佳木斯125例围产儿死亡分析与围产期保健

7年来我院共收治新生）L2233N，围产］L1683N，hi125N，病死率5．6％。24，J、时内死亡52人，O－7天内死亡112人，占总死亡数的89．6％，8－28天死亡13人，占1o．4％。死亡的疾病顺序为：肺炎48人为38．4％，占死亡第一位；肺出血4o人占第二位；颅内出血17人占第三位。通过死亡病例分析，为降低围产儿死亡率，必须从孕母开始，做好孕期保健工作，对围产窒息儿、低血糖、低血钙的防治列为治疗护理常规，并提出了处理的注意事项。     

双胎妊娠围生儿预后相关因素分析

目的　探讨双胎妊娠新生儿窒息、围生儿死亡的相关因素。方法　回顾分析 2 5 5例双胎妊娠新生儿Apgar评分、新生儿窒息、围生儿死亡与孕周、新生儿体重、分娩方式的关系。结果　双胎妊娠孕 37～ 39+ 6w组Apgar评分最高、新生儿窒息率最低 ,≥ 2 5 0 0g组Apgar评分最高 ,新生儿窒息率、围生儿死亡率最低。孕周、新生儿体重 4组比较差异均有非常显著性(P <0 0 1)。剖宫产组比阴道分娩组Apgar评分高 ,新生儿窒息率、围生儿死亡率均低 ,2组比较Apgar评分、围生儿死亡率差异无显著性 (P >0 0 5 )。 2组比较新生儿窒息率差异有非常显著性 (P <0 0 1)。结论　双胎妊娠估计每个胎儿体重≥ 2 5 0 0g时 ,宜选择 37～ 39+ 6w终止妊娠为宜。加强孕期、围生期保健 ,积极防治各种并发症 ,适当放宽剖宫产指征 ,避免早产 ,减少低体重儿出生 ,是降低双胎围生儿死亡率、改善其预后的重要措施。     

2010—2019年中国居民四类慢性非传染病的死亡趋势及差别分解分析

目的 分析2010—2019年我国居民4类主要慢性病（恶性肿瘤、糖尿病、心血管疾病和呼吸系统疾病）的死亡率变化趋势及影响其变化的因素。方法 数据来自全国疾病监测系统死亡数据资料,运用Joinpoint模型计算死亡率的年度平均变化百分比（AAPC）和年度变化百分比（APC）,并用死亡率差别分解法解释该趋势变化的影响因素。结果 2010—2019年我国居民四种慢性病的粗死亡率由456.22/10万上升至556.00/10万,标化死亡率由541.40/10万降至419.83/10万。死亡率变化是人口构成和其它危险因素共同作用的结果,其中人口构成因素促进了恶性肿瘤、糖尿病、心血管疾病和呼吸系统疾病死亡率的上升,贡献值分别48.52/10万、5.12/10万、135.28/10万、38.39/10万;其它危险因素促进糖尿病死亡率上升,而驱使另3种慢性病死亡率下降,贡献值分别- 23.11/10万、1.27/10万、- 55.87/10万、- 49.83/10万。结论 我国综合防控重大慢性病造成的死亡取得一定成效,但与此同时随着老龄化加剧,上述疾病依然是引发死亡的主要原因,卫生健康事业发展面临严峻挑战。     

2014—2019年江西省伤害死亡情况及疾病负担分析

目的 了解江西省居民伤害死亡流行情况及其疾病负担,为科学制定本省伤害防制策略和措施提供依据。方法 利用中国死因登记报告信息系统2014—2019年江西死因监测数据,应用Excel 2007和SPSS 17.0软件进行数据整理和分析。采用死亡数、粗死亡率、标化死亡率、构成比、潜在减寿年数（PYLL）、减寿率（PYLLR）和平均潜在减寿年数(AYLL)等指标进行统计学描述,趋势变化采用年度变化百分比（APC）进行分析。结果 2014—2019年江西报告伤害死亡25 638人,年均粗死亡率为 50.81/10万,年均标化死亡率为 49.55/10万。男性死亡率高于女性、城市死亡率高于农村。伤害死亡前5位死因分别为道路交通事故、跌落、溺水、自杀和中毒。溺水、交通事故、跌落分别是0～14岁、15～44和45～64岁、≥65岁的首位伤害死因。2014—2019年江西省前5位伤害死因中,跌落粗死亡率呈上升趋势（APC = 8.22%）,中毒粗死亡率均呈下降趋势。2014—2019年伤害PYLL为692 196.73人年,PYLLR为14.24‰,AYLL 为 33.77年。PYLL及PYLLR 交通事故最高,AYLL最高的为溺水。15～44岁年龄组PYLL最高。结论 江西省伤害死亡负担较重,应根据不同人群的伤害死亡特征制定相应的防控策略和措施。     

身体形态指数ABSI和身体圆度指数BRI的发展与应用

目的 对身体形态指数(ABSI)和身体圆度指数(BRI)的发展进行介绍,并对其应用情况进行综述,为人体形态测量提供参考。方法 在Pubmed、中国知网等电子文献数据库中进行文献检索,详尽收录迄今ABSI与BRI对高血压、糖尿病、代谢综合征、心血管疾病等常见疾病的发病率以及全因死亡率预测的相关研究。结果 ABSI与BRI均对高血压、糖尿病、代谢综合征、心血管疾病发病呈现出一定的预测能力。其中,BRI在预测糖尿病、代谢综合征发病方面优于ABSI,但与身体质量指数、腰围、臀围、腰高比等传统测量指标相比,并未表现出显著的差异。ABSI对全因死亡率的预测能力则明显优于传统测量指标和BRI。结论 ABSI与BRI作为两项新的形态学指标,是BMI等传统身体指数测量的补充,对疾病发病具有一定的预测能力和应用性。今后的研究可以从两项指标对疾病的单独作用以及与传统指标的联合作用着手,同时探索其在不同社会人口学特征人群中的拟合情况,提供更有利的研究证据和科学积累。     

1990—2019年中国人群早发性结直肠癌疾病负担及变化趋势分析

目的 分析1990—2019年我国早发结直肠癌（early-onset colorectal cancer,EOCRC）疾病负担及时间变化趋势。方法 利用全球疾病负担2019（Global Burden of Disease 2019,GBD 2019）数据库获取我国14～49岁人群1990—2019年间结直肠癌发病、死亡及伤残调整寿命年（disability-adjusted life years,DALYs）的数量和率,以及危险因素所致EOCRC相关DALYs百分比。计算年龄标化发病率（age-standardized incidence rate,ASIR）及死亡率（age-standardized mortality rate,ASMR）,并用Joinpoint软件对我国EOCRC的ASIR及ASMR行时间变化趋势分析。结果 2019年我国EOCRC新发病例及死亡人数为87383及26274,相比1990年分别增加264.53%及76.92%。我国EOCRC的ASIR及ASMR为10.31/10万及3.07/10万,较1990年分别增加140.32%及14.13%。时间变化趋势分析显示,我国EOCRC的ASIR及ASMR均呈显著上升趋势,其平均年变化百分比（average annual percentage change,AAPC）分别为3.0（95%CI为2.8～3.3）及0.3（95%CI为0.1～0.6）。我国EOCRC相关DALYs为1304828,占我国总体结直肠癌相关DALYs的20.40%及全球EOCRC相关DALYs的30.63%。归因分析提示我国42.85%的EOCRC相关DALYs可归因于饮食、行为及代谢因素。结论 我国EOCRC发病率及死亡率均明显升高,其导致的疾病负担十分严峻。     

Association of obesity with illness severity in hospitalized patients with COVID-19: A retrospective cohort study

BackgroundAlthough recent studies have shown an association between obesity and adverse coronavirus disease 2019 (COVID-19) patient outcomes, there is a paucity in large studies focusing on hospitalized patients. We aimed to analyze outcomes associated with obesity in a large cohort of hospitalized COVID-19 patients.MethodsWe performed a retrospective study at a tertiary care health system of adult patients with COVID-19 who were admitted between March 1 and April 30, 2020. Patients were stratified by body mass index (BMI) into obese (BMI ≥ 30 kg/m 2) and non-obese (BMI < 30 kg/m 2) cohorts. Primary outcomes were mortality, intensive care unit (ICU) admission, intubation, and 30-day readmission.ResultsA total of 1983 patients were included of whom 1031 (51.9%) had obesity and 952 (48.9%) did not have obesity. Patients with obesity were younger (P < 0.001), more likely to be female (P < 0.001) and African American (P < 0.001) compared to patients without obesity. Multivariable logistic models adjusting for differences in age, sex, race, medical comorbidities, and treatment modalities revealed no difference in 60-day mortality and 30-day readmission between obese and non-obese groups. In these models, patients with obesity had increased odds of ICU admission (adjusted OR, 1.37; 95% CI, 1.07?1.76; P = 0.012) and intubation (adjusted OR, 1.37; 95% CI, 1.04?1.80; P = 0.026).ConclusionsObesity in patients with COVID-19 is independently associated with increased risk for ICU admission and intubation. Recognizing that obesity impacts morbidity in this manner is crucial for appropriate management of COVID-19 patients.     

Potential role of intermittent fasting on decreasing cardiovascular disease in human immunodeficiency virus patients receiving antiretroviral therapy

Cardiovascular disease (CVD) has become one of the commonest causes of comorbidity and mortality among People living with human immunodeficiency virus (HIV) (PLWH) on antiretroviral therapy (ART). Nearly 50% of PLWH are likely to have an increased risk of developing CVD, including coronary heart disease, cerebrovascular disease, peripheral artery disease and aortic atherosclerosis. Aside from the common risk factors, HIV infection itself and side effects of antiretroviral therapy contribute to the pathophysiology of this entity. Potential non-pharmacological therapies are currently being tested worldwide for this purpose, including eating patterns such as Intermittent fasting (IF). IF is a widespread practice gaining high level of interest in the scientific community due to its potential benefits such as improvement in serum lipids and lipoproteins, blood pressure (BP), platelet-derived growth factor AB, systemic inflammation, and carotid artery intima-media thickness among others cardiovascular benefits. This review will focus on exploring the potential role of intermittent fasting as a non-pharmacological and cost-effective strategy in decreasing the burden of cardiovascular diseases among HIV patients on ART due to its intrinsic properties improving the main cardiovascular risk factors and modulating inflammatory pathways related to endothelial dysfunction, lipid peroxidation and aging. Intermittent fasting regimens need to be tested in clinical trials as an important, cost-effective, and revolutionary coadjutant of ART in the fight against the increased prevalence of cardiovascular disease in PLWH.     

Neighbourhood migrant composition and tobacco-related cancer mortality: A census-linked study among five origin groups in urban Belgium

We studied the role of ‘ethnic density’ in the neighbourhood for tobacco-related cancer mortality among five migrant origin groups in urban Belgium. Using full population linked census data, multilevel Poisson models were applied to model effects of three linear and categorical indicators of same-origin presence for each origin group, and to test effect mediation by migrant generation and educational level. We first of all found that increased same migrant-origin presence in the neighbourhood had protective effects on tobacco-related cancer mortality for men in most groups. Second, only Turkish men had a mortality disadvantage when Turkish concentration was higher. Third, effects were not detected across all indicators of same-origin presence, nor among most groups of women. Finally, for several groups, neighbourhood effects were mediated by generational status and educational level.     

2014—2016年肇庆市端州区恶性肿瘤发病与死亡分析

目的 分析2014—2016肇庆市端州区居民恶性肿瘤发病和死亡情况。方法 收集2014—2016年肇庆市端州区恶性肿瘤发病及死亡数据,计算恶性肿瘤发病与死亡粗率、标化率、35~64岁截缩率、累积率与前10位恶性肿瘤顺位等。结果 2014—2016年肇庆市端州区恶性肿瘤粗发病率为312.50/10万（男性为334.97/10万,女性为289.41/10万）,中标率为219.16/10万,世标率为214.30/10万,35~64岁截缩率为379.76/10万,0~74岁累积率为24.31%。粗死亡率为165.27/10万（男性为208.55/10万,女性为120.79/10万）,中标率为100.33/10万,世标率为99.52/10万,35~64岁截缩率为153.81/10万,0~74岁累积率为11.50%。端州区发病率居前10位的恶性肿瘤分别为肺癌、结直肠癌、肝癌、女性乳腺癌、鼻咽癌、脑瘤、胃癌、甲状腺癌、白血病和前列腺癌,占全部恶性肿瘤发病的74.31%。端州区死亡率居前10位的恶性肿瘤分别为肺癌、肝癌、结直肠癌、鼻咽癌、胃癌、女性乳腺癌、白血病、食管癌、胰腺癌和淋巴瘤,占全部恶性肿瘤死亡的83.06%。结论 肺癌、消化系统癌症、女性乳腺癌和鼻咽癌是严重影响肇庆市端州区居民健康的重点恶性肿瘤,应加强预防与控制。