ObjectiveTo analyze the trend of disease burden of colorectal cancer (CRC) in China from 1990 to 2019.MethodsData was obtained from Global Burden of Disease Study 2019 (GBD 2019). Incidence, mortality, disability-adjusted life year (DALY), years of life lost (YLL), years lived with disability (YLD), and their corresponding standardized rate and annual average percentage change (AAPC) were used to describe the changes of disease burden of colorectal cancer in Chinese population between 1990 and 2019.ResultsCompared with 1990, the number of new cases, standardized incidence, the number of deaths and standardized mortality of CRC in China in 2019 increased by 474.03%, 144.01%, 230.14%, and 36.15%, respectively. The standardized mortality and standardized incidence of CRC in China had reached and gradually exceeded the global level since 2010. From 1990 to 2019, the overall standard incidence (AAPC=3.6%, P<0.05), standard mortality rate (AAPC=1.4%, P<0.05), and the standard DALY rate (AAPC=1.2%, P<0.05) of CRC in China showed an increasing trend. The incidence, mortality and DALY rates of males were higher than those of females, and gradually increased with age. Compared with 1990, the DALY, YLL, and YLD of CRC in 2019 increased by 134.3%, 127.69%, and 445.00%, and their corresponding standardized rates increased by 30.53%, 27.03%, and 187.29%, respectively, showing an overall upward trend.ConclusionsFrom 1990 to 2019, the standardized incidence rate and standardized mortality rate of colorectal cancer in China have had a continuously increasing trend, and males and the elderly are high-risk groups. To reduce the burden of colorectal cancer in China, effective measures should be taken for prevention and management.
ObjectiveTo explore the clinical efficacy of percutaneous endoscopic interlaminar discectomy (PEID) and interlaminar fenestration discectomy in the treatment of lumbar (L) 5-Sacral (S) 1 lumbar disc herniation (LDH).MethodsLDH patients were retrospectively included from January 2016 to Januray 2018. And the patients were divided into the PEID group and the fenestration group according to their choice of different surgical methods. The operation time, intra-operative blood loss, and bed rest time in the two groups were recorded. The preoperative and postoperative [1 week, 1 month, 3 months, and last follow-up (>12 months)] Visual Analogue Score (VAS) of the lumbago and leg pain between the two groups were compared; the preoperative and postoperative [1 week, and last follow-up (>12 months)] Oswestry Disability Index (ODI) and also the postoperative [(>12 months)] therapeutic effect (modified MacNab) between the two groups were compared.ResultsA total of 66 patients were included, with 31 in the PEID group and 35 in the fenestration group. There was no significant difference in age, gender and course of disease between the two groups (P>0.05). There were leakage of cerebrospinal fluid and transient lumbago, leg pain and numbness, which were worse than those before operation in the PEID group (1 and 1 patient, respectively) and the fenestration group (2 and 3 patients, respectively). There were statistically significant differences between the PEID group and the fenestration group, in the operative time [(90.65±9.98) vs. (66.23±16.50) minutes], intra-operative blood loss [(51.77±18.64) vs. (184.29±78.38) mL], and bed time [(2.87±0.92) vs. (7.49±1.20) d] (t=?7.365, t’=?9.697, t=?17.374, P<0.001). There was no significant difference in the preoperative VAS score (lumbar-leg pain) and ODI index, and the ODI index at each postoperative time point, between the two groups (P>0.05). VAS score (lumbago) and VAS score (leg pain) in the PEID group at each postoperative time point were lower than those in the fenestration group (P<0.05); VAS scores (leg pain) at other time points were not statistically significant between the two groups (P > 0.05). VAS (lumbar-leg pain) score and ODI index at each postoperative time point were lower than those before the surgery. The was no statistically significant difference in the PEID group (90.32%) and fenestration group (85.71%) in the excellent rate (χ2=0.328, P=0.713).ConclusionsPEID has less surgical trauma, less bleeding, short bed rest, fast recovery, and better relief of postoperative lumbago symptoms. It is worthy of further promotion in clinical work.
Objective To analyze the burden of cardiovascular diseases (CVDs) and its trend attributed to household air pollution (HAP) from solid fuels in China from 1990 to 2019. Methods Using the data derived from the Global Burden of Disease Study 2019 (GBD 2019), including mortality rates, disability-adjusted life years (DALY), age-standardized mortality rates, age-standardized DALY rates, annual percentage change (APC), and average annual percentage change rate (AAPC), we analyzed the CVD burden and its trend attributed to HAP in China from 1990 to 2019. Results In 2019, HAP in China resulted in 227 000 deaths and 5 182 200 DALYs of CVD; the mortality rate attributed to HAP was 15.96 per 100 000, and the DALY rate was 364.34 per 100 000. In 2019, the age-standardized mortality and DALY rates in China were 12.52 and 262.65 per 100 000, respectively, which were lower than the rates globally, and the rates for males were higher than those for females (13.90 vs. 11.32 per 100 000, 291.76 vs. 234.50 per 100 000). In 2019, both mortality and DALY rates attributed to HAP increased with age, peaking in the age groups of 95 plus and 85-89, respectively. From 1990 to 2019 in China, both age-standardized mortality and DALY rates of CVD attributed to HAP showed a downward trend over time. The average annual percentage change rate (AAPC) of the age-standardized mortality rate was ?6.0% (95%CI: ?6.2% to ?5.8%), and the APCC of the age-standardized DALY rate was ?5.8% (95%CI: ?6.1% to ?5.6%). The burden of the CVD subclass also showed a downward trend. Conclusion From 1990 to 2019, the burden of CVD attributed to HAP from solid fuels in China shows a significant downward trend, with sex and age differences. Females and the elderly are the key groups of disease burden, so effective interventions should be taken for these groups.
ObjectiveTo analyze the disease burden and development trend of non-Hodgkin lymphoma (NHL) in China from 1990 to 2019. MethodsThe changes of incidence, mortality, disability-adjusted life years (DALY) and their corresponding age-normalization rates for NHL were analyzed by using the 2019 Global Burden of Disease Database. Regression analysis was performed by Joinpoint software to calculate annual percentage change (APC) and average annual percentage change (AAPC) of standardized morbidity, standardized mortality, standardized DALY rate to reflect the change trend of disease burden. And the results were compared with global data. ResultsFrom 1990 to 2019, the disease burden of NHL in China showed an overall increasing trend. Compared with 2019, the standard incidence rate, standard mortality rate and standard DALY rate of NHL in China increased by 144.72%, 27.17% and 15.61%, respectively. The annual rates of change were 3.12%, 0.80% and 0.51%, respectively. There were gender and age differences in disease burden. The burden of disease increased with age, and the burden of disease was higher in males than in females. ConclusionThe disease burden of NHL in China shows an increasing trend from 1990 to 2019. With the development of diagnosis and treatment options, the disease burden has decreased in recent years, but it is still higher than the global level. There is still a need to strengthen research on its pathogenesis and treatment options, and to actively intervene in high-risk groups to reduce the disease burden of NHL.
ObjectiveTo systematically review the disease burden of pneumoconiosis in Chinese population so as to provide references for health resources allocation and health policy making.MethodsDatabases including PubMed, EBSCO, Web of Science, CNKI, WanFang Data and VIP databases were searched for studies on investigation of the disease burden of pneumoconiosis in Chinese population from inception to 31st January, 2020. Two reviewers independently screened literature, exacted data, and assessed risk of bias of included studies. Systematic review was performed on data of pneumoconiosis associated population, mortality, and disease burden.ResultsA total of 26 studies were included. Qualitative analysis showed that the decrease of DALY and YLL of pneumoconiosis in China had been lower than that in globally, and the increase of YLD had been higher than that in globally in recent 10 years. 14 factors were included in the analysis of influencing factors on the financial burden or hospitalization expenses of pneumoconiosis patients; among them, the length of hospitalization, related complications, and pneumoconiosis stage were the most important indexes which had influence or difference on patients’ financial burden (or hospitalization expenses). The burden of pneumoconiosis in the Chinese population was primarily concentrated on males. Occupational diseases caused most of them, and middle-aged and older adults were the primary population for pneumoconiosis. However, young patients due to early-onset age, long course of disease and complications, and other factors resulting in a larger YLD phenomenon should also be considered.ConclusionsThe disease burden of pneumoconiosis patients in China is still heavy. It is recommended to continue to reduce the DALY of pneumoconiosis among the Chinese population as a long-term goal, and to strengthen control strategies to curb the early onset and death of pneumoconiosis.
Objective
To explore the clinical efficacy and safety of percutaneous kyphoplasty (PKP) in the treatment of Kummell disease.
Methods
We retrospectively analyzed the clinical data of 11 patients with Kummell disease treated by PKP between January 2013 and January 2016. There were 8 males and 3 females with an average age of 72.3 years old ranging from 64 to 78. The injured vertebra was located at T11 in 2 patients, T12 in 3, and L1 in 6. All the patients suffered from lower back pain for 2.5-15.0 months averaging 7.6 months. Preoperative CT and MRI examinations showed that there were clear signs of intravertebral vacuum cleft and abnormal fluid signals. The Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and the height and kyphotic angle of the injured vertebral body were measured to evaluate the clinical outcomes before and after surgery.
Results
Follow-up was conducted for all 11 patients. Cement leakage occurred in 4 patients with no symptoms. The vertebral height, Cobb angel of the injured vertebra, VAS and ODI improved significantly after surgery and during the latest follow-up. Compared with those parameters after surgery, only VAS score was different during the latest follow-up.
Conclusion
PKP is safe and effective in the treatment of Kummell disease.
ObjectivesTo systematically review approaches to derive disability weights (DWs) based on EQ-5D instrument.MethodsPubMed, EMbase, Web of Science, CNKI and WanFang Data databases were electronically searched to collect studies on the approaches to derive disability weights based on EQ-5D from inception to June 1st, 2019. Two reviewers independently screened literature, extracted the basic information and evaluated risk of bias of included studies. Then, systematic review on approaches to derive DWs based on EQ-5D instrument was performed.ResultsA total of 18 studies were included, which were published between 2003 and 2018. The included studies involved a variety of diseases, mostly focusing on quality of life and the burden of disease. The approaches to derive DWs based on EQ-5D health instrument were as follows: DWs=health utility scoreNormal or Control?health utility scoreDisease (7 studies), DWs=1?VAS score/100 (6 studies), DWs=1?health utility scoreDisease (3 studies), linear regression model (1 study), and mapping (1 study).ConclusionsAmong all the included studies using EQ-5D-based disability weight measurement methods involves a variety of diseases, with relatively low comparability. More methodological studies are from abroad. Among all the applied approaches, DWs equally to health utility scoreNormal or Control minus health utility scoreDisease is the most commonly used.
ObjectiveTo compare the disability conditions in different elderly populations in Sichuan province in order to get baseline data for further analyses in the future.
MethodFrom October 2011 to August 2012, face-to-face interviews were performed by trained investigators in different elderly populations from urban communities, rural communities, acute care wards and rehabilitation wards. The main content of the investigation was the Elderly Disability Assessment Scale (EDAS).
ResultsTotally, 1406 subjects were interviewed, among which, 1387 subjects completed the questionnaires. The response rate was 98.7%. The mean age of the participants was (73.8±8.2) years old. Elderly people dwelling in rural areas had a highest disability rate (81.4%), while the correspondent rate in subjects in acute care wards, rehabilitation wards, and urban community were 79.2%, 64.5%, and 53.8%, respectively (P<0.001). In each population, the disability rate increased with age. In the whole sample, most disabled subjects were of mild disability (80.5%). However, those in acute care wards or rehabilitation wards were more likely to have severe or profound disability.
ConclusionsThe disability rate and the severity of disability increase with age in different elderly populations in Sichuan province, although most of them are of mild disability. The disability rate is conspicuously higher in the elderly dwelling in rural areas.
According to system reform of the current medical insurance diagnosis related groups, quality control of rehabilitation medicine and requirements of information management, this paper constructs a rehabilitation information system by using the theoretical framework and core sets of International Classification of Functioning, Disability and Health (ICF). Then, the constructed system is embedded into the work of rehabilitation medicine team. By the four processes of ICF items evaluation, rehabilitation goal setting, team cooperation scheme formulation and reevaluation, the operation process of rehabilitation information management based on ICF is formed, which strengthens comprehensively the rehabilitation diagnosis and treatment standards and improves the efficiency of quality control management. The big data mining and multi-dimensional analysis in this platform can provide support of medical insurance payment, achieve exchanging and sharing rehabilitation medical quality control data among hospitals at different levels in different regions, assist tertiary referral and remote rehabilitation, improve the rehabilitation medical service system, and enhance the level of rehabilitation medical care. This paper will summarize the application experience of constructing ICF rehabilitation information management system.
ObjectivesTo systematically review the disease burden and epidemiological characteristics of tuberculosis in the Chinese population, and to provide reference for health resources allocation and health policy making.MethodsDatabases such as PubMed, EMbase, CNKI, VIP and WanFang Data were searched for studies investigating disease burden of tuberculosis in Chinese population from inception to August 1st, 2017. Two researchers independently screened literature, exacted data and assessed methodological quality of included studies. Statistical analysis was performed on data of tuberculosis associated population, mortality and disease burden.ResultsA total of 40 studies were included. The results of qualitative analysis showed that, since 1990, the prevalence of tuberculosis and its disease burden in China decreased year by year. However, the disease burden per patient and the total economic burden in China showed an increasing trend, and the economical disease burden increased 1.6 times from 1993 to 2003. The disease burden of men was higher than that of women, and it was higher in the countryside than in the city. In 2004, the ratio of YLL per thousand people in rural and urban areas was 2.18, and the ratio was 1.29 in 2014. Additionally, the disease burden decreased gradually in western, central and eastern regions. In 2014, compared with 2004, YLL decreased by 1.11, while the central and eastern regions were 0.48 and 0.25, respectively. The gap between the gender, the urban and rural areas and the regions was not as significant as in previous.ConclusionsThe disease burden of tuberculosis in China is seriously high and the tuberculosis prevention and control work should take into consideration the epidemiological characteristics of tuberculosis and the trends of the disease burden. It is necessary to rationally and effectively implement health intervention programs and allocate health resources based on different health demands in different regions and age groups to reduce the morbidity and mortality, and to pay more attention to drug-resistant tuberculosis. Besides, the emphasis of prevention should be placed on reducing disease burden in the elderly and strengthening prevention in the young population.
