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Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO2, NO2, CO, PM2.5, PM10, and maximum 8 h O3 concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM2.5, NO2, SO2, and O3 were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM2.5, NO2, SO2 and O3 were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.
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Objective@#To investigation the correlation between sleep duration and hypertension among adults in Zhejiang Province, and to provide scientific evidence for the prevention and control of hypertension.@*Methods@#Permanent residents at age of 18 years and older were enrolled from 10 surveillance sites for risk factors of chronic diseases included in the 2018 China Chronic Diseases and Risk Factors Surveillance Program. Subjects' demographic characteristics, smoking, alcohol consumption, sleep duration and development of hypertension were collected, and following complex weighting calculations, the association between sleep duration and hypertension were examined using a multivariable logistic regression model.@*Results@#Totally 5 770 adults were included, including 2 952 men (50.72%) and 3 178 women (49.28%), and the prevalence of hypertension was 29.39% (2 702 cases). There were 712 (8.37%), 1 077 (18.77%), 1 582 (28.68%), 1 717 (34.60%) and 682 adults (9.57%) with sleep duration of <6 h/d, 6 to 7 h/d, 7 to 8 h/d, 8 to 9 h/d and 9 h/d and longer, respectively. Taking the sleep duration of 7 to 8 h/d as a reference, multivariable logistic regression analysis identified a significant association between sleep duration of <6 h/d and the risk of hypertension (OR=1.709, 95%CI: 1.184-2.466), a significant association between sleep duration of 9 h/d and longer and the risk of hypertension (OR=1.369, 95%CI: 1.006-1.862) in men, significant associations between sleep duration of <6 h/d (OR=2.174, 95%CI: 1.528-3.093) and 6 to 7 h/d (OR=1.412, 95%CI: 1.078-1.850) and the risk of hypertension in women, and significant associations between sleep duration of <6 h/d (OR=3.095, 95%CI: 1.025-9.347) and 6 to 7 h/d (OR=2.046, 95%CI: 1.156-3.622) and the risk of hypertension in residents at ages of 18 to 44 years.@*Conclusions@#Short sleep duration may increase the risk of hypertension among adults at ages of 18 to 44 years in Zhejiang Province. Short sleep duration may increase the risk of hypertension in women and long sleep duration may increase the risk of hypertension in men.
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OBJECTIVE To establish the fingerprints of Ligusticum sinense from different habitats ，screen differential components and determine their contents. METHODS Using Z-ligustilide as reference ，HPLC fingerprints of 12 batches of L. sinense were established by using Similarity Evaluation System of Chromatographic Fingerprints of TCM （2012 edition）；common peaks were identified and their similarities were evaluated. Cluster analysis （CA），principal component analysis （PCA）and orthogonal partial least squares-discriminant analysis （OPLS-DA）were performed to screen differential components with variable importance in the projection （VIP）＞1 as standard ；meanwhile，the contents of above differential components were determined by the same HPLC method. RESULTS There were 17 common peaks in the fingerprints of 12 batches of L. sinense ，and their similarities ranged 0.989-1.000. A total of 9 common peaks were identified ，i.e. chlorogenic acid （peak 1），ferulic acid （peak 2）， senkyunolide Ⅰ（peak 7），coniferyl ferulate （peak 9），E-ligustilide（peak 13），senkyunolide A （peak 14），Z-ligustilide（peak 17）. CA results showed that 12 batches of L. sinense were divided into 3 categories，S1-S5（Wuning）were clustered into one category，S6-S8（Ruichang）were clustered into one category ，S9-S12（De’an）were clustered into one category ；the VIP values of peaks 2，13，14 and 17（corresponding to ferulic acid ，E-ligustilide，senkyunolide A ，and Z-ligustilide respectively ）were all greater than 1，respectively. In S 1-S5，S6-S8 and S 9-S12 samples，the contents of ferulic acid were 0.488-0.533，0.603-0.658 and 0.415-0.433 mg/g，respectively；senkyunolide A were 1.184-1.295，1.450-1.588 and 1.307-1.377 mg/g，respectively；E-ligustilide were 0.118-0.125，0.130-0.135 and 0.223-0.229 mg/g，respectively；Z-ligustilide were 7.200-7.681，8.076-8.643 and 4.508-4.996 mg/g， respectively；the differences between two groups were statisti-cally significant （P＜0.05）. CONCLUSIONS Established ARS-11）；fingerprint is simple and accurate ，and can be used for overall quality evaluation of L. sinense from different habitats by combining with multivariate statistical analysis. Ferulic acid ， senkyunolide A ，Z-ligustilide and E-ligustilide may be the differential components that affect the quality of L. sinense from different habitats ，the contents of the first 3 components in L. sinense from Ruichang are the highest ，and the content of E-ligustilide in samples from De’an is the highest.
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Objective@#To analyze the trends in incidence and mortality of Alzheimer's disease (AD) in Zhejiang Province from 2003 to 2017, so as to provide the evidence for the development of AD prevention and control strategies. @* Methods@#The data pertaining to the incidence and mortality of AD in China from 2003 to 2017 were collected from the Global Burden Disease Study, and standardized to the data of the Sixth National Population Census in China in 2010. The trends in incidence and mortality of AD were analyzed using annual percent change (APC) and average annual percent change ( AAPC ) in Zhejiang Province from 2003 to 2017. @*Results@#The incidence of AD increased from 96.05/105 in 2003 to 140.96/105 in 2017 in Zhejiang Province, with AAPC of 2.776% ( P<0.05 ), and the greatest APC ( 3.419% ) was found during the period between 2003 and 2005 ( P<0.05 ). The standardized incidence of AD increased 102.06/105 in 2003 to 106.09/105 in 2017 in Zhejiang Province, with AAPC of 0.274% ( P<0.05 ), and the greatest APC ( 1.177% ) was measured during the period between 2003 and 2005 ( P<0.05). The mortality of AD increased from 24.60/105 in 2003 to 41.44/105 in 2017 in Zhejiang Province, with AAPC of 3.862% ( P<0.05 ), and the greatest APC (4.667%) was found during the period between 2005 and 2011 ( P<0.05 ). The standardized mortality of AD increased 26.83/105 in 2003 to 27.16/105 in 2017 in Zhejiang Province, with AAPC of 0.142% ( P>0.05 ), and the greatest APC ( 1.048% ) was measured during the period between 2005 and 2012 ( P<0.05 ).@*Conclusion@#Both the incidence and mortality of AD appeared a tendency towards a rise in Zhejiang Province from 2003 to 2017.
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Objective@#To investigate the degree and influencing factors of glycosylated hemoglobin ( HbA1c ) control among patients with type 2 diabetes ( T2DM ) living in rural communities of Zhejiang Province, so as to provide the reference for optimizing the management of diabetes patients in rural communities.@*Methods@#Permanent adult patients with T2DM that were registered and received standardized management in all communities of Jiashan County and Suichang County, and 6 communities of Yongkang City, Zhejiang Province in 2016 were recruited, and their demographic characteristics were captured from the health record system and chronic disease management system. The height, body weight, waist circumstance and blood pressure were measured, and HbA1c and blood lipid parameters were detected. The degree of HbA1c control ( <7% ) was analyzed, and its influencing factors were identified using a multivariable logistic regression model.@*Results@#A total of 10 339 patients with T2DM were enrolled, including 4 520 men ( 43.72% ) and 5 819 women ( 56.28% ), with a mean age of ( 63.54±9.78 ) years and the mean course of diabetes of ( 6.36±4.73 ) years. The rate of HbA1c control was 47.89%. Multivariable logistic regression analysis showed that males ( OR=1.123, 95%CI: 1.024-1.233 ), region ( Suichang, OR=2.413, 95%CI: 2.106-2.765; Yongkang, OR=2.460, 95%CI: 2.188-2.767 ), course of disease ( 5-9 years, OR=1.724, 95%CI: 1.504-1.977; 10 years and longer, OR=2.881, 95%CI: 2.477-3.351 ), use of hypoglycemic drugs ( OR=1.203, 95%CI: 1.089-1.329 ), development of chronic complications ( OR=1.190, 95%CI: 1.027-1.379 ), uncontrolled blood pressure ( OR=1.140, 95%CI: 1.030-1.261 ), uncontrolled blood lipid ( OR=1.258, 95%CI: 1.104-1.433 ), and smoking ( OR=1.318, 95%CI: 1.165-1.491 ) were statistically associated with HbA1c control among T2DM patients.@*Conclusion@#The rate of HbA1c control was 47.89% among T2DM patients in rural communities of Zhejiang Province. HbA1c control should be given a high priority among men living in low-economic-level regions with long course of disease, use of hypoglycemic drugs, chronic complications, smoking, uncontrolled blood pressure and lipid.
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Objective@#To estimate the burden of disease (BOD) attributable to main risk factors of chronic diseases in Zhejiang Province in 2017, so as to provide the evidence for formulating the control strategy for chronic diseases and reducing BOD.@*Methods@#The results of the Global Burden of Disease Study 2017 ( GBD 2017 ) were extracted to evaluate years of life lost due to premature mortality ( YLL ), years lived with disability ( YLD ) and disability-adjusted life years ( DALY ). The gender- and age-specific BOD attributable to main risk factors of chronic diseases, including the environment, metabolism and behaviors, in Zhejiang Province in 2017 was estimated and compared with those in 1990.@*Results@#High DALY rates of chronic diseases were estimated attributable to tobacco use ( 2 807.08/105 ), unreasonable diet ( 2 724.72/105 ) and hypertension ( 1 878.69/105 ) in Zhejiang Province in 2017, and high DALY rates of chronic diseases were estimated in men attributable to tobacco use ( 4 764.77/105 ), unreasonable diet ( 3 297.00/105 ) and hypertension ( 2 076.92/105 ), while high DALY rates of chronic diseases were estimated in women attributable to unreasonable diet ( 2 117.16/105 ), hypertension ( 1 668.24/105 ) and hyperglycemia ( 1 100.53/105 ), respectively. Among individuals at ages of 15 to 49 years, high DALY rates of chronic diseases were estimated attributable to unreasonable diet ( 759.29/105 ), drug abuse ( 611.71/105 ) and tobacco use ( 605.37/105 ); among individuals at ages of 50 to 69 years, high DALY rates of chronic diseases were estimated attributable to tobacco use ( 5 528.37/105 ), unreasonable diet ( 4 628.18/105 ) and hypertension ( 2 757.78/105 ); and among individuals at ages of 70 years and older, high DALY rates of chronic diseases were estimated attributable to unreasonable diet ( 16 370.09/105 ), tobacco use ( 15 551.40/105 ) and hypertension ( 14 408.63/105 ). As compared to those in 1990, the DALY rates of chronic diseases attributable to high body mass index, alcohol use, hyperglycemia, high low-density lipoprotein cholesterol and drug abuse increased by 108.23%, 48.59%, 23.17%, 17.64% and 6.06%, and the DALY rates of chronic diseases attributable to air pollution, occupational risks, unreasonable diet and impaired renal function reduced by 51.11%, 44.81%, 22.49% and 19.83%, and no significant alterations were detected in DALY rates of chronic diseases attributable to tobacco use or hypertension in 2017.@*Conclusions@#There was a high BOD of chronic diseases attributable to tobacco use, unreasonable diet and hypertension in Zhejiang Province in 2017, and the BOD of chronic diseases attributable to high body mass index, alcohol use and hyperglycemia appeared a tendency towards a rise in Zhejiang Province in 2017 relative to in 1990.
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Objective:To investigate the clinical pathway operation of medical institutions in Nanjing from 2016 to 2018.Methods:Thirty-three medical institutions(15 tertiary hospitals and 18 secondary hospitals)in Nanjing were investigated for their clinical pathway operation. The relevant data such as the number of specialties, types of diseases, number of cases to be admitted, number of cases admitted, number of cases completed and number of cases of variation were counted.Results:From 2016 to 2018, the entry rate and completion rate of clinical pathway in Nanjing were relatively stable, maintaining at about 80% and 90%. The variation rate increased year by year from 7.06% to 16.50%, and the clinical pathway management ratio increased from 25.18% to 39.90%.Conclusions:The number of clinical pathway specialties and diseases in Nanjing medical institutions still need to be improved. The coverage of clinical pathway should be expanded from system design, path refinement, technology integration and other aspects, and improve the management ratio and operation efficiency of the pathway.
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@#Stroke has high incidence,long course,high mutilation rate and high mortality rate,which brings heavy economic burden to patients and the society. This article introduces the research methods and achievements of economic burden of stroke; identifies the latest trend and the gap of applying these methods in this research area in China,in order to provide methodological reference for related research in the future.
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Long-term follow-up for end point is an extremely important and arduous task in large population-based cohort studies, which is also the key to the success of large cohort studies. Thus, the fundamental question of the achievements above is how to construct a large population- based cohort in a standardized way. The Chinese Preventive Medicine Association coordinated experienced researchers from Zhejiang Provincial Center for Disease Control and Prevention and other professional institutes to write up the group standard entitled Technical specification of long-term follow-up for end point in large population-based cohort study (T/CPMA 002-2019). The standard is drafted with principles of emphasizing the scientific, normative, applicability, and feasible nature. This group standard recommended the follow-up target population, time, content, methods, quality control, and indicators assessment. The standard aims to guide the large population-based cohorts that have been or intended to be established in China, including national cohorts, regional population cohorts, and special population cohorts, hence, to improve domestic scientific research level and the international influence, and to support decision-making and practice of disease prevention and control.
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Large population-based cohort study is an important resource for population disease prevention and control, the results of which provide scientific basis for individualized treatment and precise prevention, and it is also the key strategic content of precision medicine. The Chinese Preventive Medicine Association coordinated experienced researchers from the Chinese Academy of Medical Sciences and other professional institutes to write up the group standard entitled Technical specification of management for field investigation in large population-based cohort study (T/CPMA 001-2019). Based on the research of large population-based cohort study in China and the principle of scientific, normative, applicable, and feasible, the standard proposed six aspects of management requirements including institutional arrangement, personnel composition, equipment, materials, documents and finance, as well as the basic requirements of the on-site investigation, the requirements of each position and the overall quality control requirements, etc.. The standard aims to guide the large population-based cohorts that have been or intended to be established in China, including national cohorts, regional population cohorts, and special population cohorts, hence to improve scientific research level, accelerate scientific research output and provide localization basis for disease prevention and control in China.
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Objective To explore the influencing factors related to thyroid carcinoma.Methods Matched by sex,age and original residential areas,659 pairs of cases and controls were recruited and studied.Methods including both single factor analysis and multivariate conditional logistic regression analysis were carried out to identify the influencing factors.Results Multivariate conditional logistic regression analysis showed that higher education,being diabetic,alcohol intake,tea drinking,occupational physical activity and the frequency of eating fishes/eggs etc.,were potentially protective to thyroid carcinoma.Depression,personal history of CT examination and less salt intake seemed to be risk factors on thyroid carcinoma.For males,factors as alcohol intake,tea drinking,occupational physical activity and frequent egg-eating appeared protective.For females,higher education,diabetes,tea drinking,occupational physical activity,frequent consumption of fishes/eggs,short duration of menstruation appeared as possibly protective.Conclusion Higher education,diabetes,alcohol intake,tea drinking,occupational physical activity,frequent consumption of fishes/eggs,depression,personal history of CT examination and less salt intake served as potential influencing factors to thyroid carcinoma.
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Objective To estimate the health-adjusted life expectancy (HALE) of adults in Zhejiang province and evaluate the health status of the adults.Methods This study was based on the mortality data collected from Zhejiang Chronic Disease Surveillance Information and Management System,and mortality rates from the underreporting survey and self-reported health data in 2016.Hierarchical Ordered Probit (HOPIT) model was used to estimate the severity-weighted prevalence of disability.Sullivan's method was used to calculate the HALE.Results After adjustment by HOPIT model,the severity-weighted prevalence of disability increased significantly with age (x2=5 795.81,P＜0.001),and it was higher in females than in males (x2=5 353.27,P＜0.001).The life expectancy and self-evaluated HALE were 59.08 years and 48.68 years,respectively,in those aged ≥20 years,the difference was 10.40 years due to disability.The proportion of HALE loss due to disability in the total life expectancy was 17.61％,and it increased with age.HALE was higher in males than in females (49.21 years vs.48.14 years),and in urban residents than in rural residents (49.92 years vs.47.43 years).Conclusion The proportion of loss of HALE in the total life expectancy in adults was high in Zhejiang,and it higher in males than in females,in urban residents than rural residents.Programs on improving health care in women and rural residents should be promoted.
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Objective To explore the influencing factors related to thyroid carcinoma.Methods Matched by sex,age and original residential areas,659 pairs of cases and controls were recruited and studied.Methods including both single factor analysis and multivariate conditional logistic regression analysis were carried out to identify the influencing factors.Results Multivariate conditional logistic regression analysis showed that higher education,being diabetic,alcohol intake,tea drinking,occupational physical activity and the frequency of eating fishes/eggs etc.,were potentially protective to thyroid carcinoma.Depression,personal history of CT examination and less salt intake seemed to be risk factors on thyroid carcinoma.For males,factors as alcohol intake,tea drinking,occupational physical activity and frequent egg-eating appeared protective.For females,higher education,diabetes,tea drinking,occupational physical activity,frequent consumption of fishes/eggs,short duration of menstruation appeared as possibly protective.Conclusion Higher education,diabetes,alcohol intake,tea drinking,occupational physical activity,frequent consumption of fishes/eggs,depression,personal history of CT examination and less salt intake served as potential influencing factors to thyroid carcinoma.
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Objective To estimate the health-adjusted life expectancy (HALE) of adults in Zhejiang province and evaluate the health status of the adults.Methods This study was based on the mortality data collected from Zhejiang Chronic Disease Surveillance Information and Management System,and mortality rates from the underreporting survey and self-reported health data in 2016.Hierarchical Ordered Probit (HOPIT) model was used to estimate the severity-weighted prevalence of disability.Sullivan's method was used to calculate the HALE.Results After adjustment by HOPIT model,the severity-weighted prevalence of disability increased significantly with age (x2=5 795.81,P＜0.001),and it was higher in females than in males (x2=5 353.27,P＜0.001).The life expectancy and self-evaluated HALE were 59.08 years and 48.68 years,respectively,in those aged ≥20 years,the difference was 10.40 years due to disability.The proportion of HALE loss due to disability in the total life expectancy was 17.61％,and it increased with age.HALE was higher in males than in females (49.21 years vs.48.14 years),and in urban residents than in rural residents (49.92 years vs.47.43 years).Conclusion The proportion of loss of HALE in the total life expectancy in adults was high in Zhejiang,and it higher in males than in females,in urban residents than rural residents.Programs on improving health care in women and rural residents should be promoted.
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Objective To investigate the expression of guanylate binding protein 5 (GBP5) and ArfGAP with SH3 domain ankyrin repeat and PH domain 1 (ASAP1) genes in pulmonary tuberculosis patients and tuberculosis latent population. Methods Forty pulmonary tuberculosis patients (pulmonary tuberculosis group), 40 latent tuberculosis infection patients (latent tuberculosis infection group) and 40 cases of healthy control (healthy control group) were selected from August 2016 to May 2017. The gene expression was detected in 4 ml peripheral anticoagulant blood by real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-PCR) and the relative expression of two genes in three groups were compared. Results The GBP5 gene expression in three groups was significantly differentce (F=7.23, P=0.001). The GBP5 gene relative expression in pulmonary tuberculosis group was significantly higher than that in latent infection group :1.58 ± 0.80 vs. 1.09 ± 0.68, there was significant difference (t=2.93, P=0.004). The GBP5 gene relative expression in pulmonary tuberculosis group was significantly higher than that in healthy control group: 1.58 ± 0.80 vs. 1.04 ± 0.61, there was significant difference (t=3.40, P=0.010). The GBP5 gene relative expression in latent infection group and healthy control group had no significant difference (t=0.39, P=0.700). There was no significant difference in ASAP1 expression among three groups (F=0.26, P=0.770). Conclusions The expression of GBP5 in pulmonary tuberculosis patients, latent tuberculosis infection patients and healthy controls is different, and GBP5 could screen latent tuberculosis infection patients which is expected to be a potential screening marker for latent tuberculosis infection.
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Thyroid cancer is one of the most common endocrine malignant tumors, and its molecular pathogenesis is also a process of multiple genes involved in many steps of carcinogenesis. With the development of molecular biology technology, a variety of related gene mutations and epigenetic phenomena have been found in thyroid cancer tissues. It is helpful to understand the latest progress in the research of the gene mutation and epigenetics of thyroid cancer for its early diagnosis, prevention and the development of targeted drugs.
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Objective To evaluate the impact of diabetes prevalence and mortality on health life expectancy (HLE).Methods A cause-excluded health adjusted life expectancy method was used to quantitatively analyze the impact of diabetes on HLE and the composition of health life losses (HLL),using the integrated data on population mortality,self-assessed health status and diabetes prevalence.Results The HLE for people aged 15 was 55.80 in Zhejiang,in 2013.After removing the diabetes morbidity and mortality,the HLE for men aged 15 increased by 0.86 and 1.13,respectively,with an increase of 1.04 and 0.66 for urban and rural residents.Substantial increase of HLE was observed in women and urban residents than those for men and rural residents.HLL caused by diabetes mortality and morbidity appeared as 0.10 and 0.79,with a ratio of 7.92.Conclusion HLL caused by diabetes mortality was much greater than those caused by diabetes mortality,suggesting the most effective measure in reducing the diabetes-related HLL is to promote the healthy lifestyle in urban areas and especially for women.
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Thyroid cancer is one of the most common endocrine malignant tumors, and its molecular pathogenesis is also a process of multiple genes involved in many steps of carcinogenesis. With the development of molecular biology technology, a variety of related gene mutations and epigenetic phenomena have been found in thyroid cancer tissues. It is helpful to understand the latest progress in the research of the gene mutation and epigenetics of thyroid cancer for its early diagnosis, prevention and the development of targeted drugs.
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Objective To evaluate the impact of diabetes prevalence and mortality on health life expectancy (HLE).Methods A cause-excluded health adjusted life expectancy method was used to quantitatively analyze the impact of diabetes on HLE and the composition of health life losses (HLL),using the integrated data on population mortality,self-assessed health status and diabetes prevalence.Results The HLE for people aged 15 was 55.80 in Zhejiang,in 2013.After removing the diabetes morbidity and mortality,the HLE for men aged 15 increased by 0.86 and 1.13,respectively,with an increase of 1.04 and 0.66 for urban and rural residents.Substantial increase of HLE was observed in women and urban residents than those for men and rural residents.HLL caused by diabetes mortality and morbidity appeared as 0.10 and 0.79,with a ratio of 7.92.Conclusion HLL caused by diabetes mortality was much greater than those caused by diabetes mortality,suggesting the most effective measure in reducing the diabetes-related HLL is to promote the healthy lifestyle in urban areas and especially for women.
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<p><b>OBJECTIVE</b>To estimate the disease burden of type 2 diabetes in population in Zhejiang in 2013.</p><p><b>METHODS</b>According to the method in global burden of disease study (GBD) 2010, the related disability adjusted life years (DALYs), years of life lost (YLL) and years lived with disability (YLD) were calculated by using the incidence, prevalence and mortality data of type 2 diabetes in population in Zhejiang and DISMODⅡ.</p><p><b>RESULTS</b>The overall DALYs of type 2 diabetes was 5.36 per 1000 population, which was higher in women (5.49 per 1000) than in men (5.24 per 1000), The population in urban area had higher DALYs (5.47 per 1000) than those in rural area (5.42 per 1000). The DALYs in old population was high, which peaked in age group 80-84 years (32.63 per 1000) with YLL/YLD of 0.62. The disease burden of type 2 diabetes was mainly caused by disability.</p><p><b>CONCLUSION</b>The YLL of type 2 diabetes in Zhejiang was higher than the national average level.</p>