Early effect of extracorporeal membrane oxygenation and factors related to early outcome in adult patients with fulminant myocarditis / 中华心血管病杂志

Objective: To evaluate the efficacy within the first 24 h post extracorporeal membrane pulmonary oxygenation (ECMO) and the impact of early efficacy on the prognosis of adult patients with fulminant myocarditis (FM). Methods: This retrospective case analysis study included hospitalized patients (age≥18 years) who were diagnosed with fulminant myocarditis from November 2016 to May 2021 in the First Affiliated Hospital of Zhengzhou University. Patients were divided into survival or non-survival groups according to treatment outcomes. The age, sex, treatments, drug use, ECMO use, clinical and laboratory data (before and 24 h after the use of ECMO) were analyzed. The change rate of clinical and laboratory data after 24 h use of ECMO was calculated to find differences between two groups. Multivariate logistic regression was used to analyze the related factors with in-hospital death and complication between the two groups. Results: A total of 38 FM patients treated with ECMO were included. There were 23 cases (60.5%) in the survival group, aged (39.6±13.7) years, and 17 (73.9%) cases were female. The total ECMO time was (134.4±71.3)h. There were 15 cases (39.5%) in non-survival group, aged (40.0±15.8) years, and there were 12(80.0%) female, the ECMO time was (120.1±72.4) h in this group. The proportion of tracheal intubation and continuous renal replacement therapy in the survivor group and dosage of norepinephrine within 24 h after ECMO implantation were significantly less than in non-survival group (all P<0.05). There was no significant difference in all efficacy related biochemical indexes between two groups before ECMO use. The levels of lactic acid, procalcitonin, creatinine, alanine aminotransferase, aspartate aminotransferase, creatine kinase-MB, cardiac troponin I and N-terminal B-type natriuretic peptide prosoma were significantly less in survival group than in non-survival group at 24 h after the use of ECMO (all P<0.05). Results of multivariate logistic regression analysis showed that the higher 24 h change rate of creatinine (OR=0.587, 95%CI 0.349-0.986, P=0.044) and creatine kinase-MB (OR=0.177, 95%CI 0.037-0.841, P=0.029) were positively correlated with reduced risk of in-hospital mortality. The central hemorrhage and acute kidney injury in survival group were less than in non-survivor group (P<0.05). Conclusions: After 24 h early use of ECMO in FM patients, the improvement of various efficacy related biochemical test indexes in the survival group was better than that in the non-survival group. Faster reduction of creatine kinase-MB and creatinine values within 24 h ECMO use is positively correlated with reduced risk of in-hospital mortality in adult patients with FM.

Analysis on long-term trends of cervical cancer mortality and years of life lost in Tianjin, 1999-2015 / 中华流行病学杂志

Objective To analyze the mortality and years of life lost (YLL) trends of cervical cancer in Tianjin,and provide references for the research and prevention programs of cervical cancer.Methods Mortality rate,standard mortality rate,cumulative rate (0-74 years-old) and truncated rate (35-64 years-old) of cervical cancer from 1999 to 2015 were calculated.The annual percentage change of the mortality rate and YLL rate were analyzed by using Joinpoint regression analysis,and the trend in different age-groups were analyzed.Results From 1999 to 2015,1 741 cases died of cervical cancer in Tianjin,the average crude mortality rate was 2.15/100 000.The average age-standardized rate of (ASR) China and ASR world were 1.47/100 000 and 1.50/100 000 respectively.The average YLL was 3 347.97 person-years.Deaths occurred in those aged 0-34 years,35-64 years and 65 years and over accounted for 3.10％,57.84％ and 39.06％ of the total,respectively.The mortality rate of cervical cancer in urban area was higher than that in rural area,with a ratio of 1.37 ∶ 1 between urban area and rural area.The age-specific mortality rate of cervical cancer during 1999-2015 increased with age.Two peaks of mortality rate were observed in those aged 50 years and aged 75 years,during 2014-2015.From 1999 to 2011,the mortality rate of cervical cancer was stable (APC =-0.2％,P=0.80),but there was a rapid increase from 2011 to 2015 (APC=21.6％,P＜0.01).But group aged 20-49 years,it showed an upward trend from 1999 to 2015 (APC=6.9％,P＜0.01).For group aged 50-69 years,it showed a downward trend from 1999 to 2007 (APC=-9.2％,P＜0.01),and an upward trend from 2007 to 2015 (APC=14.5％,P＜0.01).For group aged 70 years and over,it showed a downward trend from 1999 to 2009 (APC=-10.2％,P＜0.01),but the difference in the mortality were not significant from 2009 to 2015 (APC=7.8％,P=0.10).Since 2008,the YLL rate of cervical cancer in group aged 50-70 years had exceeded that in group aged ＞70 years and the gap gradually widened.Conclusions There had been a rapid increase trend of cervical cancer mortality since 2011 in Tianjin.Women aged 50-70 years were the main group of life loss.

Analysis on long-term trends of cervical cancer mortality and years of life lost in Tianjin, 1999-2015 / 中华流行病学杂志

Objective To analyze the mortality and years of life lost (YLL) trends of cervical cancer in Tianjin,and provide references for the research and prevention programs of cervical cancer.Methods Mortality rate,standard mortality rate,cumulative rate (0-74 years-old) and truncated rate (35-64 years-old) of cervical cancer from 1999 to 2015 were calculated.The annual percentage change of the mortality rate and YLL rate were analyzed by using Joinpoint regression analysis,and the trend in different age-groups were analyzed.Results From 1999 to 2015,1 741 cases died of cervical cancer in Tianjin,the average crude mortality rate was 2.15/100 000.The average age-standardized rate of (ASR) China and ASR world were 1.47/100 000 and 1.50/100 000 respectively.The average YLL was 3 347.97 person-years.Deaths occurred in those aged 0-34 years,35-64 years and 65 years and over accounted for 3.10％,57.84％ and 39.06％ of the total,respectively.The mortality rate of cervical cancer in urban area was higher than that in rural area,with a ratio of 1.37 ∶ 1 between urban area and rural area.The age-specific mortality rate of cervical cancer during 1999-2015 increased with age.Two peaks of mortality rate were observed in those aged 50 years and aged 75 years,during 2014-2015.From 1999 to 2011,the mortality rate of cervical cancer was stable (APC =-0.2％,P=0.80),but there was a rapid increase from 2011 to 2015 (APC=21.6％,P＜0.01).But group aged 20-49 years,it showed an upward trend from 1999 to 2015 (APC=6.9％,P＜0.01).For group aged 50-69 years,it showed a downward trend from 1999 to 2007 (APC=-9.2％,P＜0.01),and an upward trend from 2007 to 2015 (APC=14.5％,P＜0.01).For group aged 70 years and over,it showed a downward trend from 1999 to 2009 (APC=-10.2％,P＜0.01),but the difference in the mortality were not significant from 2009 to 2015 (APC=7.8％,P=0.10).Since 2008,the YLL rate of cervical cancer in group aged 50-70 years had exceeded that in group aged ＞70 years and the gap gradually widened.Conclusions There had been a rapid increase trend of cervical cancer mortality since 2011 in Tianjin.Women aged 50-70 years were the main group of life loss.

Analysis on the alterative trend of colorectal cancer mortality from 1999 to 2015 in Tianjin of China / 中华胃肠外科杂志

Objective@#To investigate the mortality of colorectal cancer and its trend from 1999 to 2015 in Tianjin, China, and to explore the mortality features in different populations in order to provide data for prevention and control strategies of colorectal cancer.@*Methods@#Colorectal cancer mortality data between 1999 and 2015 were collected from Tianjin population - based mortality surveillance system maintained by the Tianjin Centers for Disease Control and Prevention (CDC). Population data of permanent residents were collected from Tianjin Municipal Public Security Bureau. The number of new cases and deaths, incidence [including crude incidence, age-adjusted standardized incidence and 95% confidence interval (95% CI)], and mortality (including crude mortality, age-adjusted standardized mortality and 95% CI) of colorectal cancer were calculated. Standardized incidence and mortality of colorectal cancer were calculated using the Segi′s world standard population, adjusted with age and gender. JoinPoint regression and Cochran-Armitage trend test were used to determine the statistical significance of differences in mortality trend.@*Results@#A total of 31 376 new onset cases and 14 893 death cases of colorectal cancer were observed in Tianjin from 1999 to 2015. Colorectal cancer incidence increased from 1999 to 2015 with a standardized rate from 9.66/100 000 to 15.36/100 000 [annual percent change(APC)=3.48%, Z=23.21, P<0.001]. Colorectal cancer mortality increased from 1999 to 2015 with a standardized rate from 5.18/100 000 to 6.11/100 000 (APC=1.24%, Z=5.69, P<0.001). Both showed an increasing trend. The death proportion of colon cancer increased (39.67% in 1999 and 50.33% in 2015), while the death proportion of rectal caner decreased (60.33% in 1999 and 48.57% in 2015). The median age of colorectal cancer onset fluctuated steadily around 66 years old (APC=0.16, T=1.75, P=0.100); the median age of death increased from 69 to 73 years old (APC=0.43, T=8.81, P<0.001). From 1999 to 2015, the mortality of colorectal cancer showed a downward trend (all P<0.05) in the age groups of <35 and 35-44 years, while an upward trend (all P<0.05) in the age groups of 45-54 years, 55-64 years and ≥ 65 years. Colorectal cancer mortality in males increased with a standardized rate of 5.53/100 000 in 1999 to 7.33/100 000 in 2015(APC=2.29%, Z=7.86, P<0.001), while colorectal cancer mortality in females flatted with a standardized rate of 4.83/100 000 in 1999 to 4.89/100 000 in 2015 (APC=0.10%, Z=-0.30, P=0.752). Colorectal cancer mortality increased with a standardized rate of 6.75/100 000 in 1999 to 7.33/100 000 in 2015 (APC=0.54%, Z=1.98, P=0.048) in urban areas and of 3.18/100 000 in 1999 to 4.38/100 000 in 2015 (APC=2.47, Z=6.46, P<0.001) in rural areas, whose differences were significant. Standardized mortality rate in rural area was lower but the rising velocity was faster as compared to urban area.@*Conclusions@#Crude mortality and standardized mortality of colorectal cancer increase from 1999 to 2015 in Tianjin population. The people of elder, male and urban area have higher mortality. The mortality in people of male and rural area presents a faster rising state. Further efforts to reduce colorectal cancer mortality in Tianjin are needed to prevention and control of colorectal cancer.

Analysis on trend of leukemia mortality from 1999 to 2015 in Tianjin, China / 中华预防医学杂志

From 1999 to 2015, there were 6 186 cases of leukemia deaths in tianjin residents, the males accounted for 58.28% (3 605) and 52.31% (3 236) deaths lived in urban areas; the crude mortality rate of Leukemia increased from 3.47/100 000 to 4.28/100 000 [t=7.09, P<0.001, annual percent change (APC)=1.30%] and the standardized mortality rate decreased from 3.15/100 000 to 3.01/100 000 (t=-2.95, P=0.006, APC=-0.65%). Special attention should be focused on children, the elderly, males and rural residents.