ObjectiveTo systematically analyze the spatiotemporal distribution characteristics and epidemiological trends of tracheal, bronchus, and lung cancer (TBL) disease burden attributed to air pollution globally and in China and the United States from 1990 to 2021. Furthermore, based on predictive models, assess the patterns of disease burden changes from 2022 to 2031, providing a scientific basis for formulating targeted TBL prevention and control strategies. MethodsBased on the Global Burden of Disease (GBD) 2021 database, we analyzed the disease burden data of TBL attributed to air pollution globally and in China and the United States from 1990 to 2021. R Studio 4.3.2 software was used to analyze the corresponding trends and the Bayesian age-period-cohort (BAPC) prediction model was used to predict the status of the disease burden of TBL attributed to air pollution in the world and in China and the United States from 2022 to 2031. ResultsIn 2021, the highest number of deaths and disability-adjusted life years attributed to air pollution were in China (211 400 patients and 4.8947 million person-years), followed by the United States (6 000 patients and 124 300 person-years). The age standardized mortality rate (ASMR) and age standardized disability-adjusted life years rate (ASDR) of TBL due to air pollution in the world and in China and the United States showed a decreasing trend (with an average annual percentage change of<0). From 1990 to 2021, the ASMR and ASDR of TBL in China due to air pollution were much higher than those in the United States and the global average. In terms of gender, from 1990 to 2021, the disease burden of male patients with TBL attributed to air pollution in the world and in China and the United States was much higher than that of female patients. The BAPC prediction model showed that from 2022 to 2031, the ASMR and ASDR of TBL attributed to air pollution will showed an upward trend globally, while they showed a downward trend in China and the United States. ConclusionOver the past 30 years, the air pollution-related TBL disease burden in the world and in China and the United States has continued to decline, but China's level is still significantly higher than the global average. The disease burden in men far exceeds that in women, with men and the elderly population aged ≥50 years being high-risk groups. In the future, the global disease trend may reverse and rise, while China and the United States are expected to continuously decline. However, precise prevention and control for high-risk groups remains a key challenge.
ObjectiveTo explore the effectiveness of the procedure of reconstructing the transverse arch of the forefoot by anastomosing adductor hallucis and abductor hallucis tendons in correcting hallux valgus. MethodsA retrospective analysis was made on the clinical data from 28 patients (40 feet) with hallux valgus treated with the procedure of reconstructing the transverse arch of the forefoot by anastomosing adductor hallucis and abductor hallucis tendons between January 2010 and January 2014. There were 3 males (6 feet) and 25 females (34 feet), with an average age of 51.7 years (range, 20-71 years). The unilateral foot was involved in 16 cases and bilateral feet in 12 cases. The mean disease duration was 8.9 years (range, 1-30 years). All the cases had pain of the first metacarpophalangeal joint; 22 feet had collapsed transverse arch of the forefoot combined with plantar callus, and 8 feet had collapsed transverse arch of the forefoot combined with hammer toe deformity. American Orthopaedic Foot and Ankle Society (AOFAS) score was 59.07±8.49. Preoperative X-ray showed that the hallux valgus angle (HVA) was (33.68±8.10)°, and the intermetatarsal angle (IMA) was (15.60±4.07)°. According to classification of the hallux valgus by Mann, 9 feet were rated as mild, 23 feet as moderate, and 8 feet as severe. ResultsSuperficial infection of incision occurred in 1 case (1 foot) after surgery, and healing by first intention was obtained in the others. Two cases (3 feet) had numbness in the toes. All of 28 cases were followed up from 6 months to 4 years (1.8 years on average). Based on the AOFAS score, the results were excellent in 24 feet, good in 9 feet, fair in 4 feet, and poor in 3 feet, and the excellent and good rate was 82.5%. At last follow-up, the HVA, IMA, and AOFAS score were (15.10±5.28)°, (9.05±2.42)°, and 86.03±7.45 respectively, showing significant differences compared with preoperative ones (P=0.00). The collapsed transverse arch of the forefoot was recovered to some extent, plantar callus disappeared (14 feet), or decreased (8 feet). Recurrence of hallux valgus deformity was observed in 2 cases (3 feet) at 2 and 3 months after surgery respectively, and no hallux varus was found. ConclusionThis procedure not only can effectively reduce the increased hallux valgus angle, and narrow the angle between the 1st and 2nd metatarsal, but also can relocate the sesamoid system, reconstruct the transverse arch of the forefoot, and effectively restore the physiological anatomy structure and biological function of the forefoot.
Objective To analyze the disease burden and trends of tracheal, bronchus, and lung cancer (TBL) attributable to occupational carcinogens in China from 1990 to 2021, in order to provide parameters for the prevention and control of TBL in China. Methods Based on the Global Burden of Disease database 2021, with occupational carcinogens as relevant risk factors and tracheal, bronchus, and lung cancer as the study diseases, data on mortality and disability-adjusted life years (DALYs) attributable to occupational carcinogens in China from 1990 to 2021 were extracted and age-standardized. Joinpoint regression models were used to calculate the annual percent change (APC) and average annual percent change (AAPC). Hiplot was used to visualize the distribution of disease burden by gender and age. The grey model GM (1, 1) was used to predict the disease burden and trends of TBL attributable to occupational carcinogens in China from 2022 to 2031. Results From 1990 to 2021, the overall mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China increased from 1.85/100 000,53.93/100 000, 2.64/100 000, and 69.50/100 000 in 1990 to 5.22/100 000, 129.29/100 000, 3.49/100 000, and 83.80/100 000in 2021, respectively. The growth rates were 181.62%, 139.77%, 32.40%, and 20.59%, respectively. Joinpoint regression analysis showed that the AAPC values of overall mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China from 1990 to 2021 were 3.41%, 2.87%, 0.92%, and 0.62%, respectively (all P<0.05), showing an overall upward trend, with higher values in females than in males. In 2021, the overall mortality rate of TBL attributable to occupational carcinogens in China gradually increased with age, with high mortality rates mainly concentrated in those aged>65 years, and higher rates in males than in females. The overall DALYs rate showed a trend of increasing first and then slowly decreasing with age, peaking at 65-74 years old, with higher rates in males than in females. The grey prediction model GM (1, 1) showed that the predicted values of mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China from 2022 to 2031 all showed an upward trend. By 2031, the predicted values of mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate will reach 7.19/100 000, 175.63/100 000, 4.16/100 000, and 93.64/100 000, respectively. Conclusion From 1990 to 2021, the mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China all showed an upward trend. Males and the elderly are the main populations affected by the disease burden of TBL attributable to occupational carcinogens in China. It is necessary to strengthen the prevention and control of occupational carcinogens and promote health education.