山西省、重庆市4县区农村居民身体活动状况研究

目的 了解山西、重庆农村地区居民身体活动状况及影响因素。方法 选取山西、重庆4县区当地居住≥1年,且2年内没有迁出计划的≥18岁居民为调查对象。通过面对面问卷调查,收集调查对象每日身体活动时间,静坐时间,相关知识、态度情况等数据。结果 调查对象身体活动不足率为14.9%,从不锻炼率为88.7%,每日静坐时间（3.91±2.06）h,多因素分析结果显示文化程度、人均月收入和身体活动行为阶段是身体活动不足的影响因素。结论 调查地区从不锻炼率高于全国农村平均水平,应采取措施全面提高锻炼率。对“有锻炼意愿、但无行动”人群和已增加身体活动的人群,在加强健康教育的同时,应有针对性地提供指导。     

2015—2017年中国城市居民肿瘤早治疗意识现况及相关因素分析

目的分析中国城市居民肿瘤早治疗意识及其人口学、社会学等影响因素。方法采用横断面调查的方法,于2015—2017年以2015年度"城市癌症早诊早治项目"覆盖的16个项目省份为研究现场,采用整群及方便抽样的方法,将年龄≥18岁、能够理解调查程序的居民纳入研究。共纳入32257名研究对象,其中社区居民、癌症风险评估/筛查干预人群、现患癌症患者及职业人群分别有15524、8016、2289、6428名。调查问卷收集个人信息、肿瘤早治疗态度及影响其态度的原因等信息。比较不同组别早治疗态度构成比的差异;采用多因素logistic回归模型分析肿瘤早治疗态度的影响因素。结果假设本人被确诊为癌前病变/癌症,社区居民、癌症风险评估/筛查干预人群、现患癌症患者和职业人群选择积极治疗者分别占89.97%、91.84%、93.00%和91.52%(P<0.001);假设直系亲属被确诊为癌前病变/癌症,4组人群选择鼓励亲属早期治疗者分别占91.96%、91.94%、92.44%、91.55%(P<0.001)。公司职员、家庭年收入4万元及以上者、其他3个亚组人群选择积极治疗意愿相对较高(P<0.05);男性、丧偶、无业人员、中西部地区的受访者积极治疗的意愿较低(P<0.05)。结论2015—2017年中国城市居民肿瘤早治疗意识较高;婚姻状况、职业、家庭年收入、区域是居民肿瘤早治疗意识的影响因素。     

中国1996-2015年食管癌经济负担研究的系统综述

目的 探讨中国1996-2015年食管癌经济负担研究开展情况。方法 采用经济负担、费用等作为关键词,全面检索PubMed、中国知网和万方数据库1996-2015年间发表的文献,对纳入文献行信息摘录和统计分析。采用美国卫生保健质量和研究机构推荐包含11条目的横断面研究质量评价标准,由双人独立对纳入的研究进行评价。以中国医疗保健消费价格指数对费用数据进行统一贴现,采用平均增长速度计算年均增长率。结果 最终纳入23篇文献（个体研究21篇和群体研究2篇）,其中12篇发表于近5年。21篇个体研究中,有17篇为个体患者病案摘录,纳入文献质量一般,数据多为单一直接医疗费用,分析指标以例均、次均和日均费用等多见。1996-2012年中国食管癌患者例均费用中位数为7 463～37 647元（年均增长率为7.68%）,1996-2013年次均费用中位数为6 851～57 554元（年均增长率为11.89%）,1996-2010年日均费用中位数为225～1 319元（年均增长率为12.53%）。直接医疗次均费用存在地区差异,以北京、山西和湖北较高。无论个体还是群体研究,对直接非医疗费用和间接费用造成的经济负担报道均较少。结论 中国食管癌经济负担评价数据仍有限且结果可比性一般,尤其是人群层面和间接负担的研究较少。直接医疗费用呈上升趋势,且地区差异较大。     

Predictive value of lactate dehydrogenase combined with the abbreviated burn severity index for acute kidney injury and mortality in severe burn patients

BackgroundExtensive burns are devastating trauma. This study aimed to explore the predictive value of early lactate dehydrogenase (LDH) level, the abbreviated burn severity index (ABSI) and their combination on acute kidney injury (AKI) and mortality after severe burns.Methods and results194 severe burn patients (TBSA ≥ 30%) were included. After multivariate analyses, early LDH value (first 24 h after admission) was an independent risk factor for early AKI (OR=1.095, CI,1.025–1.169,p = 0.007) and AKI (OR=1.452, CI,1.131–1.864, p = 0.003) in severe burn patients and was still a significant risk factor for mortality (OR=1.059, CI,1.006–1.115,p = 0.03). In ROC analysis, after combining LDH and ABSI, the AUC values were 0.925 for AKI, 0.926 for stage 3 AKI, and 0.904 for mortality. Based on cut-off values, patients were divided into different risk groups. The cumulative incidence of AKI (within 5 days, 30 days) and survival rate (within 60 days) were analyzed by the Kaplan-Meier method. The mortality, AKI incidence, and AKI staging showed a significant upward trend with the increasing risk level (P < 0.001).ConclusionEarly LDH level is an independent risk factor for early AKI and AKI. LDH combined with ABSI can better predict mortality and AKI than single indicators.     

1990-2019年中国儿童青少年哮喘疾病负担分析

目的分析1990-2019年我国1～19岁儿童青少年哮喘疾病负担及其变化趋势, 为优化儿童青少年哮喘的健康管理提供依据。方法利用2019年全球疾病负担中国分省研究结果, 比较1990年和2019年中国儿童青少年哮喘的发病、患病、死亡和伤残调整寿命年(DALY), 描述1990-2019年我国各省份儿童青少年哮喘疾病负担的分布情况。结果 2019年我国儿童青少年哮喘发病人数、患病人数和死亡人数分别为215.41万[95%不确定区间(UI):137.80万～319.76万]、869.07万(95%UI:579.83万～1 312.65万)和78(95%UI:63～106), 发病率、患病率和死亡率分别为718.23/10万(95%UI:459.47/10万～1 066.17/10万)、2 897.73/10万(95%UI:1 933.33/10万～4 376.75/10万)和0.03/10万(95%UI:0.02/10万～0.04/10万)。相较于1990年, 2019年儿童青少年哮喘发病率和患病率均上升[变化率为3.28%(95%UI:-0.66%～7.27%)和0.58%(95%UI:...     

基于多水平模型的四川省心血管疾病主要危险因素及聚集情况

目的 探讨四川省不同地域居民心血管疾病(cardiovascular disease,CVD)主要危险因素的分布及高危类型聚集情况.方法 采用多阶段整群抽样的方法,随机抽取四川省10个县(区),于2015-2019年开展CVD高危人群筛查,共29 300名35～75岁常住居民纳入本次研究.采用多水平Logistic回归...     

Assessment of long-term survival of cancer patients using cancer registry data from eastern China: Period analysis is superior to traditional methods

We aimed to provide a systematical evaluation of the performance of period analysis compared to traditional cohort and complete methods, using cancer registry data from Taizhou, eastern China. Overall, 5-year relative survival (RS) estimate was calculated using cohort analysis, complete analysis and period analysis, respectively; further analyses were stratified by sex, region, age at diagnosis and cancer sites. Deviation value (DV), defined as the deviation between the estimated 5-year RS obtained from each method and the observed actual survival, was calculated to evaluate the accuracy of each method. Overall, 5-year RS derived by period analysis were much closer to the observed actual survival (51.4%), compared to those by complete and cohort methods, with the estimates of 48.7% (DV: −2.7%), 43.2% (DV: −8.2%) and 36.3% (DV: −15.1%), respectively. Further stratifications by sex, age at diagnosis, region and cancer sites also supported period analysis provided more precise estimates, compared to complete and cohort methods. We found, for first time systematically using cancer registry data from eastern China, period analysis provided more up-to-date precise estimates of long-term survival for overall and stratifications by sex, age at diagnosis, region and cancer sites, compared to traditional cohort and complete methods. Nevertheless, further investigations using large cancer registry data across China are warranted for the widespread use of period analysis in China.     

山东省心血管健康现状及改善情况评价

  目的  了解山东省各市心血管健康现状及改善情况，为政府部门针对性制定心血管疾病防控策略提供依据。  方法  构建包含5个维度52个指标的山东省分市心血管健康指数（cardiovascular health index，CHI）体系，对各指标进行同向化、标准化、百分化及加权求和等处理，并计算各指标得分的加权合计总分，得分越高表明表现越好。  结果  从CHI总分来看，最高分为威海市（78.21分），最低分为聊城市（30.96分）；威海市、青岛市、东营市、济南市和烟台市得分居前五位，人群心血管健康状况相对较好；聊城市、菏泽市、德州市、枣庄市和滨州市得分位居后五位，人群心血管健康状况相对较差。从单个维度来看，总分排名靠前的城市也有相对较弱的方面，比如排名靠前的济南市在D维度心血管病救治情况排名第11位，处于全省下游水平。从52个指标的得分排名来看，各市均有需要具体改善的方面，如青岛市冠心病早死概率（A03，第9位）、肥胖率（B06，第13名）、糖尿病患病率（B09，第10名）、血脂异常患病率（B10，第14名）、血压检测率（C01，第12位）、糖尿病控制率（C08，第12位）、心血管内科神经内科医生数量（D01，第11名）、导管室数量（D02，第16名）、危险因素干预药物的使用情况（E04，第15名）和疾控人员数（E07，第12名）等指标得分排名较为靠后。与2018年比较，威海市、烟台市、日照市、济宁市、临沂市和菏泽市6个市总分排名均有不同程度上升，其他地市排名有所下降或保持不变。  结论  山东省各地市心血管健康状况不尽相同，东中部地市整体好于鲁西北、鲁西南地区，各市在心血管疾病防控的每一个维度和指标均有进步的空间。     

中国淮安地区2009年至2011年食管癌流行病学特征分析

Objective

The aim of our study was to investigate the epidemiological characteristics of esophageal cancer from 2009 to 2011 in Huai’an area, China.

Methods

The data about the incidence and mortality of esophageal cancer were provided by Huai’an Cancer Registry, and the epidemiological characteristics of the disease were analyzed.

Results

Esophageal cancer was not only the first most common cancer, but also the leading cause of cancer death in Huai’an area. The crude and standardized incidence rates were 62.91/10⁵ and 49.92/10⁵, and the crude and standardized mortality rates were 46.75/10⁵ and 36.87/10⁵, respectively. The sex ratio (male-female) was 1.69:1 in incidence, and the incidence increased in people aged 40 years and over, reaching the peak at the ages of 70–75 years. The mortality rate was at low level under the age of 50 years, but increased after the age of 50 years, reaching the peak at the age of 75–85 years. Incidence and mortality rates varied regionally with the highest rate found in Chuzhou district (90.76/10⁵ and 67.17/10⁵) and lowest rate observed in Qinghe district (32.41/10⁵ and 8.75/10⁵).

Conclusion

Esophageal cancer is the major burden of cancer in Huai’an area, and has marked geographic distribution difference. The key period of age for screening and prevention of the disease is 55–85 years old.