Objective To analyze the incidence and mortality of acute viral hepatitis in China, project its trends from 2022 to 2030, and provide valuable insights for the prevention and control of viral hepatitis. Methods The incidence and mortality rates of acute viral hepatitis in China from 1990 to 2021 were extracted from the Global Burden of Disease 2021 database. The change rates and the estimated annual percentage change (EAPC) for each indicator were calculated. Additionally, an autoregressive integrated moving average (ARIMA) model was used to project the incidence and mortality of acute viral hepatitis in China from 2022 to 2030. Results From 1990 to 2021, the incidence rates of acute hepatitis A (AHA), acute hepatitis B (AHB), acute hepatitis C (AHC), and acute hepatitis E (AHE) in China all showed a declining trend (EAPC=?1.980%, ?2.664%, ?2.078%, ?1.686%; P<0.05), with a particularly marked decrease in mortality (EAPC=?11.662%, ?7.411%, ?12.541%, ?7.504%; P<0.05). According to ARIMA model projections, the incidence rates of AHA and AHB were expected to continue declining from 2022 to 2030, while the incidence rates of AHC and AHE were expected to rise. In 2030, the projected incidence rates of AHA, AHB, AHC, and AHE were 890.425/100000, 824.158/100000, 59.202/100000, and 300.377/100000, respectively. The mortality rates of AHA, AHC, and AHE were projected to remain stable from 2022 to 2030, while the mortality rate of AHB was expected to decline. In 2030, the projected mortality rates of AHA, AHB, AHC, and AHE were 0.002/100000, 0/100000, 0.004/100000, and 0.011/100000, respectively. Conclusions From 1990 to 2021, the overall incidence and mortality of acute viral hepatitis in China showed a downward trend. However, the incidence rates of AHC and AHE may present an upward trend in the future, which suggests that the government and relevant health authorities should adjust their prevention and control strategies in a timely manner.
Abstract： Objective To establish a risk prediction model and risk score for inhospital mortality in heart valve surgery patients, in order to promote its perioperative safety. Methods We collected records of 4 032 consecutive patients who underwent aortic valve replacement, mitral valve repair, mitral valve replacement, or aortic and mitral combination procedure in Changhai hospital from January 1,1998 to December 31,2008. Their average age was 45.90±13.60 years and included 1 876 (46.53%) males and 2 156 (53.57%) females. Based on the valve operated on, we divided the patients into three groups including mitral valve surgery group (n=1 910), aortic valve surgery group (n=724), and mitral plus aortic valve surgery group (n=1 398). The population was divided a 60% development sample (n=2 418) and a 40% validation sample (n=1 614). We identified potential risk factors, conducted univariate analysis and multifactor logistic regression to determine the independent risk factors and set up a risk model. The calibration and discrimination of the model were assessed by the HosmerLemeshow (H-L) test and [CM(159mm]the area under the receiver operating characteristic (ROC) curve,respectively. We finally produced a risk score according to the coefficient β and rank of variables in the logistic regression model. Results The general inhospital mortality of the whole group was 4.74% (191/4 032). The results of multifactor logistic regression analysis showed that eight variables including tricuspid valve incompetence with OR=1.33 and 95%CI 1.071 to 1.648, arotic valve stenosis with OR=1.34 and 95%CI 1.082 to 1.659, chronic lung disease with OR=2.11 and 95%CI 1.292 to 3.455, left ventricular ejection fraction with OR=1.55 and 95%CI 1.081 to 2.234, critical preoperative status with OR=2.69 and 95%CI 1.499 to 4.821, NYHA ⅢⅣ (New York Heart Association) with OR=2.75 and 95%CI 1.343 to 5641, concomitant coronary artery bypass graft surgery (CABG) with OR=3.02 and 95%CI 1.405 to 6.483, and serum creatinine just before surgery with OR=4.16 and 95%CI 1.979 to 8.766 were independently correlated with inhospital mortality. Our risk model showed good calibration and discriminative power for all the groups. P values of H-L test were all higher than 0.05 (development sample: χ2=1.615, P=0.830, validation sample: χ2=2.218, P=0.200, mitral valve surgery sample: χ2=5.175,P=0.470, aortic valve surgery sample: χ2=12.708, P=0.090, mitral plus aortic valve surgery sample: χ2=3.875, P=0.380), and the areas under the ROC curve were all larger than 0.70 (development sample: 0.757 with 95%CI 0.712 to 0.802, validation sample: 0.754 and 95%CI 0.701 to 0806; mitral valve surgery sample: 0.760 and 95%CI 0.706 to 0.813, aortic valve surgery sample: 0.803 and 95%CI 0.738 to 0.868, mitral plus aortic valve surgery sample: 0.727 and 95%CI 0.668 to 0.785). The risk score was successfully established: tricuspid valve regurgitation (mild:1 point, moderate: 2 points, severe:3 points), arotic valve stenosis (mild: 1 point, moderate: 2 points, severe: 3 points), chronic lung disease (3 points), left ventricular ejection fraction (40% to 50%: 2 points, 30% to 40%: 4 points, ＜30%: 6 points), critical preoperative status (3 points), NYHA IIIIV (4 points), concomitant CABG (4 points), and serum creatinine (＞110 μmol/L: 5 points).Conclusion Eight risk factors including tricuspid valve regurgitation are independent risk factors associated with inhospital mortality of heart valve surgery patients in China. The established risk model and risk score have good calibration and discrimination in predicting inhospital mortality of heart valve surgery patients.
ObjectiveTo compare the mortality in lung cancer patients infected with coronavirus disease 2019 (COVID-19) versus other cancer patients infected with COVID-19. MethodsA computer search of PubMed, EMbase, The Cochrane Library, Web of Science, Wanfang database, VIP database and CNKI database was conducted to compare the mortality of lung cancer and other cancers patients infected with COVID-19 from the inception to December 2021. Two thoracic surgeons independently screened the literature, extracted data, and then cross-checked the literature. After evaluating the quality of the included literature, a meta-analysis was performed on the literature using Review Manager 5.4 software. ResultsA total of 12 retrospective cohort studies were included, covering 3 065 patients infected with COVID-19, among whom 340 patients suffered from lung cancer and the remaining 2 725 patients suffered from other cancers. Meta-analysis results showed that the lung cancer patients infected with COVID-19 had a higher mortality (OR=1.58, 95%CI 1.24 to 2.02, P<0.001). Subgroup analysis results showed that the mortality of two groups of patients in our country was not statistically different (OR=0.90, 95%CI 0.49 to 1.65, P=0.72). Whereas, patients with lung cancer had a higher mortality than those with other cancers in other countries (Brazil, Spain, USA, France, Italy, UK, Netherlands) (OR=1.78, 95%CI 1.37 to 2.32, P<0.001). ConclusionThere is a negligible difference in mortality between lung cancer and other cancers patients who are infected with COVID-19 in our country; while a higher mortality rate is found in lung cancer patients in other countries. Consequently, appropriate and positive prevention methods should be taken to reduce the risk of infecting COVID-19 in cancer patients and to optimize the management of the infected population.
Blood pressure variability (BPV) is a novel predictor related to blood pressure level, and a large number of studies based on the hypertension cohort have shown that BPV is an independent predictor of target organ damages and cardiovascular adverse outcomes. Due to the significant hemodynamic changes, BPV in patients with chronic kidney disease (CKD) and hemodialysis is higher than the simple hypertension cohort, suggesting that BPV may be of great significance to patients with chronic kidney disease and hemodialysis. In recent years, studies based on CKD and hemodialysis cohort have published in succession whose results revealed that BPV of this cohort is of great prognostic significance for predicting target organ damages and cardiovascular disease risks. This article aims to provide an overview on these research, so as to survey and predict the clinical significance of BPV in CKD and hemodialytic patients.
Objective To systematically evaluate the effect of vitamin C supplementation on the mortality of patients with sepsis and septic shock. Methods The Cochrane Library, PubMed, EMbase, Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure Database and Chinese Science and Technology Periodical Database were searched by computer for randomized controlled trials (RCTs) on the effect of vitamin C on the mortality of patients with sepsis. The retrieval time of each database was from the establishment of the database to January 20, 2022. Two researchers independently screened the literature, extracted data, and evaluated the quality, and then used STATA 16.0 software for meta-analysis. Results A total of 15 RCTs were included, with a total of 2077 patients, including 1041 in the experimental group and 1036 in the control group. The results of literature quality showed that 7 studieswere grade A and 8 studies were grade B, indicating that the overall quality of the included literature was good. The results of meta-analysis showed that compared with the control group, the mortality of patients with sepsis and septic shock in the experimental group were effectively reduced [odds ratio (OR)=0.81, 95% confidential interval (CI) 0.67 - 0.98, P=0.027]. The results of subgroup analysis showed that vitamin C supplementation therapy for more than 4 days could significantly reduce the mortality of the patients with sepsis (OR=0.67, 95%CI 0.49 - 0.90, P=0.008); single treatment could significantly reduce the mortality rate of patients with sepsis (OR=0.50, 95%CI 0.34 - 0.74, P=0.001); vitamin C supplementation can effectively reduce the short-term (≤30 days) mortality of patients with sepsis (OR=0.77, 95%CI 0.63 - 0.96, P=0.017). The funnel plot showed that the included literature was basically symmetrical, and publication bias could not be considered. Conclusions Vitamin C supplementation can effectively reduce the mortality rate of patients with sepsis and septic shock. Vitamin C supplementation treatment course of 4 days or less and single treatment can reduce the mortality rate of patients with sepsis and septic shock, but cannot reduce the long-term (90 days) mortality rate of patients.
ObjectivesTo systematically review the prognostic value of plasma soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) level in predicting 28-day mortality in sepsis.MethodsPubMed, The Cochrane Library, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect studies about the prognostic value of plasma sTREM-1 in early 28-day mortality in sepsis from inception to April 16th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 14.0 software.ResultsA total of 13 studies involving 1 115 patients were included. The results of meta-analysis showed that the sensitivity and specificity were 79% and 77%, respectively. The positive likelihood ratio and the negative likelihood ratio were 3.4 and 0.28, respectively. The diagnostic ratio was 12. The overall area under the summary receiver operator characteristic (SROC) curve was 0.80.ConclusionsCurrent evidence shows that plasma sTREM-1, as a single index, may play a prognostic role in the early 28-day mortality of sepsis in patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To assess the completion of the under 5 mortality rate (U5MR) of Millennium Development Goals in 194 member countries of WHO, and to analyze the present situation of the global U5MR. Methods Based on the U5MR and the proportion of main causes of death in the "World Health Statistics 2015", the Millennium Development Goals of the decline of U5MR from 1990 to 2013 was assessed, the U5MR was analyzed by comparison between 2000 and 2013. Bivariate Pearson correlation analysis was used to determine the correlation between mortality and the ratio of infection to non infectious diseases and GDP per person in U5MR. Results By 2013, in 194 WHO member states, the U5MR in 46 (23.71%) countries achieved the millennium development goals. Comparison between 2000 and 2013, there was significant difference between low and high mortality groups in six continents (P<0.05), there was no significant difference between the moderate death groups (P>0.05), there was no significant difference in the ratio of infection to non infectious diseases between the middle and low mortality groups (P>0.05), however there was significant difference between the high mortality groups (P<0.05). There was significant difference in the average decline of U5MR and the ratio of non infectious diseases between low and medium, middle and high mortality groups (P<0.05). The Global U5MR had significant regional differences, the highest U5MR was in Africa, the lowest U5MR was in Europe, the medium U5MR was in North America, Oceania, South America, Asia was becoming the middle level. The U5MR was highly correlated with the ratio of infection to non-infectious diseases in every country (r2000y=0.934,r2013y=0.911,P<0.05), and it was low negatively correlated with GDP per capita (r2000y=–0.443,r2013y=–0.433,P<0.05). Conclusions There is a long way to reduce global child mortality. Prevention and control should focus on Africa and Asia. Prevention and control of infectious diseases is an effective measure for middle and high mortality countries. Prevention and control of non-infectious diseases is an important measure for low mortality countries. Increasing health investment is an important means to further reduce global U5MR.
ObjectiveTo analyze the epidemiological characteristics and trends of gallbladder cancer incidence and mortality in Zhejiang cancer registration areas from 2000 to 2021, providing a basis for formulating prevention and control strategies for gallbladder cancer. MethodsData on incidence and mortality were collected from 22 cancer registry areas in Zhejiang Province from 2000 to 2021, calculating the crude incidence (mortality), age-standardized incidence / mortality rate by Chinese standard population(ASR China), age-standardized incidence /mortality rate by World standard population (ASR World) and cumulative rate (0–74 years old). The average annual percentage change (AAPC) was calculated by using Joinpoint software. ResultsIn 2021, the crude incidence of gallbladder cancer in Zhejiang cancer registration areas was 6.79 per 100 000. The ASR China and ASR World were 2.99 and 2.96 per 100 000, respectively, ranking 18th of all new cancer cases. The incidence ASR China in female (3.13 per 100 000) was higher than that in male (2.85 per 100 000). The incidence ASR China in rural areas (3.01 per 100 000) was slightly higher than that in urban areas (2.97 per 100 000). The crude mortality of gallbladder cancer was 5.14 per 100 000, with the mortality ASR China and ASR World of 2.09 and 2.10 per 100 000, respectively, ranking 10th of all new cancer deaths. The mortality ASR China in female (2.19 per 100 000) was higher than that in male (1.98 per 100 000). The mortality ASR China in urban areas (2.11 per 100 000) was slightly higher than that in rural areas (2.07 per 100 000). Both the crude incidence and mortality of gallbladder cancer increased with age. The crude incidence and mortality showed an upward trend over time, with AAPC of 2.59% and 3.75%, respectively (P<0.001). The incidence ASR China did not show significant changes over time (AAPC=0.05%, P=0.856). The incidence ASR China in male and rural areas showed increasing trends over time, with AAPCs of 0.89% (P=0.016) and 1.14% (P=0.001), respectively. The incidence ASR China in female and urban areas showed no significant trends over time, with AAPCs of –0.26% (P=0.503) and –0.02% (P=0.967), respectively. The mortality showed a slower upward trend after adjusting the age structure (AAPC=1.01%, P=0.020). ConclusionsThe elderly population in rural areas, especially elderly women, are the primary targets for the prevention and control of gallbladder cancer. Aging is the main factor contributing to the increase in the incidence and mortality of gallbladder cancer. After adjusting for demographic factors, the overall upward trend of the incidence in the male population and rural areas, as well as mortality, cannot be ignored.
In 2022, the National Cancer Center (NCC) of China reported the nationwide statistics of 2016 using population-based cancer registry data from all available cancer registries in China, which was mainly about the cancer incidence and mortality. Cancer remains a major health problem currently in our country and requires long term cooperation to deal with. This article provided a key point interpretation and analysis of cancer prevalence data in China, and provided an analysis of several main risk factors for cancer, which was conducive to the development of cancer prevention and control programs in different regions.
ObjectiveTo analyze and compare the incidence, mortality, temporal trends, and cancer spectrum differences between China and the United States (US), providing theoretical support for cancer prevention and control in China. MethodsAge standardized incidence rate (ASIR), age standardized mortality rate (ASMR), and cancer site composition were extracted from GLOBOCAN, Cancer Statistics 2025, the China Cancer Registry Annual Report, and other epidemiological sources. Spatial (urban-rural, sex specific) and temporal distributions were described, and average annual growth rate (AAGR) were calculated. ResultsFrom 2005 onward, China exhibited a modest rise in ASIR, whereas the US showed a decline (AAGR: 0.58 vs –0.42); nevertheless, China’s overall incidence remained lower (2022 ASIR = 201.61/100 000) than that of the US (303.60/100 000). Both countries experienced decreasing ASMR (AAGR: –1.03 vs –1.72). In both nations, male ASIR and ASMR were higher than female. Since 2005, the top three US cancers had remained prostate (men) or breast (women), lung and colorectal cancer. In China, incidences of lung, colorectal, female breast and thyroid cancers had continued to rise, while stomach and liver cancer incidences had declined yet still rank high among men. Urban ASIR in China exceeded rural rates, whereas rural ASMR was higher than urban counterparts. ConclusionsAccelerating population ageing and lifestyle transitions have driven an upward incidence trend in China, accompanied by a shift towards a mixed pattern of traditional and emerging cancer risks. Drawing on US experience, China should intensify tobacco control measures, expand organized screening and early detection programs, implement comprehensive interventions for priority cancers, strengthen primary level capacity and improve treatment access in rural areas, thereby establishing a more effective national cancer prevention and control system.