Trends of incidence and mortality rates of stroke from 1983 to 2000 in Hanzhong rural population

Objective: To explore the trends of incidence and mortality rates of stroke in Hanzhong rural population. Methods: Acting as the WHO MONICA project. Results: The incidence rate of stroke was 152. 9/100 000. There was decline trend in male(P <0. 05). The mortality rate of stroke was 115.9/100 000. There was no significant decline trend during 18-year period (P < 0. 05). The incidence and mortality rates of stroke of male were higher than those of female(P<0. 05). The incidence and mortality rates were all increased with age(P <0. 01 ). Conclusion: It must stick to the long- term prevention measures to decrease incidence rate, and improve the condition of medical treatment to reduce the mortality rate in rural population.     

中国居民1987—2015年鼻咽癌死亡趋势

目的：分析中国居民1987—2015年鼻咽癌死亡的时间变化趋势。方法：利用Joinpoint模型估算各人群(城 市男性、城市女性、农村男性、农村女性)及各年龄组鼻咽癌死亡率的时间变化趋势,采用负二项回归模型分析鼻 咽癌死亡在人群水平上的危险因素。结果：中国居民鼻咽癌年龄标化死亡率呈下降趋势,城市女性、农村女性、城 市男性、农村男性中标死亡率平均年度变化百分比(AAPC)分别为–2.97%,–2.60%,–2.01%,–1.68%(P<0.05);城市居 民在85岁以上死亡率无明显下降趋势,男性AAPC为–1.54%,女性AAPC为–0.60%(P>0.05);65岁以上农村男性截缩率 无明显下降趋势(AAPC=–0.56%,P>0.05),农村女性在85岁以上死亡率无明显下降趋势(AAPC=1.17%,P>0.05);城 市居民鼻咽癌的死亡风险是农村居民的1.11倍(P<0.01),男性是女性的2.34倍(P<0.01),每增加5岁死亡风险平均增大 23%(OR=1.23,P<0.01),1987—2015年每过1年死亡风险平均减少2%(OR=0.98,P<0.01)。结论：中国居民鼻咽癌死亡 率变化呈下降趋势,并且存在明显的性别、年龄差异;中国居民在85岁以上鼻咽癌死亡率无明显下降趋势。     

Lung Cancer Mortality Trends in Canada, 1931-1960

Trends in mortality due to lung cancer in Canada since 1931 were reviewed and data for 1960 presented. In 1960, 2223 male deaths were due to lung cancer. In each five-year age group over 45, there has been a distinct increase in male lung cancer death rates since 1931. The greatest increase occurred between the ages of 65 and 79. The age group 70-74, where the lung cancer mortality rates increased from 10.7 in the period 1931-33 to 173.5 in 1958-60, indicates the trend. Between 1931 and 1960, the proportion of male lung cancer deaths to all male cancer deaths increased from 3% to 18.8%. Female deaths due to lung cancer numbered 321 in 1960. Between 1931 and 1960 the proportion of female lung cancer deaths to all female cancer deaths increased only from 1.4% to 3.2%.     

Interstate differences in trends in coronary mortality and risk factors in Australia

Mortality from coronary heart disease has declined by approximately 50% in Australia over the past 20 years and now accounts for approximately 25% of all deaths. Most of the decline in mortality from all causes in each State of Australia over the period 1972-1988 is due to the decline in mortality from coronary heart disease. In Tasmania, the rate of decline in mortality from all causes is significantly less in both sexes (P less than 0.01) than in the mainland States, and the discrepancy is due to a lesser decline in mortality from coronary heart disease (P less than 0.01). Trends in deaths related to hypertension show no differences between Tasmania and the other States, which suggests that the discrepancy with coronary heart disease is due to factors other than the prevalence and/or treatment of hypertension. Analysis of trends data on cigarette smoking prevalence, and cross-sectional data on plasma cholesterol levels and diet, shows that Tasmanian differences in food intake (including fat and cholesterol), in plasma cholesterol levels and (to a lesser extent) in cigarette smoking are consistent with, but are unlikely to explain completely, the slower rate of decline in mortality from coronary heart disease.     

1974－2015年上海市杨浦区肝胆系统恶性肿瘤死亡趋势分析

目的利用上海市杨浦区1974－2015年肝胆系统恶性肿瘤的死亡数据,分析肝癌和胆道癌症死亡趋势变化及影响因素。方法应用Joinpoint回归模型分析上海市杨浦区肝癌和胆道癌症死亡趋势,应用年龄-时期-队列（APC）模型评估年龄和队列因素对肝癌和胆道癌症死亡率的影响。结果 1974－2015年杨浦区共报告肝癌死亡9 866例,男女比例为2.7∶1,粗死亡率为23.09/10万,标化死亡率为18.87/10万;胆道癌症死亡2 173例,男女比例为1∶1.7,粗死亡率为5.04/10万,标化死亡率为3.82/10万。Joinpoint回归分析显示1974－2015年肝癌标化死亡率呈下降趋势,而胆道癌症标化死亡率呈上升趋势。在APC模型中,随着年龄的增长,肝癌和胆道癌症的死亡风险整体呈上升趋势。总人群中1930年之前出生者肝癌和胆道癌症死亡风险呈上升趋势;1930－1949年出生的男性肝癌、男女性胆道癌症死亡风险呈下降趋势,1949年之后出生者呈上升趋势;而1930年之后出生的女性肝癌死亡风险呈下降趋势。结论 1974－2015年杨浦区肝癌死亡率呈下降趋势,男性肝癌死亡数高于女性;胆道癌症死亡率呈上升趋势,女性死亡人数高于男性;由老龄化因素造成的肝癌和胆道癌症死亡率上升;暴露因素对肝癌和胆道癌症的影响较一致,可能与当时社会经济因素有关。     

广西2013—2017年死因监测点主要慢性病早死概率及变化趋势

目的 分析广西死因监测点心脑血管疾病、癌症、糖尿病和慢性呼吸系统疾病4种慢性病死亡率、早死概率及变化趋势,为制定策略提供科学依据。方法 收集2013—2017年广西死因监测点报告的死亡数据,计算死亡率、标化死亡率、构成比、早死概率和年度变化百分比（APC）,用SPSS 17.0 进行统计分析,率的比较用χ²检验,趋势变化采用曲线估计指数分布回归模型进行判别。结果 男性、农村死亡率分别高于女性、城市,差异均有统计学意义（P<0.01）。男性、女性、城市、农村死亡率APC分别为-0.40%、1.14%、4.39%、-0.20%,变化趋势差异均无统计学意义（P>0.05）。主要慢性病死亡率由477.76/10万上升至491.80/10万,APC为0.30%,变化趋势差异无统计学意义（F=0.17,P=0.707）,标化死亡率由343.78/10万下降至336.04/10万,APC为-1.49%,变化趋势差异无统计学意义（F=1.44,P=0.316）。主要慢性病早死概率在16.92%~17.68%之间波动,APC为0.50%,变化趋势差异无统计学意义（F=0.51,P=0.525）。男性、农村早死概率分别高于女性、城市,男性、女性、城市、农村早死概率分别以0.60%、0.40%、2.74%、0.20%的速度上升。心脑血管疾病、慢性呼吸系统疾病早死概率分别以1.39%、7.23%的速度下降;癌症、糖尿病早死概率分别以3.15%、11.40%的速度上升。结论 广西死因监测点4种慢性病早死概率处于较高的水平,男性、女性、城市、农村早死概率均呈上升趋势,癌症和糖尿病是导致早死概率上升的主要疾病,建议以男性和农村居民为重点人群,进一步加强慢性病的综合防治。     

重庆市九龙坡区1957-2012年流行性脑脊髓膜炎流行病学特征分析

目的：了解重庆市九龙坡区1957-2012年间流行性脑脊髓膜炎的流行特点和趋势,为制订有效的预防控制策略提供科学依据。方法对历年流脑疫情资料采用EXCEL建立数据库,进行描述性流行病学分析。结果1957-2012年累计报告流脑发病4720例,死亡271例,年平均发病率为16.03/10万,死亡率为0.92/10万,病死率为5.74%,于1959年和1967年出现两次流行高峰,发病率分别为529.44/10万、262.68/10万。56年来流脑发病率和死亡率呈持续下降趋势,至2001-2012年全区流脑年均发病率和死亡率分别下降到0.16/10万和0.01/10万。发病有明显的季节性高峰,1~4月占发病总数的86.48%;农村发病数多于城市;年龄集中在10岁以下儿童占93.84%;职业以儿童（56.21%）和学生（39.62%）为主。结论近年来重庆市九龙坡区流脑发病率和死亡率呈明显下降趋势,预防控制效果显著,这与流脑疫苗的应用有关,应继续加强流脑疫苗接种和疫情监测等综合措施,达到基本消除流脑的目标。     

Trends in mortality among California physicians after giving up smoking: 1950-79

A study was conducted to assess how lung cancer and other mortality trends among California physicians had been influenced by the high proportion who had given up smoking since 1950. Several sample surveys indicated that the proportion of California physicians who currently smoked cigarettes had declined dramatically from about 53% in 1950 to about 10% in 1980. During the same period the proportion of other American men who smoked cigarettes had declined only modestly, from about 53% to 38%. Using the 1950 American Medical Directory a cohort of 10 130 California male physicians was established and followed up for mortality till the end of 1979, during which time 5090 died. The information from follow up and death certification was exceptionally good. The standardised mortality ratio for lung cancer among California male physicians relative to American white men declined from 62 in 1950-9 to 30 in 1970-9. The corresponding decline in standardised mortality ratio was from 100 to 63 for other smoking related cancer, from 106 to 71 for ischaemic heart disease, and from 62 to 35 for bronchitis, emphysema, and asthma. The standardised mortality ratio remained relatively constant for other causes of death not strongly related to smoking. The overall ratio declined in all age groups at a rate of about 1% a year. The total death rate among all physicians converged towards the rate among non-smoking physicians. By the end of the study period physicians had a cancer rate and total death rate similar to or less than those among typical United States non-smokers. This "natural experiment" shows that lung cancer became relatively less common on substantial elimination of the primary causal factor, cigarette smoking. Other smoking related diseases also became relatively less common, though factors other than cigarette smoking may have contributed to this change.     

扶绥县1974～2005年恶性肿瘤死亡率分析

目的探讨扶绥县32年来恶性肿瘤死亡率变化趋势。方法利用扶绥县肿瘤防治研究所登记处肿瘤登记资料,分别计算1974~2005年各年度粗死亡率、中国人口标化率、世界人口标化率。结果扶绥县1974~2005年恶性肿瘤死亡病例为10 156例,粗死亡率84.47/10万,中国标化率80.04/10万,世界标化率102.59/10万。前5位恶性肿瘤为肝、胃、肺、鼻咽、结直肠癌,占全部恶性肿瘤86.00%。男女死亡率性比例为3.09∶1。结论扶绥县恶性肿瘤死亡率一直处于高水平状态,尤其是肝癌死亡,进一步加强肿瘤防治工作具有深远意义。     

Decline in cardiovascular mortality in North Karelia and other parts of Finland

The trends in mortality from ischaemic heart disease, cerebrovascular stroke, and all cardiovascular diseases were analysed for the province of North Karelia and for the rest of Finland. Linear trends in mortality were computed for the population aged 35 to 64 for the period from 1969 to 1982, and changes in mortality between the three year means of 1969-71 and 1980-2 were calculated. In North Karelia, where a community based preventive programme has been carried out since 1972, the annual decline in mortality from ischaemic heart disease in men was on average 2.9%, whereas in the rest of Finland it was 2.0%. For women the respective average annual declines in mortality were 4.9% and 3.0%. The net decline from 1969-71 to 1980-2 in North Karelia was 100 deaths/100,000 men. The annual mortality from all cardiovascular disease in men decreased by 2.9% in North Karelia and by 2.6% in the rest of Finland; in women the decreases were 6.0% and 5.0% a year, respectively. The net decline in North Karelia was 71 deaths/100,000 men. The decline in mortality from all causes was also appreciable in both sexes in North Karelia, but it did not differ significantly from national trends.     

Factors affecting child mortality in Saudi Arabia

OBJECTIVE: To estimate levels and trends, gender differentials, effect of modes of living, regional differentials, and the effect of parental educational on infant and child mortality. METHODS: A nationwide stratified random sample was used to estimate levels, trends and differentials of infant and child mortality in Saudi Arabia. The study was executed during the period February 2006 to June 2006 and covered all the 20 health regions of Saudi Arabia. The randomly selected sample was limited to ever married Saudi women in the reproductive age group (15-49 years). RESULTS: The findings show a continuous and considerable infant and child mortality decline during the 1994-2004 period. The infant mortality rate has decline from 22 per 1,000 live births in 1994 to 17 per 1,000 live births in 2004; while the child mortality rate has declined from 34 to 22 per 1,000 live births in the same period. There is a strong relation between infant and child mortality and the mode of living and parental education. CONCLUSION: The study proves the continuous decline of infant and child mortality during the study period and affirms the effect of parental education on these indicators.     

Changing trends in mortality and morbidity from abortion in Singapore (1964 to 1970)

The number of abortions treated in Kandang Kerbau Hospital and Thomson Road Hospital from 1964-70 were obtained from the operation registers. The number of abortion deaths were obtained from the hospital death registers. A retrospective study shows the incidence of total abortions have remained fairly constant, but the incidence of septic abortion and mortality from abortions have been declining over the past 7 years. The decline is attributed to the declining incidence of criminal abortions performed by nonmedically qualified abortionists. The incidence of total abortions each year between 1964-70 have remained at a constant level of 8% or 80/1000 deliveries. The average number of obstetric deaths was about 18 per year; the average number of abortion deaths is 5 each year. Singapore has about 22% of maternal deaths attributed to abortion. There appeared a falling trend in mortality from 12/1000 in 1964 to 8/1000 in 1970. The liberalization of abortion laws has brought about a decline in deaths from abortion complications.     

Diabetes and decline in heart disease mortality in US adults

CONTEXT: Mortality from coronary heart disease has declined substantially in the United States during the past 30 years. However, it is unknown whether patients with diabetes have also experienced a decline in heart disease mortality. OBJECTIVE: To compare adults with diabetes with those without diabetes for time trends in mortality from all causes, heart disease, and ischemic heart disease. DESIGN, SETTING, AND PARTICIPANTS: Representative cohorts of subjects with and without diabetes were derived from the First National Health and Nutrition Examination Survey (NHANES I) conducted between 1971 and 1975 (n = 9639) and the NHANES I Epidemiologic Follow-up Survey conducted between 1982 and 1984 (n = 8463). The cohorts were followed up prospectively for mortality for an average of 8 to 9 years. MAIN OUTCOME MEASURE: Changes in mortality rates per 1000 person-years for all causes, heart disease, and ischemic heart disease for the 1982-1984 cohort compared with the 1971-1975 cohort. RESULTS: For the 2 periods, nondiabetic men experienced a 36.4% decline in age-adjusted heart disease mortality compared with a 13.1% decline for diabetic men. Age-adjusted heart disease mortality declined 27% in nondiabetic women but increased 23% in diabetic women. These patterns were also found for all-cause mortality and ischemic heart disease mortality. CONCLUSIONS: The decline in heart disease mortality in the general US population has been attributed to reduction in cardiovascular risk factors and improvement in treatment of heart disease. The smaller declines in mortality for diabetic subjects in the present study indicate that these changes may have been less effective for people with diabetes, particularly women.     

Incidence of phenylketonuria in British Columbia, 1950-1971

The incidence of PKU in British Columbia in the 1950-1971 period is 1/18,750 which corresponds to that found in two other Canadian studies.^{2, 3} Evidence is presented which shows a trend toward a decline in incidence; however, this is not statistically significant. There is a preponderance of male cases in all age groups.     

新型冠状病毒肺炎死亡病例变化趋势及其从发病到死亡时间的特征分析

目的分析新型冠状病毒肺炎死亡病例变化趋势以及其从发病到死亡时间的特征,为有效降低新型冠状病毒肺炎病死率提供理论依据。方法整理国家卫生健康委、湖北省卫生健康委在2019年1月10日至2020年2月11日发布的全国31个省（自治区、直辖市）每日新增确诊病例数、死亡病例数以及17例死亡病例资料。结果截至2020年2月11日24时,全国新型冠状病毒肺炎病死率为2.49%,湖北省为3.19%,其他省（自治区、直辖市）为0.4%。新型冠状病毒肺炎病死率1月15日达高峰点（全国、湖北省均为4.9%）,后开始持续下降,1月19日病死率达低点（全国、湖北省均为2.02%）,1月24-26日达到另一高峰期[全国在2.85%~3.22%,湖北省在4.94%~5.35%,其他省（自治区、直辖市）1月25日达高峰点为0.44%],后开始持续下降,全国、湖北省2月5日达低点（分别为2.01%、2.79%）,其他省（自治区、直辖市）2月4日病死率达最低点为0.14%,从2月5日开始呈持续上升趋势。男性、≥70岁、无咳嗽症状、有气促或喘息或呼吸困难、无乏力或全身酸痛发病到死亡时间较短,但差异均无统计学意义（P>0.05）。结论新型冠状病毒肺炎病死率可能继续呈现上升趋势,应加强防控知识宣传提高及早就医意识缩短就诊时间。     

Changing profile of disease contributing to mortality in a resettlement colony of Delhi

BACKGROUND: The past decade has seen a decline in the disability-adjusted life years (DALYs) contributed by communicable diseases while lifestyle changes and rapid urbanization have led to an increase in DALYs contributed by non-communicable diseases. We studied the causes of death in a low socioeconomic area over 11 years to help identify changes in the pattern of disease. METHODS: We did this study in Gokulpuri, a resettlement colony in East Delhi. All deaths occurring from 1994 to 2004 were analysed using a verbal autopsy questionnaire completed by trained health workers during their home visits in the area. RESULTS: A total of 515 deaths occurred during the period; 340 in men (66%) and 175 in women (34%). The six commonest causes of death were tuberculosis (24.8%), chronic obstructive pulmonary disease (11.6%), pneumonia (8.7%), accidents and poisoning (8.6 %), coronary heart disease (8.2%) and cancer (4.6%). The age-specific mortality rate was highest among people > 45 years of age. The cause-specific mortality rate due to communicable diseases showed a decline while that due to non-communicable diseases showed a rising trend in all age groups. CONCLUSION: Our study shows the coexistence of communicable and non-communicable diseases in a low socioeconomic area with a rising trend in non-communicable diseases. Surveillance for risk factors of non-communicable diseases should be done even in predominantly low socioeconomic areas. The coexistence of communicable and non-communicable diseases and the increase in non-communicable diseases among the economically deprived sections of our society suggest the need to re-prioritize components of healthcare among these sections.     

重庆市居民主要死因构成及顺位动态分析

目的 了解重庆市居民主要死因构成及顺位情况,评价重庆市居民疾病流行模式的变动趋势.方法 根据<重庆市卫生统计资料汇编>年报数据,计算粗死亡率、死因构成比、死因顺位等指标.结果 直辖10年来重庆市居民粗死亡率呈现下降趋势,男性死亡率高于女性,前5位死因为循环系统疾病、呼吸系统疾病、肿瘤、损伤和中毒、消化系统疾病.结论 慢性非传染性疾病是危害重庆市居民生命健康的主要疾病,应协调社会各方力量,开展健康教育,改变不良生活行为,加强环境保护,改善交通,积极控制慢性病的危害.     

医院获得性肺炎发病情况与危险因素动态研究

目的 了解1996～2000年某医院医院获得性肺炎发病和死亡情况及危险因素的变化趋势。方法 在住院愚耆中建立医院感染监测网,按照国家医政司制订医院感染诊断标准．监测住院患者的医院获得性肺炎（NP）发病率和死亡率及危险因素。结果 监测1996～2000年间NP中平均年发病率为161／万,其中男性为131／万,明显高于女性35／万,并以4．01％平均增长速度绝对增长。NP中年平均死亡率为21／万,占感染例80．28％,男性高于女性,死亡率呈下降趋势,NP中发病率随年龄的增长而增长,男女发病年龄差异不大,但2000年平均发病年龄为50．31岁,比1996年提前了6．23岁（56．54）,无论男女性,基础疾病、住院天数、ICU天数、手术、呼吸道插管、泌尿道插管、动静脉插管和其他介入操作、头孢菌素和第3代头孢菌素用量皆有逐年升高趋势．病危、年龄、抗生素使用天数有下降趋势,免疫抑制治疗、抗生素使用种类无明显变化。结论 1996～2000年NP发生率呈上升趋势．死亡率呈下降趋势,大部分NP中的危险因素也呈上升趋势。     

Life style and national and international trends in coronary heart disease mortality

An international comparison of trends in mortality from coronary heart disease (CHD) since 1968 shows a sizeable decline in the U.S.A., Australia, New Zealand, Finland, Canada, Belgium and Japan. By contrast England, Wales and Scotland had shown no evidence of decline in CHD mortality until 1979. This has resulted in a marked deterioration in the CHD ranking of Scotland and England and Wales relative to other countries. Sweden, Hungary, Poland, Yugoslavia, Bulgaria, Rumania and the U.S.S.R. have all had increases in CHD mortality. There are many possible reasons for these changes. In general, countries that had had a decrease in CHD mortality have experienced changes in the type and/or quantity of fat in the national diet. The changes in CHD mortality in Sweden and Japan are out of line with the pattern in other countries. There is some evidence that changes in smoking and blood pressure control may have contributed to changes in CHD mortality. Changes in physical activity may have also played a part.     

2003～2005年南通市第3次恶性肿瘤死因调查分析

目的:了解南通市居民恶性肿瘤死亡现状及变化趋势。方法:通过2003～2005年第3次死因回顾调查南通地区海门市、启东市结果与前2次死因回顾调查结果比较,分析南通市恶性肿瘤死亡的变化趋势。结果:2003～2005年南通市居民恶性肿瘤粗死亡率230.77/10万,与前2次死因回顾调查相比呈上升趋势;标化死亡率为109.43/10万,与前2次死因回顾调查相比呈下降趋势。男性粗死亡率为319.94/10万,女性粗死亡率为149.54/10万,男性粗死亡率明显高于女性。2003～2005年与1990～1992年相比,标化死亡率上升趋势最明显的是肺癌,其次是白血病、乳腺癌、鼻咽癌,而宫颈癌、胃癌、食管癌、肝癌、结直肠癌、膀胱癌则呈下降趋势。肺癌在3次死因回顾调查中,无论是粗死亡率还是标化死亡率,上升幅度最大,均居于首位。标化死亡率上升幅度1973～1990年大于1990～2003年,死亡率儿童青少年组和70岁以上老年组上升明显,青壮年组和中年组呈下降趋势。结论:在进行恶性肿瘤防治同时,必须加强对肺癌、白血病、乳腺癌的防治工作,尤其必须加强肺癌的防治工作。