1173例淋巴瘤患者死亡原因调查

目的:分析淋巴瘤患者人群的死亡原因和长期预后情况。方法:收集北京大学肿瘤医院1995年1月至2017年12月收治的6 200例淋巴瘤患者的基线资料,筛选其中已经发生死亡且死亡原因已知的患者,并收集其临床资料和死亡信息。结果:共筛选出1173例患者,其中男性742例(63.3%),女性431例(36.7%)。中位年龄为56(8~ 92)岁。霍奇金淋巴瘤(Hodgkin's lymphoma,HL) 77例(6.6%),非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL) 1095例(93.4%),病理分类不明确1例。总体人群生存期为0~ 253个月,中位生存期为20个月。直接死亡原因包括淋巴瘤688例(58.7%),各类感染性疾病119例(10.1%),心血管疾病(car diovascular disease,CVD) 96例(8.2%),第二原发肿瘤68例(5.8%),其他疾病202例(17.2%)。根本死亡原因包括淋巴瘤936例(79.8%),第二原发肿瘤94例(8.0%), CVD75例(6.4%),呼吸系统疾病32例(2.7%)和其他疾病36例(3.1%)。生存期超过5年的217例患者根本死亡原因为淋巴瘤129例(59.4%),第二原发肿瘤38例(17.5%), CVD35例(16.1%)和其他疾病15例(6.9%)。生存期超过10年的60例患者根本死亡原因为淋巴瘤28例(46.7%),第二原发肿瘤17例(28.3%), CVD7例(11.7%)和其他疾病8例(13.3%)。结论:原发肿瘤仍是淋巴瘤患者死亡的主要原因。第二原发肿瘤和CVD是除原发肿瘤以外最常见的死亡原因,并且随着生存期的延长,二者所致的死亡风险明显增加。

The China Alzheimer Report 2022

China’s population has rapidly aged over the recent decades of social and economic development as neurodegenerative disorders have proliferated,especially Alzheimer’s disease(AD)and related dementias(ADRD).AD’s incidence rate,morbidity,and mortality have steadily increased to make it presently the fifth leading cause of death among urban and rural residents in China and magnify the resulting financial burdens on individuals,families and society.The‘Healthy China Action’plan of 2019-2030 promotes the transition from disease treatment to health maintenance for this expanding population with ADRD.This report describes related epidemiological trends,evaluates the economic burden of the disease,outlines current clinical diagnosis and treatment status and delineates existing available public health resources.More specifically,it examines the public health impact of ADRD,including prevalence,mortality,costs,usage of care,and the overall effect on caregivers and society.In addition,this special report presents technical guidance and supports for the prevention and treatment of AD,provides expertise to guide relevant governmental healthcare policy development and suggests an information platform for international exchange and cooperation.

The Establishment of a New Air Health Index Integrating the Mortality Risks Due to Ambient Air Pollution and Non-Optimum Temperature

A composite Air Health Index(AHI)is helpful for separately emphasizing the health risks of multiple stimuli and communicating the overall risks of an adverse atmospheric environment to the public.We aimed to establish a new AHI by integrating daily mortality risks due to air pollution with those due to non-optimum temperature in China.Based on the exposure-response(E-R)coefficients obtained from time-series models,the new AHI was constructed as the sum of excess mortality risk associated with air pollutants and non-optimum temperature in 272 Chinese cities from 2013 to 2015.We examined the association between the“total AHI”(based on total mortality)and total mortality,and further compared the ability of the“total AHI”to predict specific cardiopulmonary mortality with that of“specific AHIs”(based on specific mortalities).On average,air pollution and non-optimum temperature were associated with 28.23%of daily excess mortality,of which 23.47%was associated with non-optimum temperature while the remainder was associated with fine particulate matter(PM2.5)(1.12%),NO2(2.29%,),and O3(2.29%).The new AHI uses a 10-point scale and shows an average across all 272 cities of 6 points.The E-R curve for AHI and mortality is approximately linear,without any thresholds.Each one unit increase in“total AHI”is associated with a 0.84%increase in all-cause mortality and 1.01%,0.98%,1.02%,1.66%,and 1.71%increases in cardiovascular disease,coronary heart disease,stroke,respiratory diseases,and chronic obstructive pulmonary disease mortality,respectively.Cause-specific mortality risk estimates using the“total AHI”are similar to those predicted by“specific AHIs.”In conclusion,the“total AHI”proposed herein could be a promising tool for communicating health risks related to exposure to the ambient environment to the public.

中国糖尿病发病率和检出率地域性差异——98058例成年受试者数据多水平空间分析

目的探究中国糖尿病发病率和检出率地域性差异。方法选取分布在中国大陆162个地区的98058例18岁以上成年受试者的自述报告和生物学数据(90.5%反馈率),采用美国糖尿病协会糖尿病诊疗标准评估受试者的糖尿病症状,根据先前诊断结果 ,做出其是否患有糖尿病的判断。以各省为单位,使用分区统计图表法评估各调研数据结果的地域性差异。应用多元logistic回归分析法,校正个体和地域层级的差别后,评估每个结果出现的概率。结果各省糖尿病患者的地理分布反映出中国糖尿病发病率和检出率地域性差异。校正年龄、性别和城市/农村社会经济状况等因素后,糖尿病发病率自东北部向北部,从8.3%(95%CI 7.2%,9.7%)上升至12.7%(11.1%,14.6%)。从较好社会经济状况(socioeconomic circumstances,SEC)的城市到农村较差社会经济状况的县/区,糖尿病发病率呈下降趋势,分别为13.1%(12.0%,14.4%)和8.7%(7.8%,9.6%)。校正健康知识水平和个人原因两个因素后,地域性差异仍具有统计学意义。仅三分之一的糖尿病患者在接受此次测试前有糖尿病诊断史,但此结果因地域不同而不同。校正年龄、性别和城市/农村SEC后,糖尿病检出率自北向西南从40.4%(34.9%,46.3%)下降至15.6%(11.7%,20.5%)。与较好SEC县市的40.8%(37.3%,44.4%)检出率相比,农村较差SEC地区的检出率最低,仅为20.5%(17.7%,23.7%)。糖尿病检出率的地域性差异并不完全是个体差异造成的。结论加强防控糖尿病意识,提高检测准确率应从地域性因素出发。

The Burden of Hypertension-Related Chronic Kidney Disease—China,2010–2019

What is already known about this topic?The global burden of chronic kidney disease(CKD)is on the rise.What is added by this report?In 2019,5.58 million individuals in China were affected by CKD related to hypertension,leading to 70,260 fatalities and 1.69 million disability-adjusted life years(DALYs).The most affected groups were men,older individuals,and residents of western China.Over the period from 2010–2019,the age-standardized prevalence rate(ASPR)remained constant,and the agestandardized mortality rate(ASMR)and agestandardized DALY rate(ASDR)showed a decreasing trend.However,there was an increase in the number of cases,deaths,and DALYs associated with this condition.What are the implications for public health practice?Hypertension significantly contributes to the burden of CKD;therefore,raising awareness and implementing early screening measures are essential.

Burden of digestive system diseases in China and its provinces during 1990-2019:Results of the 2019 Global Disease Burden Study

Background:Evaluating the impact of digestive system diseases is vital for devising effective prevention strategies.However,comprehensive reports on the burden of digestive system diseases in China are lacking.Our study aimed to provide an overview of the burden and trends of digestive system diseases from 1990 to 2019 in China and its provinces.Methods:This cross-sectional study utilized the Global Disease Burden Study 2019 to estimate the incidence,mortality rate,disability-adjusted life years(DALYs),years of life disability,years of life lost,and changes in the burden of digestive diseases across Chinese provinces from 1990 to 2019.The analysis of disease burden primarily examines the characteristics of sub-disease distribution,time trends,age distribution,and sex distribution.Additionally,we compared provincial age-standardized DALYs for digestive diseases with the expected rates based on the socio-demographic index(SDI).Results:In 2019,there were 499.2 million cases of digestive system diseases in China,resulting in 1,557,310 deaths.Stomach cancer,colon and rectal cancer,and esophageal cancer are the top three diseases associated with mortality and DALY related to digestive system diseases.Meanwhile,cirrhosis and other chronic liver diseases,gastroesophageal reflux disease,and gallbladder and biliary diseases are the top three kinds of diseases with the highest prevalence among digestive system diseases.The risk of gastric cancer sharply increases among men after the age of 40 years,leading to a significant disparity in burden between men and women.As the SDI increased,the DALYs associated with digestive system diseases in China and its provinces showed a downward trend.Conclusion:Our study highlights the inverse correlation between DALYs associated with digestive system diseases and the SDI.

Epidemiological characteristics of centenarian deaths in China during 2013-2020:A trend and subnational analysis

Background:Studies that comprehensively address the characteristics of centenarian deaths are rare.The present study aimed to depict the characteristics of centenarian deaths in China and their changing trends.Methods:Data on centenarian deaths between 2013 and 2020 were obtained from the national mortality surveillance system of China,including date,place of death(PoD),and underlying cause of death(CoD).Descriptive analyses were performed to understand the epidemiological characteristics,and a joinpoint regression model was adopted to examine the changing trends in the proportions of different PoDs,CoDs among centenarians,and centenarian deaths accounting for all deaths and deaths among people aged 65 years and older.Results:There were 46,938 registered centenarian deaths between 2013 and 2020 that included 34,311 females(73.10%)and 12,627 males(26.90%).January(12.05%),February(9.99%),and December(9.74%)were the top three months with the highest number of deaths.The proportions of deaths that occurred in homes,hospitals,and nursing homes were 81.71%,13.63%,and 2.68%,respectively.The proportion of deaths in nursing homes increased by 9.60%(95%confidence intervals[CIs],6.4-12.9%)from 2014 to 2020.Heart disease(35.72%)was the leading cause of death,followed by respiratory diseases(17.63%),cerebrovascular disease(15.60%),and old age(11.22%).The proportion of respiratory diseases decreased by 4.8%(95%CI,-8.8 to-0.7%),and the proportion of deaths from old age decreased by 2.3%(95%CI,-4.4 to-0.1%)per year.Shanghai had the highest proportions of deaths in hospitals(39.38%)and nursing homes(14.68%).Sichuan had the highest proportion of deaths attributed to respiratory diseases(32.30%),while Jiangsu(26.58%)and Zhejiang(23.61%)had the highest proportions of deaths from old age.Conclusion:Unlike other countries,centenarian deaths in China are characterized by a higher proportion of home and heart disease deaths,and this death pattern differs across provinces.

Incidence,prevalence,and causes of spinal injuries in China,1990-2019:Findings from the Global Burden of Disease Study 2019

Background:Spinal injuries are an urgent public health priority;nevertheless,no China-wide studies of these injuries exist.This study measured the incidence,prevalence,causes,regional distribution,and annual trends of spinal injuries in China from 1990 to 2019.Methods:We used data from the Global Burden of Diseases,Injuries,and Risk Factors Study 2019 to estimate the incidence and prevalence of spinal injuries in China.The data of 33 provincial-level administrative regions(excluding Taiwan,China)provided by the National Center for Chronic and Noncommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention(CDC)were use to systematically analyze the provincial etiology,geographical distribution,and annual trends of spinal injuries.The Bayesian meta-regression tool DisMod-MR 2.1 was used to ensure the consistency among incidence,prevalence,and mortality rates in each case.Results:From 1990 to 2019,the number of living patients with spinal injuries in China increased by 138.32%,from 2.14 million to 5.10 million,while the corresponding age-standardized prevalence increased from 0.20%(95%uncertainty interval[UI]:0.18-0.21%)to 0.27%(95%UI:0.26-0.29%).The incidence of spinal injuries in China increased by 89.91%(95%UI:72.39-107.66%),and the prevalence increased by 98.20%(95%UI:89.56-106.82%),both the most significant increases among the G20 countries;71.00%of the increase could be explained by age-specific prevalence.In 2019,the incidence was 16.47(95%UI:12.08-22.00,per 100,000 population),and the prevalence was 358.30(95%UI:333.96-386.62,per 100,000 population).Based on the data of 33 provincial-level administrative regions provided by CDC,age-standardized incidence and prevalence were both highest in developed provinces in Eastern China.The primary causes were falls and road injuries;however,the prevalence and specific causes differed across provinces.Conclusions:In China,the overall disease burden of spinal injuries increased significantly during the past three decades but varied considerably according to geographical location.The primary causes were falls and road injuries;however,the prevalence and specific causes differed across provinces.

Mortality Burden of Liver Cancer in China: An Observational Study From 2008 to 2020

Background and Aims:China accounts for nearly half of liver cancer deaths globally.A better understanding of the current liver cancer mortality will be helpful to establishing priorities for intervention and to decreasing the disease burden of liver cancer.The study aimed to explore and predict the mortality burden of liver cancer in China.Methods:Data were extracted from the Disease Surveillance Point system of the Chinese Center for Disease Control and Prevention from 2008 to 2020.Crude and age-standardized liver cancer mortality rates were reported by sex,urban or rural residence,and region.Trends in liver cancer mortality rates from 2008 to 2020 were estimated as average annual percentage change(AAPC).The changing trend of live cancer mortality in the future is also predicted.Results:In 2020,the crude mortality of liver cancer was 25.57/100,000,and males and people lived in rural areas had higher age-standardized liver cancer mortality rates than females and people lived in people in urban areas.Crude mortality and age-standardized mortality rates in southwest provinces(Guangxi,Sichuan,Tibet)and in a northeast province(Heilongjiang)were higher than that in other provinces,and age-specific mortality rates increased with age.From 2008 to 2020,liver cancer mortality rates decreased,but people under 50 years of age had a higher AAPC than those over 50 years of age,possibly because of the adoption of hepatitis B virus vaccination in newborns and children.Furthermore,the mortality of liver cancer in 2021–2030 is predicted to have a downward trend.Conclusions:Liver cancer mortality rates declined in China from 2008 to 2020.Future interventions to control liver cancer mortality need to focus on people of male sex,older age,and living in rural areas or less developed provinces.

Assessment of disability weights at the provincial and city levels based on 93,254 respondents in Fujian,China:Findings from the Fujian disability weight measurement study

To the Editor:Disability weights(DWs)are essential factors to quantify health losses relating to non-fatal outcomes for estimates of disability-adjusted life years(DALYs).Although national and subnational sets of DWs were published recently in the Chinese mainland,[1]data from only 4925 participants who responded to population health equivalence(PHE)questions used to anchor the 0-1 DWs scale did not include participants from Fujian province.Moreover,it remains unknown whether people living in different cities share the same DWs.This study provided an alternative approach using non-parametric regression to locate the DWs scale,as used in European surveys,[2]aimed at measuring DWs at the provincial and subprovincial levels in Fujian.

A comprehensive index to evaluate cognitive health at the population scale

Cognitive health is a major determinant of human survival and quality of life.As an increasing proportion of the global population reaches old age(defined as 60 years and older),dementia has become a public health and social care priority.[1]China contains about 15.07 million people with dementia,accounting for 25%of the world’s total dementia population.[2]Due to a relatively high proportion of individuals reaching old age,China is expected to have the sharpest increase in dementia cases of any country over the next few decades,causing ever-greater social and economic impacts.

Trends in Mortality of Cirrhosis in China: An Analysis of the China Death Surveillance Database from 2008 to 2020

Background and Aims:China accounts for 14.9%of total cirrhosis deaths worldwide.A detailed and comprehensive understanding of the contemporary status of cirrhosis mortality in China is crucial for establishing strategies for intervention and decreasing the disease burden of cirrhosis worldwide.The study aimed to report the cirrhosis mortality rates in our whole country or province over time.Methods:Mortality data from 2008 to 2020 were retrieved from the Disease Surveillance Point System(DSPs)of the Chinese Center for Disease Control and Prevention.The crude mortality rate and age-standardized mortality rate of patients with cirrhosis were stratified by sex,residential location,and region.The average annual percentage change(AAPC)in cirrhosis mortality rates from 2008 to 2020 was also calculated.Results:The crude mortality rate of cirrhosis was 4.57/100,000 people in 2020.Compared with females and individuals living in urban areas,males and people living in rural areas had greater age-standardized mortality.The crude mortality rate and age-standardized mortality rate in provinces in Southwest China(Guangxi,Yunnan,Guizhou,and Qinghai)were greater than those in other provinces.Moreover,with increasing age,the age-specific mortality rate increased significantly.From 2008 to 2020,the mortality rate of cirrhosis in China decreased except for in males aged 50–59 years,females aged 45–49 years and females aged 80–84 years.Conclusions:The mortality rate of patients with cirrhosis in China decreased from 2008 to 2020.In the future,interventions of cirrhosis mortality control need to pay more attention to all males,females aged 45–49 and 80–84 years,and people living in rural areas and in provinces in Southwest China.

Chronic Obstructive Pulmonary Disease-Associated Mortality — China, 2014–2021

Introduction:China faces a growing burden of chronic obstructive pulmonary disease(COPD).Previous mortality estimations were primarily based on the underlying cause of death.This study analyzed COPD-associated death and its comorbidities using all COPD cases listed on the chain of events on death certificates.Methods:A retrospective analysis of the National Mortality Surveillance System(NMSS)was conducted to estimate COPD-associated mortality from 2014 to 2021.Age-standardized mortality rates(ASMRs)were calculated stratified by sex,region,and residence.Joinpoint regression was used to estimate the average annual percentage change(AAPC)during the study period.Results:From 2014 to 2021,the ASMR of COPD decreased from 91.85 to 45.90 per 100,000 population.Significant but uneven decreases in COPD mortality were observed across gender[females:AAPC:−11.2%,95%confidence interval(CI):−11.9 to−10.4%;males:AAPC:−8.0%,95%CI:−9.2 to−6.8%],regions(eastern:AAPC:−10.7%,95%CI:−11.5 to−9.9%;central:AAPC:−9.9%,95%CI:−10.9 to−8.9%;western:AAPC:−7.7%,95%CI:−10.6 to−4.7%),and residential areas(urban:AAPC:−10.9%,95%CI:−12.3 to−9.5%;rural:AAPC:−8.3%,95%CI:−9.1 to−7.4%).Other than COPD,cardiovascular diseases and respiratory conditions were the major underlying causes of death in COPDassociated mortality.Conclusions:COPD is a significant comorbidity of other disorders in China.Although COPDassociated mortality substantially decreased from 2014 to 2021,the burden remained high in underdeveloped regions.

The Association Between Depression and All-Cause,Cause-Specific Mortality in the Chinese Population—China,2010-2022

What is already known about this topic?Depression is linked to higher all-cause and cardiovascular mortality rates,but its effects on specific subgroups and non-cardiovascular mortality in the Chinese population remain unclear.What is added by this report?Both severe and mild to moderate depression were found to elevate mortality rates among the Chinese population.The impact was particularly notable among males,urban residents,younger individuals,and those with higher education levels.Depression exhibited a stronger connection with fatalities related to suicide and non-suicidal injuries.What are the implications for public health practice?Individuals experiencing mild depression require healthcare attention to avoid negative consequences.Enhanced physical and psychological support is particularly crucial for high-risk subgroups.

1990年和2019年中国分省精神障碍伤残负担分析

目的分析1990年和2019年中国人群精神障碍患病及伤残负担变化情况, 为降低精神障碍健康危害提供参考。方法利用2019年全球疾病负担(Global Burden of Disease Study 2019, GBD2019)中国研究结果, 分析2019年中国人群不同年龄、不同性别、不同省份精神障碍患病及伤残负担, 比较1990年与2019年中国精神障碍的患病和伤残损失寿命年(years of life lived with disability, YLDs)指标变化情况。结果 2019年中国精神障碍50~69岁年龄组患病率最高(13.2%, 患病人数为4 853.0万), 0~14岁年龄组患病率最低(7.3%, 患病人数为1 645.6万);女性总体YLDs数量高于男性(1 091.0万人年/938.2万人年);2019年抑郁障碍、焦虑症、精神分裂症的标化患病率分别为2.7%、3.2%、0.3%, 患病人数分别为5 005.6万、4 784.2万、549.9万;与1990年比较, 抑郁障碍和焦虑症的标化患病率下降幅度分别为9.1%和9.8%, 精神分裂症的标化患病率上升幅度为3.1%;2019年中国精神障碍标化患病率前3位的省份分别是湖南省(12.2%)、甘肃省(12.1%)和宁夏回族自治区(11.8%), 3个省份的精神障碍患病人数分别为890.1万、336.4万、87.3万。标化YLDs率位于前3位的省份分别为山东省(1 470.0/10万)、甘肃省(1 415.6/10万)和湖南省(1 399.3/10万)。结论精神障碍是威胁中国人群身心健康的重要疾病, 2019年中国精神障碍伤残负担仍处于较高水平;女性精神障碍伤残负担更加严重;应提早采取干预措施, 减少精神障碍伤残负担。

Burden of epilepsy in China and its provinces,1990 to 2019:findings from the Global Burden of Disease Study 2019

Background: Epilepsy accounts for a significant portion of the global disease burden. However, little is known about the disease burden of epilepsy in China and its provinces. Methods: We assessed the burden of epilepsy in China and its provinces, municipalities, and autonomous regions from 1990 to 2019. Burden was measured as incidence, prevalence, deaths, years lived with disability, years of life lost, and disability-adjusted life years (DALYs), by age, sex, year, and province. We used the Socio-Demographic Index (SDI) to determine the association between the provincial development level and age-standardized DALY rates of epilepsy from 1990 to 2019. Results: In 2019, epilepsy caused 1367.51 thousand (95% uncertainty interval [UI]: 979.92–1837.61 thousand) DALYs, and the age-standardized DALY rate was 99.77 (95% UI: 71.33–133.52)/100,000. The age-standardized incidence and prevalence rates for epilepsy in China were 24.65/100,000 and 219.69/100,000, increased by 45.00% (95% UI: 8.03–98.74%) and 35.72% (95% UI: 0.47–86.19%) compared with that in 1990, respectively. From 1990 to 2019, the proportion of DALY caused by epilepsy in the age group under 25 years steadily decreased. The proportion of DALYs caused by epilepsy in people aged 50 years and over increased from 9.45% and 10.22% in 1990 to 29.01% and 32.72% for male and female individuals in 2019, respectively. The highest age-standardized mortality rates were seen in Tibet (4.26 [95% UI: 1.43–5.66]/100,000), Qinghai (1.80 [95% UI: 1.15–2.36]/100,000), and Yunnan (1.30 [95% UI: 0.88–1.62]/100,000), and the lowest mortality rates were in Guangdong (0.48 [95% UI: 0.39–0.64]/100,000), Zhejiang (0.56 [95% UI: 0.44–0.70]/100,000), and Shanghai (0.57 [95% UI: 0.41–0.73]/100,000). The age-standardized DALY rates across the country and in provinces, municipalities, and autonomous regions generally decreased as their SDI increased. Conclusions: The disease burden of epilepsy is still heavy in China, especially in the western provinces. The incidence and prevalence of epilepsy increased between 1990 and 2019, and the burden of epilepsy in the elderly increases gradually. This study provides evidence on epilepsy prevention and care of different regions in China.

The main and added effects of heat on mortality in 33 Chinese cities from 2007 to 2013

Increases in ambient temperatures and the frequency of extreme heat events constitute important burdens on global public health.However,evidence on their effects on public health is limited and inconclusive in China.In this study,data on daily deaths recorded in 33 Chinese cities from 2007 to 2013 was used to evaluate the effect of heat on mortality in China.In addition to the definition of a heatwave established by the China Meteorological Administration,we combined four city-specific relative thresholds(90th,92.5th,95th,and 97.5th percentiles)of the daily mean temperature during the study period and three durations of≽2,≽3,and≽4 days,from which 13 heatwave definitions were developed.Then,we estimated the main and added effects of heat at the city level using a quasi-Poisson generalized additive model combined with a distributed lag nonlinear model.Next,the estimates for the effects were pooled at the national level using a multivariable meta-analysis.Subgroup analysis was performed according to sex,age,educational attainment,and spatially stratified heterogeneity.The results showed that the mortality risk increased from 22.3%to 37.1%due to the effects of the different heatwave definitions.The added effects were much lower,with the highest increase of 3.9%(95%CI:1.7%–6.1%)in mortality risk.Females,the elderly,populations with low educational levels,and populations living inland in China were found to be the most vulnerable to the detrimental effects of heat.These findings have important implications for the improvement of early warning systems for heatwaves.

Breast Cancer Screening Coverage—China,2018-2019

Summary What is already known about this topic?In 2015,only 18.9%of adult women underwent breast cancer screening in China.What is added by this report?Breast cancer screening coverage for women aged 20 years and above in China reached 22.3%during 2018-2019.Women with lower socioeconomic status had lower screening coverage.There were significant variations across the provincial-level administrative divisions.

Loss of life expectancy due to stroke and its subtypes in urban and rural areas in China,2005-2020

Stroke is characterised by high mortality and disability rate in China.This study aimed to explore the temporal trends in years of life lost(YLL)and loss of life expectancy due to stroke and its subtypes in urban and rural areas in China during 2005-2020.Data were obtained from China National Mortality Surveillance System.Abbreviated life and stroke-eliminated life tables were generated to calculate loss of life expectancy.The YLL and loss of life expectancy due to stroke in urban and rural areas at both national and provincial level during 2005-2020 were estimated.In China,the age-standardised YLL rate due to stroke and its subtypes were higher in rural areas than in urban areas.The YLL rate due to stroke showed a downward trend in both urban and rural residents from 2005 to 2020,decreased by 39.9%and 21.5%,respectively.Loss of life expectancy caused by stroke decreased from 1.75 years to 1.70 years from 2005 to 2020.During which,loss of life expectancy due to intracerebral haemorrhage(ICH)decreased from 0.94 years to 0.65 years,while that of ischaemic stroke(IS)increased from 0.62 years to 0.86 years.A slightly upward trend was observed in loss of life expectancy caused by subarachnoid haemorrhage(SAH),from 0.05 years to 0.06 years.Loss of life expectancy due to ICH and SAH was always higher in rural areas than in urban areas,whereas that of IS was higher in urban areas than in rural areas.Rural males suffered the greatest loss of life expectancy due to ICH and SAH,while the highest loss of life expectancy caused by IS was found in urban females.Furthermore,Heilongjiang(2.25 years),Tibet(2.17 years)and Jilin(2.16 years)were found to have the highest loss of life expectancy caused by stroke in 2020.Loss of life expectancy caused by ICH and SAH was higher in western China,while the disease burden of IS was heavier in northeast China.Stroke remains a major public health problem in China,although the age-standardised YLL rate and loss of life expectancy due to stroke decreased.Evidence-based strategies should be conducted to reduce the premature death burden caused by stroke and prolong life expectancy in Chinese population.

Trends of Mortality in End-Stage Liver Disease—China,2008–2020

Introduction:Liver cancer and cirrhosis represent the most prevalent forms of end-stage liver diseases(ESLDs).Notably,in China,deaths attributed to ESLDs contribute significantly to the global mortality rate of these disorders.Enhanced comprehension of the mortality profile associated with ESLDs in China could provide crucial insights into intervention prioritization,which could in turn help reduce the overall global burden of these diseases.Methods:Data were obtained from China’s Disease Surveillance Points system.The presentation includes both crude and age-standardized mortality rates,stratified by sex,residential location,and region.Using Joinpoint Regression,trends in annual mortality rates were estimated from the period of 2008 to 2020 and expressed as the average annual percentage change(AAPC).Results:In 2020,the gross mortality rate of ESLD stood at 30.08 cases per 100,000 individuals.A higher age-standardized ESLD mortality rate was observed in males and rural populations in comparison to their female and urban counterparts,respectively.Noticeably,the highest mortality rates associated with liver cancer and cirrhosis were reported in South and Southwest China,respectively.A positive correlation was noticed between age-specific ESLD mortality rates and advancing age.Interestingly,an annual decrease in the ESLD mortality rate was observed from 2008 to 2020.In urban contexts,the AAPC of cirrhosis was noted to be higher than that of liver cancer.Conclusions:The mortality rate associated with ESLDs in China decreased between 2008 and 2020.Nevertheless,the death burden attributable to ESLD continues to be alarmingly high.Future initiatives should prioritize the reduction of ESLD mortality in particular populations:males,elderly individuals,and those residing in rural regions of South and Southwest China.The emphasis of future interventions should beplaced on antiviral therapy for adults diagnosed with viral hepatitis,and on the prevention of hepatitis B virus(HBV)infection across all demographics.