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Purpose: To describe the incidence and management of alimentary tract Buckyball ingestion in Chinese pediatric patients, and discuss the precautionary measures through multicenter investigation. Methods: Medical records of 74 pediatric patients from 9 large Chinese hospitals were included in this study. Questionnaires were distributed online, and medical records were reviewed. Follow-up was through telephone and outpatient service. Results: Among the 74 cases were 50 boys (68%) and 24 girls (32%). The age was 36.00 (21.75, 77.00) months, range from 7 months to 11 years old, and it showed two peaks, between one and three years old, and from six to eleven years old. The annual case number showed sharp increase, and the total case number in the last 2 years of 2017 and 2018 showed a 9.25 folds increase than the first 2 years of 2013 and 2014. Only 3 of them had exact reasons for the swallowing, the rest 71 patients had no intension for the ingestion. From onset to the emergency time was 2.00 (1.00, 5.25) days, varied from 4 hours to 40 days. Twenty-one patients had no symptoms, and the rest cases had abdominal pain, vomiting, fever, abdominal distension, fiercely crying, melena, and flatus and defecation stopped. Gastroscope, coloscope, laparoscopic operation, and laparotomy operation were adopted according to the algorithm. Gastrointestinal mucosa erosion, ischemia and necrosis, perforation, and abdominal abscess, ileus, fistula was found in the patients. The numbers of Buckyball ingested was 4 (2, 8), with a range from 1 to 39. During the follow-up period of 6 (1, 15) months, three patients had ileus, and one suffered a second operation. The remaining 71 patients were uneventful. None of the 74 patients reported a second swallowing of foreign bodies. Conclusions: The incidence of pediatric alimentary tract magnets ingestion in China is still increasing. Management of such patients should follow the algorithm. Precautionary measures toward the issue should be taken from three levels. Keywords: Pediatric, Alimentary tract, Magnetic foreign body, Buckball

Introduction: Periodic population surveys of smoking behaviour can inform development of effective tobacco control strategies. We investigated smoking patterns, cessation and knowledge about smoking hazards in China. Methods: A nationally representative cross-sectional survey recruited 176,318 people aged ≥18 years across 31 provinces of China in 2013-14, using multi-stage stratified cluster sampling methods. The smoking patterns, cessation and knowledge about smoking hazards were analysed, overall and in population subgroups, adjusting for sample selection weight and post-stratification factors. Results: Among men, 60.7% were ever smokers, with proportions of regular, occasional and former smokers being 46.3%, 5.5%, and 8.8% respectively. Among women, only 2.8% has ever smoked. The prevalence of ever smoking in men was higher in rural than urban areas (63.2% vs 57.6%) and varied from 39.5% to 67.4% across 31 provinces. Among male regular smokers, the mean daily number of cigarettes smoked was 17.8, with mean age at first starting to smoke daily being 20.1 years. Among current smokers, one third (32.6% men, 32.1% women) had tried to quit before and 36.8% (36.8% men, 35.5% women) intended to quit in the future. Of the Chinese adults, 75.9% recognized that smoking was hazardous, with the proportions believing that smoking could cause lung cancer, heart attack or stroke being 67.0%, 33.2% and 29.5%, respectively and with 26.0% reporting that smoking could cause all these conditions. Conclusion: Among Chinese adults, the smoking prevalence remained high in men but was low in women. In both men and women knowledge about smoking hazards was poor. Implications:This study showed that tobacco smoking remained highly prevalent among adult men in China in 2013-14. Moreover, men born in recent decades were more likely to start smoking at younger ages and to smoke more cigarettes than those born in previous generations. There was a large regional variation in male smoking prevalence, with the least economically developed regions having higher prevalence. In contrast, few women in China smoked, especially among those born in recent decades. The contrasting smoking patterns in men and women is likely to result in an increasingly large gender disparity in life expectancy in the coming decades.

Multiple comparison procedures combined with modeling techniques (MCP-Mod) (Bretz et al., 2005) is an efficient and robust statistical methodology for the model-based design and analysis of dose-finding studies with an unknown dose–response model. With this approach, multiple comparison methods are used to identify statistically significant contrasts corresponding to a set of candidate dose–response models, and the best model is then used to estimate the target dose. Power and sample size calculations for this methodology require knowledge of the covariance matrix for the estimators of the (placebo-adjusted) mean responses among the dose groups. In this article, we consider survival endpoints and derive an analytic form of the covariance matrix for the estimators of the log hazard ratios as a function of the total number of events in the study. We then use this closed-form expression of the covariance matrix to derive the power and sample size formulas. We discuss practical considerations in the application of these formulas. In addition, we provide an illustration with a motivating example on chronic obstructive pulmonary disease. Finally, we demonstrate through simulation studies that the proposed formulas are accurate enough for practical use. © 2018, The International Biometric Society