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| 1 | Mortality outcomes of low-dose computed tomography screening for lung cancer in urban China:a decision analysis and implications for practice显示文摘Background: Mortality outcomes in trials of low-dose computed tomography(CT) screening for lung cancer are inconsistent. This study aimed to evaluate whether CT screening in urban areas of China could reduce lung cancer mortality and to investigate the factors that associate with the screening effect.Methods: A decision tree model with three scenarios(low-dose CT screening, chest X-ray screening, and no screening) was developed to compare screening results in a simulated Chinese urban cohort(100,000 smokers aged45-80 years). Data of participant characteristics were obtained from national registries and epidemiological surveys for estimating lung cancer prevalence. The selection of other tree variables such as sensitivities and specificities of low-dose CT and chest X-ray screening were based on literature research. Differences in lung cancer mortality(primary outcome), false diagnoses, and deaths due to false diagnosis were calculated. Sensitivity analyses were performed to identify the factors that associate with the screening results and to ascertain worst and optimal screening effects considering possible ranges of the variables.Results: Among the 100,000 subjects, there were 448,541, and 591 lung cancer deaths in the low-dose CT, chest X-ray, and no screening scenarios, respectively(17.2% reduction in low-dose CT screening over chest X-ray screening and 24.2% over no screening). The costs of the two screening scenarios were 9387 and 2497 false diagnoses and 7and 2 deaths due to false diagnosis among the 100,000 persons, respectively. The factors that most influenced death reduction with low-dose CT screening over no screening were lung cancer prevalence in the screened cohort, lowdose CT sensitivity, and proportion of early-stage cancers among low-dose CT detected lung cancers. Considering all possibilities, reduction in deaths(relative numbers) with low-dose CT screening in the worst and optimal cases were16(5.4%) and 288(40.2%) over no screening, respectively.Conclusions: In terms of mortality outcomes, our findings favor conducting low-dose CT screening in urban China.However, approaches to reducing false diagnoses and optimizing important screening conditions such as enrollment criteria for screening are highly needed. | Zixing Wang Wei Han Weiwei Zhang Fang Xue Yuyan Wang Yaoda Hu Lei Wang Chunwu Zhou Yao Huang Shijun Zhao Wei Song Xin Sui Ruihong Shi Jingmei Jiang | 2017 | Chinese Journal of Cancer2017，36，8： | 9 |
| 2 | 中国城市人群低剂量计算机断层扫描筛查肺癌的死亡率结果:决策分析和实践意义显示文摘背景与目的不同低剂量计算机断层扫描(computed tomography,CT)筛查肺癌试验得出的死亡率结果不一致。本研究旨在评价中国城市CT筛查是否能够降低肺癌死亡率,并探讨影响筛查效果的因素。方法建立了3种场景(低剂量CT筛查、胸部X线筛查和无筛查)的决策树模型来比较模拟的中国城市人群(100,000例年龄45–80岁的吸烟者)的筛查结果。从国家登记和流行病学调查中获得了参与者特征数据并估算了肺癌患病比例。根据文献调研选择了低剂量CT和胸部X线筛查的灵敏度和特异度等其他树变量。计算了3种筛查方法间肺癌死亡率(主要结局)、误诊和误诊导致死亡的差异。通过敏感性分析找出了与筛查结果相关的因素,并确定了在变量可能范围内的最差和最优筛查效果。结果 100,000例研究对象中,低剂量CT、胸部X线和无筛查场景分别有448例、541例和591例肺癌死亡(低剂量CT筛查比胸部X线筛查死亡人数减少17.2%,比无筛查减少24.2%)。100,000例研究对象中,2种筛查场景的代价分别为9387例和2497例误诊及7例和2例误诊导致的死亡。低剂量CT筛查比无筛查的死亡数降低,影响最大的因素是筛查人群的肺癌患病比例、低剂量CT的灵敏度和低剂量CT检出肺癌中早期癌的比例。综合了所有可能性,低剂量CT筛查肺癌的死亡人数(相对数)在最坏和最好情况下分别比无筛查降低了16例(5.4%)和288例(40.2%)。结论就死亡率结局而言,我们的研究结果支持在中国城市人群中进行低剂量CT筛查。然而,急需策略来减少误诊和优化纳入标准等重要筛查条件。 | Zixing Wang Wei Han Weiwei Zhang Fang Xue Yuyan Wang Yaoda Hu Lei Wang Chunwu Zhou Yao Huang Shijun Zhao Wei Song Xin Sui Ruihong Shi Jingmei Jiang | 2018 | 癌症2018，37，8： | 3 |
| 3 | Challenges and research opportunities for lung cancer screening in China显示文摘Following publication of the results of the National Lung Screening Trial in the United States,a randomized controlled trial in Italy(ITALUNG)and two simulation studies in China reported similar findings in 2017 favoring lung cancer screening with low-dose computed tomography among smokers.With such advances in lung cancer screening,worldwide interest has gradually shifted from evaluating whether refining lung cancer screening protocols is effective in preventing deaths.However,there are several practical problems to be resolved,including the balance of enroll-ment criteria and cost effectiveness,precise measurements to reduce false positive findings,risk-based optimization of screening frequency,challenges associated with cancer heterogeneity,strategies to combine image screening with novel biomarkers,dynamic monitoring of the natural history of cancer,accurate identification and diagnosis of cases among huge populations,and the impact of tobacco control policy and environment protection.As one in three individuals with lung cancer worldwide resides in China,these questions pose great challenges as well as research opportunities for population screening programs in China. | Zixing Wang Yuyan Wang Yao Huang Fang Xue Wei Han Yaoda Hu Lei Wang Wei Song Jingmei Jiang | 2018 | Cancer Communications2018，38，1： | 3 |
| 4 | 2D layered black arsenic-phosphorus materials:Synthesis,properties,and device applications显示文摘Phosphorene,especially black phosphorus(BP),has attracted considerable attention due to the unique characteristics,such as tunable direct bandgap,high carrier mobility,and strong in-plane anisotropy.Recently,a new modification strategy for black phosphorus has been developed by alloying black phosphorus with the congener element arsenic.The elemental composition tuning of black phosphorus with arsenic can not only maintain its special crystal structure and high anisotropy but also modify its electrical and optical properties for the further applications of multifunctional devices.The achieved two-dimensional(2D)black arsenic-phosphorus materials exhibit outstanding optical,electrical,and photoelectric properties,such as very narrow band gap,anisotropic infrared absorption,and bipolar transfer characteristics,presenting great potential in infrared photodetectors and highperformance field effect transistors(FETs).In this review,we introduce the recent progress made in the synthesis and applications of black arsenic-phosphorus,and provide an outlook and perspectives on the current challenges and future opportunities in this field.We hope that this review can bring new insights and inspirations on the further development of 2D black arsenic-phosphorus based materials and devices. | Junchuan Liang Yi Hu Kaiqiang Zhang Yaoda Wang Xinmei Song Anyang Tao Yuzhu Liu Zhong Jin | 2022 | Nano Research2022，15，4： | 1 |
| 5 | Evaluation of ICUs and weight of quality control indicators:an exploratory study based on Chinese ICU quality data from 2015 to 2020显示文摘This study aimed to explore key quality control factors that affected the prognosis of intensive care unit(ICU)patients in Chinese mainland over six years(2015–2020).The data for this study were from 31 provincial and municipal hospitals(3425 hospital ICUs)and included 2110685 ICU patients,for a total of 27607376 ICU hospitalization days.We found that 15 initially established quality control indicators were good predictors of patient prognosis,including percentage of ICU patients out of all inpatients(%),percentage of ICU bed occupancy of total inpatient bed occupancy(%),percentage of all ICU inpatients with an APACHE II score≥15(%),three-hour(surviving sepsis campaign)SSC bundle compliance(%),six-hour SSC bundle compliance(%),rate of microbe detection before antibiotics(%),percentage of drug deep venous thrombosis(DVT)prophylaxis(%),percentage of unplanned endotracheal extubations(%),percentage of patients reintubated within 48 hours(%),unplanned transfers to the ICU(%),48-h ICU readmission rate(%),ventilator associated pneumonia(VAP)(per 1000 ventilator days),catheter related blood stream infection(CRBSI)(per 1000 catheter days),catheter-associated urinary tract infections(CAUTI)(per 1000 catheter days),in-hospital mortality(%).When exploratory factor analysis was applied,the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation:nosocomial infection management(21.35%),compliance with the Surviving Sepsis Campaign guidelines(17.97%),ICU resources(17.46%),airway management(15.53%),prevention of deep-vein thrombosis(14.07%),and severity of patient condition(13.61%).Based on the different weights of the core elements associated with the 15 indicators,we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management+17.97%xcompliance with SSC guidelines+17.46%×ICU resources+15.53%×airway management+14.07%×DVT prevention+13.61%×severity of patient condition.This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system. | Longxiang Su Xudong Ma Sifa Gao Zhi Yin Yujie Chen Wenhu Wang Huaiwu He Wei Du Yaoda Hu Dandan Ma Feng Zhang Wen Zhu Xiaoyang Meng Guoqiang Sun Lian Ma Huizhen Jiang Guangliang Shan Dawei Liu Xiang Zhou China-NCCQC | 2023 | Frontiers of Medicine2023，17，4： | 0 |
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