Objective To analyze the incidence and mortality of acute viral hepatitis in China, project its trends from 2022 to 2030, and provide valuable insights for the prevention and control of viral hepatitis. Methods The incidence and mortality rates of acute viral hepatitis in China from 1990 to 2021 were extracted from the Global Burden of Disease 2021 database. The change rates and the estimated annual percentage change (EAPC) for each indicator were calculated. Additionally, an autoregressive integrated moving average (ARIMA) model was used to project the incidence and mortality of acute viral hepatitis in China from 2022 to 2030. Results From 1990 to 2021, the incidence rates of acute hepatitis A (AHA), acute hepatitis B (AHB), acute hepatitis C (AHC), and acute hepatitis E (AHE) in China all showed a declining trend (EAPC=−1.980%, −2.664%, −2.078%, −1.686%; P<0.05), with a particularly marked decrease in mortality (EAPC=−11.662%, −7.411%, −12.541%, −7.504%; P<0.05). According to ARIMA model projections, the incidence rates of AHA and AHB were expected to continue declining from 2022 to 2030, while the incidence rates of AHC and AHE were expected to rise. In 2030, the projected incidence rates of AHA, AHB, AHC, and AHE were 890.425/100000, 824.158/100000, 59.202/100000, and 300.377/100000, respectively. The mortality rates of AHA, AHC, and AHE were projected to remain stable from 2022 to 2030, while the mortality rate of AHB was expected to decline. In 2030, the projected mortality rates of AHA, AHB, AHC, and AHE were 0.002/100000, 0/100000, 0.004/100000, and 0.011/100000, respectively. Conclusions From 1990 to 2021, the overall incidence and mortality of acute viral hepatitis in China showed a downward trend. However, the incidence rates of AHC and AHE may present an upward trend in the future, which suggests that the government and relevant health authorities should adjust their prevention and control strategies in a timely manner.
ObjectiveTo analyze the epidemiological characteristics and trends of gallbladder cancer incidence and mortality in Zhejiang cancer registration areas from 2000 to 2021, providing a basis for formulating prevention and control strategies for gallbladder cancer. MethodsData on incidence and mortality were collected from 22 cancer registry areas in Zhejiang Province from 2000 to 2021, calculating the crude incidence (mortality), age-standardized incidence / mortality rate by Chinese standard population(ASR China), age-standardized incidence /mortality rate by World standard population (ASR World) and cumulative rate (0–74 years old). The average annual percentage change (AAPC) was calculated by using Joinpoint software. ResultsIn 2021, the crude incidence of gallbladder cancer in Zhejiang cancer registration areas was 6.79 per 100 000. The ASR China and ASR World were 2.99 and 2.96 per 100 000, respectively, ranking 18th of all new cancer cases. The incidence ASR China in female (3.13 per 100 000) was higher than that in male (2.85 per 100 000). The incidence ASR China in rural areas (3.01 per 100 000) was slightly higher than that in urban areas (2.97 per 100 000). The crude mortality of gallbladder cancer was 5.14 per 100 000, with the mortality ASR China and ASR World of 2.09 and 2.10 per 100 000, respectively, ranking 10th of all new cancer deaths. The mortality ASR China in female (2.19 per 100 000) was higher than that in male (1.98 per 100 000). The mortality ASR China in urban areas (2.11 per 100 000) was slightly higher than that in rural areas (2.07 per 100 000). Both the crude incidence and mortality of gallbladder cancer increased with age. The crude incidence and mortality showed an upward trend over time, with AAPC of 2.59% and 3.75%, respectively (P<0.001). The incidence ASR China did not show significant changes over time (AAPC=0.05%, P=0.856). The incidence ASR China in male and rural areas showed increasing trends over time, with AAPCs of 0.89% (P=0.016) and 1.14% (P=0.001), respectively. The incidence ASR China in female and urban areas showed no significant trends over time, with AAPCs of –0.26% (P=0.503) and –0.02% (P=0.967), respectively. The mortality showed a slower upward trend after adjusting the age structure (AAPC=1.01%, P=0.020). ConclusionsThe elderly population in rural areas, especially elderly women, are the primary targets for the prevention and control of gallbladder cancer. Aging is the main factor contributing to the increase in the incidence and mortality of gallbladder cancer. After adjusting for demographic factors, the overall upward trend of the incidence in the male population and rural areas, as well as mortality, cannot be ignored.
ObjectiveTo analyze the epidemic trend of thyroid cancer in China from 2005 to 2018, and understand the estimated epidemiological situation of thyroid cancer in China in 2022 based on the thyroid cancer registration data reported by the National Cancer Registration Center and the China Cancer Registration Annual Report. MethodsThe cases of new thyroid cancer and deaths in China were analyzed according to the data of approximately 700 cancer registries in 2018 and the data of 106 cancer registries from 2005 to 2018, then stratified by sex, age, urban and rural areas, and main regions in China. And the estimated incidence and mortality of thyroid cancer in China in 2022 were analyzed based on the population data in 2020. Results① The age standardized incidence rate (ASIR) and age standardized mortality (ASMR) of thyroid cancer in China from 2005 to 2018: in the whole population, the ASIR showed a relatively rapid upward trend and the ASMR showed a relatively slower upward trend; The ASIR and ASMR of men were lower than those of women and the trend of change was also slower than that of women; The ASIR of thyroid cancer in the whole urban population was markedly higher than that in the rural population and the average annual rising rate (AARR) in the urban and rural areas was 6.31% and 0.38% respectively, while the ASMR had no obviously difference between the urban and rural populations (the AARR was 3.23% and 2.33% respectively); The ASIR of thyroid cancer was the highest in the eastern region with a markedly rising, but its ASMR had a relatively lower rising rate, while the ASIR in the western region was relatively lower and the ASMR also showed a downward trend, and the ASMR in the central region had a relatively obvious rising rate. ② The estimated incidence and mortality of thyroid cancer in China in 2022: the estimated ASIR and ASMR of the whole population in 2022 was still rising as compared with in 2018 (ASIR: 24.64 per 100 000 vs. 12.01 per 100 000; ASMR: 0.45 per 100 000 vs. 0.37 per 100 000 ); The estimated ASIR and ASMR in women were still much higher than in men (ASIR: 36.51 per 100 000 vs. 13.25 per 100 000; ASMR: 0.55 per 100 000 vs. 0.35 per 100 000); Among the urban and rural populations, the estimated ASIR in urban was still higher than in rural areas (27.87 per 100 000 vs. 17.66 per 100 000), while the estimated ASMR had no marked difference between them (0.41 per 100 000 vs. 0.52 per 100 000). Compared with 2018, the development trend of the ASIR was still rising (urban: 27.87 per 100 000 vs. 15.58 per 100 000; rural: 17.66 per 100 000 vs. 8.95 per 100 000). The age specific ASIR of thyroid cancer showed a marked sex differences, that is, it began to rise rapidly from the 20–30 years old group, and reached the peak at the 45–50 years old group (the highest ASIR was 97.00 per 100 000) in women; However, which had been in a slower upward trend from the 0 to 20 years old group, while it had been rising rapidly from the 20 to 25 years old group, reaching the peak at the 30–35 years old group (the highest ASIR was 31.60 per 100 000) in men. The overall trend of age specific ASMR for thyroid cancer was similar for both males and females, with a slower increase starting from the 0–35 years old age group and continuous rising till 85 years old and above. ConclusionsThe incidence and mortality of thyroid cancer in China are rising, and the disease burden is still severe and the differences are existed in urban and rural areas, sex, age, and main regions. Overall, the prevention and control situation is complex and severe in China.
Objective To study the incidence and etiological distribution of lower respiratory tract infection (LRTI) after airway metal stent implantation in patients with malignant central airway obstruction (MCAO). Methods The clinical data of 149 patients with MCAO who underwent airway metal stent implantation in Department of Pulmonary and Critical Care Medicine of Hunan Provincial People's Hospital from April 2014 to April 2021 were selected for a retrospective study. The incidence of LRTI after treatment was counted. According to whether LRTI occurred after operation, they were divided into infected group and uninfected group. The clinical data of the two groups were compared and the influencing factors of LRTI were analyzed. Sputum samples and/or bronchoalveolar lavage fluid samples from patients infected with LRTI were collected for pathogen detection and drug susceptibility test, and the distribution and drug resistance of main pathogens were analyzed. Results A total of 149 patients who met the criteria were included in this study and the incidence of LRTI was 21.48%. People in the infected group was older than that in the uninfected one, and the proportion of people with a history of smoking, chemoradiotherapy, covered metal stents, and stent-related granulation tissue proliferation was higher, and the proportion of people with postoperative standardized aerosol inhalation was lower (P<0.05). Age, smoking history, chemoradiotherapy, covered metal stents, stent-related granulation tissue hyperplasia and postoperative standardized aerosol inhalation were all influencing factors of LRTI in these patients (P<0.05). A total of 38 pathogens were detected in 32 patients with LRTI. Gram negative bacteria, gram positive bacteria and fungi accounted for 68.42% (26/38), 21.05% (8/38) and 10.53% (4/38) respectively. Pseudomonas aeruginosa, the main Gram-negative bacteria, had no resistance to tobramycin, gentamicin and amikacin, but had high resistance to compound sulfamethoxazole, tigecycline and ampicillin; Klebsiella pneumoniae had low resistance to tobramycin, amikacin and tigecycline, and high resistance to cefotaxime, ciprofloxacin and cefepime; the main Gram-positive Staphylococcus aureus had no drug resistance to vancomycin, linezolid, compound sulfamethoxazole and quinuptin/dafuptin, but had high drug resistance to tetracycline, penicillin G, levofloxacin, oxacillin and ciprofloxacin; the main fungi Candida albicans showed no resistance to fluconazole, itraconazole, voriconazole, 5-fluorocytosine and amphotericin B. These results of pathogenic detection and drug susceptibility test contributed to the improvement of the rational application rate of antibiotics. Conclusions LRTI occurs in about a quarter of patients with MCAO after airway metal stent implantation. The pathogens are mainly Pseudomonas aeruginosa and Staphylococcus aureus. Antimicrobial treatment should be based on the results of etiological detection and drug susceptibility test.
Hypertension and its associated cardiovascular diseases such as stroke and ischemic heart disease result in a high burden of disease and health losses, making it the most burdensome disease in the world and one of the important public health issues in China. Currently Chinese scholars have carried out a large number of studies on the prevalence of hypertension, including regional and national prevalence studies. However, long-term follow-up studies on incidence of hypertension are relatively few and mostly limited to specific ages and regions. This paper summarizes the prevalence, incidence and epidemiological trend of hypertension in Chinese adults. The hypertension prevalence increased from 5.1% in 1959 to 27.5% in 2018, and presents an overall trend of high in the north and low in the south. The hypertension incidence is at a high level (the cumulative incidence was 33.4% after 22 years-follow-up), but there are few researches on the trend of hypertension incidence in huge region.
Objective To evaluate the predictive effect of three machine learning methods, namely support vector machine (SVM), K-nearest neighbor (KNN) and decision tree, on the daily number of new patients with ischemic stroke in Chengdu. Methods The numbers of daily new ischemic stroke patients from January 1st, 2019 to March 28th, 2021 were extracted from the Third People’s Hospital of Chengdu. The weather and meteorological data and air quality data of Chengdu came from China Weather Network in the same period. Correlation analyses, multinominal logistic regression, and principal component analysis were used to explore the influencing factors for the level of daily number of new ischemic stroke patients in this hospital. Then, using R 4.1.2 software, the data were randomly divided in a ratio of 7∶3 (70% into train set and 30% into validation set), and were respectively used to train and certify the three machine learning methods, SVM, KNN and decision tree, and logistic regression model was used as the benchmark model. F1 score, the area under the receiver operating characteristic curve (AUC) and accuracy of each model were calculated. The data dividing, training and validation were repeated for three times, and the average F1 scores, AUCs and accuracies of the three times were used to compare the prediction effects of the four models. Results According to the accuracies from high to low, the prediction effects of the four models were ranked as SVM (88.9%), logistic regression model (87.5%), decision tree (85.9%), and KNN (85.1%); according to the F1 scores, the models were ranked as SVM (66.9%), KNN (62.7%), decision tree (59.1%), and logistic regression model (57.7%); according to the AUCs, the order from high to low was SVM (88.5%), logistic regression model (87.7%), KNN (84.7%), and decision tree (71.5%). Conclusion The prediction result of SVM is better than the traditional logistic regression model and the other two machine learning models.
Objective To explore the effect of multimodal interventions in improving the compliance rate of core infection control measures on reducing the incidence rate of vessel catheter associated infection (VCAI). Methods Inpatients with intravascular catheters in 5 departments with high rates of vascular catheterization and infection of Dongguan People’s Hospital between January 2021 and December 2022 were selected. According to the hospital stay, patients were divided into a pre-intervention group (January to December 2021) and a post-intervention group (January to December 2022). The core infection control measures assessment pass rates of medical staff between the two periods and the differences in the incidence rate of VCAI, average catheterization days, and catheterization rate before and after intervention in both groups were compared. Results A total of 8174 patients were included. Among them, there were 3915 patients in the pre-intervention group and 4259 patients in the post-intervention group. In the pre-intervention group, the total length of hospital stay was 122885 days, the total number of catheterization days was 48028 days, and 28 cases of VCAI occurred. In the post-intervention group, the total length of hospital stay was 126966 days, the total number of catheterization days was 51253 days, and 12 cases of VCAI occurred. After intervention, the compliance rate of VCAI core infection control measures was improved [69.21% (2907/4200) vs. 91.24% (3832/4200); χ2=642.090, P＜0.001], the pass rate of medical staff’s core infection control measures assessment was improved [53.33% (128/240) vs. 91.67% (220/240); χ2=88.443, P＜0.001], the catheterization rate was increased [39.08% (48028/122885) vs. 40.37% (51253/126966); χ2=42.979, P<0.001], and the incidence rate of VCAI was reduced [0.58‰ (28/48028) vs. 0.23‰ (12/51253); incidence-rate ratios =0.40, 95% confidence interval (0.20, 0.79), P=0.008]. Conclusions Improving the compliance rate of VCAI core infection control measures through multimodal interventions can significantly improve the passing rates of core infection control measures of medical staffs. This will help to reduce the incidence of VCAI and ensuring patient safety, provide evidence-based support for the prevention and control of VCAI.
ObjectiveTo systematically analyze the incidence and mortality of pancreatic cancer globally and in China from 2018–2022 based on GLOBOCAN 2018, 2020, and 2022 editions released by the International Agency for Research on Cancer, and summarize the main influencing factors to provide reference for the formulation of prevention and control strategies and clinical practice of pancreatic cancer in China. MethodsWe collected and organized data on pancreatic cancer incidence cases, death cases, crude incidence, crude mortality, age-standardized incidence rate by world standard population (ASIRW), and age-standardized mortality rate by world standard population (ASMRW) from the GLOBOCAN database. Combined with socioeconomic parameters such as human development index (HDI) and national income levels, we conducted comparative analysis of the distribution characteristics of pancreatic cancer globally and in China across different regions, age groups, and genders. ResultsFrom 2018 to 2022, incidence number of global pancreatic cancer increased from 458 000 cases to 511 000 cases in 2022, with crude incidence rising from 5.4/100 000 to 6.5/100 000. Deaths increased from 432 000 cases to 467 000 cases, with crude mortality rising from 5.7/100 000 to 5.9/100 000, while ASMRW decreased from 4.4/100 000 to 4.3/100 000. In China, incidence number of pancreatic cancer increased from 116 000 cases in 2018 to 119 000 cases in 2022, accounting for 23.3% of global cases, with crude incidence maintained at (8–9)/100 000. Deaths decreased from 110 000 cases to 106 000 cases, with crude mortality declining from 7.8/100 000 to 7.5/100 000 and ASMRW decreasing from 4.9/100 000 to 3.9/100 000. In 2022, countries with very high HDI had pancreatic cancer ASIRW of 7.9/100 000 and ASMRW of 6.9/100 000, significantly higher than low HDI countries at 1.4/100 000 and 1.3/100 000. Pancreatic cancer incidence showed clear age-related patterns, with the ≥75 age group having 191 157 new cases globally (crude incidence of 63.3/100 000) and 37 722 cases in China (crude incidence of 51.2/100 000). Both globally and in China, males showed higher incidence and mortality than females. ConclusionsPancreatic cancer is becoming an important public health challenge globally and in China, with incidence and mortality likely to continue rising in the future. Comprehensive prevention and control measures including tobacco control, obesity management, and diabetes monitoring should be strengthened. Early screening and standardized diagnosis and treatment for high-risk populations are crucial for improving pancreatic cancer survival rates. Improving the national cancer registry system and integrating multidisciplinary collaborative models can lay a solid foundation for precision prevention and treatment of pancreatic cancer.
Objective To establish the control range of monthly nosocomial infection incidences in different departments and put them into practice, to provide a scientific and effective method for nosocomial infection control. Methods The surveillance data about nosocomial infection cases in Nanchong Central Hospital from January 2016 to December 2018 were used to set the warning limits and control limits in different departments based on the theory of medical reference range. From January 2019, the clinical departments would be alerted if their nosocomial infection incidences were beyond the warning limits, and investigated and intervened if the incidences were beyond the control limits. Results The control range of monthly nosocomial infection incidences in different departments had been made. For identifying risk events, the sensitivity was 83.3%, the specificity was 96.2%, the positive predictive value was 29.4%, the negative predictive value was 99.7%, the coincidence rate was 96.0%, and the consistency was medium (kappa=0.419, P<0.001). The effective rate of the initial alert intervention was 83.3%, and the effective rate of the field intervention was 100.0%. Conclusion The establishment and application of the control range of monthly nosocomial infection incidences in different departments can identify potential risk events and realize precise nosocomial infection control.
In 2022, the National Cancer Center (NCC) of China reported the nationwide statistics of 2016 using population-based cancer registry data from all available cancer registries in China, which was mainly about the cancer incidence and mortality. Cancer remains a major health problem currently in our country and requires long term cooperation to deal with. This article provided a key point interpretation and analysis of cancer prevalence data in China, and provided an analysis of several main risk factors for cancer, which was conducive to the development of cancer prevention and control programs in different regions.