2006—2020年苏州市相城区胃癌发病与死亡情况分析

目的：分析苏州市相城区胃癌发病和死亡特征,为相城区开展胃癌防控工作提供有效的科学依据。方法：收集2006—2020年相城区胃癌发病和死亡的数据,计算粗发病率/粗死亡率、标化发病率/标化死亡率、年度变化百分比等指标。结果：2006—2020年,苏州市相城区胃癌新发病例为4 751例、死亡3 151例,粗发病率和粗死亡率分别为80.20/10万和53.19/10万,标化发病率和标化死亡率分别为42.19/10万和26.55/10万。2006—2020年,相城区胃癌粗发病率、粗死亡率、标化发病率和标化死亡率整体呈现下降趋势;胃癌平均发病年龄由64.26岁上升至70.22岁,总体呈上升趋势。结论：相城区胃癌发病和死亡呈下降趋势,但仍高于江苏省和全国水平,应继续采取有效措施,切实做好胃癌防控工作。     

An observational study on the incidence of tuberculosis among a cohort of HIV infected adults in a setting with low prevalence of tuberculosis

Background: Tuberculosis (TB) remains a main cause of morbidity and mortality among individuals infected with HIV. We investigated the incidence of TB among a cohort of HIV infected patients attending a setting with low TB burden where screening for latent TB infection is not routinely carried out.

Methods: an observational cohort study on HIV-infected adults attending the HIV clinic at Queen Elizabeth Hospital Birmingham, UK between 1 January 2011 and 30 September 2015. Patients with culture-proven TB after HIV diagnosis, or those treated for clinical diagnosis of the infection, were classified as having “active TB”.

Results: 1824 patients were included in the study (5347 patient years of follow up), of whom 21 patients developed TB (16 microbiology confirmed). Of the 666 new HIV diagnoses, six patients developed TB within one month, giving a TB prevalence at the time of HIV diagnosis of 0.9%. The total TB incidence for the remaining 1818 patients was 2.81 cases per 1000 patient years (95% CI: 1.63–4.53). TB incidence was significantly more common among patients with CD4 ≤ 200 cells/mm³ compared to those with CD4 > 500 cells/mm³ (28.2 vs. 1.22 per 1000 patient years, p < 0.001), and in patients with VL ≥ 40 copies/mL compared to <40 copies/mL (8.30 vs. 1.42, p < 0.001).

Conclusion: In settings with low TB prevalence, early start of combined antiretroviral therapy and intensified TB case finding protocols may significantly reduce the incidence of TB.     

1990-2012年广西乙型病毒性肝炎发病趋势分析

目的：分析广西1990—2012年乙型肝炎发病的流行趋势,发现重点人群,进一步探讨防治策略。方法根据历年乙肝报告的发病资料和人口资料,计算年发病率以及性别、年龄别发病率,并建立简单线性回归模型进行统计分析。结果1990—2012年广西共报告乙肝发病581727例,年平均发病率为56.78/10万,男性发病率（75.03/10万）高于女性（36.56/10万）;总体发病率呈上升趋势,但0～9岁年龄组呈显著下降趋势;平均发病年龄呈后移趋势,20～29岁人群发病率最高。结论男性青壮年为乙肝发病的重点人群,预防乙肝应在提高对新生儿乙肝疫苗接种率和阻断母婴传播的基础上,加强对其他人群尤其是高危人群的接种工作。     

Diabetic retinopathy: An epidemic at home and around the world

Prevention of blindness due to diabetic retinopathy (DR) requires effective screening strategies, for which eye care providers need to know the magnitude of the burden and the risk factors pertinent in their geographical location. It is estimated that around 72 million of the global adult population (around 8.2%) has diabetes and about one-fifth of all adults with diabetes lives in the South-East Asia. In India, around 65 million people have diabetes. As the global prevalence of diabetes increases, so will the number of people with diabetes-related complications, such as DR; nearly one-third of them are likely to develop this complication. This article reviews the present status of diabetes and DR in India, the current situation of DR services and the projections on the load of morbidity associated with retinopathy. The article compiles the Indian studies elucidating the risk factors for DR.     

Competing risk bias in Kaplan–Meier risk estimates can be corrected

BackgroundKaplan–Meier (KM) analyses are frequently used to measure outcome risk over time. These analyses overestimate risk whenever competing events are present. Many published KM analyses are susceptible to such competing risk bias. This study derived and validated a model that predicted true outcome risk based on the biased KM risk.MethodsWe simulated survival data sets having a broad range of 1-year true outcome and competing event risk. Unbiased true outcome risk estimates were calculated using the cumulative incidence function (CIF). Multiple linear regression was used to determine the independent association of CIF-based true outcome risk with the biased KM risk and the proportion of all outcomes that were competing events.ResultsThe final model found that both the biased KM-based risk and the proportion of all outcomes that were competing events were strongly associated with CIF-based risk. In validation populations that used a variety of distinct survival hazard functions, the model accurately predicted the CIF (R² = 1).ConclusionsTrue outcome risk can be accurately predicted from KM estimates susceptible to competing risk bias.     

Encephalitis,Ontario, Canada, 2002–2013

Encephalitis, a brain inflammation leading to severe illness and often death, is caused by >100 pathogens. To assess the incidence and trends of encephalitis in Ontario, Canada, we obtained data on 6,463 Ontario encephalitis hospitalizations from the hospital Discharge Abstract Database for April 2002–December 2013 and analyzed these data using multiple negative binomial regression. The estimated crude incidence of all-cause encephalitis in Ontario was ≈4.3 cases/100,000 persons/year. Incidence rates for infants <1 year of age and adults >65 years were 3.9 and 3.0 times that of adults 20–44 years of age, respectively. Incidence peaks during August–September in 2002 and 2012 resulted primarily from encephalitis of unknown cause and viral encephalitis. Encephalitis occurred more frequently in older age groups and less frequently in women in Ontario when compared to England, but despite differences in population, vector-borne diseases, climate, and geography, the epidemiology was overall remarkably similar in the two regions.     

Falling Plasmodium knowlesi Malaria Death Rate among Adults despite Rising Incidence,Sabah, Malaysia, 2010–2014

Deaths from Plasmodium knowlesi malaria have been linked to delayed parenteral treatment. In Malaysia, early intravenous artesunate is now recommended for all severe malaria cases. We describe P. knowlesi fatalities in Sabah, Malaysia, during 2012–2014 and report species-specific fatality rates based on 2010–2014 case notifications. Sixteen malaria-associated deaths (caused by PCR-confirmed P. knowlesi [7], P. falciparum [7], and P. vivax [1] and microscopy-diagnosed “P. malariae” [1]) were reported during 2012–2014. Six patients with severe P. knowlesi malaria received intravenous artesunate at hospital admission. For persons >15 years of age, overall fatality rates during 2010–2014 were 3.4, 4.2, and 1.0 deaths/1,000 P. knowlesi, P. falciparum, and P. vivax notifications, respectively; P. knowlesi–associated fatality rates fell from 9.2 to1.6 deaths/1,000 notifications. No P. knowlesi–associated deaths occurred among children, despite 373 notified cases. Although P. knowlesi malaria incidence is rising, the notification-fatality rate has decreased, likely due to improved use of intravenous artesunate.     

广元地区妊娠期糖尿病发病情况及影响因素分析

目的探讨广元地区妊娠期糖尿病(gestational diabetes mellitus,GDM)发病情况及影响因素,为该地区育龄妇女GDM防治提供参考依据。方法将广元地区2012~2013年住院分娩的产妇作为研究对象,抽取全市分娩数最多的前5家医院作为临床资料样本收集单位,使用调查表收集孕妇年龄、身高、体重、文化程度、收入状况、饮食习惯、既往史、家族史、分娩孕周、体重增长等情况,分别采用单因素和Logistic回归分析对调查数据进行分析。结果 10 973例孕妇中有201例GDM孕妇,GDM发病率为1.83%;单因素分析显示年龄、文化程度、家庭月总收入、体质量指数(Body Mass Index,BMI)、糖尿病家族史、饮食习惯、异常孕产史、血型、孕期增重等是GDM发病的影响因素(P0.05);居住地、既往史、孕前及孕期服用叶酸情况、孕产次与GDM发病无关(P0.05);Logistic多因素分析显示:年龄、BMI、糖尿病家族史、异常孕产史、饮食习惯、血型、孕期增重是GDM发病的独立危险因素(P0.05)。结论广元地区GDM发病率与年龄、孕前BMI、家族史、异常孕产史、饮食习惯、血型、孕期增重等有密切关系。