ObjectiveTo analyze the trend of disease burden of colorectal cancer (CRC) in China from 1990 to 2019.MethodsData was obtained from Global Burden of Disease Study 2019 (GBD 2019). Incidence, mortality, disability-adjusted life year (DALY), years of life lost (YLL), years lived with disability (YLD), and their corresponding standardized rate and annual average percentage change (AAPC) were used to describe the changes of disease burden of colorectal cancer in Chinese population between 1990 and 2019.ResultsCompared with 1990, the number of new cases, standardized incidence, the number of deaths and standardized mortality of CRC in China in 2019 increased by 474.03%, 144.01%, 230.14%, and 36.15%, respectively. The standardized mortality and standardized incidence of CRC in China had reached and gradually exceeded the global level since 2010. From 1990 to 2019, the overall standard incidence (AAPC=3.6%, P<0.05), standard mortality rate (AAPC=1.4%, P<0.05), and the standard DALY rate (AAPC=1.2%, P<0.05) of CRC in China showed an increasing trend. The incidence, mortality and DALY rates of males were higher than those of females, and gradually increased with age. Compared with 1990, the DALY, YLL, and YLD of CRC in 2019 increased by 134.3%, 127.69%, and 445.00%, and their corresponding standardized rates increased by 30.53%, 27.03%, and 187.29%, respectively, showing an overall upward trend.ConclusionsFrom 1990 to 2019, the standardized incidence rate and standardized mortality rate of colorectal cancer in China have had a continuously increasing trend, and males and the elderly are high-risk groups. To reduce the burden of colorectal cancer in China, effective measures should be taken for prevention and management.
ObjectiveTo analyze the epidemiological burden and change trend of five sexually transmitted infections (STIs) in China from 1990 to 2019. MethodsThe estimated numbers and standardized rates of STIs incidence, prevalence, and disability-adjusted life years (DALY) in China and other regions were obtained from the Global Burden of Disease Study 2019. The epidemic burden and change trend of STIs in China were compared and evaluated. ResultsIn 2019, STIs affected about 242 million people in China, resulting in 173 million new cases and 350 000 person years of DALY losses. Compared with 1990, the prevalence and incidence of STIs increased by 59.75% and 30.02%, respectively, and the number of DALY decreased by 35.19%. From 1990 to 2019, the incidence rate of chlamydia infection and gonococcal infection in the young and middle-aged group (aged 15-49 years) showed an upward trend; in addition, the DALY rate of genital herpes and trichomoniasis also increased. Among the 5 STIs, the disease burden caused by trichomoniasis infection in women was much higher than that in men. With the increase in the socio-demographic index (SDI), the burden of STIs in China gradually decreased. After the SDI exceeded 0.65, the decline rate of standardized DALY rate sharply increased. ConclusionThe disease burden of STIs in China shows a downward trend from 1990 to 2019, and the disease burden of the young and middle-aged group (aged 15-49 years) is the most significant, especially in trichomoniasis and chlamydia infection.
ObjectiveTo explore the clinical efficacy of percutaneous endoscopic interlaminar discectomy (PEID) and interlaminar fenestration discectomy in the treatment of lumbar (L) 5-Sacral (S) 1 lumbar disc herniation (LDH).MethodsLDH patients were retrospectively included from January 2016 to Januray 2018. And the patients were divided into the PEID group and the fenestration group according to their choice of different surgical methods. The operation time, intra-operative blood loss, and bed rest time in the two groups were recorded. The preoperative and postoperative [1 week, 1 month, 3 months, and last follow-up (>12 months)] Visual Analogue Score (VAS) of the lumbago and leg pain between the two groups were compared; the preoperative and postoperative [1 week, and last follow-up (>12 months)] Oswestry Disability Index (ODI) and also the postoperative [(>12 months)] therapeutic effect (modified MacNab) between the two groups were compared.ResultsA total of 66 patients were included, with 31 in the PEID group and 35 in the fenestration group. There was no significant difference in age, gender and course of disease between the two groups (P>0.05). There were leakage of cerebrospinal fluid and transient lumbago, leg pain and numbness, which were worse than those before operation in the PEID group (1 and 1 patient, respectively) and the fenestration group (2 and 3 patients, respectively). There were statistically significant differences between the PEID group and the fenestration group, in the operative time [(90.65±9.98) vs. (66.23±16.50) minutes], intra-operative blood loss [(51.77±18.64) vs. (184.29±78.38) mL], and bed time [(2.87±0.92) vs. (7.49±1.20) d] (t=?7.365, t’=?9.697, t=?17.374, P<0.001). There was no significant difference in the preoperative VAS score (lumbar-leg pain) and ODI index, and the ODI index at each postoperative time point, between the two groups (P>0.05). VAS score (lumbago) and VAS score (leg pain) in the PEID group at each postoperative time point were lower than those in the fenestration group (P<0.05); VAS scores (leg pain) at other time points were not statistically significant between the two groups (P > 0.05). VAS (lumbar-leg pain) score and ODI index at each postoperative time point were lower than those before the surgery. The was no statistically significant difference in the PEID group (90.32%) and fenestration group (85.71%) in the excellent rate (χ2=0.328, P=0.713).ConclusionsPEID has less surgical trauma, less bleeding, short bed rest, fast recovery, and better relief of postoperative lumbago symptoms. It is worthy of further promotion in clinical work.
ObjectiveTo systematically review the disease burden and epidemiological characteristics of diabetes mellitus in Chinese population, and to provide references for health resources allocation and health policy making. MethodsDatabases such as PubMed, EMbase, CNKI, VIP and WanFang Data were searched for studies investigating disease burden of diabetes mellitus in Chinese population up to January 1st, 2014. According to the inclusion and exclusion criteria, two researchers screened literature, exacted data, and assessed methodological quality of included studies. Statistical analysis was performed with the data of diabetes associated population, mortality and disease burden were analyzed. ResultsA total of 39 studies were included, one of which was not included for further qualitative analysis due to low quality. The results of qualitative analysis involving 38 studies showed that, since 1980, the prevalence of diabetes increased rapidly in China, especially in the younger age group. The disease burden of woman was higher than that of man; it was slightly higher in the city than in the countryside; but the gap between urban and rural areas was gradually narrowed. Disease burdens in Eastern, Central and Western regions orderly decreased, all of which were all at high levels. ConclusionThe disease burden of diabetes mellitus in China is seriously high and the prevention and control work is very hard. It is necessary to rationally and effectively allocate health resources based on different health demands in different regions among urban-rural and age groups; to reduce the burden in the elderly; and to pay more attention to the young age population at the same time. Besides, the emphasis of prevention should be placed on suppressing the increase of prevalence of diabetes mellitus and reducing disease burden due to its complications.
ObjectiveTo identify primary osteoporosis patients’ function and environment status based on International Classification of Functioning, Disability and Health (ICF) and provide evidence to clinical treatment, rehabilitation therapy and rehabilitation nursing.MethodsA questionnaire survey was conducted among osteoporosis patients hospitalized in the Center of rehabilitation Medicine of West China Hospital of SiChuan University, from May 2017 to December 2019. The research design was based on a cross-sectional survey. ICF was applied to simplify the core classification set, and a convenient sampling method was adopted.ResultsA total of 240 patients were investigated. All of the patients’ function showed limitation but different level. Meanwhile, including Walking (D450), Sensation of pain(B280), Structure of trunk (S760), Lifting and carrying objects (D430), Mobility of joint function (B710), the proportion of injuries were more than 90%, most of which the limitation level were light and moderate injuries indicating 5%-49% injuries; more than 50% pointed the three parts of environment factors were facilitative factors including Products or substances for personal consumption (E110), Health professionals (E355), Health services, systems and policies (E580), of which the proportion of Health services, systems and policies (E580) were highest.ConclusionOsteoporosis has a significant effect on patients’ function, we should develop clinical treatment, rehabilitation therapy, rehabilitation nursing based on the current evaluation of function.
Objective To analyze the burden of cardiovascular diseases (CVDs) and its trend attributed to household air pollution (HAP) from solid fuels in China from 1990 to 2019. Methods Using the data derived from the Global Burden of Disease Study 2019 (GBD 2019), including mortality rates, disability-adjusted life years (DALY), age-standardized mortality rates, age-standardized DALY rates, annual percentage change (APC), and average annual percentage change rate (AAPC), we analyzed the CVD burden and its trend attributed to HAP in China from 1990 to 2019. Results In 2019, HAP in China resulted in 227 000 deaths and 5 182 200 DALYs of CVD; the mortality rate attributed to HAP was 15.96 per 100 000, and the DALY rate was 364.34 per 100 000. In 2019, the age-standardized mortality and DALY rates in China were 12.52 and 262.65 per 100 000, respectively, which were lower than the rates globally, and the rates for males were higher than those for females (13.90 vs. 11.32 per 100 000, 291.76 vs. 234.50 per 100 000). In 2019, both mortality and DALY rates attributed to HAP increased with age, peaking in the age groups of 95 plus and 85-89, respectively. From 1990 to 2019 in China, both age-standardized mortality and DALY rates of CVD attributed to HAP showed a downward trend over time. The average annual percentage change rate (AAPC) of the age-standardized mortality rate was ?6.0% (95%CI: ?6.2% to ?5.8%), and the APCC of the age-standardized DALY rate was ?5.8% (95%CI: ?6.1% to ?5.6%). The burden of the CVD subclass also showed a downward trend. Conclusion From 1990 to 2019, the burden of CVD attributed to HAP from solid fuels in China shows a significant downward trend, with sex and age differences. Females and the elderly are the key groups of disease burden, so effective interventions should be taken for these groups.
ObjectiveTo analyze the disease burden and development trend of non-Hodgkin lymphoma (NHL) in China from 1990 to 2019. MethodsThe changes of incidence, mortality, disability-adjusted life years (DALY) and their corresponding age-normalization rates for NHL were analyzed by using the 2019 Global Burden of Disease Database. Regression analysis was performed by Joinpoint software to calculate annual percentage change (APC) and average annual percentage change (AAPC) of standardized morbidity, standardized mortality, standardized DALY rate to reflect the change trend of disease burden. And the results were compared with global data. ResultsFrom 1990 to 2019, the disease burden of NHL in China showed an overall increasing trend. Compared with 2019, the standard incidence rate, standard mortality rate and standard DALY rate of NHL in China increased by 144.72%, 27.17% and 15.61%, respectively. The annual rates of change were 3.12%, 0.80% and 0.51%, respectively. There were gender and age differences in disease burden. The burden of disease increased with age, and the burden of disease was higher in males than in females. ConclusionThe disease burden of NHL in China shows an increasing trend from 1990 to 2019. With the development of diagnosis and treatment options, the disease burden has decreased in recent years, but it is still higher than the global level. There is still a need to strengthen research on its pathogenesis and treatment options, and to actively intervene in high-risk groups to reduce the disease burden of NHL.
ObjectiveTo quantify the global burden of chronic obstructive pulmonary disease (COPD) attributable to high temperature, low temperature, and non-optimal temperatures from 1990 to 2021 using Global Burden of Disease (GBD) 2021 data. MethodsWe analyzed global, regional, and national COPD mortality and disability-adjusted life years (DALYs) attributable to high, low, and non-optimal temperatures. Joinpoint regression, age-period-cohort modeling, and Bayesian prediction models were employed. ResultsGlobally, age-standardized mortality rates (ASMRs) and DALY rates for COPD attributable to low temperature and non-optimal temperatures declined. However, the burden from high temperature increased. Low temperature consistently exerted a greater burden than high temperature across all metrics. Significant geographical disparities emerged: high-temperature mortality was highest in South Asia; low-temperature burden was most severe in East Asia; and high-income North America exhibited accelerated high-temperature mortality growth. The highest low-temperature burden occurred in middle-SDI regions, while high-temperature impacts predominated in low-middle-SDI regions. Age patterns showed rising high-temperature burden in the 15-39 age group and increasing low-temperature burden among adults aged ≥80 years. Bayesian projections revealed divergent gender trajectories: a continuing decline in low-temperature burden for males versus a decelerated decline for females (2020-2030). ConclusionLow temperature exposure remains the primary risk factor for COPD within non-optimal temperatures globally, although high-temperature impacts are increasing. Significant regional variations necessitate targeted interventions for three key populations: older adults vulnerable to cold, working-age adults with occupational heat exposure, and older women requiring rehabilitative support.
Objective To develop the short version of the elderly disability assessment scale (EDAS-SF), and to evaluate its validity and reliability. Methods We conducted a face-to-face investigation in five rural communities in Suining and three urban communities in Chengdu city for elderly adults. We consulted gerontologists and rehabilitation physicians through an internet survey. Proper items were selected from the EDAS according to the results from the following statistical methods: critical ration, Cronbach’s α, correlation coefficient and exploratory factor analysis. Based on these work, the EDAS-SF was developed. The Cronbach’s α was used to assess the internal reliability and confirmatory factor analysis (CFA) to assess the construct validity of the EDAS-SF. Results A totally of 916 elderly adults were surveyed, among which, 887 finished the questionnaire, accounting for 96.8%. The mean age of the studied population was 70.8±6.9 years old. Finally, seven items were chosen for the EDAS-SF which included mental function, organ function, communication, activity, self-care, family function, economic and social function. The Cronbach’s α of the scale was 0.836. Except for the " economy and social function” dimension and the " communication” dimension, the Cronbach’s α of other dimensions were higher than 0.8. EDAS-SF was proved to have good internal reliability. In addition, the CFA indicated that the theoretical model of the EDAS-SF was well fit to the data of the checking sample, which meant EDAS-SF had good construct validity. Conclusion The current study develops the short version of elderly disability assessment scale. The internal reliability and construct validity of the EDAS-SF are good.
ObjectiveTo systematically review the disease burden of pneumoconiosis in Chinese population so as to provide references for health resources allocation and health policy making.MethodsDatabases including PubMed, EBSCO, Web of Science, CNKI, WanFang Data and VIP databases were searched for studies on investigation of the disease burden of pneumoconiosis in Chinese population from inception to 31st January, 2020. Two reviewers independently screened literature, exacted data, and assessed risk of bias of included studies. Systematic review was performed on data of pneumoconiosis associated population, mortality, and disease burden.ResultsA total of 26 studies were included. Qualitative analysis showed that the decrease of DALY and YLL of pneumoconiosis in China had been lower than that in globally, and the increase of YLD had been higher than that in globally in recent 10 years. 14 factors were included in the analysis of influencing factors on the financial burden or hospitalization expenses of pneumoconiosis patients; among them, the length of hospitalization, related complications, and pneumoconiosis stage were the most important indexes which had influence or difference on patients’ financial burden (or hospitalization expenses). The burden of pneumoconiosis in the Chinese population was primarily concentrated on males. Occupational diseases caused most of them, and middle-aged and older adults were the primary population for pneumoconiosis. However, young patients due to early-onset age, long course of disease and complications, and other factors resulting in a larger YLD phenomenon should also be considered.ConclusionsThe disease burden of pneumoconiosis patients in China is still heavy. It is recommended to continue to reduce the DALY of pneumoconiosis among the Chinese population as a long-term goal, and to strengthen control strategies to curb the early onset and death of pneumoconiosis.