Impact of low whole grain intake on the burden and trend of colorectal cancer among Chinese residents aged 70 and above from 1990 to 2019：Based on GBD data / 公共卫生与预防医学

Objective To analyze the impact of low whole grain intake on the burden and trend of colorectal cancer in China, and to explore health management strategies for high-risk populations. Methods Using the 2019 Global Burden of Disease Study (GBD 2019) data, the Joinpoint regression model was used to analyze the mortality rate and disability adjusted life years (DALYs) of colorectal cancer in China caused by low whole grain intake from 1990 to 2019. Results The number of colorectal cancer deaths, mortality and DALYs of residents over 70 years old caused by low whole grain intake in China increased from 4 615, 12.06/105 and 187.66/100 000 in 1990 to 21 094 , 19.54/100 000 and 291.02/100 000 in 2019. The trend analysis found that the total crude mortality rate of colorectal cancer in Chinese residents over 70 years old caused by low whole grain intake increased by 2.03% year by year, with men increasing by 2.61% year by year, and women increasing by 1.24% year by year (all P<0.001). From 1990 to 2019, the disease burden of colorectal cancer in China was higher than that of countries with middle, low-middle, and low SDI, but lower than the global average, and high and middle-high SDI countries or regions. The growth rate in China was higher than the above regions (China 1.86% vs. global -0.25%, high SDI -0.88%, middle-high SDI -0.09%, middle SDI 1.53%, low-middle SDI 1.12%, and low SDI 0.63%). Conclusion Based on the current situation and trend of colorectal cancer disease burden of residents over 70 years of age in the world and China, precise health management of unhealthy lifestyles of high-risk populations will help to achieve the goals of healthy aging and healthy China 2030.

Related factors of three-vessel disease in patients with stable coronary artery disease / 中华全科医师杂志

Objective:To analyze the risk factors of three-vessel disease (TVD) in patients with stable coronary artery disease (SCAD).Methods:The clinical data of 447 patients with SCAD diagnosed in Zhongshan Hospital from May 2019 to April 2020 were retrospectively analyzed, including 108 cases with the single-vessel disease (SVD), 136 cases with the two-vessel disease, and 203 cases with three-vessel disease. The general data and hematological indexes were compared between patients with SVD and those with TVD; the related factors for TVD in SCAD patients were analyzed with univariate and multivariate logistic regression.Results:There were 244 males (78.5%) and 67 females (21.5%) with a median age of 57 years (64, 69). Univariate analysis showed that there were significant differences in diabetes history ( χ2=7.75, P=0.005), uric acid ( Z=-2.10, P=0.036), glycosylated hemoglobin ( Z=-2.77, P=0.006) and high density lipoprotein cholesterol (HDL-C) ( Z=-2.99, P=0.003) levels between SVD and TVD groups. Multivariate analysis showed that the high level of blood uric acid ( OR=1.01, 95% CI: 1.00-1.01, P<0.05) and the low level of HDL-C ( OR=3.29, 95% CI:1.23-8.85, P<0.05) were related risk factors of TVD. Conclusion:High blood uric acid level and low HDL-C level are related factors for TVD in patients with SCAD.

Clinical analysis of 105 cases of Kawasaki disease complicated by hypoproteinemia / 中国基层医药

Objective:To analyze the clinical characteristics of children with Kawasaki disease complicated by hypoproteinemia.Methods:The clinical data of 105 children patients with Kawasaki disease who received treatment in Ji'an Central People's Hospital, China between January 2015 and December 2019 were retrospectively analyzed. These patients were divided into normal-level albumin (ALB) group (≥ 35 g/L, n = 54) and low-level ALB group (< 35 g/L, n = 51). White blood cell count, hemoglobin, C-reactive protein, erythrocyte sedimentation rate, alanine aminotransferase, aspartate aminotransferase, total bile acid, and coronary artery B-ultrasound examination results were compared between the two groups. Results:The incidence of hypoproteinemia was similar among all age groups. There was significant difference in coronary artery dilatation rate between the two groups (χ 2 = 5.49, P < 0.05). There were no significant differences in the percentage of patients with hand and foot scleredema and urinary protein-positive rate between the two groups (χ 2 = 0.40, 0.39, both P > 0.05). White blood cell count, erythrocyte sedimentation rate, C-reactive protein level in the low-level ALB group were 15.2 × 10 9/L, (82.1 ± 26.1) mm/h, 94.7 mg/L, respectively, which were significantly higher than those in the normal-level ALB group [11.5 × 10 9/L, (54.5 ± 26.2) mm/h, 43.65 mg/L, Z = -2.94, t = 5.40, Z = -6.01, all P < 0.01]. There were no significant differences in alanine aminotransferase, aspartate aminotransferase, and total bile acid levels between the two groups (all P > 0.05). Conclusion:The incidence of Kawasaki disease complicated by hypoproteinemia is unrelated to age and it is related to inflammatory reaction. Hypoproteinemia is a risk factor of coronary artery dilatation. This study is of great science.

Analysis of the mortality and years of life lost of common gynecological malignant tumors among female residents in Pudong New Area of Shanghai in 2002-2019 / 公共卫生与预防医学

Objective To explore the epidemiological characteristics and the potential years of life lost of gynecological malignant tumors among female residents in Pudong New Area of Shanghai between 2002 and 2019. Methods Crude mortality rate (CMR), age-standardized mortality rate (SMR), potential years of life lost (PYLL), average years of life lost (AYLL) and annual percent change (APC) of the cervical cancer，uterine cancer and ovarian cancer deaths were calculated to analyze the mortality situation of gynecological malignant tumors among female residents in Pudong New Area. Results The crude mortality rate were 2.65/100 000, 2.44/100 000 , 4.55/100 000, and age-standardized mortality rate were 1.33/100 000, 1.06/100 000, 2.26/100 000, respectively, among female residents in Pudong New Area during 2002 to 2019. In the study period, both the crude mortality rate and the age-standardized mortality rate of cervical cancer rose over the years; Both the crude mortality rate and the age-standardized mortality rate of uterine cancer kept stable; The crude mortality rate of ovarian cancer showed an upward trend, and the age-standardized mortality rate kept stable. The PYLL of cervical cancer was 7335 years, the PYLL rate was 0.30‰, and the AYLL was 11.20 years per person; The PYLL of uterine cancer was 3556 years, the PYLL rate was 0.14‰, and the AYLL was 5.90 years per person; The PYLL of uterine cancer was 10017 years, the PYLL rate was 0.41‰, and the AYLL was 8.91 years per person. Conclusion The mortality rate of cervical cancer and ovarian cancer rose over years, and the mortality of uterine cancer kept stable among female residents in Pudong New Area during 2002 to 2019. The gynecological malignant tumors caused severe disease burden.

Analysis of the mortality and years of life lost from chronic obstructive pulmonary disease among residents in Pudong New Area of Shanghai in 2002-2019 / 公共卫生与预防医学

Objective To explore the death characteristics and the potential years of life lost from chronic obstructive pulmonary disease (COPD) among residents in Pudong New Area of Shanghai from 2002 to 2019, so as to provide a reference for formulating corresponding prevention and control strategies for chronic obstructive pulmonary disease. Methods The death data of chronic obstructive pulmonary disease was extracted from the Pudong New Area's death surveillance system. Crude mortality, age-standardized mortality, potential years of life lost (PYLL), average years of life lost (AYLL) and annual percent change (APC) of chronic obstructive pulmonary disease deaths were calculated to analyze the situation of COPD death in Pudong New Area. Results The crude mortality and age-standardized mortality of chronic obstructive pulmonary disease among residents in Pudong New Area between 2002 and 2019 were 64.94/100,000 and 21.04/100 000, respectively. The chronic obstructive pulmonary disease showed a downward trend (APC=-2.05%, Z=- 5.342, P<0.001), and the standardized mortality rate decreased year by year (APC=-6.23%, Z=-13.052, P<0.001). The crude mortality and age-standardized rates in male residents were both higher than those in females (Z-crude mortality=46.471, P<0.001, Z-standardized mortality=-48.961, P<0.001). The PYLL of chronic obstructive pulmonary disease was 16,997 years, the PYLL rate was 0.34‰, and the AYLL was 0.53 years per person. Conclusion From 2002 to 2019, the mortality of chronic obstructive pulmonary disease among residents in Pudong New Area was relatively high and caused serious life loss. Both crude mortality and age-standardized rate showed a downward trend during the study period. Comprehensive prevention and control measures should be further developed.

Analysis of the main causes of death and life loss of residents in Pudong New Area of Shanghai, 2009-2018 / 公共卫生与预防医学

Objective To understand the distribution characteristics of death causes and potential life loss of residents in Pudong New Area from 2009 to 2018, assess the disease burden caused by different diseases, and provide a basis for formulating regional prevention and control strategies. Methods The mortality data of residents in Pudong New Area of Shanghai from 2009 to 2018 were collected. The death causes were classified by International Classification of Diseases (ICD-10). The crude mortality rate, standardized mortality rate, potential years of life lost (PYLL), potential years of life lost rate (PYLLR), and average years of life lost (AYLL) were calculated. Results The crude mortality and standardized mortality of residents in Pudong New Area between 2009 and 2018 were 7.55‰ and 3.65‰, respectively. The top five causes of death in Pudong New Area residents were circulatory system diseases, tumors, respiratory diseases, endocrine nutrition and metabolic diseases, and injury and poisoning, accounting for 87.85% of the total deaths. The PYLL was 687 729 person-years, the PYLLR was 24.11‰ and the AYLL was 3.19 years per person. The top 5 causes of life loss of residents in Pudong New Area was tumor, circulatory system disease, injury and poisoning, endocrine nutrition and metabolism illness, and congenital anomalies, accounting for 82.08% of total life loss of residents. Conclusion Chronic non-infectious diseases, including circulatory diseases, tumors, and endocrine nutritional metabolism diseases, were the main causes of death of residents in Pudong New Area, and caused a heavy disease burden, which should be the focus of prevention and control in the future. Comprehensive preventive and control measures should be taken to protect the residents from the harm due to chronic non-communicable diseases and improve the health condition of the residents in Pudong New Area.

Progress of molecular markers related to papillary thyroid carcinoma / 肿瘤研究与临床

Papillary thyroid carcinoma is the most common malignant tumor in the head and neck. The incidence of papillary thyroid carcinoma has been increasing in recent years. Although the prognosis of most papillary thyroid carcinoma is better, many patients have poor prognosis due to recurrence or metastasis. Molecular markers play an important role in the development, diagnosis, treatment and prognosis of papillary thyroid carcinoma. This paper reviews the progress of molecular markers related to papillary thyroid carcinoma.

Mortality Trends and Quantitative Analysis of Influencing Factors for Non-neoplastic Anorectal Diseases Among Registered Population in Pudong New Area, Shanghai (1995-2017) / 胃肠病学

Background: It is difficult to evaluate the long-term outcome of colorectal cancer screening project in a short period because of the long course of disease. Aims: To explore the epidemiological characteristics and mortality trends of non-neoplastic anorectal diseases among registered population in Pudong New Area, Shanghai from 1995 to 2017, so as to reflect on other aspects or indirectly the efficacy of colorectal cancer screening project. Methods: According to the Mortality Registration System of household registered residents in Pudong New Area, the crude mortality rate, standardized mortality rate, annual percentage change (APC) and other indicators were used to analyze the mortality trends of non-neoplastic anorectal diseases (K50-K52, K55-K63); the contribution of demographic and non-demographic factors to disease death before and after the implementation of colorectal cancer screening project was calculated by the differential decomposition method. Results: From 1995 to 2017, the total crude mortality rate of non-neoplastic anorectal diseases in Pudong New Area was 2.79/100 000, and the standardized mortality rate was 1.23/100 000; the crude mortality rate showed an upward trend (APC=1.67, P=0.009), whereas the standardized mortality rate showed a downward trend (APC=-3.45, P<0.001). For population aged ≥65 years, the crude mortality rate showed an upward trend from 1995 to 2009, and a downward trend from 2009 to 2017, respectively (APC=2.19, P=0.044; APC=-6.85, P=0.007). Death predominantly occurred in population aged ≥80 years. Before and after the screening project (1995-2012 vs. 2013-2017), the added value of demographic and non-demographic factors on total mortality was 1.24/100 000 and -1.33/100 000, respectively. With 1995 as the baseline, the contribution of non-demographic factors to the added value of mortality after screening was -2.25/100 000, with a contribution rate of 48.94%, which was superior to that before screening (-0.92/100 000, with a contribution rate of 45.37%). Conclusions: Aging of the population is the main cause of increased crude mortality rate of non-neoplastic anorectal diseases in Pudong New Area. Screening for colorectal cancer is an effective intervention to reduce the mortality of anorectal diseases and deserves further promotion.

Incidence, mortality and survival rates of pancreatic cancer among residents in Pudong New Area of Shanghai from 2002 to 2010 / 中华胰腺病杂志

Objective To analyze the incidence,mortality and survival rates of pancreatic cancer in Pudong New Area of Shanghai from 2002 to 2010.Methods The residents in Pudong New Area of Shanghai were recruited in this study during the period 2002 ～ 2010,the incidence,mortality were calculated according to different age groups and genders.The standardized morbidity and mortality of pancreatic cancer were calculated by world standard population.Logarithmic linear regression was used to calculate the annual percentage change (APC) of incidence and mortality.The 1 ～ 5 year survival of pancreatic cancer patients was analyzed by Kaplan-Meier method and COX regression analysis,and the survival of patients with different TNM staging,with or without operation was determined.Results Among 3089 newly occurred pancreatic cancer cases during 2002 ～ 2010,1707 and 1382 cases were males and females,respectively,with an average age of (69 ± 12) and (73 ± 12) years old,the crude incidence for both genders was 13.32/100 000,and it was 14.71/100 000 for males,which was higher than that in females (11.93/100 000).The ratio of male and female for incidence of age standardize was 1.57:1.There were 2963 death in total,including 1627 males and 1336 females,with a crude mortality rate of 12.78/100 000.The crude mortality rate for males was 14.02/100 000,which was higher than that in females (11.53/100 000).The ratio of male and female ASR for mortality was 1.55:1.Both incidence and mortality significantly increased for males aged over 35 and females aged over 40.The peak of morbidity and mortality appeared in male over 80 years old,and in female over 85 years old.The 1 ～ 5 year survival rates of pancreatic cancer patients were 16.59％,7.31％,5.23％,4.33％ and 3.87％,respectively.The differences in 1 ～5 year survival rates between surgical and non-surgical management groups were statistically significant (P ＜ 0.05).The median survival time of TNM 0 ～ Ⅱ,Ⅲ and Ⅳ staging was (250.00 ± 33.37),(224.00 ± 15.82),(86.00 ± 4.52) d.There was a statistically significant difference among the survival of TNM-Ⅳ and TNM 0 ～ Ⅰ,TNM Ⅲ (P ＜ 0.001).Conclusions The incidence and mortality of pancreatic cancer in males are higher than those in females in Pudong New Area of Shanghai.The survival is associated with TNM staging at diagnosis and whether surgical operation is performed.