Disease burden and mortality forecast of prostate cancer in Wuhan in 2010-2019 / 公共卫生与预防医学

Objective To analyze the data of prostate cancer in Wuhan from 2010 to 2019, understand the characteristics and trends of incidence, mortality, and YLL, and provide decision-making basis for Wuhan's cancer prevention and control strategies. Methods Data on deaths and incident cases of prostate cancer in Wuhan from 2010 to 2019 and from 2013 to 2017, respectively, were collected from the Wuhan Death Monitoring System. Indicators such as incidence rate, mortality rate, and years of life lost due to premature death (YLL) of prostate cancer in Wuhan were calculated using Excel 2016 and Python. The Bayesian Age-Period-Cohort Model (BAPC) was used to predict the mortality rate of prostate cancer in Wuhan from 2020 to 2024. The trend changes were described using the annual average percentage change (AAPC). Results From 2010 to 2019, the incidence, mortality, and YLL rates of prostate cancer in Wuhan showed an overall increasing trend (AAPC >0, P <0.05). The standardized mortality and incidence rates in the central urban area were significantly higher than those in the outer urban area, and the age group of 85 and above had the highest incidence and mortality rates. The age group of 0-54 had the largest increase in incidence and mortality rates. From 2020 to 2024, prostate cancer in Wuhan is expected to continue to increase slightly (an increase of 0.94%). Conclusion The incidence, mortality, and YLL rates of prostate cancer in Wuhan are showing an overall increasing trend, and this trend may continue. The characteristics are higher in the central urban area than in the outer urban area, and higher in the older age group than in the younger age group. Targeted measures need to be taken, and screening for high-risk populations should be strengthened.

Status and trend of refractive disorder burden in China based on a global perspective / 公共卫生与预防医学

Objective Based on the global burden of disease (GBD) study data, to analyze the current situation and changing trend of refractive disorders in China by comparing Japan, India, the United States, the United Kingdom and the world. Methods The prevalence, years lived with disability (YLD) rate of refractive disorders from 1990 to 2019 were obtained from the global health exchange (GHDx）database. The disease burden and change trend of refractive disorders were analyzed using Joinpoint and other software. Results In 2019, the number of refractive disorders in China exceeded 27 million, with the prevalence and YLD rate were 19.18‰ and 89.40/100,000 respectively. From 1990 to 2019, the prevalence and YLD rate of refractive disorders showed an increasing trend globally (except India), with the largest increase in China (up by 53.21% and 53.96% respectively). The age standardized YLD rates in China, Japan, the United States, and the United Kingdom were all lower than the global average level, but China's age standardized YLD rates were higher than the developed countries (Japan, the United States, and the United Kingdom). Conclusion From 1990 to 2019, there was a certain gap between China and developed countries in the control of refractive disorders. Therefore, it is necessary to understand the disease status from a global perspective in order to better prevent and control refractive disorders in the future.

Influencing factors of hospitalization costs for lung cancer patients in Wuhan in 2018-2020 / 公共卫生与预防医学

Objective To summary the hospitalization costs of lung cancer patients, and analyze the influence factors in these patients, and provide basis for controlling hospitalization costs of lung cancer patients. Methods The hospitalization costs data of hospitalized lung cancer cases in Wuhan from 2018 to 2020 were collected from medical records. Nonparametric test was used to analysis the data for single factor analysis. The patients were divided into two groups according on the upper quartile value of hospitalization cost, that is high-cost group (the cost ≥ the upper quartile value) and normal cost group (the cost “four major hospitals in Hubei” respectively. The hospital type is an independent influencing factors, compared with specialized hospital, the OR is 4.726 for general hospital. The hospitalization days is the independent influencing factors, more hospitalization days has high cost. The treatment mode is the independent influencing factors, compared with non-operative treatment, the OR is 556.129, 18.156 and 5.212 for surgical model, radio therapy model and interventional model respectively. Conclusion The age, hospital level, hospital type, hospitalization days and treatment mode are the independent influencing factors of hospitalization costs. To reduce the hospitalization cost of lung cancer patients, we should standardize the diagnosis of lung cancer patients, and focus on standardizing the treatment mode, also considering other influencing factors, such as hospital level, hospital type.

Current status and trend analysis of breast cancer incidence and mortality in Wuhan / 公共卫生与预防医学

Objective To assess the prevalence of female breast cancer in the city using data from the Wuhan Disease and Cause of Death Surveillance System for the past 10 years to provide a reference for breast cancer prevention and control. Methods The incidence case data from 2013 to 2017 and death case data from 2010 to 2019 in all districts of Wuhan city were collected. The incidence and mortality and their age-standardized rates were calculated. The joinpoint linear regression model was used to analyze the average annual percentage change (AAPC) , and the Bayesian age-period-cohort model (BAPC) was used to predict the mortality and age-standardized mortality of breast cancer among women in Wuhan from 2020 to 2024. Results The incidence and age-standardized incidence were 56.56/100 000 and 45.37/100 000 in 2013, and 67.46/100 000 and 52.01/100 000 in 2017, respectively. The changes showed an upward trend, but the difference was not statistically significant (P>0.05). The mortality and age-standardized mortality were 9.80/100 000 and 8.07/100 000 in 2010, and 10.47/100 000 and 7.13/100 000 in 2019, respectively. Although the rough mortality increased, the age-standardization mortality declined significantly (AAPC=2.13%, P<0.05). BAPC prediction results show that the standardized mortality rate of female breast cancer in Wuhan will drop to 6.33/100 000 in 2024. The peak age of incidence was in the age groups of 45-74 years and the peak age of mortality was in the age group of 85 years or older. In addition , the morbidity and mortality rates in the central urban area were higher than those in the distant urban area , and the difference decreased year by year. The BAPC predicted that the age-standardized mortality for breast cancer in women in Wuhan will decrease to 6.33 per 100 000 in 2024. Conclusion Breast cancer incidence and mortality rates in females in Wuhan show an increasing trend . However , the age-standardized mortality is on a significant downward trend due to the delay in the age of death. The elderly and those in central urban areas are the high-risk groups, so we should pay more attention to these groups , analyze the related risk factors , and take targeted prevention and control measures.

Analysis on respiratory health effects and economic losses of particulate matter Pollution in Wuhan / 公共卫生与预防医学

Objective To evaluate the impact of particulate matter (PM) pollution on the hospitalization for respiratory diseases (RD), to estimate the avoidable economic loss by reducing the level of PM pollution, and to provide a basis for evaluating the cost-effectiveness of air pollution control. Methods The data of RD inpatients in two class-A tertiary hospitals in Wuhan from 2015 to 2019, PM concentration and meteorological data in Wuhan in the same period were collected. The generalized additive model (GAM) was used to estimate the impact of PM on the number of RD inpatients, and the cost of illness approach (COI) was used to estimate the avoidable economic loss caused by the reduction of PM concentration. Results PM pollution caused an increase in the number of RD inpatients. Each 10 g/m3 increase in PM2.5 and PM10 concentrations resulted in an increase of 1.71% and 0.71% in the number of RD inpatients, respectively. Among them, men and children aged 0-14 years were more affected. For every 10 g/m3 increase in PM2.5 concentration, the number of hospitalized men and children aged 0-14 years increased by 1.97% and 2.65%, respectively. For every 10 g/m3 increase in PM10 concentration, the number of hospitalized men and children aged 0-14 years increased by 0.87% and 0.88%, respectively. PM pollution caused 63 300 hospitalizations and 1.214 billion yuan of economic losses in 2015-2019,Wuhan. If the PM concentration is reduced to the recommended value of the World Health Organization in the same period, 194 million yuan of economic loss and 10100 hospitalizations could be avoided every year in Wuhan. Conclusion PM exposure can lead to heavy disease burden and economic loss. Taking effective measures to control PM concentration will bring great economic benefits.

The current status and trends of chronic kidney disease (CKD) burden in China based on GBD Data / 公共卫生与预防医学

Objective To analyze the current status and trends of chronic kidney disease (CKD) burden in China from the global perspective, and to provide reference for the prevention and control of CKD in China. Methods The incidence, prevalence, mortality and disability adjusted life year (DALY) rate of China and other regions were retrieved from GBD 2019. Comparative analyses were carried out to reflect the burden of CKD. Results In 2019, the incidence and the prevalence in females were higher than those in males, while the mortality and the DALY rates in females were lower than those in males. There were obvious distinctions in different age groups and people over 65 years old had a higher CKD burden. The burden of CKD mainly came from hypertensive nephropathy and type 2 diabetic nephropathy. From 1990 to 2019, the DALY rate of CKD in China showed an overall upward trend. After eliminating the differences in age composition, the standardized DALY rate of CKD in China was higher than that in Japan, Korea and Ukraine although lower than the global. The main influencing factors of the burden of CKD were metabolic factors. Conclusion The burden of CKD in China is continuously rising. It is still necessary to pay attention to the three-level prevention and control, and focus on the key people groups and high-risk factors to further reduce the burden of CKD in China.

Analysis of the burden of pneumoconiosis in China through comparison with the United States and Germany based on GBD Data / 公共卫生与预防医学

Objective To analyze the burden of pneumoconiosis in China through comparison with the United States, Germany and the world based on GBD 2017 data, and to provide references for direction and reform measures for the Pneumoconiosis Prevention and Control Battle and the Occupational Health Protection Action in China. Methods The indexes of disease burden for pneumoconiosis in China, the United States, Germany and the Global level from 1990 to 2017 on the basis of GBD 2017 was obtained, and epidemiological characteristics and trends of pneumoconiosis were analyzed to compare the differences in the disease burden of pneumoconiosis. The main reasons for pneumoconiosis were analyzed, and the strategies for the improvement of prevention and control policies were discussed. Results From 1990 to 2017, the prevalence of pneumoconiosis in China rose from 12.96/100 000 to 20.45/100 000, an increase of 57.79%. The years lived with disability rose from 1.95/100 000 to 3.05/100 000, with an increase of 56.41%. In 2017, the YLL/DALY of China's pneumoconiosis was 82.60%, and the years of life lost caused by premature death was still the main component of China's pneumoconiosis disease burden. In 2017, the standardized DALY rate and standardized YLL rate of occupational exposure to silicon in China accounted for 66.19% and 72.62% of the total burden of environmental occupational factors, respectively, which were higher than the United States (30.24%, 35.06%) and Germany (52.17%, 52.65%) ), as well as the world (50.95%, 54.80%). From 1990 to 2017, the standardized DALY rate of pneumoconiosis in China, the United States, Germany, and the world all showed a downward trend, with a decrease of 51.99%, 37.69%, 58.33%, and 48.20%, respectively. However, in 2017, the standardized DALY rate of China (12.57/100 000) was still higher than the United States (4.10/100 000), Germany (3.45/100 000), and the world (6.32/100 000). Conclusion Until at least 2017, the disease burden of pneumoconiosis in China was still higher than that of the United States, Germany and the world. It is necessary to learn from the experience of countries with better prevention and control effects, strengthen laws and regulations, and focus on dust control to prevent pneumoconiosis.

Status and trend of cardiovascular disease burden in China from a global perspective / 公共卫生与预防医学

Objective To analyze the epidemic trends and risk factors of cardiovascular disease (CVD) burden in China from 1990 to 2019, based on the Global Burden of Disease (GBD) study 2019, by comparing with the world, the USA, Japan and India. Methods Data were obtained from the Global Health Data Exchange (GHDx) database, and the prevalence, incidence, mortality, disability adjusted life years (DALY) rate and main risk factors of CVD in China in 2019 were analyzed by gender and age. Age-standardized rates were used to compare the trends of CVD burden in the world and other four countries. Results In 2019, the number of CVD patients, incidences and deaths in China was 120.33 million, 12.34 million, and 4.58 million, respectively. The prevalence, morbidity, mortality and DALY rate increased from 4 235.43/100 000, 447.81/100 000, 204.75/100 000 and 5 091.03/100 000 in 1990 to 8 460.08/100 000, 867.65/100 000, 322.30/100 000, and 6 463.47/100 000 in 2019, respectively, all of which were increasing with age. The burden of CVD in males was higher than that in females. After eliminating the influence of population aging, the age-standardized mortality rate of CVD in China decreased from 381.21/100 000 in 1990 to 276.93/100 000 in 2019, and the age-standardized DALY rate decreased from 7 412.81/100 000 to 4 938.38/100 000. However, they were still slightly higher than those in the world and significantly higher than those in the USA and Japan. In addition, the leading four risk factors of CVD in China in 2019 were hypertension, dietary risks, air pollution and tobacco. A higher burden of CVD caused by all these factors in China were above the global average level. Conclusion Due to hypertension, dietary factors, air pollution, tobacco and other reasons, coupled with the rapid aging of the population, the burden of CVD in China is still very serious, and relevant departments need to pay more attention to it.

Current situation and trend analysis of AIDS burden in China, the United States and Japan / 公共卫生与预防医学

Objective By analyzing the incidence, prevalence, mortality, Disability Adjusted of Life Years (DALY) situations and trends of AIDS in China from 1990 to 2019, this paper provides scientific basis for the preventions and controls of AIDS in China. Methods The incidence, prevalence, mortality and DALY rate of AIDS from 1990 to 2019 are obtained from GBD 2019 data. The standardardized rate of four indicators are used to compare and analyze the AIDS changes in China, the United States, Japan and the global with the development of years. Results The four indicators of AIDS in China present increasing trends, with male higher than female. The incidence rate increased from 0.82/100 000 in 1990 to 2.24/100 000 in 2019, the prevalence increased from 5.63/100 000 to 38.77/100 000, and the mortality increased from 0.23/100 000 to 2.23/100 000. The DALY rate increased from 13.18/100 000 to 98.15/100 000. Compared with the global and the United States, the standardized rate of four indicators of AIDS in China in 2019 showed a trend of low level, but it was higher than that in Japan. Conclusion In recent years, some progress has been made in AIDS preventions and controls in China, but the disease burden of AIDS is still on the rise. The situation of AIDS preventions and controls is still serious and unremitting efforts should be made to reduce the burden of AIDS.

The concept of Socio-Demographic Index(SDI) and its application / 公共卫生与预防医学

Objective To introduce the Socio-Demographic Index (SDI) and explore its relationship with disease burden indicators. Methods Based on the data of GBD 2017, we describe the correlation between HALE, DALY rate, YLD rate, YLL rate and SDI from 1990 to 2017 in the global and other 7 countries to explore the practical application value of SDI. Results 1. With the increase of SDI, HALE increased significantly; YLL rate and DALY rate decreased significantly. 2. The trend of YLD rate in low-SDI countries was the same as that of YLL rate and DALY rate; in the high-SDI and middle-SDI countries with longer life spans, as SDI increased, YLD rate also increased. 3. Because the socio-demographic characteristics of different diseases (such as Cardiovascular diseases and Neoplasms) are quite different, we should specifically analyze their relationship with SDI. Conclusion SDI is a good indicator, which can be used as an important covariate to predict disease burden and health outcomes in various areas.

COVID-19 analysis and forecast based on Exponential Smoothing Model in Hubei Province / 公共卫生与预防医学

Objective To analyze and forecast the epidemic of the new coronavirus pneumonia (COVID-19) in Hubei Province. Methods Exponential Smoothing Model was applied to fit the tendency of the number of confirmed cases, discharged cases, death cases, severe cases and critical cases. Results The epidemic of COVID-19 in Hubei province has been gradually alleviated, the rapid remission period and slow remission period were occurred after February 18th and March 21st, respectively. The Exponential Smoothing Model was significantly fit well and the fitting values were basically consistent with the actual values. Predicted results indicated that the number of existing confirmed cases was expected to reduce to less than 1 000 on April 2nd, and was mainly consist of severe and critical cases. Conclusions The prevention and control measures of COVID-19 in Hubei province were effective, and the Exponential Smoothing Model was applicable to predicate the epidemic of COVID-19.

Distribution and Influencing Factors of Patients with Extra-long Hospital Stay from 128 Hospitals in Hubei Province / 公共卫生与预防医学

Objective Analyze the distribution and influencing factors of inpatients with extra-long hospital stay in Hubei Province. Methods Length of stay≥30 days was defined as the extra-long hospital stay, and logistic regression was used to determine the risk factors. Results There were 26 043 cases with extra-long hospital stay, which accounting for 2.88% of the total cases. Proportion of extra-long hospital stay was increased with age, the proportion of the group aged 65 and above was the highest (3.25%), and which were higher in males than that of females, the sex ratio was 1.58. Patients with extra-long hospital stay mainly had injury/poisoning and certain other consequences of external causes (16.88%), circulatory system disease (12.72%), neoplasms (11.23%), genitourinary system diseases (8.13%), mental and behavioral disorders (6.27%), and the proportion totaled up to 52.23%. Multivariate logistic regression analysis indicated that gender, age, type of disease, surgery or not and hospital grade were the influencing factors of extra-long hospital stay. Conclusions There are differences in the distribution of extra-long hospital stay in different individuals, diseases and medical treatment, targeted measures should be taken to shorten the length of stay.

Joinpoint regression analysis for the mortality trend of breast cancer in Chinese female from 1987 to 2014 / 中南大学学报(医学版)

Objective:To analyze the current situation for the mortality of Chinese female breast cancer and the trend of change in the past thirty years,and to provide scientific basis for prevention and control of breast cancer in China.Methods:The mortality data of breast cancer in Chinese female from 1987 to 2014 were collected,the trends of age-standardized rates and age-adjusted rates were described,and the variations via Joinpoint regression models were analyzed.Results:From 1987 to 2014,the mortality for the urban female breast cancer was greater than that for the rural females.There was a downward trend for urban women with an average decrease of 0.3％ for each year (P=0.06).While the average annual change for rural females showed an upward trend (AAPC=l.26％,P＜0.01).The gap between urban and rural females is narrowing gradually.The 40-59 age-adjusted rate for urban females decreased first and then it was increased with time moving forward.The mortality for rural females was continuously increased.Conclusion:From 1987 to 2014,the breast cancer mortality for urban females was overall higher than that for rural females.The mortality for rural females was continuously increased in the past years.The gap between urban and rural females is narrowing.We should pay specific attention to the prevention and treatment of breast cancer for the rural females.

Mortality trend in nasopharynx cancer in Chinese resident from 1987 to 2015 / 中南大学学报(医学版)

To analyze epidemical features, distribution and time trend for nasopharynx cancer deaths in China from 1987 to 2015.
 Methods: Negative binomial regression model was used to explore population-level risk factors for nasopharynx cancer deaths and a joinpoint regression model was used to estimate annual changes in nasopharynx cancer mortality in various populations.
 Results: A falling trend in age-standardized nasopharynx cancer mortality rates was observed among Chinese residents with the average annual percent change (AAPC) at -2.97% among urban female residents and -2.60% among rural female residents (P<0.05), -2.01% among urban male residents, and -1.68% among rural male residents (P<0.05), respectively. It decreased yearly for urban male aged over 85 years with AAPC at -1.54% and the age-specific mortality rates decreased yearly for the urban female aged over 85 years with AAPC at -0.60%, the age-specific mortality rates decreased yearly for rural male residents aged more than 65 years with AAPC at -0.56% and for rural female residents aged more than 85 with AAPC at 1.17%, with no significant difference (P<0.05). The nasopharynx cancer deaths risks were higher in urban residents than those in rural residents (OR=1.11, P<0.01), and they were also higher in male residents than those in female residents (OR=2.34, P<0.01). A 5-year increment in age was associated with a 23% increase in nasopharynx cancer mortality (OR=1.23, P<0.01) and a one year increment in calendar year was related to a 2% decrease in mortality (OR=0.98, P<0.01). 
 Conclusion: There was a significant gender and age difference in a decreased trend of nasopharynx cancer mortality among Chinese residents in a long period; no increased trend was observed in the overall populations over 85 years old.

Trend analysis of the burden of ischemic heart disease in China, 1990 to 2015 / 中华预防医学杂志

Objective@#The objective of this study is to analyze the trend of burden of ischemic heart disease (IHD) in China between 1990 and 2015.@*Methods@#Data were collected from the results of 2015 Global Burden of Disease Study. We arranged and analyzed the mortality and disability-adjusted life year (DALY) for IHD by sexes, ages and provinces (excluding Taiwan, China) in China between 1990 and 2015. The age-standardized rates were determined using the average world population age structure in the period of 2010-2035 as a reference, and the changes of the related indicators were calculated.@*Results@#In 2015, IHD caused 1 461 thousand deaths, and its age-standardized death rate was 114.8 per 100 000. Number of DALYs from IHD were 25 765 thousand in 2015, with the age-standardized DALY rate at 1 760.2 per 100 000. From 1990 to 2015, the age-standardized death rate for IHD in China increased by 13.3% but age-standardized DALY rate decreased by 3.9%. Number of IHD DALYs among male (16 664 thousand) was higher than it among female (9 101 thousand) in China in 2015, and 83.5% of total DALYs from IHD occurred among people aged over 50 years old. Province with highest age-standardized death rate was Heilongjiang, with rate at 187.4 per 100 000 in 2015. Qinghai (54.0%) increased most and Macao (-52.3%) decreased most from 1990 to 2015. Province with highest age-standardized DALY rate was Xinjiang, with rate at 3 040.8 per 100 000 in 2015. Qinghai (33.2%) increased most while Macao (-59.0%) decreased most between 1990 and 2015.@*Conclusion@#Burden of IHD in China increased remarkably from 1990 to 2015, especially among males and people aged over 50 years old. The differences among provinces were obvious.

Joinpoint regression analysis for the trends of cervical cancer mortality between 1987-2014 in China / 中国癌症杂志

Background and purpose: Cervical cancer is one of the most common malignant tumors and poses a great threat to women's fitness. Monitoring its present status and variations over the past 3 decades could provide scientific basis for prevention and control strategies of cervical cancer in China. Methods: This study collected the mortality rates of cervical cancer data in Chinese women from 1987 to 2014, described the features and trends of age-standardized rates and truncated rates, and estimated the variations via joinpoint regression models. Results:The mortality rates of cervical cancer for rural women were roughly higher than those for urban women. It showed downward trends for both urban and rural women, and the average rate of decrease for rural women (AAPC=3.94％, P<0.01) was higher than that for urban women (AAPC=1.79％, P<0.01). The gap between urban and rural areas was narrowing, with urban rates exceeding rural rates after 2010. The mortality rates of cervical cancer increased with time for urban women aged from 30 to 54, decreased with time for the elderly urban women and all the rural women. Conclusion: The overall mortality rates of cervical cancer took a desirable turn in China over the past 3 decades, while the status for the middle-aged urban women was getting worse as well as the elderly in both urban and rural areas during the past 10 years.

Impact of daily mean temperature, cold spells, and heat waves on stroke mortality a multivariable Meta-analysis from 12 counties of Hubei province, China / 中华流行病学杂志

Objective To assess the acute effects of daily mean temperature,cold spells,and heat waves on stroke mortality in 12 counties across Hubei province,China.Methods Data related to daily mortality from stroke and meteorology in 12 counties across Hubei province during 2009-2012,were gathered.Distributed lag nonlinear model (DLNM) was first used,to estimate the county-specific associations between daily mean temperature,cold spells,heat waves and stroke mortality.Multivariate Meta-analysis was then applied to pool the community-specific relationships between temperature and stroke mortality (exposure-response relationship) as well as both cold-and-heatassociated risks on mortality at different lag days (lag-response relationship).Results During 2009-2012,a total population of 6.7 million was included in this study with 42 739 persons died of stroke.An average of 2.7 (from 0.5 to 6.0) stroke deaths occurred daily in each county,with annual average mean temperature as 16.6 ℃ (from 14.7 ℃ to 17.4 ℃)during the study period.An inverse J-shaped association between temperature and stroke mortality was observed at the provincial level.Pooled mortality effect of cold spells showed a 2-3-day delay and lasted about 10 days,while effect of heat waves appeared acute but attenuated within a few days.The mortality risks on cold-spell days ranged from 0.968 to 1.523 in 12 counties at lag 3-14,with pooled effect as 1.180 (95％ CI:1.043-1.336).The pooled mortality risk (ranged from 0.675 to 2.066) on heat-wave days at lag 0-2 was 1.114 (95％CI:1.012-1.227).Conclusions An inverse J-shaped association between temperature and stroke mortality was observed in Hubei province,China.Both cold spells and heat waves were associated with increased stroke mortality,while different lag patterns were observed in the mortality effects of heat waves and cold spells.

Impact of daily mean temperature, cold spells, and heat waves on stroke mortality a multivariable Meta-analysis from 12 counties of Hubei province, China / 中华流行病学杂志

Objective To assess the acute effects of daily mean temperature,cold spells,and heat waves on stroke mortality in 12 counties across Hubei province,China.Methods Data related to daily mortality from stroke and meteorology in 12 counties across Hubei province during 2009-2012,were gathered.Distributed lag nonlinear model (DLNM) was first used,to estimate the county-specific associations between daily mean temperature,cold spells,heat waves and stroke mortality.Multivariate Meta-analysis was then applied to pool the community-specific relationships between temperature and stroke mortality (exposure-response relationship) as well as both cold-and-heatassociated risks on mortality at different lag days (lag-response relationship).Results During 2009-2012,a total population of 6.7 million was included in this study with 42 739 persons died of stroke.An average of 2.7 (from 0.5 to 6.0) stroke deaths occurred daily in each county,with annual average mean temperature as 16.6 ℃ (from 14.7 ℃ to 17.4 ℃)during the study period.An inverse J-shaped association between temperature and stroke mortality was observed at the provincial level.Pooled mortality effect of cold spells showed a 2-3-day delay and lasted about 10 days,while effect of heat waves appeared acute but attenuated within a few days.The mortality risks on cold-spell days ranged from 0.968 to 1.523 in 12 counties at lag 3-14,with pooled effect as 1.180 (95％ CI:1.043-1.336).The pooled mortality risk (ranged from 0.675 to 2.066) on heat-wave days at lag 0-2 was 1.114 (95％CI:1.012-1.227).Conclusions An inverse J-shaped association between temperature and stroke mortality was observed in Hubei province,China.Both cold spells and heat waves were associated with increased stroke mortality,while different lag patterns were observed in the mortality effects of heat waves and cold spells.

Implication of reported viral hepatitis incidence rate change in Hubei Province, China, between 2004-2010 / 华中科技大学学报（医学）（英德文版）

This study examined the change of reported incidence rate for viral hepatitis in Hubei province, China, between 2004 to 2010 to provide scientific evidence for viral hepatitis control. Reported viral hepatitis infection cases were queried from Centre for Disease Control of Hubei Province, China. The incidence of viral hepatitis A decreased steadily across the study period. Viral hepatitis B composed 85% of the viral hepatitis cases. When reported incidence rates for chronic hepatitis B increased, the rates of acute and unclassified cases dropped from 2005 to 2010. The reported viral hepatitis B incidence rate for males was around 1.5-2 times higher than for females. The average annual percentage change of reported viral hepatitis B incidence rates was 4%. The same index for viral hepatitis C was 28%. The reported viral hepatitis B incidence rate of people under 20 years old declined over the period. This decrease was mainly attributed to the recent implementation of vaccination plan. Reported incidence rate of viral hepatitis E also rose in those years. Having a better understanding on reported incidence rates of the present surveillance system is important for developing strategies for further prevention of viral hepatitis. In addition, the data showed that a surveillance system that differentiates new and former infected cases will be more effective in providing evidence for disease control.

Implication of reported viral hepatitis incidence rate change in Hubei Province, China, between 2004-2010 / 华中科技大学学报（医学）（英德文版）

This study examined the change of reported incidence rate for viral hepatitis in Hubei province, China, between 2004 to 2010 to provide scientific evidence for viral hepatitis control. Reported viral hepatitis infection cases were queried from Centre for Disease Control of Hubei Province, China. The incidence of viral hepatitis A decreased steadily across the study period. Viral hepatitis B composed 85% of the viral hepatitis cases. When reported incidence rates for chronic hepatitis B increased, the rates of acute and unclassified cases dropped from 2005 to 2010. The reported viral hepatitis B incidence rate for males was around 1.5-2 times higher than for females. The average annual percentage change of reported viral hepatitis B incidence rates was 4%. The same index for viral hepatitis C was 28%. The reported viral hepatitis B incidence rate of people under 20 years old declined over the period. This decrease was mainly attributed to the recent implementation of vaccination plan. Reported incidence rate of viral hepatitis E also rose in those years. Having a better understanding on reported incidence rates of the present surveillance system is important for developing strategies for further prevention of viral hepatitis. In addition, the data showed that a surveillance system that differentiates new and former infected cases will be more effective in providing evidence for disease control.