[Prevalence investigation of solitary plasmacytoma in China: A calculation based on national urban medical insurance in 2016]

目的

分析我国孤立性浆细胞瘤患者分布特征并测算2016年患病率。

方法

基于2016年1月1日至12月31日我国21个省城镇职工和城镇居民医疗保险数据开展研究。通过疾病诊断名称、疾病诊断编码识别孤立性浆细胞瘤患者。根据性别、地区和年龄进行亚组分析，并进行敏感性分析以考察结果的稳健性。基于我国2010年全国人口普查数据、欧洲2013年标准人口数据、美国2010年人口数据以及澳大利亚2011年人口数据计算按年龄调整的标化患病率。

结果

2016年我国孤立性浆细胞瘤患病率为1.18/10万（95%CI 1.06~1.31），其中男性患病率为1.26/10万（95%CI 1.10~1.43），女性患病率为1.10/10万（95%CI 0.93~1.29）。基于我国2010年全国人口普查数据所得标化患病率为0.85/10万（95%CI 0.82~0.88）。

结论

本研究利用全国城镇医疗保险数据测算我国孤立性浆细胞瘤的患病率，为孤立性浆细胞瘤相关医疗政策制定以及基础研究提供线索。

Direct pyrolysis and ultrasound assisted preparation of N, S co-doped graphene/Fe3C nanocomposite as an efficient electrocatalyst for oxygen reduction and oxygen evolution reactions

Bifunctional electrocatalysts to enable efficient oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) are essential for fabricating high performance metal-air batteries and fuel cells. Here, a defect rich nitrogen and sulfur co-doped graphene/iron carbide (NS-GR/Fe₃C) nanocomposite as an electrocatalyst for ORR and OER is demonstrated. An ink of NS-GR/Fe₃C is developed by homogeneously dispersing the catalyst in a Nafion containing solvent mixture using an ultrasonication bath (Model-DC150H; power - 150 W; frequency - 40 kHz). The ultrasonically prepared ink is used for preparing the electrode for electrochemical studies. In the case of ORR, the positive half-wave potential displayed by NS-GR/Fe₃C is 0.859 V (vs. RHE) and for the OER, onset potential is 1.489 V (vs. RHE) with enhanced current density. The optimized NS-GR/Fe₃C electrode exhibited excellent ORR/OER bifunctional activities, high methanol tolerance and excellent long-term cycling stability in an alkaline medium. The observed onset potential for NS-GR/Fe₃C electrocatalyst is comparable with the commercial noble metal catalyst, thereby revealing one of the best low-cost alternative air-cathode catalysts for the energy conversion and storage application.

Electrochemical determination of caffeic acid in antioxidant beverages samples via a facile synthesis of carbon/iron-based active electrocatalyst

An electrochemical method has described for the voltammetric determination and oxidation of caffeic acid (CA) at a glassy carbon electrode (GCE) modified carbon/iron-based active catalyst as a sensing platform. In this study, we have developed a highly sensitive electrochemical CA sensor with f-MWCNTs/α-NaFeO₂ composite, which was developed by a simple ultrasonication method. The microstructural features of the f-MWCNTs/α-NaFeO₂ composite characterized by different physicochemical and analytical techniques. Under the optimized condition, the developed sensor archive the ultra-sensitivity (44.6859 μA μM^-1cm^-2) at a lower concentration with excellent linearity (R² = 0.9943) and which shows low detection limit (LOD = 0.002 μM) and Limit of quantification (LOQ = 0.0068 μM) by using differential pulse voltammetry (DPV) technique. The suggested sensor may improve the effective and efficient platform to the determination of CA in the healthcare system.

[Calculation of the prevalence of progressive muscular atrophy among adults in China based on urban medical insurance data from 15 provinces]

OBJECTIVE

To analyze the characteristics of patients with progressive muscular atrophy (PMA) and calculate the prevalence of PMA in China in 2016.

METHODS

A retrospective analysis based on China's urban employee basic medical insurance data and the urban residence basic medical insu-rance data from January 1, 2016 to December 31, 2016 was carried out. Children under 18 years old were excluded. Patients with progressive muscular atrophy were identified by disease names and codes. Subgroup analyses by gender, region and age were carried out to calculate the gender-specific, region-specific and age-specific prevalences. Age-adjusted national prevalence was estimated based on 2010 Chinese census data. Sensitivity analyses were done by only considering the observed cases and by excluding the top 10% provinces regarding the missing rate of diagnostic information, respectively.

RESULTS

A total of 996.09 million person-years were included in this study, with 518.41 million person-years in males and 477.67 million person-years in females. The age and gender distribution of the study population was similar to that of the 2010 Chinese census data, therefore the study population was nationally representative. The prevalence of PMA in China in 2016 was 0.28 per 100 000 person-years (95%CI: 0.24-0.33), with 0.21 per 100 000 person-years (95%CI: 0.16-0.26) and 0.35 per 100 000 person-years (95%CI: 0.28-0.42) for females and males, respectively. Regional disparity existed in the Chinese PMA prevalence, with the lowest prevalence in Southwest region (0.11 per 100 000 person-years, 95%CI: 0.07-0.15) and the highest prevalence in Northwest region (3.47 per 100 000 person-years, 95%CI: 0.80-7.99). Age trend in the PMA prevalence was not obvious, but the prevalence among those aged 70 years and older was relatively higher. The age-adjusted prevalence based on 2010 Chinese census data was 0.29 per 100 000 person-years (95%CI: 0.27-0.31). The national prevalences calculated by only considering the observed cases and by excluding the top 10% provinces regar-ding the missing rate of diagnostic information were 0.17 per 100 000 person-years (95%CI: 0.14-0.20) and 0.24 per 100 000 person-years (95%CI: 0.20-0.28), respectively.

CONCLUSION

This study is to calculate the prevalence of PMA among adults in urban China, which can provide basic statistics for the enactment of PMA related medical policies, and clues for the studies on the mechanisms of PMA.

[Heritability of alcohol intake among adult twins, calculate by the structural equation model]

Objective: To explore the genetic and environmental effects on alcohol intake. Methods: Data on 9 231 pairs of adult twins of the same sex was collected from the Chinese National Twin Registry (CNTR), between 2015 and 2018 and used in this study. Structural equation model was used to estimate the effects of genetic and environmental factors on alcohol intake. Results: A total of 9 231 pairs of twins were included in the analysis, of which 6 085 pairs were monozygotic (MZ). The average age of MZ was (36.91±13.07) years old, and males accounted for 56.80%. The average age of dizygotic twins (DZ) was (35.22±12.48) years old, and males accounted for 55.91%. There were 350 pairs of alcohol-drinking twins were with high-risk, accounting for 1.90% and another 367 pairs (1.99%) were with medium-risk. Alcohol-drinkers with medium-risk were affected by additive genetics, common and unique environmental factors, seen among the twins. The overall heritability appeared as 24.3% (95%CI: 0 to 56.8%). Furthermore, 50.7% of the variation (95%CI: 20.4%-79.0%) could be explained by the common environmental factors and 24.9% (95%CI: 18.3%-36.5%) by unique environmental factors. High-risk related drinking behavior was affected by both common and unique environmental factors. The common environmental component appeared as 75.6% (95%CI: 69.6%-80.8%) and unique environmental component as 24.4% (95%CI: 19.2%-30.4%), respectively. Gender difference was seen in the heritability of those with medium or high-risk drinking behaviors. The heritability of men was 30.8% (95%CI: 9.8%-53.5%), while in women it was mainly affected by the environment. Conclusion: Both alcohol drinkers with medium and high-risk drinking behaviors were mainly affected by the environment factors and gender. With the increase of drinking volume, the effect of environment on drinking behaviors became more obvious.

Layered nanocomposite of zinc sulfide covered reduced graphene oxide and their implications for electrocatalytic applications

Herein, we have synthesized zinc sulfide nanospheres (ZnS NPs) encapsulated on reduced graphene oxide (RGO) hybrid by an ultrasonic bath (50 kHz/60 W). The physical and structural properties of ZnS NPs@RGO hybrid were analyzed by TEM, XRD, EIS and EDS. As-prepared ZnS NPs@RGO hybrid was applied towards the electrochemical determination of caffeic acid (CA) in various food samples. The ZnS NPs@RGO hybrid modified electrode (GCE) exhibited an excellent electrocatalytic performance towards caffeic acid detection and determination, when compared to other modified electrodes. Therefore, the electrochemical sensing performance of the fabricated and nanocomposite modified electrode was significantly improved owing to the synergistic effect of ZnS NPs and RGO catalyst. Furthermore, the hybrid materials provide highly active electro-sites as well as rapid electron transport pathways. The proposed electrochemical caffeic acid sensor produces a wide linear range of 0.015-671.7 µM with a nanomolar level detection limit (3.29 nM). In addition, the real sample analysis of the proposed sensor has applied to the determination of caffeic acid in various food samples.

[Heritability of coronary heart disease, based on the data from the Chinese adult twins]

Objective: To analyze the heritability of coronary heart disease (CHD) among the Chinese twin adults. Methods: A total of 20 477 same-sex twin pairs aged 25 years and older from the Chinese National Twin Registry were interviewed. Structure equation model was used to estimate the heritability of CHD. Results: After adjusting for age and gender, the overall heritability of CHD was 0.75(0.68-0.81). Stratified analyses showed that genetic factors play a more important role in CHD incidence in ≥40 years or female twins. While the development of CHD was mainly influenced by environmental factors in 25-39 years or male twins. Conclusion: CHD is influenced by both genetic and environmental factors and the heritability is high.

[Introduction of the Prediction model Risk Of Bias ASsessment Tool: a tool to assess risk of bias and applicability of prediction model studies]

This paper introduceds the tool named as "Prediction model Risk Of Bias ASsessment Tool" (PROBAST) to assess the risk of bias and applicability in prediction model studies and the relevant items and steps of assessment. PROBAST is organized into four domains including participants, predictors, outcome and analysis. These domains contain a total of 20 signaling questions to facilitate structured judgment of risk of bias occurring in study design, conduct or analysis. Through comprehensive judgment, the risk of bias and applicability of original study is categorized as high, low or unclear. PROBAST enables a focused and transparent approach to assessing the risk of bias of studies that develop, validate, or update prediction models for individualized predictions. Although PROBAST was designed for systematic reviews, it can be also used more generally in critical appraisal of prediction model studies.

[Birth weight predicts physical indicators in adulthood: a large population-based study in Chinese twins]

Objective: To quantitate the association between birth weight and phenotypes of physical indicators in adulthood, i.e. BMI and waist circumference (WC) and to what degree genetic or environmental factors affect birth weight-obesity association. Methods: A total of 6 623 gender matched twin pairs aged 25 to 79 years were recruited through the Chinese National Twin Registry. The twins reported their own birth weight, current height and weight, and WC using a self-administered questionnaire. BMI was calculated according to the self-reports of body height and weight. Within twin-pair design was used to quantitate the association between birth weight and phenotypes related to obesity while bivariate structural equation models were used to decompose the phenotype correlation. Results: After adjusted for multiple factors, twin-pair analyses within monozygotic (MZ) showed that, on average, a 1.0 kg increase in birth weight corresponded to an increase of 0.33 kg/m(2) in BMI and 0.95 cm in WC in adulthood (P<0.001). Bivariate structural equation models showed significant positive unique environmental correlation between birth weight and the two obesity-related phenotypes. Conclusion: The study supported the role of twin-specific supply line factors on relationship between birth weight and physical indicators in adulthood.

[Experience and challenge on interoperability of big data in health care]

Problems in interoperability is the biggest barrier limiting the use of big data in health care worldwide. Interoperability contains five dimensions: business, security, ethics, semantics and technology. Based on the comparison of the three common interoperability models led by government, enterprise or research institution, and the current status of big data development in China, this paper proposes a new operation model which can be led by university, aided by enterprise and supported by government, and summarizes the three major challenges in the development of big data interoperability in China: professional standard and specification, data security and ethics, incentive mechanism and assessment. Only when a feasible model is adopted, technical difficulties are overcome and data are truly shared, we can achieve maximized integration of multi-source data, expanding its application fields and establish a multi-business mode to comprehensively improve the population based health decision-making and management.

[A cross-sectional study on current status of rare disease related health information based on WeChat official accounts in China]

Objective: To understand the current status of rare disease related health information release in WeChat official accounts in China. Methods: We used a series of key words containing "rare diseases" and the names of the top 30 rare diseases in hospitalizations in China to search WeChat official accounts. Eligible articles were selected by systematic sampling. All including WeChat official accounts and articles were evaluated to extract the basic information. Results: No relevant WeChat official accounts were found for 14 rare diseases (46.67%). Most of the WeChat official accounts (52.17%) were initiated by patients and patient groups. No significant difference was detected in the total number of articles between the official accounts related with Traditional Chinese Medicine (TCM) and non-TCM related ones, however, the frequency of the monthly information release was significantly higher in TCM related official accounts (P<0.001), while the average reading number of articles was significantly higher in non-TCM related official accounts (P<0.001). Nearly 80% of the WeChat official accounts had navigation menu, and the average reading number of official accounts with menus was larger than those without menus. The top three topics were rare disease diagnosis and treatment knowledge (46.00%), public welfare activity for rare diseases (12.81%) and uncorrelated things (8.65%), while the first three leading topics were cutting-edge information, public welfare activity and patient story, respectively. Conclusions: The scale for rare disease related health information release based on WeChat official accounts in China has been basically formed, but it is still in development stage. Many improvements should be made in their coverage of rare diseases, release frequency, topic and form. It is urgent to establish or recreate some high-quality WeChat official accounts in order to provide precise information and effectively facilitate the prevention and treatment of rare diseases.

Experimental and numerical study of SO2 removal from a CO2/SO2 gas mixture in a Cu-BTC metal organic framework

The mechanism of SO₂ removal from a CO₂/SO₂ gas mixture in a copper benzene-1, 3, 5-tricarboxylate (Cu-BTC) material is investigated at the molecular level by the grand canonical Monte Carlo method. The effects of seven kinds of force-field relationships among CO₂, SO₂ and Cu-BTC on the selectivity for a SO₂/CO₂ gas mixture at different temperatures are studied in detail. The accuracy of the simulation model is validated by the experimental data. The results show that more SO₂ molecules are adsorbed than CO₂, and the electrostatic interactions involving SO₂ are more sensitive to temperature than CO₂ is. The multilayer desorption for SO₂ and CO₂ occurs in large-square channels. The effect of the electrostatic interactions involving SO₂ is stronger than the interactions of CO₂. The forms of CO₂ and SO₂ adsorption in Cu-BTC with electrostatic interactions are Cu²⁺∙∙∙OCO and Cu²⁺∙∙∙OSO, respectively.

A novel amperometric determination of flufenamic acid using CuMOF ribbons incorporated with activated carbon

Electrochemical detection of FFA using AC–CuMOF modified electrode.

Rationally designed RGO@CuO@Mn2O3 as an excellent electrocatalyst for the rapid and real-time detection of 2-nitrophenol

Rationally designed and functional electronic structures of TMOs (precisely Cu and Mn) with purposeful morphologies were prepared using a facile synthetic method.

A ternary nanocomposite based on nickel(iii) oxide@f-CNF/rGO for efficient electrochemical detection of an antipsychotic drug (Klonopin) in biological samples

The formation of the Ni₂O₃@f-CNF/rGO composite for the electrochemical detection of KNP.

Fabrication of Magnetic Fe₃O₄ Nanoparticles with Unidirectional Extension Pattern by a Facile and Eco-Friendly Microwave-Assisted Solvothermal Method

This study synthesizes iron(III) oxide magnetic nanoparticles (MNPs) using a facile and eco-friendly microwave-assisted solvothermal method. The highly porous particles become stable after a 60-min reaction when the temperature is fixed at 200 °C, in which the particle size is kept at 100-150 nm. The magnetic properties, crystal structure, surface morphology, and microstructures of the prepared MNPs are then analyzed. The microstructure analysis suggests that a MNP consists of numerous small Fe₃O₄ particles with a size smaller than 10 nm; therefore, a large amount of microcracks is observed between grains. Moreover, the orientations in these particles are very close, implying that they grow toward the same direction that may be provided by the nuclei. The prepared MNPs thus possess a highly porous structure and have a 3-times larger specific surface area than the commercially-available MNPs. Finally, the growth mechanism of iron(III) oxide MNPs by the present process is proposed.

Novel sonochemical synthesis of Fe3O4 nanospheres decorated on highly active reduced graphene oxide nanosheets for sensitive detection of uric acid in biological samples

In this study, a super-active Iron (II, III) oxide nanospheres (Fe₃O₄ NPs) decorated reduced graphene oxide (rGOS) nanocomposite was developed. Fe₃O₄ NPs were stabilized on rGOS through electrostatic interactions in the aqueous medium. This process involves an ultrasound assisted reduction reaction of the GOS. The as-synthesized Fe₃O₄ NPs@rGOS was characterized through the HRTEM, SEM, XRD, Raman, elemental mapping and EDX analysis. The Fe₃O₄ NPs@rGOS modified GCE was developed for the determination of biomarker. Uric acid is important biomarker based on gout and kidney stone with high adverse effect in human body. The results obtained showed that the modified electrode Fe₃O₄ NPs@rGOS shows good electrochemical reduction peak compared to bare electrode and control electrodes. The Fe₃O₄ NPs@rGOS modified sensor linear range 0.02-783.6 µM was observed with nanomolar LOD 0.12 nM. In addition, the modified Fe₃O₄ NPs@rGOS/GCE sensor has been applied to determination of uric acid concentration in urine and blood serum samples. Furthermore, advantages of the modified sensor are high stability, repeatability and reproducibility.

A novel electrochemical sensor for determination of DNA damage biomarker (8-hydroxy-2'-deoxyguanosine) in urine using sonochemically derived graphene oxide sheets covered zinc oxide flower modified electrode

To explore a novel and multi-layer based graphene oxide covered zinc oxide nanoflower (ZnO NFs@GOS) as a modified electrode materials by sonochemical technique (40 kHz, 300 W). Herein, novel nanocomposite is successfully characterized by various characterization analysis (FESEM, HRTEM, XRD, XPS and (EIS) electrochemical impedance spectroscopy) and employed as high sensitive modified electrode (ZnO NFs@GOS nanocomposite) for the electrochemical determination of biomarker. 8-hydroxy-2'-deoxyguanosine (8-HDG) is one of the important cancer and oxidative stress biomarker. The results demonstrated that the ZnO NFs@GOS modified SPCE reveal well-defined electro-oxidation peak at 0.36 V (vs. Ag/AgCl). The high sensitive properties of the optimized flower like modified electrode are because of the excellent synergistic effect of the ZnO flower and the graphene oxide nanosheets, as evidenced by a superior bio-sensing performance. The nanocomposite fabricated modified biosensor was facilitating the analysis of 8-HDG in the concentration ranges of 0.05-536.5 µM with a low detection limit is 8.67 nM. The ZnO NFs@GOS modified sensor can also employed for the determination of 8-HDG in human urine samples, promising its application towards the quantification of cancer biomarker in biological samples.

[An overview of validation methods based on the medical claims database]

Medical claims database is an important source of data for studying the characteristics, and burden of diseases, to provide a basis for the development of policy on management. The database is usually used to identify patients through International Classification of Diseases and free text-building algorithms, thus it is crucial to validate whether the algorithm is correctly identifing the targeted population. This paper introduces both traditional and emerging validation methods including machine learning, natural language processing and database linkage etc.. We also have tried to present a suitable validation method for the current situation in China, so as to promote the application of big data in medical areas and to provide reference for epidemiology studies, based on medical claims database in this country.

Facile sonochemical synthesis of perovskite-type SrTiO3 nanocubes with reduced graphene oxide nanocatalyst for an enhanced electrochemical detection of α-amino acid (tryptophan)

In this paper, perovskite-type SrTiO₃ nanocubes decorated reduced graphene oxide is synthesized by sonochemical method. The as-synthesized SrTiO₃@RGO nanocomposite was confirmed by XRD, TEM, SEM, elemental mapping and electrochemical technique. Furthermore, surface morphological and X-ray diffraction studies revealed the formation and high loading of SrTiO₃ nanocubes on reduced graphene oxide matrix. The SrTiO₃@RGO nanocomposite modified electrode shows an excellent electrochemical detection towards of amino acid (tryptophan). The developed sensor was showed a wide linear range from 30 nM to 917.3 µM and detection limit is 7.15 nM. Furthermore, the sensitivity was calculated to be 9.11 µA µM^-1 cm². In addition, the proposed modified sensor is exhibited good selectivity, stability, reproducibility and repeatability. The SrTiO₃@RGO catalyst modified electrode was successfully applied to tryptophan analysis in biological samples.

Ultrasound-assisted synthesis of tungsten trioxide entrapped with graphene nanosheets for developing nanomolar electrochemical (hormone) sensor and enhanced sensitivity of the catalytic performance

Herein, we have reported a simple sonochemical synthesis of multi-layer graphene covered tungsten trioxide nanoballs (WO₃ NBs) and the nanocomposite was characterized by FESEM, HRTEM, XRD, XPS, CV and EIS. Furthermore, progesterone (PGT) is a preferred marker for various biological problems like pregnancy problem, mood swings, anxiety, depression, nervousness and body pain. Therefore, its selective and sensitive determination in various biological fluids is beneficial for the evaluation of malformation problems. We describe the fabrication of an amperometric and non-enzymatic biosensor based on WO₃ NBs@GR nanocomposite modified electrode for nanomolar detection of PGT. The results showed that the nanocomposite modified electrode exhibit well-defined electro-oxidation peak compared to bare and control electrodes, demonstrating the superior electrocatalytic ability and performances. The fabricated modified sensor was facilitates the analysis of PGT in the concentration ranges of 0.025-1792.5 µM with a low detection limit of 4.28 nM. Further, the as-prepared WO₃ NBs@GR electrode has been applied to determination of PGT in human blood samples with outstanding recovery results and more importantly, the facile and environment-friendly sonochemical construction strategy extended here, may be open a cost-effective way for setting up the nanocomposites based (bio) sensing platform.

[Clinical characteristics of 84 children with invasive Haemophilus influenzae infection from 2014 to 2018]

Objective: To investigate the clinical characteristics of invasive Haemophilus influenzae (HI) infection in children. Methods: The clinical manifestations, laboratory examinations and treatment outcomes of 84 children with HI infection confirmed by bacterial culture in 7 tertiary children's hospitals from 2014 to 2018 were analyzed retrospectively. Results: Among the 84 cases, 50 were males. The age was 1.54 years (ranged from 5 days to 13 years).Twenty cases (24%) had underlying diseases and 48 cases (57%) had not received antibiotics before collecting specimens. Eighty-two cases (98%) had fever and 75 cases (89%) had clear infection foci, among which 31 cases (37%) had meningitis and 27 cases (32%) had pneumonia. Blood culture was positive in 62 cases (74%), cerebrospinal fluid culture was positive in 10 cases (12%), blood culture and cerebrospinal fluid culture were both positive in 11 cases (13%). Antibiotics susceptibility test showed that 27% (22/82) of all HI strains produced β-lactamases and 48% (37/77) strains were resistant to ampicillin. The drug resistance rates to cefuroxime, ampicillin-sulbactam, trimethoprim-sulfamethoxazole and azithromycin were 25% (20/80) , 20% (9/45) , 71% (44/62) and 19%(11/58), respectively. All strains were sensitive to meropenem, levofloxacin and ceftriaxone. After sensitive antibiotic therapy, 83% (70/84) of all patients were cured and improved, the mortality rate and loss of follow-up rate were 13% (11/84) and 4% (3/84) respectively. Conclusions: Meningitis and pneumonia are common presentation of invasive HI infections in children. Mortality in HI meningitis children is high and the third generation of cephalosporins, such as ceftriaxone can be used as the first choice for the treatment of invasive HI infection.

[Detection and analysis of FAM19A4 promoter methylation in cervical exfoliated cells]

Objective: To investigate the cinical value of FAM19A4promoter methylation in cervicalexfoliated cells for triage of cervical cancer. Methods: A total of 162 high-risk HPV-infected patients who were pathologically confirmed as different cervical lesions from August 2017 to December 2017 were collected in Guangdong Women and Children Hospital. Taqman probe-based quantitative PCR (qPCR) was used to detect the methylation of FAM19A4 promoterin different grades of cervical lesions, and the value of FAM19A4 methylation in predicting cervical HSIL and the above lesions was calculated by diagnostic test. Results: (1)The positive rates of FAM19A4 methylation in cervical exfoliated cells increased with the severity of cervical lesions, which were 7.69% (4/52) , 34.62% (9/26) , 55.56% (20/36) , 95.83% (46/48) in normal cervix/cervicitis, cervical LSIL, HSIL, and cervical cancer, respectively(P<0.05).(2)There was no significant difference in the detection rates of FAM19A4 methylation between different age groups, pathological types, clinical stage, tumor size and lymph node metastasis status (P>0.05). (3) The specificity and positive predictive value of FAM19A4 methylation in detecting cervical HSIL alone and ≥HSIL lesions were the optimal, with the AUC of 0.69 and 0.84, respectively. When combined with HPV16/18 genotyping, the sensitivity was significantly improved. Conclusions: The detection of FAM19A4 promoter methylation in cervical exfoliated cells has a high clinical value of discriminating ≥HSIL lesions; and the cotest of methylated FAM19A4 and HPV16/18 genotyping can identify ≥HSIL lesions more sensitively.

[Randomized controlled trial based on big data]

A large amount of data has been accumulated in Chinese medical area. Problems as how to use big data to carry out randomized controlled trials have also been increasingly noteworthy. Through learning the successful experiences in conducting randomized controlled trials on big data from abroad, this article introduces the knowledge regarding sources of data, identification of research subjects and outcomes, interventions, methods of randomization and the implementation of informed consent, etc., all related to big data, hoping to shed light on studies of this kind, for the years to come in China.