ObjectiveTo analyze the trend of disease burden changes in congenital birth defects in China from 1990 to 2019. MethodsUsing the global burden of disease study 2019 (GBD 2019), we analyzed the morbidity, mortality, and disability-adjusted life years (DALYs) of congenital birth defect diseases and their corresponding age-standardized rates and average annual percentage change (AAPC) to analyze the changes in the disease burden of congenital birth defects in China and compared them with global data from 1990 to 2019. ResultsIn 2019, the age-standardized incidence, mortality, and DALY in China were 147.41/100 000, 4.62/100 000, 480.95/100 000, respectively. Compared with 1990, the age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALY rate increased by 12.08% and decreased by 70.38% and 66.82%, respectively. In recent years, although the age-standardized incidence of congenital birth defect disease in China is on the rise and higher than the global level, the disease burden is roughly on the decline and lower than the global level, which is closely related to earlier intervention and treatment of the disease resulting in a lower standardized mortality rate. ConclusionThe age-standardized mortality rate of children with congenital birth defects in China showed a decreasing trend from 1990 to 2019, and the burden of disease ranged from slightly higher than global to lower than global levels, but the age-standardized incidence rate was significantly higher, but the age-specific incidence rate has increased significantly.
Objective To analyze the causes of injury-related deaths of permanent residents in Zigong city, so as to provide scientific references for the prevention and control of injury deaths and for putting forward to relevant health policies as well. Methods Based on the death surveillance data of Zigong from 2001 to 2009, following indicators were analyzed, such as cause specific mortality, age specific mortality and potential years of life lost (PYLL). Results An accumulative total of 10 957 people died of injury from 2001 to 2009, and the crude mortality was 38.13/100 thousands, while the standardized mortality was 36.07/100 thousands. The highest mortality was at the age of more than 65 years of age. The first six injury death causes were as follows: drowning, transport accidents except motor vehicle, suicide, motor vehicle accidents, accidental falling and accidental poisoning. The PYLL of injury death was 334 325.50 person year, APYLL was 34.67 year, and the PYLL rate was 11.63‰ which was higher in male than that of female. Conclusion The epidemiological analysis of injury-related deaths shows an ascending trend, which is the main reason resulting in the loss of residents’ life. Injury has become one of the most serious problems of public health, and it should be prevented and controlled by formulating effective measures and strategies aiming at the injury death spectrum and the target population of Zigong city.
ObjectiveTo evaluate the prognosis factors for early death (within 60 days) of acute myocardial infarction (AMI) patients for early identification and prevention of the disease. MethodsWe analyzed the information of AML patients who were admitted to the emergency department between May 2009 and July 2010, and analyzed their clinical data, such as gender, age, prehospital time, myocardial enzyme, electrocardiogram, complications, whether the patients had thrombolysis therapy, time of thrombolysis, end point observation and time of death, ect. Cox multivariate survival analysis was performed with the use of SPSS 18.0 software. ResultsSeventy-one cases were collected with one of them excluded for fragmented data. After analysing, we found that patients' age and isoenzymes of creatine kinase (CK-MB) level were prognosis factors for early death. Further analysis showed that the relative risk (RR) of age was 1.166 (P=0.023), and the RR of CK-MB was 1.001 (P=0.004). ConclusionPatients' age has predictive value for early death of AML. More attention should be paid to AML patients with advanced age. Detecting myocardial enzymes levels, especially the CK-MB level, is significant for predicting early death. Other indicators need to be further explored due to the possible limitation of our study.
Objective To retrospectively analyze the morbidity, mortality, epidemiologic trends and distribution characteristic of top-three malignant tumors in Chengdu from 1990 to 2010, and to be aware of the incidence risk factors, and types and syn-position of main tumors, so as to provide evidence for the policy-making of tumor prevention and control. Methods ICD-10 coding method was used to categorize diseases and analyze the morbidity and mortality of malignant tumors seen in different ages, genders, areas and types, based on the surveillance data in Chengdu collected since 1990. Results The morbidity reports of top-three malignant tumors in Chengdu from 1999 to 2010 were lung cancer, liver cancer and colorectal cancer, the same as the mortality reports from 1999 to 2005, But the mortality of gastric cancer exceeded that of colorectal cancer and ranked as the third from 2005 to 2010. The mortality of top-three malignant tumors in male patients was higher than those in female patients. No difference was observed between urban and rural areas. The mortality of main malignant tumors rose along with the age growth. Conclusion Lung cancer, liver cancer and gastric cancer have become the main malignant tumors threatening Chengdu civilians, and their morbidity and mortality are rising yearly, which suggests that the prevention and control measures such as early diagnosis and treatment should be implemented aiming directly at those main tumors.
ObjectiveTo analyze the trends of incidence, mortality, and burden of disease of cervical cancer in Chinese females from 1990 to 2019.MethodsThe global burden of disease database (GBD) and China health statistics yearbook data was used to analyze the incidence, standardized incidence, mortality, standardized mortality, urban and rural mortality, and burden of cervical cancer among Chinese females using Excel, SPSS 21.0 and Joinpoint Regression Program 4.8.0.1.ResultsThe standardized incidence of cervical cancer among Chinese females increased from 9.21/100 000 in 1990 to 12.06/100 000 in 2019, and the standardized mortality decreased from 8.40/100 000 to 7.36/100 000. The standardized mortality of cervical cancer in 2018 decreased when compared with 2015 in both urban and rural areas. Changes in age-group incidence and mortality indicated that there was a younger trend in cervical cancer. The disease burden indicators (DALY, YLL, and YLD) were increased from 86.49, 84.01, and 1.52 ten thousand person/years to 162.22, 157.40, and 4.83 ten thousand person/years, in which the YLD increased the most (217.76%). The APC of DALY, YLL and YLD were 2.39%, 2.56% and 4.25%, respectively. The proportion of cervical cancer disease burden in female cancer increased in 2019 compared with 1990. And DALY, YLL and YLD increased in the age group of 40 or over, in which DALY of the age group 50-54 increased 167.15%.ConclusionsThe situation of cervical cancer is not optimistic in China. Although the mortality of cervical cancer has decreased in recent years, the number of cases and mortalities is still increasing. Not only the burden of disease is continuously increasing, there is also a younger trend in cervical cancer. Active preventive measures should be taken to reduce the burden of cervical cancer.
Objective We investigated the effect of supplementation with alanyl-glutamine dipeptide on insulin resistance and outcome in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. Methods A prospective, randomized, open and controlled trial was conducted. Patients with COPD and respiratory failure were recruited between Jan 2005 to Feb 2006 and randomly assigned to a trial group (n=14) with glutamine dipeptide supplmented parenteral nutrition and a control group (n=16) with isocaloric, isonitrogenic parenteral nutrition. On the third day and fifth day of nutrition treatment, blood glucose was clamped at level of 4.4 to 6.1 mmol/L by intravenously bumped insulin. Blood gas, blood glucose level, insulin dosage were recorded everyday. The outcomes were mortality, length of stay (LOS) in hospital and in ICU, mechanical ventilation times and the costs of ICU and hospital.Results Thirty patients successfully completed the trial. There was no difference in blood gas between two groups, but PaO2 increased gradually. Compared with control group, blood glucose level had trend to decrease in trial group. The average insul in consumption decreased significantly in trial group on the fifth day. There was no statistical difference between two groups in mortality, length of stay in hospital and the costs of hospital. But compared with control group, length of stay in ICU and mechanical ventilation days had trend to decrease in trial group. Conclusion Alanyl-glutamine dipeptide do not improve pulmonary function of patients with COPD and respiratory failure. However, alanyl-glutamine dipeptide attenuated insul in resistance and stabilized blood glucose. This trial does not confirm alanyl-glutamine di peptide can improve outcome in critically ill patients with COPD and respiratory failure between two groups in mortality at the end of 30 days, length of stay in hospital and the costs of hospital. But the length of stay in ICU and the duration of mechanical ventilation does decrease, but not significantly, in the trial group.
ObjectiveTo explore the value of three brief scales (BAP-65 class, DECAF score, and CAPS) on assessing the severity of acute exacerbation in patients with chronic obstructive pulmonary disease(COPD) complicated by hypercapnic respiratory failure. MethodsTwo hundred and forty-four cases with acute exacerbation of COPD complicated by hypercapnic respiratory failure, admitted in West China Hospital from August 2012 to December 2013, were analyzed retrospectively.The scores of each scale were calculated.The areas under the receiver operating characteristic curves (AUROC) of each scale for hospital mortality, mechanical ventilation use, mortality of patients requiring mechanical ventilation, invasive mechanical use were analyzed and compared. ResultsThe AUROCs of BAP-65 class, DECAF score and CAPS for hospital mortality were 0.731, 0.765, and 0.711; for mechanical ventilation were 0.638, 0.702, and 0.617; for mortality of patients requiring mechanical ventilation were 0.672, 0.707, and 0.677; for invasive mechanical ventilation use were 0.745, 0.732, and 0.627(BAP-65 vs.CAPS, P < 0.05).Mortality and mechanical ventilation use increased as the three scales escalated.In the patients whose BAP-65 or DECAF score were more than 4 points, the hospital mortality was nearly 50%, and about 95% of the patients underwent mechanical ventilation. ConclusionsThe BAP-65 class, DECAF score, and CAPS of patients on admission have predictive values on assessing the severity of acute exacerbation in patients with COPD complicated by hypercapnic respiratory failure, especially the simple and practical BAP-65 class and DECAF score.
Objective To explore the early prevention measures of severe acute pancreatitis （SAP） complicated with infection. Methods The foreign and native related literatures of SAP complicated with infection in recent 10 yearswere retrieved， and the effect of sooner measures for SAP complicated with infection were discussed. Results It was beneficial to reduce the incidence of infection and improve the outcome in SAP by using antibiotics of apt through the blood-pancreatic barrier， using proton pump inhibitor properly， and using enteral nutrition， hemofiltration， and hyperbaric oxygen as soon as possible， and then combined with traditional Chinese medicine. Conclusions SAP complicated with infection is the one of the main reasons of death. It is a must to take effective and comprehensive measures in the early stage in order to reduce the rate of infection. However， there are several unclear problems to probe in the future on this issue.
Objective To explore the correlation between gender and long-term prognosis of patients with type-B acute aortic dissection (AAD) after endovascular therapy (EVT). Methods From January to December 2012, all patients with type-B AAD undergoing EVT were enrolled by retrospective and observational study. They were divided into male and female groups. Kaplan-Meier analysis was used to analyze the correlation between gender and the cumulative survival rate. Results A total of 131 tyep-B AAD patients who had undergone EVT were selected, including 97 males (74.0%), and 34 females (26.0%). The medium follow-up duration was 2.1 years. Smoking history, cholesterol, white blood cell count, hemoglobin, creatinine and uric acid of the patients in males were higher than those in females (P<0.05); while the difference in other indexes were not significant (P>0.05). The inhospital mortality of male patients was 10 (10.3%), and was 3 (8.8%) in female patients; there was no significant difference between the two groups (P=0.803). Kaplan-Meier analysis showed that there was no significant difference in cumulative survival rate between the two groups (84.5% vs. 82.4%; Logrank test χ2=0.023, P=0.880). Conclusion No correlation between gender and long-term prognosis in patients with type-B AAD after EVT is found.
Objective To explore the perioperative management of the coexisting diseases for the elderly patients with gastric cancer. Methods The clinical data of perioperative management for coexisting diseases in 528 patients with gastric cancer over 70 years old treated in the First Affiliated Hospital of China Medical University from March 1980 to November 2008 were analyzed retrospectively. Results The main coexisting diseases included cardiovascuclar disease (259 cases, 49.05%), respiratory disease (161 cases, 30.49%), diabetes (72 cases, 13.64%). Adjusting blood pressure and blood glucose, improving cardiopulmonary function, and hepatic and renal function were mainly given. The common postoperative complications included intestinal obstruction (10 cases), pneumonia (10 cases), reflux esophagitis (9 cases), functional evacuation disorder of gastric remnant (7 cases), and anastomotic leakage (5 cases). Ten patients died during perioperative period: 6 died of heart and lung failure, 2 of acute myocardial infarction, 1 of anastomotic leakage, 1 of intestinal obstruction. Conclusions The common coexisting diseases in the elderly patients with gastric cancer are hypertension， bronchitis and diabetes. Complete assessment of the patient’s general health before operation and intensive perioperative management of the coexisting diseases not only can decrease the risk of surgical procedures， but also decrease the incidence of complication and perioperative mortality.