2004-2018年中国老年居民慢性非传染性疾病死亡水平与变化趋势

目的分析2004-2018年中国≥65岁老年居民慢性非传染性疾病(慢性病)死亡水平及变化趋势,预测2019-2023年慢性病年龄标化死亡率。方法利用2004-2018年中国死因监测数据集中老年居民死亡数据,分析不同性别、城乡、地区的慢性病粗死亡率、年龄标化死亡率、构成比及变化趋势。采用2010年第六次全国人口普查的人口构成计算年龄标化死亡率;采用加权最小二乘法拟合Joinpoint回归模型,计算全时间段内平均年度变化百分比(AAPC)及95%可信区间;采用对数线性模型预测年龄标化死亡率。结果2004-2018年我国老年居民慢性病年龄标化死亡率从4697.05/10万降至3555.35/10万,平均每年下降2.0%(95%CI:-2.7%~-1.3%)。不同性别、城乡、地区间年龄标化死亡率呈下降趋势。东部地区(AAPC=-2.1%,95%CI:-2.8%~-1.3%)、中部地区(AAPC=-2.8%,95%CI:-3.4%~-2.1%)下降速度均快于西部地区(AAPC=-0.8%,95%CI:-1.8%~0.2%)。慢性病死亡构成比从89.82%上升至91.41%,平均每年上升0.1%(95%CI:0.1%~0.2%)。预计至2023年,男性年龄标化死亡率(3906.23/10万)仍高于女性(2708.43/10万);农村年龄标化死亡率(3283.20/10万)与城市(3250.01/10万)相接近;西部地区(3782.48/10万)与东部地区(3037.01/10万)、中部地区(3249.24/10万)的年龄标化死亡率的差距将进一步拉大。结论2004-2018年我国老年居民慢性病年龄标化死亡率呈下降趋势,死亡构成比呈上升趋势,建议以老年人群中男性居民和西部地区居民作为今后慢病防控关注的重点人群。     

Combined effect of Controlling Nutritional Status and Acute Kidney Injury on severe COVID-19 short-term outcomes

Introduction/ObjectivesAcute kidney injury (AKI) and malnutrition are two complications commonly reported in severe forms of COVID-19, their combined effect on short-term mortality is, however, not yet investigated. The objective of this study is to determine both their individual and combined effects on short-term prognosis.Materials and methodsThis is a prospective, uni-centric study, including 247 severe COVID-19 patients, admitted between April 25th and June 20th, 2020, at the University Hospital of Blida. AKI was defined according to the KDIGO-2012 guidelines. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score. The association with in-hospital mortality was assessed using the Kaplan-Meier method and proportional Cox regression.ResultsAmong the 247 severely affected COVID-19 patients included in this study, 34.4% developed AKI, 30.4 and 1.2%, respectively, had moderate and severe CONUT scores, 17.7% worsened and progressed to a critical state and 26.7% did not survive. Both AKI and CONUT score were significantly associated with mortality in a dose-response manner (pLog-Rank < 0.0001). Their relative risks are respectively (HR = 3.25 CI 95% [1.99–5.3] and HR = 2.42 CI 95% [1.5–3.9], p < 0.0001). In multivariate analysis, the highest risk was observed for the AKI-CONUT-high combination (HR = 3.0, 95% CI [1.5–6.1], p = 0.002).ConclusionA possible synergistic interaction between AKI and CONUT score for COVID-19 short-term mortality has been highlighted. Monitoring of renal function associated with assessment of nutritional status should be performed routinely and systematically from the early stages of admission.     

钩藤碱降低内毒素血症小鼠死亡率的机制研究

目的： 观察钩藤碱对内毒素血症小鼠死亡率及器宫损伤的影响，并探讨其作用机制。方法: 雄性小鼠随机分为对照组、脂多糖（LPS）组、钩藤碱（Rhy）防治组和Rhy对照组，分别予以生理盐水、Rhy皮下注射，1 time/d，连续3 d，第3 d皮下注射后1 h，腹腔注射生理盐水或LPS（20 mg/kg）。观察各组小鼠的死亡率，肺、小肠组织病理改变；测定注射LPS后12 h各组肺湿/干重比值 (W/D)及血清丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、尿素氮（BUN）和肌酐（Cr）的水平；用酶联免疫吸附法（ELISA）测定血清肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）及白细胞介素-10（IL-10）的含量，用硝酸还原酶法试剂盒测定血清一氧化氮（NO）的含量。进一步复制盲肠结扎穿孔的脓毒症模型， 观察钩藤碱对脓毒症小鼠生存率的影响。结果: LPS攻击后24 h小鼠的生存率明显低于对照组，8、16 mg/kg的钩藤碱防治组小鼠生存率高于LPS组。但钩藤碱并不能降低CLP小鼠的死亡率，而且，8 mg/kg钩藤碱治疗组小鼠的死亡率反而高于CLP小鼠的死亡率。LPS攻击后12 h病理检查发现LPS组小鼠肺及小肠组织均有严重的炎症表现；肺W/D、血清ALT、AST、BUN、Cr水平显著高于对照组；LPS攻击后2 h血清TNF-α、IL-1β及IL-10含量及8 h血清NO水平显著高于对照组。LPS攻击后12 h， Rhy防治组肺及小肠组织损伤无明显改善；肺W/D、血清ALT、AST、BUN、Cr水平与LPS组比较无显著差异；LPS攻击后2 h血清TNF-α水平显著低于LPS组，但2 h血清IL-1β及IL-10含量及8 h血清NO水平与LPS组比较无显著差异。结论: 钩藤碱能降低内毒素血症小鼠的死亡率，但不能降低脓毒症小鼠的死亡率，抑制TNF-α的生成可能是钩藤碱降低内毒素血症小鼠死亡率的机制之一。     

Effect of Age and Sex on Stroke Mortality of Young and Middle-aged Adults in China, 2002–2019, and Predictions to 2030

Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system. Significant changes in mortality were assessed by Joinpoint regression. Age-period-cohort analysis was used to explain the reasons for the changes. Future mortality and counts were predicted by the Bayesian age-period-cohort model.Results Between 2002 and 2019, a total of 6,253,951 stroke mortality in young ...     

加拿大华人癌肿死亡率研究(摘要)

本文比较加拿大华人与加拿大人的癌肿死亡率。结果显示加拿大华人癌肿死亡率无论男、女均高于加拿大人,男标化死亡比(SMR)为141;女SMR为116,其差异在统计学上有极显著意义。各部位癌肿死亡情况与美国华人极为相似。加拿大华人无论男、女其鼻咽癌、肝癌死亡率明显高于加拿大人。肺、胃、肠癌死亡率亦高于加拿大人。加拿大华人男性前列腺癌低于加拿大人;加拿大华人女性肺癌、子宫颈癌均高于加拿大人;但乳腺癌、卵巢癌明显低于加拿大人。加拿大华人男、女皮肤癌死亡率均明显低于加拿大人。这对进一步研究加拿大华人癌肿病因提供一可靠依据。