The age-structured incidence and mortality of pulmonary tuberculosis reported in China,in 2005–15: a longitudinal analysis of national surveillance data

Background

With the rapid pace of population ageing, tuberculosis in older people has become a public health challenge in China. However, the age-structured epidemiological transition and its impact on achieving the end tuberculosis targets by 2035 have not been understood well. We analysed the age-structured incidence and mortality of pulmonary tuberculosis reported in China to inform current and future control programmes.

Secular trends in mortality and causes of death among children and adolescents aged 1–19 years in China from 1953 to 2016: a national and subnational variations systematic analysis

Background

The level and pace of mortality, and causes of death in children and adolescents might vary across regions within China. We aimed to analyse the national and subnational mortality trends, and the principal causes of deaths among Chinese children and adolescents aged 1–19 years from 1953 to 2016.

Trends on clinical characteristics and medical service use of lung cancer in China 2005–14: a multicentre retrospective survey

Background

Nationwide data on clinical diagnosis and treatment of lung cancer is scarce in China. The aim of this study was to investigate the 10-year profile of lung cancer on clinical characteristics and medical service use in China.

The clinical and laboratory features associated with cancer in patients with primary biliary cholangitis: a longitudinal survey–based study

Clinical Rheumatology - To analyze the clinical and laboratory features of primary biliary cholangitis (PBC) patients complicated with cancer, and explore the potential factors associated with...     

Prevalence and trend of isolated and complicated congenital hydrocephalus and preventive effect of folic acid in northern China, 2005–2015

Metabolic Brain Disease - Congenital hydrocephalus (CH) was a major birth defect of the central nervous system besides neural tube defects (NTDs). Few studies have focused on both the prevalence...     

The medical insurance system’s weakness to provide economic protection for vulnerable citizens in China: A five-year longitudinal study

ObjectivesLittle is known about the magnitude of catastrophic health expenditure (CHE) attributable to critical disease, especially in the middle-aged and elderly population. This research aimed to exploring the key aspects of how the health insurance fails to protect the middle-aged and elderly against CHE in the past five years. And propose corresponding measures to improve.MethodsData were obtained from the 2011 to 2015 China Health and Retirement Longitudinal Study. The method was adapted from WHO to calculate the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME), and use Generalized Linear Mixed Models (GLMMs) to comprehensively analyze the risk factors that cause middle-aged and elderly people to fall into CHE.ResultsThe incidence of CHE of China’s middle-aged and elderly population has been rose in the five years from 2011 (10.5 %) to 2013 (17.5 %) to 2015 (19.7 %). The CHE of richest families was almost 6 times from 2011 to 2015. Urban Employee Medical Insurance Scheme, the incidence of CHE was up 10 percentage from 2011 to 2015. According to the GLMMs, families have inpatient cares as the most important factor to CHE. The incidence of CHE increased by 2.25 times compared with those who did not use inpatient services.ConclusionsThe health system needs to control the irrational growth of health expenses and reduce residents’ overuse of health services. Government should take supplementary measures to comprehensively strengthen the advantages of health insurance. Raise residents' awareness of health care, enhance citizens' physical fitness, and avoid unnecessary waste of health resources.     

Clinical characteristics and management of patients with early acute severe pancreatitis:Experience from a medical center in China

AIM:To study clinical characteristics and management ofpatients with early severe acute pancreatitis (ESAP).METHODS:Data of 297 patients with severe acutepancreatitis (SAP) admitted to our hospital within 72 h afteronset of symptoms from January 1991 to June 2003 werereviewed for the occurrence and development of early severeacute pancreatitis (ESAP).ESAP was defined as presence oforgan dysfunction within 72 h after onset of symptoms.Sixty-nine patients had ESAP,228 patients without organdysfunction within 72 h after onset of symptoms had SAP.The clinical characteristics,incidence of organ dysfunctionduring hospitalization and prognosis between ESAP and SAPwere compared.RESULTS:Impairment degree of pancreas (Balthazar CTclass) in ESAP was more serious than that in SAP (5.31±0.68vs 3.68±0.29,P<0.01).ESAP had a higher mortality thanSAP (43.4% vs 2.6%,P<0.01),and a higher incidence ofhypoxemia (85.5% vs 25%,P<0.01),pancreas infection(15.9% vs7.5%,P<0.05),abdominal compartment syndrome(ACS) (78.3% vs 23.2%,P<0.01) and multiple organdysfunction syndrome (MODS)(78.3% vs 10.1%,P<0.01).In multiple logistic regression analysis,the main predisposingfactors to ESAP were higher APACHE Ⅱ score,Balthazar CTclass,MODS and hypoxemia.CONCLUSION:ESAP is characterised by MODS,severepathological changes of pancreas,early hypoxemia andabdominal compartment syndrome.Given the poor prognosisof ESAP,these patients should be treated in specializedintensive care units with special measures such as closesupervision,fluid resuscitation,improvement of hypoxemia,reduction of pancreatic secretion,elimination of inflammatorymediators,prevention and treatment of pancreatic infections.     

Symptoms and diagnosis of asthma in a general population – longitudinal results from the SHIP database

Background. Against the background of an increasing prevalence of allergies, the epidemiology of asthma in relation to age is still a matter of debate. To further clarify the prevalence of asthma, asthmatic symptoms, and their change over time within a population sample, we analyzed longitudinal data from the Study of Health in Pomerania (SHIP). Methods. Standardized questionnaires for asthma and asthmatic symptoms were available in 4310 individuals aged 20–75 years. The population sample underwent a 5-year follow-up with 3300 subjects reexamined. The questionnaire evaluated estimates to describe the prevalence in wheeze, chest tightness, shortness of breath, coughing, nocturnal symptoms, and asthma attacks in the past 12 months, current medications, current asthma, and nasal allergies at baseline and its longitudinal net change. Results. The prevalence of current asthma at the baseline study was 1.8% [95% confidence interval (CI 1.4–2.2)], those of nasal allergies 16.7% (95% CI 15.6–17.9). Sixteen percent of asthmatic individuals were not medically treated. The net changes in asthmatic symptoms per 60 months of follow-up ranged between a decrease by 2.0% (chest tightness at night) and an increase by 1.2% (nocturnal attack of coughing). The proportions of subjects with current asthma remained unchanged. The prevalence of current asthma and symptoms was higher in young individuals, whereas the net change over time was slightly increasing at the age of 36 and above. Conclusion. Despite the fact of a high prevalence of subjects complaining of nasal allergies, the overall prevalence of current asthma remained low over time. The prevalence in asthma and asthmatic symptoms as well as its net changes over 5 years were age dependent.     

Trends in the age-related incidence of colon and rectal cancers in China, 2005–2015

BackgroundRecent evidences showed that the incidence of colorectal cancer decreased among older adults, yet this decline didn't appear in adults younger than 50 years. Our aim was to evaluate age-related incidence trends of colon and rectal cancers in China during 2005-2015.MethodsA retrospective study of colon and rectal cancers was conducted using population-based data from the Chinese Cancer Registry Annual Report. Age at diagnosis was analyzed in five sub-groups (0–19, 20–34, 35–49, 50–64 and 65 years). Data including new cases, incidence, and age-standardized rates (ASRs) were classified by sex and area. Temporal trends of ASRs were determined with Joinpoint regression analysis.ResultsFrom 2005 to 2015, colon cancer incidence decreased by -2.2% (95%CI: -3.1, -1.3) per year. A more steady decrease was seen in rectal cancer with AAPC of -0.9% (95%CI: -1.4, -0.4). Stratified by age at diagnosis, incidence trends followed a similar pattern, without age-related disparity. Females showed pronounced declines relative to males. The exception was that rural individuals showed opposite increasing trends, with 2.7% of AAPCs for colon cancer and 2.0% for rectal cancer.ConclusionA slight decline was observed in colon and rectal cancers during 2005–2015, regardless of age at diagnosis.     

Equity of health resource distribution in China during 2009–15: an analysis of cross-sectional nationwide data

Background

In 2009, China initiated health-care reforms, which aimed to provide affordable and accessible medical care for the country's entire population by 2020. We aimed to analyse the equity of the distribution of China's health resources since the health-care reform.

Clinical characteristics and management of patients with early acute severe pancreatitis： Experience from a medical center in China

AIM: To study clinical characteristics and management of patients with early severe acute pancreatitis (ESAP). METHODS: Data of 297 patients with severe acute pancreatitis (SAP) admitted to our hospital within 72 h after onset of symptoms from January 1991 to June 2003 were reviewed for the occurrence and development of early severe acute pancreatitis (ESAP). ESAP was defined as presence of organ dysfunction within 72 h after onset of symptoms. Sixty-nine patients had ESAP, 228 patients without organ dysfunction within 72 h after onset of symptoms had SAP. The clinical characteristics, incidence of organ dysfunction during hospitalization and prognosis between ESAP and SAP were compared. RESULTS: Impairment degree of pancreas (Balthazar CT class) in ESAP was more serious than that in SAP (5.31+/-0.68 vs 3.68+/-0.29, P<0.01). ESAP had a higher mortality than SAP (43.4% vs 2.6%, P<0.01), and a higher incidence of hypoxemia (85.5% vs 25%, P<0.01), pancreas infection (15.9% vs 7.5%, P<0.05), abdominal compartment syndrome (ACS) (78.3% vs 23.2%, P<0.01) and multiple organ dysfunction syndrome (MODS)(78.3% vs 10.1%, P<0.01). In multiple logistic regression analysis, the main predisposing factors to ESAP were higher APACHE II score, Balthazar CT class, MODS and hypoxemia. CONCLUSION: ESAP is characterised by MODS, severe pathological changes of pancreas, early hypoxemia and abdominal compartment syndrome. Given the poor prognosis of ESAP, these patients should be treated in specialized intensive care units with special measures such as close supervision, fluid resuscitation, improvement of hypoxemia, reduction of pancreatic secretion, elimination of inflammatory mediators, prevention and treatment of pancreatic infections.     

Neighbourhood poverty and psychological distress in adolescents aged 11–15 in China: a multilevel study of 507 local communities

Background

Neuropsychiatric conditions have become the leading cause of disability in adolescents aged 11–24 globally. Higher neighbourhood economic status was found to be associated with lower incidence of neuropsychiatric conditions in children and adolescents in developed countries, but there is a lack of evidence in China. This study aims to examine the associations between neighbourhood poverty and psychological distress among adolescents in China.