterns with SDS scores were examined by linear-mixed models; associations of dietary patterns with the odds of having depressive symptoms were examined by mixed-effects logistic models. The associations of the healthy diet score with both dietary patterns and depressive symptoms were also explored. Results Six dietary patterns were identified in 17,430 pregnant women, namely ‘Varied’ (n = 3902, 22.4%), ‘Vegetables’ (n = 3269, 18.8%), ‘Meats’ (n = 2951, 16.9%), ‘Cereals’ (n = 2719, 15.6%), ‘Milk’ (n = 2377, 13.6%), and ‘Fruits’ (n = 2212, 12.7%). There were 19.3% and 15.7% of participants with depressive symptoms in early and late pregnancy, respectively. Compared with the ‘Varied’ pattern, all other patterns were associated with lower SDS scores during pregnancy except for ‘Cereals’ (‘Vegetables’: adjusted β [aβ] −0.78, 95% CI −1.16, −0.40; ‘Meats’: aβ −0.48, 95% CI −0.87, −0.09; ‘Milk’: aβ −0.52, 95% CI −0.94, −0.10; ‘Fruits’: aβ −0.85, 95% CI −1.27, −0.42). The ‘Vegetables’ (adjusted OR [aOR] 0.79, 95% CI 0.67, 0.93), ‘Milk’ (aOR 0.76, 95% CI 0.63, 0.91), and ‘Fruits’ (aOR 0.77, 95% CI 0.64, 0.93) patterns were associated with lower odds of having depressive symptoms during pregnancy than the ‘Varied’ pattern. Results for the healthy diet score revealed the healthiness of the ‘Vegetables’, ‘Fruits’, and ‘Milk’ patterns and supported an inverse association between healthy dietary patterns and depressive symptoms throughout pregnancy. Conclusions Diets rich in vegetables, fruits, nuts, and dairy products had an inverse association with depressive symptoms throughout pregnancy. Our findings add support to the existing dietary guidelines that healthy diets might also have potential benefits to maternal mental health.

Objective To examine the longitudinal associations of fetal growth with adverse child growth outcomes and to assess whether maternal metabolic factors modify the associations. Design Prospective cohort study. Setting Born in Guangzhou Cohort Study, China. Population A total of 4818 mother–child pairs. Methods Fetal growth was assessed according to estimated fetal weight (EFW) from 22 weeks of gestation until birth and the measurement of the birthweight. Fetal growth Z‐scores were computed from random effects in the multilevel linear spline models to represent fetal size in early pregnancy (22 weeks of gestation) and growth in mid‐pregnancy (22–27 weeks of gestation), early third trimester (28–36 weeks of gestation) and late third trimester (≥37 weeks of gestation). Main outcome measures Z‐scores for childhood stunting, low weight, overweight or obesity, length/height for age (LAZ/HAZ), weight for age (WAZ) and body mass index for age (BMIZ) at the age of 3 years. Adjusted associations were examined using multiple Poisson or linear regression models. Results Increased Z‐scores of fetal size in early pregnancy and growth in mid‐pregnancy and early third trimester were associated with a higher risk of childhood overweight or obesity (risk ratios 1.25–1.45). Fetal growth in each period was negatively associated with stunting and low weight, with the strongest associations observed for fetal size in early pregnancy and growth in mid‐pregnancy. The results for continuous outcomes (LAZ/HAZ, WAZ and BMIZ) were similar. The associations of fetal growth with overweight or obesity in childhood were stronger among mothers who were underweight and who were overweight or obese than among mothers of normal weight. Conclusions Accelerated fetal growth before 37 weeks of gestation is associated with children who are overweight or obese, whereas the critical period for stunting and low weight occurs before 28 weeks of gestation. Tweetable abstract Fetal growth during different periods is differentially associated with childhood stunting, underweight and overweight or obesity.

Background:. Cancer is one of the leading causes of death globally, but its burden is not uniform. GLOBOCAN 2020 has newly updated the estimates of cancer burden. This study summarizes the most recent changing profiles of cancer burden worldwide and in China and compares the cancer data of China with those of other regions. Methods:. We conducted a descriptive secondary analysis of the GLOBOCAN 2020 data. To depict the changing global profile of the leading cancer types in 2020 compared with 2018, we extracted the numbers of cases and deaths in 2018 from GLOBOCAN 2018. We also obtained cancer incidence and mortality from the 2015 National Cancer Registry Report in China when sorting the leading cancer types by new cases and deaths. For the leading cancer types according to sex in China, we summarized the estimated numbers of incidence and mortality, and calculated China's percentage of the global new cases and deaths. Results:. Breast cancer displaced lung cancer to become the most leading diagnosed cancer worldwide in 2020. Lung, liver, stomach, breast, and colon cancers were the top five leading causes of cancer-related death, among which liver cancer changed from the third-highest cancer mortality in 2018 to the second-highest in 2020. China accounted for 24% of newly diagnosed cases and 30% of the cancer-related deaths worldwide in 2020. Among the 185 countries included in the database, China's age-standardized incidence rate (204.8 per 100,000) ranked 65th and the age-standardized mortality rate (129.4 per 100,000) ranked 13th. The two rates were above the global average. Lung cancer remained the most common cancer type and the leading cause of cancer death in China. However, breast cancer became the most frequent cancer type among women if the incidence was stratified by sex. Incidences of colorectal cancer and breast cancer increased rapidly. The leading causes of cancer death varied minimally in ranking from 2015 to 2020 in China. Gastrointestinal cancers, including stomach, colorectal, liver, and esophageal cancers, contributed to a massive burden of cancer for both sexes. Conclusions:. The burden of breast cancer is increasing globally. China is undergoing cancer transition with an increasing burden of lung cancer, gastrointestinal cancer, and breast cancers. The mortality rate of cancer in China is high. Comprehensive strategies are urgently needed to target China's changing profiles of the cancer burden.

Key Points Question Is the modified newborn genetic and hearing screening feasible in China? Findings In this population-based cohort study including 32 512 infants, incorporating the limited and expanded genetic screening into physiological screening was associated with identifying 31 newborns with hearing loss missed by the conventional hearing screening, providing etiologic information to 1299 participants, and targeting 517 children at risk of late-onset hearing loss to improve prevention. Meaning Large observational studies are needed to evaluate the cost-effectiveness and long-term benefits of integrated genetic and hearing screening programs., This cohort study investigates the feasibility and utility of a modified genetic and hearing screening program among newborn infants in Nantong, China., Importance Early identification and intervention for newborns with hearing loss (HL) may lead to improved physiological and social-emotional outcomes. The current newborn hearing screening is generally beneficial but improvements can be made. Objective To assess feasibility and evaluate utility of a modified genetic and hearing screening program for newborn infants. Design, Setting, and Participants This population-based cohort study used a 4-stage genetic and hearing screening program at 6 local hospitals in Nantong city, China. Participants were newborn infants born between January 2016 and June 2020 from the Han population. Statistical analysis was performed from April 1 to May 1, 2021. Exposures Limited genetic screening for 15 variants in 4 common HL-associated genes and newborn hearing screening (NHS) were offered concurrently to all newborns. Hearing rescreening and/or diagnostic tests were provided for infants with evidence of HL on NHS or genetic variants on screening. Expanded genetic tests for a broader range of genes were targeted to infants with HL with negative results of limited genetic tests. Main Outcomes and Measures The detection capability for infants with hearing impairment who passed conventional hearing screening, as well as infants with normal hearing at risk of late-onset HL due to genetic susceptibility. Results Among a total of 35 930 infants, 32 512 infants completed the follow-up and were included for analysis. Among the infants included in the analysis, all were from the Han population in China and 52.3% (16 988) were male. The modified genetic and hearing screening program revealed 142 cases of HL and 1299 cases of genetic variation. The limited genetic screening helped identify 31 infants who passed newborn hearing screening, reducing time for diagnosis and intervention; 425 infants with normal hearing with pathogenic SLC26A4 variation and 92 infants with MT-RNR1 variation were at risk for enlarged vestibular aqueduct and aminoglycoside-induced ototoxicity respectively, indicating early aversive or preventive management. Conclusions and Relevance This study found that performing modified genetic and hearing screening in newborns was feasible and provides evidence that the program could identify additional subgroups of infants who need early intervention. These findings suggest an advantage for universal adoption of such a practice.

Background Most lung cancer patients are diagnosed after the onset of symptoms. However, whether the symptoms of lung cancer were independently associated with the diagnosis of lung cancer is unknown, especially in the Chinese population. Methods We conducted a 10 years (2005‐2014) nationwide multicenter retrospective clinical epidemiology study of lung cancer patients diagnosed in China. As such, this study focused on nonsmall cell lung cancer (NSCLC). We calculated the odds ratios (ORs) for variables associated with the symptoms and physical signs using multivariate unconditional logistic regressions. Results A total of 7184 lung cancer patients were surveyed; finally, 6398 NSCLC patients with available information about their symptoms and physical signs were included in this analysis. The most common initial symptom and physical sign was chronic cough (4156, 65.0%), followed by sputum with blood (2110, 33.0%), chest pain (1146, 17.9%), shortness of breath (1090, 17.0%), neck and supraclavicular lymphadenectasis (629, 9.8%), weight loss (529, 8.3%), metastases pain (378, 5.9%), fatigue (307, 4.8%), fever (272, 4.3%), and dyspnea (270, 4.2%). Patients with squamous carcinoma and stage III disease were more likely to present with chronic cough (P

Background Prevalence of neonatal microcephaly in populations without Zika-epidemics is sparse. The study aimed to report baseline prevalence of congenital microcephaly and its relationship with prenatal factors in an area at risk of Zika outbreak. Methods This study included singletons born after 24 gestational weeks in 2017–2018 at four hospitals in Guangzhou, China. Microcephaly was defined as a head circumference at birth >3SD below the mean for sex and gestational age. Prevalence of microcephaly was estimated by binomial exact method. Multivariable logistic regression was used to examine the associations of microcephaly with prenatal factors. The population attributable fraction (PAF) for associated risk factors was calculated. Results Of 46,610 live births included, 154 (3.3, 95% CI 2.8–3.9 per 1000 live births) microcephalies were identified. Maternal hepatitis B virus carriers (HBV, OR 1.80, 95% CI 1.05–3.10) and primipara (OR 2.68, 95% CI 1.89–3.81) had higher risk of having a microcephalic baby. Higher prevalence of microcephaly was observed in women who had premature labor (OR 1.98, 95% CI 1.17–3.34) and had a baby with fetal growth restriction (OR 16.38, 95% CI 11.81–22.71). Four identified factors (HBV, primiparity, preterm labor, and fetal growth restriction) contributed to 66.4% of the risk of microcephaly. Conclusions The prevalence of microcephaly in Guangzhou was higher than expected. This study identified four prenatal risk factors that, together, contributed to two-thirds of the increased risk of microcephaly. This is the first reported association between maternal HBV carrier status and microcephaly.

Objective To assess potential risk factors in identifying women at risk for gestational diabetes mellitus (GDM). Methods The present study included data collected as part of a prospective cohort study, and included women with singleton pregnancies who underwent initial prenatal examination at a tertiary women and children's hospital in Guangzhou, China between February 1, 2012, and December 31, 2015. Maternal characteristics and medical history were investigated to evaluate associations with GDM. A risk factor scoring system for the prediction of GDM was generated using logistic regression. Results Overall, 1129 (13.5%) of 8381 women were diagnosed with GDM. Women older than 35 years had a 3.95‐fold increased risk of GDM (95% confidence interval 2.80–5.58) compared with women aged 16–25 years; obese women had a 6.54‐fold higher risk (95% confidence interval 3.50–12.23) compared with underweight women. A risk scoring system was established based on age, body mass index, family history of diabetes, weight gain, and history of GDM. Screening for women with a score of 12 or more would have reduced the number undergoing oral glucose tolerance testing by 2131 (25.4%) patients with a sensitivity of 87% for GDM detection. Conclusion The assessment of risk factors for GDM could provide a foundation for improving risk‐based screening strategies in this and similar populations.

Background Previous studies proposed that there were racial or ethnic disparities in fetal growth, challenging the use of international standards in specific populations. This study was to evaluate the validity of applying the INTERGROWTH-21st standard to a Chinese population for identifying abnormal head circumference (HC), in comparison with a newly generated local reference. Methods There were 24,257 singletons delivered by low-risk mothers in four perinatal health-care centers in Southern China. New HC reference was constructed and comparison in distribution of HC categories was performed between the INTERGROWTH-21st standard and new reference after applying these two tools in study population. Logistic regression was used to examine the association between abnormal HC and adverse neonatal outcomes. Results There were 4.40% of the newborns identified with microcephaly (HC > 2 standard deviation below the mean) using the INTERGROWTH-21st standard, comparing to the proportion of 2.83% using new reference. The newborns identified with microcephaly only by the INTERGROWTH-21st standard were not at a higher risk of adverse neonatal outcome, compared with those identified as non-microcephaly by both tools (OR 0.73, 95% CI 0.47-1.13). Conclusion The new HC reference may be more appropriate for newborn assessment in Chinese populations than the INTERGROWTH-21st standard.

Background The study was conducted to examine changes in diagnostic and staging imaging methods for lung cancer in China over a 10-year period and to determine the relationships between such changes and socioeconomic development. Methods This was a hospital-based, nationwide, multicenter retrospective study of primary lung cancer cases. The data were extracted from the 10-year primary lung cancer databases at eight tertiary hospitals from various geographic areas in China. The chi-squared test was used to assess the differences and the Cochran-Armitage trend test was used to estimate the trends of changes. Results A total of 7184 lung cancer cases were analyzed. Over the 10-year period, the utilization ratio of diagnostic imaging methods, such as chest computed tomography (CT) and chest magnetic resonance imaging (MRI), increased from 65.79% to 81.42% and from 0.73% to 1.96%, respectively, while the utilization ratio of chest X-ray declined from 50.15% to 30.93%. Staging imaging methods, such as positron emission tomography-CT, neck ultrasound, brain MRI, bone scintigraphy, and bone MRI increased from 0.73% to 9.29%, 22.95% to 47.92%, 8.77% to 40.71%, 42.40% to 62.22%, and 0.88% to 4.65%, respectively; abdominal ultrasound declined from 83.33% to 59.9%. These trends were more notable in less developed areas than in areas with substantial economic development. Conclusion Overall, chest CT was the most common radiological diagnostic method for lung cancer in China. Imaging methods for lung cancer tend to be used in a diverse, rational, and regionally balanced manner.

Spatial heterogeneity of N

Few studies have explored the relationship between dietary patterns and the risk of gestational diabetes mellitus (GDM). Evidence from non-Western areas is particularly lacking. In the present study, we aimed to examine the associations between dietary patterns and the risk of GDM in a Chinese population. A total of 3063 pregnant Chinese women from an ongoing prospective cohort study were included. Data on dietary intake were collected using a FFQ at 24–27 weeks of gestation. GDM was diagnosed using a 75 g, 2 h oral glucose tolerance test. Dietary patterns were determined by principal components factor analysis. A log-binomial regression model was used to examine the associations between dietary pattern and the risk of GDM. The analysis identified four dietary patterns: vegetable pattern; protein-rich pattern; prudent pattern; sweets and seafood pattern. Multivariate analysis showed that the highest tertile of the vegetable pattern was associated with a decreased risk of GDM (relative risk (RR) 0·79, 95 % CI 0·64, 0·97), compared with the lowest tertile, whereas the highest tertile of the sweets and seafood pattern was associated with an increased risk of GDM (RR 1·23, 95 % CI 1·02, 1·49). No significant association was found for either the protein-rich or the prudent pattern. The protective effect of a high vegetable pattern score was more evident among women who had a family history of diabetes (P for interaction = 0·022). These findings suggest that the vegetable pattern was associated with a decreased risk of GDM, while the sweets and seafood pattern was associated with an increased risk of GDM. These findings may be useful in dietary counselling during pregnancy.

Purpose: To analyze the incidence and mortality of laryngeal cancer in cancer registration areas of China in 2010. Materials and Methods: Until June 1, 2013, 219 population-based cancer registries submitted data of 2010 to the National Central Cancer Registry of China covering about 207,229,403 population, and 120 cancer registries were selected after quality evaluation for this analysis. Laryngeal cancer cases were selected from the database according to International Classification of Diseases 10th Revision coded as "C32." We calculated the crude incidence and mortality rates of laryngeal cancer by sex, age, and location (urban/rural). The China population in 2000 and Segi's population were used as standardized populations for the calculation of age-standardized rates. Results: In 2010, it was estimated that there were 20,272 new cases diagnosed as laryngeal cancer in China, including 17,703 males and 2569 females. The crude incidence rate of laryngeal cancer was 1.54/100,000 in 2010, accounting for 0.66% of overall new cancer cases. The age-standardized by China population (ASRcn) and by world population (ASRwld) were 1.18/100,000 and 1.20/100,000, respectively. Cumulative rate (0–74 years old) and truncated age-standardized rate (35–64 years old) were 0.15% and 1.98/100,000, respectively. Moreover, it was estimated that there were 11 914 cases died in laryngeal cancer in China, including 10,038 males and 1876 females. The crude mortality rate was 0.91/100,000, accounting for 0.61% of overall cancer deaths. The ASRcn and ASRwld were 0.68/100,000 and 0.69/100,000, respectively. Cumulative rate and truncated age-standardized rates were 0.08% and 0.88/100,000, respectively. Conclusions: Both incidence and mortality of laryngeal cancer in China were still low in 2010.

Nasopharyngeal carcinoma (NPC) is common in South China. Although regional epidemiological data on NPC in China is available, national epidemiological data have been unavailable up to now. The goal of this study was to analyze the NPC incidence and mortality data in some domestic cancer registries, estimate these rates in China in 2010, and provide scientific information that can be harnessed for NPC control and prevention. To accomplish this goal, NPC incidence and mortality data for 2010 were collected from 145 Chinese cancer registries from which data were included in the 2013 National Cancer Registry Annual Report. Such indices as its incident and death numbers, crude rates, age-standardized rates and truncated rates were calculated and analyzed. The incidence and mortality in China and constituent areas were estimated according to the national population in 2010. An estimated 41,503 new cases and 20,058 deaths were attributed to NPC in China in 2010, accounting for 1.34% of all new cancer cases and 1.03% of all cancer-related deaths that year in China. Crude incidence and mortality were 3.16/100,000 and 1.53/100,000, respectively. World age-standardized incidence and mortality were 2.44/100,000 and 1.18/100,000, respectively. Incidence and mortality were higher among males than among females and slightly higher in urban areas than in rural areas. Among seven Chinese administrative regions, NPC incidence and mortality were obviously higher in South China than in other regions and lowest in North China. The male and female age-specific incidence and mortality both rose quickly from age 25-29 years, but peaked at different ages and varied by location. These results demonstrated that NPC incidence and mortality in China especially in South China were at high levels in the world, and suggested that control and prevention efforts should be enhanced.

Liver cancer is a common malignant tumor in China and a major health concern. We aimed to estimate the liver cancer incidence and mortality in China in 2010 using liver cancer data from some Chinese cancer registries and provide reference for liver cancer prevention and treatment. We collected and evaluated the incidence and mortality data of liver cancer in 2010 from 145 cancer registries, which were included in the 2013 Chinese Cancer Registry Annual Report, calculated crude, standardized, and truncated incidences and mortalities, and estimated new liver cancer cases and deaths from liver cancer throughout China and in different regions in 2010 from Chinese practical population. The estimates of new liver cancer cases and deaths were 358,840 and 312,432, respectively, in China in 2010. The crude incidence, age-standardized rate by Chinese standard population (ASR China), and age-standardized rate by world standard population (ASR world) were 27.29/100,000, 21.35/100,000, and 20.87/100,000, respectively; the crude, ASR China, and ASR world mortalities were 23.76/100,000, 18.43/100,000, and 18.04/100,000, respectively. The incidence and mortality were the highest in western regions, higher in rural areas than in urban areas, and higher in males than in females. The age-specific incidence and mortality of liver cancer showed a rapid increase from age 30 and peaked at age 80-84 or 85+. Our results indicated that the 2010 incidence and mortality of liver cancer in China, especially in undeveloped rural areas and western regions, were among high levels worldwide. The strategy for liver cancer prevention and treatment should be strengthened.

Background Breast cancer is the most common cancer among women. Population‐based cancer registration data from the National Central Cancer Registry were used to analyze and evaluate the incidence and mortality rates in China in 2013, providing scientific information for cancer prevention and control. Methods Pooled data were stratified by area (urban/rural), gender, and age group. National new cases and deaths were estimated using age‐specific rates and the corresponding population in 2013. The Chinese population in 2000 and Segi's world population were used to calculate age‐standardized rates. Results The estimated number of new breast cancer cases was about 278 800 in China in 2013. The crude incidence, age‐standardized rate of incidence by Chinese standard population, and age‐standardized rate of incidence by world standard population were 42.02/100 000, 30.41/100 000, and 28.42/100 000, respectively. The estimated number of breast cancer deaths was about 64 600 in China in 2013. The crude mortality, age‐standardized rate of mortality by Chinese standard population, and age‐standardized rate of mortality by world standard population were 9.74/100 000, 6.54/100 000, and 6.34/100 000, respectively. Both incidence and mortality were higher in urban than in rural areas. Age‐specific breast cancer incidence significantly increased with age, particularly after age 20, and peaked at 50–55 years, while age‐specific mortality increased rapidly after 25 years, peaking at 85+ years. Conclusions Breast cancer is the most common cancer in Chinese women, especially women in urban areas. Comprehensive measures are needed to reduce the heavy burden of breast cancer.

This study aimed to examine the reproducibility and validity of a new food frequency questionnaire (FFQ) used in a birth cohort study to estimate the usual consumption frequencies of foods during pregnancy. The reference measure was the average of three inconsecutive 24 h diet recalls (24 HR) administrated between two FFQs, and the reproducibility was measured by repeating the first FFQ (FFQ1) approximately eight weeks later (FFQ2). A total of 210 pregnant women from the Born in Guangzhou Cohort Study (BIGCS) with full data were included in the analysis. The Spearman’s correlation coefficients of FFQ1 and FFQ2 ranged from 0.33 to 0.71. The intraclass correlation coefficients of the two FFQs ranged from 0.22 to 0.71. The Spearman’s correlation coefficients of the 24 HR and FFQ2 ranged from 0.23 to 0.62. Cross-classification analysis showed 65.1% of participants were classified into same and contiguous quintiles, while only 3.2% were misclassified into the distant quintiles. Bland-Altman methods showed good agreement for most food groups across the range of frequencies between FFQ1 and FFQ2. Our findings indicated that the reproducibility and validity of the FFQ used in BIGCS for assessing the usual consumption frequencies of foods during pregnancy were acceptable.

Historically low breast cancer incidence rates among Asian women have risen worldwide; purportedly due to the adoption of a ‘Western’ life style among younger generations (i.e., the more recent birth-cohorts). However, no study has simultaneously compared birth-cohort effects between both younger and older women in different Asian and Western populations. Using cancer registry data from rural and urban China, Singapore, and the United States (1990–2008), we estimated age-standardized incidence rates (ASR), annual percentage change (EAPC) in the ASR, net drifts, birth-cohort specific incidence rates and cohort rate ratios (CRR). Younger (30–49 years, 1943–1977 birth-cohorts) and older women (50–79 years; 1913–1957 birth-cohorts) were assessed separately. CRRs among Chinese populations were estimated using birth-cohort specific rates with US non-Hispanic white women (NHW) serving as the reference population with an assigned CRR of 1.0. We observed higher EAPCs and net drifts among those Chinese populations with lower ASRs. Similarly, we observed the most rapidly increasing cohort-specific incidence rates among those Chinese populations with the lowest baseline CRRs. Both trends were more significant among older than younger women. Average CRRs were 0.06~0.44 among older and 0.18~0.81 among younger women. Rapidly rising cohort specific rates have narrowed the historic disparity between Chinese and US NHW breast cancer populations particularly in regions with the lowest baseline rates and among older women. Future analytic studies are needed to investigate risk factors accounting for the rapid increase of breast cancer among older and younger women separately in Asian populations.

This study explored the prevalence of peer physical aggression (PPA) and its association with aggressive beliefs, empathy, self-control, and cooperation skills among 1,719 7th-to-9th-grade students in a rural town in the central China province of Henan. The data were collected by the self-administered questionnaire anonymously. Results showed that 17.9% of the students reported that they had one or more times of physical aggressive behaviors toward their peers in the past 12 months. The reported rate of PPA was significantly higher in boys (24.7%) than in girls (10.7%). After adjusting the factors of gender and grade, result of logistic regression analysis showed that having a higher level of aggressive beliefs was PPA risk factor; a higher level of self-control was protective factor, but there were no significant association between PPA and the factors of empathy and cooperation skills. These results indicated that helping students to decrease their aggressive beliefs and to improve their self-control skill would aid in the prevention of youth violence.

Purpose: To analyze the incidence and mortality of oral cavity cancer in the cancer registration areas of China in 2010. Materials and Methods: Until June 1, 2013, 219 population-based cancer registries submitted the data of 2010 to the National Central Cancer Registry of China covering about 207,229,403 population, and 120 cancer registries were selected after the quality evaluation for this analysis. Oral cavity cancer cases were selected from the database according to the International Classification of Diseases-10 coded as "C00-C10, C11-C12." We calculated the crude incidence and mortality rates of oral cavity cancer by sex, age, and location (urban/rural). The China population in 2000 and Segi's population were used as standardized populations for the calculation of age standardized rates. Results: In 2010, it was estimated that there were 34,319 new cases diagnosed as oral cavity cancer in China, including 23,096 males and 11,223 females. The crude incidence rate of oral cavity cancer was 2.61/100,000 in 2010, accounting for 1.11% of overall new cancer cases, ranked the 20th in all cancer sites. The age standardized by China population (ASRcn) and by world population (ASRwld) were 2.06/100,000 and 2.02/100,000, respectively. Cumulative rate (0–74 years old) and truncated age standardized rate (35–64 years old) were 0.23% and 3.82/100 000, respectively. In 2010, it was estimated that there were 14,652 cases died in oral cavity cancer in China, including 10,363 males and 4289 females. The crude mortality rate of oral cavity cancer was 1.11/100,000 in 2010, accounting for 0.75% of overall cancer deaths, ranked the 20th in all cancer sites. The ASRcn and ASRwld were 0.86/100,000 and 0.85/100,000, respectively. Cumulative rate and truncated age standardized rates were 0.10% and 1.30/100,000, respectively. Conclusions: Both the incidence and mortality of oral cavity cancer in China were still low in 2010. Primary prevention such as smoking control, reducing alcohol consumption, changing the habit of chewing betel nut, and chemical prevention should be enhanced in the general population.

Using the EPA method, emission of volatile organic compounds (VOCs) , sampled from barbecue, Chinese and Western fast-food, Sichuan cuisine and Zhejiang cuisine restaurants in Beijing was investigated. VOCs concentrations and components from different cuisines were studied. The results indicated that based on the calibrated baseline ventilation volume, the VOCs emission level from barbecue was the highest, reaching 12.22 mg · m(-3), while those from fast-food of either Chinese or Western, Sichuan cuisine and Zhejiang cuisine were about 4 mg · m(-3). The components of VOCs from barbecue were different from those in the other cuisines, which were mainly propylene, 1-butene, n-butane, etc. The non-barbecue cuisines consisted of high concentration of alcohols, and Western fast-food contained relatively high proportion of aldehydes and ketones organic compounds. According to emission concentration of baseline ventilation volume, barbecue released more pollutants than the non-barbecue cuisines at the same scale. So, barbecue should be supervised and controlled with the top priority.

Previous reports suggested that female breast cancer is associated with earlier ages at onset among Asian than Western populations. However, most studies utilized cross-sectional analyses that may be confounded by calendar-period and/or birth cohort effects. We, therefore, considered a longitudinal (forward-looking) approach adjusted for calendar-period changes and conditioned upon birth cohort.Invasive female breast cancer data (1988-2009) were obtained from cancer registries in China, Hong Kong, South Korea, Taiwan, Singapore, and the United States. Age-period-cohort models were used to extrapolate longitudinal age-specific incidence rates for the 1920, 1944, and 1970 birth cohorts.Cross-sectional age-specific incidence rates rose continuously until age 80 years among US white women, but plateaued or decreased after age 50 years among Asian women. In contrast, longitudinal age-specific rates were proportional (similar) among all Asian countries and the United States with incidence rates rising continuously until age 80 years. The extrapolated estimates for the most recent cohorts in some Asian countries actually showed later ages at onset than in the United States. Additionally, over successive birth cohorts, the incidence rate ratios (IRRs) for the longitudinal curves converged (narrowed) between Asian and US white women.Similar longitudinal age-specific incidence rates along with converging IRRs indicate that the age effects for invasive breast cancer are more similar among Asian and Western populations than might be expected from a solely cross-sectional analysis. Indeed, the Asian breast cancer rates in recent generations are even surpassing the historically high rates in the United States, highlighting an urgent need for efficient prevention and treatment strategies among Asian populations.

Effects of river (Yangtze River)-lake (Poyang Lake) relation on the distribution and potential ecological risk of Cu, Pb, Zn, Cr and Cd were investigated in surface sediment of Poyang Lake under different waterregimens. The results indicated: (1) the sediments of Poyang Lake were polluted by various concentrations of heavy metals mainly originated from particulates of Yangtze River, and Cu and Pb were the main pollution factors. The pollution level of determined heavy metals followed the order of CuPbZnCrCd. The concentration ranges of Cu, Pb, Zn, Cr and Cd in the sediment of Poyang Lake were 13.1-108.1 mg.kg-1 , 37-119.1 mg.kg-1, 29.9-129.9 mgkg-1, 13.3-98.6 mgkg-1 and 0. 19-2.77 mg.kg-1 during the wet period, and 3.05-69.7 mg.kg-1, 27.5-105 mgkg-1, 18.8-95.4 mg.kg-1, 7.34-70 mg.kg- and 0.033-0.406 mg.kg-1 during the dry period respectively. The region with the highest heavy metal concentrations was located in water input area of the " Five River" and water output area of " Hukou" ; (2)The regions with high risk of heavy metals in sediment were mainly located in the area of the trail of "Five Rivers" during the wet period; while during the dry period, the area with high risk of heavy metals in sediment enlarged, which was not only limited in the area of the trail of "Five Rivers", but also enlarged northwards. The potential ecological risk of "Hukou" was relatively high, however, the potential ecological risk of the sediment in the whole lake during the dry period was lower than that during the wet period. (3) With the change of river-lake relation, water level rose, the maintaining time was shortened during the wet period, the dry season appeared ahead of schedule, the transformation course of Poyang Lake from "Lake morphology" to " River morphology" increased, and the typical river properties were enhanced, which resulted in the decreased potential ecological risk of heavy metals in sediment of the whole lake, however, the area of high risk-region was enlarged northwards.

The health burden of cancer is increasing in China, with more than 1·6 million people being diagnosed and 1·2 million people dying of the disease each year. As in most other countries, breast cancer is now the most common cancer in Chinese women; cases in China account for 12·2% of all newly diagnosed breast cancers and 9·6% of all deaths from breast cancer worldwide. China's proportional contribution to global rates is increasing rapidly because of the population's rising socioeconomic status and unique reproductive patterns. In this Review we present an overview of present control measures for breast cancer across China, and emphasise epidemiological and socioeconomic diversities and disparities in access to care for various subpopulations. We describe demographic differences between China and high-income countries, and also within geographical and socioeconomic regions of China. These disparities between China and high-income countries include younger age at onset of breast cancer; the unique one-child policy; lower rates of provision and uptake for screening for breast cancer; delays in diagnosis that result in more advanced stage of disease at presentation; inadequate resources; and a lack of awareness about breast cancer in the Chinese population. Finally, we recommend key measures that could contribute to improved health outcomes for patients with breast cancer in China.

To evaluate the trend of cervical cancer incidence and mortality rates during 1989-2008 in Chinese women, so as to inform the development of relevant policies and strategies in China.The incidence and mortality rates of cervical cancer during 1989-2008 in urban and rural areas were calculated based on the data from the National Cancer Registry Database. Age-standardized rates were calculated using the Chinese population of 1982 and World Segi's population of 1985. Joinpoint regression analysis was performed to obtain annual percentage changes (APC) so as to assess the trend of incidence and mortality rates over the period from 1989 to 2008.The crude incidence rate of cervical cancer in Chinese women increased from 3.06/10(5) in 1989-1990 to 11.87/10(5) in 2007-2008 (from 4.96/10(5) to 11.98/10(5) in urban registration areas and from 2.39/10(5) to 11.77/10(5) in rural registration areas).The crude mortality rate slightly increased from 2.19/10(5) in 1989-1990 to 3.20/10(5) in 2007-2008 (from 3.21/10(5) to 2.56/10(5) in urban registration areas and from 1.82/10(5) to 3.75/10(5) in rural registration areas). Generally, the upward trends of crude incidence rates were shown over the year 1989-2008, with an APC of 14.4% after 1997 in urban areas and 22.5% after 1999 in rural areas.After age standardization of world population, the APC of incidence rates in recent decade in urban areas remained stable, and the one in rural areas slightly decreased.Although the overall crude and world age-standardized mortality rates had no significant changes during 1989-2008, the crude mortality rates increased by 8.1% annually after 1999.The upward trends were also shown for crude and world age-standardized mortality rates in urban areas after 2001 with an APC of 7.3%.The crude mortality rates in rural areas increased by 3.9% annually during 1989-2008, but no significant change was found after age standardization.Over the last decade, the cervical cancer incidence and mortality rates ascended by year in China. It is particularly urgent to establish a comprehensive prevention and control system that combines cervical cancer screening and human papillomavirus vaccination, so as to reduce the burden of cervical cancer in Chinese women.

VOCs emission from petrochemical storage tanks is one of the important emission sources in the petrochemical industry. In order to find out the VOCs emission amount of petrochemical storage tanks, Tanks 4.0.9d model is utilized to calculate the VOCs emission from different kinds of storage tanks. VOCs emissions from a horizontal tank, a vertical fixed roof tank, an internal floating roof tank and an external floating roof tank were calculated as an example. The consideration of the site meteorological information, the sealing information, the tank content information and unit conversion by using Tanks 4.0.9d model in China was also discussed. Tanks 4.0.9d model can be used to estimate VOCs emissions from petrochemical storage tanks in China as a simple and highly accurate method.

To estimate the contribution of known identified risk factors to breast cancer incidence and mortality in China, and provide evidence to support the prevention and control of breast cancer for Chinese females.We calculated the proportion of breast cancer attributable to specific risk factors. Data on exposure prevalence were obtained from Meta-analyses and large-scale national surveys of representative samples of the Chinese population. Data on relative risks were obtained from Meta-analyses and large-scale prospective studies. Cancer mortality and incidence were taken from the Third National Death Survey and from cancer registries in China.The first 5 risk factors of breast cancer in China were benign breast disease (RR = 2.62), family history of breast cancer (RR = 2.39), smoking (RR = 1.86), overweight (RR = 1.60) and age at menarche (RR = 1.54). The proportion of breast cancer deaths attributable to reproductive factors, lifestyle factors, benign breast disease, the use of external hormone and family history of breast cancer was 27.84%, 23.55%, 15.09%, 3.60% and 2.49%, respectively. The total population attributable fraction (PAF) was 55.95% for risk factors in our study. Overall, we estimated that 79 862 breast cancer cases and 22 456 deaths were attributed to the five risk factors in China in 2005.The prevention and control of unhealthy lifestyle factors may significantly reduce the number and death of breast cancer in China.

To analyze the incidence and mortality of oral cavity and pharyngeal cancer in cancer-registration areas of China in 2009.We collected data about incidence of oral cavity and pharyngeal from 72 cancer registry sites of National Central Registry Database in 2009, covering 85 470 522 person (57 489 009 were from urban areas, 27 981 513 were from rural areas).Incidence and mortality rates, proportions, cumulative rate (0-74 years old), cut rate (35-64 years old), age-specific rate were then calculated and analyzed respectively. The age-standardized rate was calculated and adjusted by the Chinese standard population in 1982 as well as the Segi's world standard population.There were 2803 new diagnosed oral cavity and pharyngeal cancer cases, 1793 male and 1010 female, with the sex ratio at 1.78: 1. The crude incidence rate of oral cavity and pharyngeal cancer was 3.28/100 000(2803/85 470 522). The crude incidence rate of males was 4.15/100 000(1793/43 231 554) while it was 2.39/100 000(1010/42 238 968) among females. The age-standardized incidence rates by Chinese standard population (ASIRC) and the world standard population were 1.72/100 000 and 2.23/100 000 respectively, and the cumulative rate and cut rate was separately 0.26% and 4.02/100 000. The crude incidence and ASIRC of oral cavity and pharyngeal cancers were 3.87/100 000 (2225/57 489 009) and 1.97/100 000 in urban areas, whereas in rural areas, they were 2.07/100 000(578/27 981 513) and 1.17/100 000. There were 1172 death cases, including 825 males and 347 females. The crude mortality rate was 1.37/100 000 (1172/85 470 522), while it was 1.91/100 000(825/43 231 554) among males and 0.82/100 000(347/42 238 968) among females. The age-standardized incidence rates were 0.64/100 000 and 0.88/100 000 respectively, by Chinese standard population (ASMRC) and the world standard population. The cumulative mortality rate (0-74 age years old) and cut rate were separately 0.10% and 1.34/100 000. The mortality and ASMRC were 1.59/100 000(915/57 489 009) and 0.72/100 000 in urban areas, whereas in rural areas, they were 0.92/100 000(257/27 981 513) and 0.48/100 000 respectively.Both the incidence and mortality of oral cavity and pharyngeal cancer in China were still low in 2009.

Nasopharyngeal carcinoma (NPC) is rare globally but common in China and exhibits a distinct ethnic and geographic distribution. In 2009, the National Central Cancer Registry in China provided real-time surveillance information on NPC. Individual NPC cases were retrieved from the national database based on the ICD-10 topography code C11. The crude incidence and mortality of NPC were calculated by sex and location (urban/rural). China's population in 1982 and Segi's world population structures were used to determine age-standardized rates. In regions covered by the cancer registries in 2009, the crude incidence of NPC was 3.61/100,000 (5.08/100,000 in males and 2.10/100,000 in females; 4.19/100,000 in urban areas and 2.42/100,000 in rural areas). Age-standardized incidences by Chinese population (ASIC) and Segi's world population (ASIW) were 2.05/100,000 and 2.54/100,000, respectively. The crude mortality of NPC was 1.99/100,000 (2.82/100,000 in males and 1.14/100,000 in females; 2.30/100,000 in urban areas and 1.37/100,000 in rural areas). The age-standardized mortalities by Chinese population (ASMC) and world population (ASMW) were 1.04/100,000 and 1.35/100,000, respectively. The incidence and mortality of NPC were higher in males than in females and higher in urban areas than in rural areas. Both age-specific incidence and mortality were relatively low in persons younger than 30 years old, but these rates dramatically increased. Incidence peaked in the 60-64 age group and mortality peaked in the over 85 age group. Primary and secondary prevention, such as lifestyle changes and early detection, should be carried out in males and females older than 30 years of age.

To analyze the incidence and mortality of oral and pharyngeal cancers from 32 cancer registration centers, 2003 to 2007.Data from 32 eligible cancer registries were included in this study. Both crude and age-standardized incidence and mortality of oral and pharyngeal cancers from 2003 to 2007 were calculated and stratified by area and gender. Age-stratified incidence and mortality, as well as the proportions of new and death cases of oral and pharyngeal cancer were also calculated at each site.Mouth, tongue and salivary gland were the most predilection sites of oral and pharyngeal cancers. The crude incidence for both oral and pharyngeal cancers was 3.15/10(5) from 2003 to 2007. The age-standardized incidence rates using the Chinese population (1982) and the World Segi's population were 1.75/10(5) and 2.26/10(5). The crude mortality of oral and pharyngeal cancer was 1.37/10(5) from 2003 to 2007; with age-standardized mortality rates, using the Chinese population (1982) and the World Segi's population were 0.69/10(5) and 0.94/10(5). Both incidence and mortality were higher in males than in females, higher in urban than in rural areas, and ascended with age. Age-standardized incidence and mortality in Zhongshan city ranked first among all the cancer registration areas. Age-standardized incidences by gender and area increased slightly from 2003 to 2007, while age-standardized mortalities were stable.Although the incidence and mortality of oral and pharyngeal cancer were low in China from 2003 to 2007, attention should also be paid since the exposure of relative risk factors did not seem to have reduced and the incidence increased slightly.

To analyze and predict the incidence trends and burden of pancreatic cancer from 2008 to 2015.Registration data on pancreatic cancer of cancer registration in 1998 - 2007, were retrieved and utilized for analyzing the annual incidence of pancreatic cancer. Age-standardized rate by Chinese population (ASR) was calculated, using the direct method. JoinPoint software was applied for trend analysis. Bayesian Age-Period-Cohort Modeling Prediction Package was used to estimate age, period and cohort effects as well as to predict the incidence rates.From 1998 to 2007, the annual incidence for men and women in urban areas showed an increase of 1.86% and 2.1% per year, but the increasing trend on the age-standardized rate was not obvious in both men and women. However, the incidence rates for men and women in rural areas increased by 7.54% and 7.83% and the age-standardized rates increased by 4.82% and 5.48% per year.from the projection model showed that the trends were mainly caused by age, period and cohort effects. Based on the analysis, up to 2015, the annual new cases of pancreatic cancer would be 103 428 (60 500 for males and 42 928 for females), with 15 277 cases more than that of 2008.There appeared an increasing trend of pancreatic cancer incidence which was more significant in the rural areas than the slowly increasing trend in the urban areas. The increasing trend of pancreatic cancer would be slow until the year 2015. However, in the short term pancreatic cancer is still a major cancer.

The menstrual history of 162 cases of female lung adenocarcinoma and 19 cases of squamous cell carcinoma was compared with 187 age-matched female controls, and analyzed for statistical significant differences that may exist between the two groups using the Epi-infor program, the Chi-square test, and the Bartlett test for homogeneity of variance. Parameters related to menstrual history included: age of menarche, menstrual cycle, number of days of menstrual period, amount of menstrual flow, menstrual pain, breast bloating/tenderness, and total number of menstrual cycles prior to menopause or diagnosis of lung cancer. The results show that cases of squamous cell carcinoma have a higher total number of menstrual cycles than controls, raising the possibility that estrogen may play a role in the induction of squamous cell carcinoma. Cases with adenocarcinoma were found to have shorter menstrual periods than controls, suggesting that activity of the corpus luteum may be related to the occurrence of adenocarcinoma. Progesterone (PR) and estrogen (ER) receptor levels were also measured in 21 adenocarcinoma surgical specimens. A positive ER and PR receptor expression was correlated with later menarche and earlier menopause.

To summarize the recent findings on the epidemiology of medically important, opportunistic invasive fungal infections (IFIs) in China and discuss the relevant social, economical reasons and medical factors.We performed a comprehensive search of both English and Chinese literatures of opportunistic IFIs from China up to April 2012.Relevant literatures involving researches and cases/case series were identified, retrieved and reviewed.The incidence of opportunistic IFIs in China was steadily increasing. The incidence and mortality of IFIs were different in patients with various underlying conditions/diseases, from 4.12% to 41.18% and 9.8% to 60.0%, respectively. Candida species, Aspergillus species and Cryptococcus neoformans species complex were the most frequent isolated pathogens. Other uncommon opportunistic IFIs were also been reported, including trichosporonosis, mucormycosis, hyalohyphomycosis (hyaline hyphomycetes) and phaeohyphomycosis (dematiaceous hyphomycetes). Reports of Chinese patients differed from those of many other countries as there were a higher number of patients without identifiable underlying diseases/conditions.Because of the rapid economic development, changing population structure and a growing number of immunocompromised hosts with risk factors, today opportunistic IFIs in China have a significant impact on public health, associated with high morbidity/mortality and higher care costs. Now information related to the epidemiology of opportunistic IFIs in China is still sparse, so we need more organized groups of clinical scientists performing related researches to help the clinicians to obtain more accurate epidemiological characteristics.

To analyze the trend of incidence and mortality on thyroid cancer in China.Data from 32 cancer registry sites in China was collected and Jionpoint model was used to obtain the crude, age-specified incidence and mortality, both Chinese national and world age-standardized rates of incidence and mortality and their trends.The crude incidence of thyroid cancer was 4.44/10(5), and the Chinese national and world age-standardized rates were 2.89/10(5) and 3.31/10(5) respectively. The crude mortality of thyroid cancer was 0.44/10(5), with the Chinese national and world age-standardized rates as 0.21/10(5) and 0.29/10(5) during 2003 - 2007 in the country. Thyroid cancer accounted for 1.67% and 0.26% of the Chinese national and world age-standardized proportions, for total cancers. Both incidence and mortality of thyroid cancer were higher in females than in males, 3.38 and 1.75 times higher in urban areas than those in rural areas. The incidence of thyroid cancer showed annually increase of 14.51% while the mortality had an increase of 1.42%.The incidence and mortality of thyroid cancer increased rapidly in China, calling for more control efforts on this disease.

Cooking oil fume is one of the important sources of atmospheric volatile organic compounds (VOCs), which are the key precursors of ozone and secondary organic aerosols in air. In this study, the production of cooking oil fume was simulated by heating typical pure vegetable oils (peanut oil, sunflower oil, soybean oil, olive oil and blend oil) at different temperatures in beakers to investigate the VOCs emission characteristics. The emitted VOCs were sampled with a Tenax adsorption tube and analyzed using GC-MS after thermal desorption. The results showed that the emission of VOCs increased with the increase of the heating temperature for all the investigated cooking oils, and at a given temperature, the blend oil emitted the lowest amount of VOCs. The VOCs emission intensity at different heating temperatures fitted well with binomial equations and ranged from 1.6-11.1 mg x (kg x min)(-1).

Based on the registered female breast cancer data from 1998 to 2007, to analyze the incidence of female breast cancer during the period and then to predict its trend from 2008 to 2015.The incidence data of breast cancer from 1998 to 2007 were sorted from National Cancer Registry Database, including 74 936 cases from urban areas and 8230 cases from rural areas, separately covering 164 830 893 and 55 395 229 person years. The crude incidence rates in urban and rural areas were calculated, and the age-standardized rate (ASR) was adjusted by World Segi's population composition. JoinPoint software was applied to analyze the 10 years' incidence trend and calculated the annual percentage of changing (APC), while Age-Period-Cohort Bayesian Model was used to fit the data and predict the incidence of breast cancer between 2008 and 2015.From 1998 to 2007, the incidence of breast cancer in the urban cancer registration areas was 45.46/100 000 (74 936/164 830 893), whose ASR was 31.28/100 000. While in rural registration areas, the incidence and ASR was 14.86/100 000 (8230/55 395 229) and 12.13/100 000. The breast cancer incidence in urban and rural areas separately rose from 36.17/100 000 (3920/10 838 355) and 10.39/100 000 (436/4 197 806) in 1998 to 51.24/100 000 (11 302/22 057 787) and 19.61/100 000 (1475/7 522 690) in 2007. During the 10 years, the breast cancer incidence increased both in urban and rural areas, but the increase rate in rural incidence (6.3%) was more significant than it in urban areas (3.9%). Age-Period-Cohort Bayesian Model predicted that the breast cancer incidence would increase to 53.87/100 000 (185 585 new cases) in urban areas and 40.14/100 000 (132 432 new cases) in rural areas, respectively.The breast cancer incidence has been increasing annually both in urban and rural areas in China; and an annually increase number of new cases have been predicted.

Cancer is one of the leading causes of death in China. The study aimed to examine the temporal trend of cancer mortality rate during 1989-2008 in urban and rural areas of China.The mortality data of all cancers from 1989 to 2008 from National Cancer Registry database were sorted and checked. Age standardized mortality rates were calculated by the direct methods using the China population of 1982 and World Segi's population. Joinpoint regression was performed to obtain the annual percentage changes (APC) in mortality rates. The top ten cancer sites were calculated and analyzed. The mortality rates were compared with statistics of the United States.From 1989 to 2008, the trend of crude cancer mortality increased with an annual percentage change (APC) of 1.0%. After age standardization, the mortality rate was significantly decreased, with an APC of -1.2%. In urban areas, lung cancer was the most common cancer of death, whereas in rural areas, stomach cancer and esophageal cancer remained top cancers of death. Especially, in both urban and rural areas, the mortality of lung cancer was on increase. The mortality rates of stomach and esophageal cancers showed a decrease in urban areas. Compared with the cancer mortality rates of the United States, the Chinese cancer mortality rate in males remained highest. The decreasing trend of cancer mortality in females of China was less obvious than that of the United States.The crude mortality rates of cancer in China show an increase whereas the age standardized mortality raters has declined between 1989 and 2008. Cancer is still a major public health issue threatening people's life in China. Effective intervention for cancer control and prevention is needed in the future.

Nationwide cancer incidence data were used to analyze the trends of cancer incidence in China in order to provide basic information for making cancer control strategy.We retrieved and re-sorted valid cancer incidence data from the National Central Cancer Registry Database over the 20 year-period 1989-2008. Crude incidence rate and age-standardized incidence rate were calculated for analysis. Annual percent changes in incidence for all cancers combined were estimated using Joinpoint software.The cancer incidence rate in cancer registration areas was increased from 184.81/10(5) in 1989 to 286.69/10(5) in 2008 (from 209.33/10(5) to 307.04/10(5) in urban and from 176.10/10(5) to 269.57/10(5) in rural areas). Uptrends of crude cancer incidence were shown in both male and female in urban and rural areas over the 20 year-period. After standardized by age, overall incidence rate kept stable with 0.5% annual increase in urban and no change in rural areas. Since 2000, the cancer incidences in both sexes and areas were significantly increased. The incidence increased for most major cancers, especially lung cancer, colorectal cancer, female breast cancer and cervical cancer.Over the 20 year-period 1989-2008, cancer incidence of most cancers has been increasing by time. The incidences of gastric cancer, liver cancer and esophageal cancer still keep gradually increasing. The incidences of lung cancer, female breast cancer, colorectal cancer and cervical cancer are markedly going up, so that cancer prevention and control should be enhanced. Cancer registration will play an important role on cancer control in China along with the number of registries increasing and data quality improving.

Based on the national cancer incidence database from 1998 to 2007, to analyze the cancer incidence trend and predict the cancer burden between 2008 and 2015.We picked up the cancer incidence data of 40 cancer registry sites from National Central Cancer Registry Database between 1998 and 2007. In total, 1 109 594 cancer cases were registered, covering 446 734 668 person-year. The separate incidence by district and gender were calculated, and the standardized incidence rate was calculated by world's population age structure. The incidence trend between the 10 years was analyzed by JoinPoint software, as well as the age-percentage-changes (APC). Age-Period-Cohort Bayesian Model was applied to fit the cancer incidence data stratified by age, district and gender. The cancer incidence between 2008 and 2015 was then predicted.During the period of 1998 - 2007, in urban areas, the male cancer incidence rate was 277.61/100 000 (472 307/170 131 309), with the age standardized rate (ASR) at 202.05/100 000; while the female cancer incidence rate was 236.35/100 000 (389 586/164 830 893), with the ASR at 159.15/100 000; in rural areas, the male and female cancer incidence rates were separately 272.23/100 000 (153 478/56 377 236) and 170.09/100 000 (94 223/55 395 230), with the corresponding ASR at 244.34/100 000 and 137.90/100 000. Crude incidence rate in urban men increased from 247.00/100 000 (27 758/11 237 967) in 1998 to 305.76/100 000 (68 953/22 551 353) in 2007; while it increased from 207.37/100 000 (22 476/10 838 355) to 263.20/100 000 (58 055/22 057 787) among urban women. The crude incidence rate in rural men increased from 232.33/100 000 (10 045/4 323 628) to 303.65/100 000 (23 313/7 677 484) and it increased from 139.03/100 000 (5836/4 197 806) to 197.40/100 000 (14 850/7 522 690) among rural women. After age adjustment, the urban male APC value (95%CI) was 0.5% (-0.2% - 1.3%), showed no significantly statistical difference. However, the urban female APC value (95%CI), rural male APC value (95%CI) and rural female APC value (95%CI) were separately 1.7% (1.3% - 2.0%), 1.8% (0.9% - 2.6%) and 2.8% (1.8% - 3.7%), all showed an obvious uptrend. The outcome of Age-Period-Cohort Bayesian model predicted that by year 2015, the incidence cancer rate in urban areas will reach 309.13/100 000 (1.140 million new cases) among males and 303.79/100 000 (1.046 million new cases) among females; while in rural areas the rate will reach 288.66/100 000 (1.019 million new cases) among males and 222.59/100 000 (0.734 million new cases) among females.The cancer incidence has increased annually; the uptrend in rural areas was more obvious than it in urban areas; the uptrend in females was more obvious than it in males. It is predicted that the annual incidence will continue to increase in the next years, and effective control programs should be carried out immediately.

Based on the cancer registry data during 1998 - 2007, to analyze the incidence of liver cancer in China and predict the trend of incidence of liver cancer between 2008 and 2015.Liver cancer incidence data from cancer registry between 1998 and 2007 was collected, including a total of 115 417 cases, covering 446 734 668 person-year. We calculated the annual incidence rate of liver cancer by gender and area. Age-standardized rate (ASR) was calculated by the world's population age structure. JoinPoint software was applied to analyze the incidence trend and calculate annual percent change (APC). Age-Period-Cohort Bayesian Model was used to fit the incidence trend and predict the incidence trend between 2008 and 2015.From 1998 to 2007, according to the data from cancer registry, the liver cancer incidence was 25.84/100 000 (115 417/446 734 668), with the ASR at 18.82/100 000. In urban areas, the male incidence was 34.30/100 000 (58 353/170 131 309), with ASR at 24.99/100 000; while the female incidence was 12.33/100 000 (20 324/164 830 893), with ASR at 7.99/100 000. In rural areas, the male incidence was 48.56/100 000 (27 378/56 377 236), with ASR at 42.27/100 000; while the female incidence was 16.90/100 000 (9362/55 395 230), with ASR at 13.52/100 000. During the decade, in urban areas, the APC of male and female liver cancer incidence rates were separately 1.1% and -0.5%, with ASR at -0.5% and -1.9%; while in rural areas, the APC of male and female liver cancer incidence rates were separately 3.7% and 3.1%, with ASR at 1.9% and 1.3%. Age-Period-Cohort Bayesian Model predicted that in urban areas, the male and female incidence of liver cancer in 2015 would reach 30.73/100 000 (113 279 cases) and 10.44/100 000 (35 978 cases), with ASR at 23.70/100 000 and 7.21/100 000, respectively; while in rural areas, the incidence rates would increase to 51.67/100 000 (182 382 cases) and 15.03/100 000 (49 580 cases), with ASR at 39.80/100 000 and 10.45/100 000, respectively.The incidence of liver cancer will increase between 2008 and 2015, but its ASR will decrease slightly. In the near future, the number of new liver cancer cases will keep increasing. Liver cancer is still the dominant cancer and one key point for cancer prevention and control in China.

Based on the data from National Cancer Registry between 1998 and 2007, to analyze the colorectal cancer incidence trend in China, and further to predict its incidence between 2008 and 2015.We picked up the incidence data of 111 281 cases of colorectal cancer in total from National Central Cancer Registry Database between 1998 and 2007, covering 446 734 668 person-year. The annual incidence rate of colorectal cancer both by area and gender were calculated; while the age standardized rate (ASR) was standardized by world's population age structure. The incidence trend was analyzed and the annual percentage change (APC) was calculated by JoinPoint software. Age-Period-Cohort Bayesian Model was applied to fit the colorectal cancer incidence trend in China between 1998 and 2007; and further to predict its incidence between 2008 and 2015.From 1998 to 2007, the colorectal cancer registered incidence was 24.91/100 000 (111 281/446 734 668), with the ASR at 17.67/100 000. The incidence in male population was 26.50/100 000 (60 015/226 508 545), with ASR at 19.90/100 000; and the incidence in female was 23.28/100 000 (51 266/220 226 123), with ASR at 15.73/100 000. In urban area, the male incidence rose from 23.29/100 000 (2617/11 237 967) in 1998 to 37.84/100 000 (8534/22 551 353) in 2007; while the female incidence increased from 21.75/100 000 (2357/10 838 355) to 31.34/100 000 (6913/22 057 787). And in rural areas, the male and female incidences rose from 10.36/100 000 (448/4 323 628) and 8.86/100 000 (372/4 197 806) in 1998 to 16.80/100 000 (1290/7 677 484) and 13.00/100 000 (978/7 522 690) in 2007 respectively. In this decade, the colorectal cancer incidence has increased both in urban and rural areas. In urban area, the male APC value was 5.5% and the female APC value was 4.0%; while in rural area, the male and female APC values were 6.0% and 4.3% respectively. After adjusted by age structure, the uptrend became gently; with the urban male and urban female APC values separately increased by 3.7%, 2.5% and 2.3%. The rural male APC value rocketed up by 8.4% after its inflection point in 2004. The Bayesian model predicted that the male and female colorectal cancer incidences would separately reach 33.92/100 000 (125 thousand cases) and 27.13/100 000 (93 thousand cases) in urban areas; and 13.61/100 000 (48 thousand cases) and 13.68/100 000 (45 thousand cases) in rural areas by year 2015.The colorectal cancer incidence in China has been increasing annually; and it will continue to rise in the next years.

Based on the registered esophageal cancer data from 1998 to 2007, to analyze the incidence of esophageal cancer during the period and then to predict its trend between year 2008 and 2015.The incidence data of esophageal cancer between 1998 and 2007 were sorted from National Cancer Registry Database. Data from forty selected registries were qualified and recruited in the study, including 86 427 cases in total, covering 446 734 668 person years. Crude incidence rates were calculated by area and gender. The standardized incidence rate was adjusted by World Segi's population composition. JoinPoint software was applied to analyze the 10 years' incidence trend and calculated the annual percentage change, while Age-Period-Cohort Bayesian Model was used to fit the data and predict the incidence between 2008 and 2015.Between 1998 and 2007, the crude incidence rates among males and females in urban areas were separately 16.58/100 000 (28 207/170 131 309) and 7.14/100 000 (11 761/164 830 893), with standardized rates at 12.06/100 000 and 4.55/100 000, respectively. In rural areas, the crude incidence rates and the standardized rates were separately 51.98/100 000 (29 303/56 377 236) and 47.18/100 000 among males, and 30.97/100 000 (17 156/55 395 230) and 25.30/100 000 among females. During the ten years, the crude incidence trend of esophageal cancer among urban females decreased from 10.29/100 000 (1115/10 838 355) in 1998 to 6.29/100 000 (1387/22 057 787) in 2007. However, the crude incidence rate among rural males increased from 47.69/100 000 (2062/4 323 628) to 54.80/100 000 (4207/7 677 484) in the same period. And the rate among rural females and urban males did not change obviously. After adjusting population structure, in urban areas, the male incidence rate decreased by 2.1% annually and female incidence rate dropped by 7.5% annually. In rural areas, the female incidence rate fell by 1.3% annually, while the male incidence rate remained the same without significant changes. The prediction model estimated that there would be 134 474 new esophageal cancer cases diagnosed in year 2015, including 104 400 males and 30 074 females, while 52 506 cases came from urban areas and the other 81 968 cases were from rural areas.The esophageal cancer incidence showed a downtrend, especially among urban females. By year 2015, the threat of esophageal cancer will be alleviated.

To analyze corpus uteri epidemiology in selected cancer registering areas of China during 2003 - 2007, and to provide scientific information for its prevention and control in China.The incident and mortality data of corpus uteri cancer in 32 cancer registering areas of China with better quality during 2003 - 2007, which were selected according to the criteria of and provided by National Center for Cancer Registration, were analyzed.There were 8850 new cases and 1559 death cases of corpus uteri cancer, which accounted for 2.96% (8 850/299 306) of all female new cancer cases and 0.94% (1 559/166 305) of all female cancer death cases, respectively. Corpus uteri cancer was the 9th most common cancer for all new female cancer cases which world age adjusted incidence rates was 5.04/10⁵, and 19th most common cancer for all female cancer death cases which world age adjusted mortality rate was 0.83/10⁵ in 32 selected cancer registering areas of China during 2003 - 2007. Zhongshan city, Guangzhou city in Guangdong province and Beijing were the areas with the highest incidence rates in which were 14.51/10⁵, 8.51/10⁵ and 6.69/10⁵, respectively. Zhongshan city in Guangdong province, Dafeng city in Jiangsu province and Feicheng city in Shandong province were the areas with the highest mortality rates, in which were 4.03/10⁵, 3.19/10⁵ and 1.65/10⁵ respectively during 2003 - 2007. There were increasing trends for its incidence rates in above 32 areas during 2003 - 2007, its world age adjusted incidence rates increased from 3.94/10⁵ in 2003 to 5.56/10⁵ in 2007 (P = 0.026), while its urban world age adjusted incidence rates increased from 4.57/10⁵ in 2003 to 6.18/10⁵ in 2007 (P = 0.038), and rural rates increased from 1.74/10⁵ in 2003 to 3.01/10⁵ in 2007 (P = 0.013), and the results showed that urban areas obviously higher than rural areas (P0.01). Although there was a slow increasing trend for its world age adjusted mortality rates in above 32 areas during 2003 - 2007 which increased from 0.64/10⁵ in 2003 to 0.87/10⁵ in 2007 (P = 0.214), and from 0.66/10⁵ in 2003 to 0.88/10⁵ in 2007 in urban areas (P = 0.340), and from 0.57/10⁵ in 2003 to 0.83/10⁵ in 2007 in rural areas (P = 0.070), while increasing trends without statistical significance.But mortality rates in urban areas were obviously higher than those of rural areas (P0.01).Although the world standardized incidence and mortality rates of corpus uteri cancer were at low level worldwide, there were increasing trends for its incidence rates during 2003 - 2007 in the 32 selected cancer registering areas of China. Moreover, its incidence and mortality rates were at high level worldwide in some areas such as Zhongshan city of Guangdong province and Dafeng city of Jiangsu province during the period, in which suggested that its prevention and control should be enhanced.