Satisfaction of Village Doctors with the Township and Village Health Services Integration Policy in the Western Minority-inhabited Areas of China

Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.

Spatial Differentiation Characteristics of Human Settlements and Their Responses to Natural and Socioeconomic Conditions in the Marginal Zone of an Uninhabited Area,Changtang Plateau,China

The Changtang Plateau(CTP)in Qinghai-Tibet Plateau of China is one of the top-10 uninhabited areas with the most important ecological value in the world.It is of great academic and practical significance to carry out research on human settlements in the marginal zones of the uninhabited areas to promote harmonious coexistence between humans and nature on the CTP.Using high-definition remote-sensing images to visually interpret and identify settlement-patch data,combined with field investigations,this study explores the spatial characteristics of human settlements in Shuanghu and Nyima counties and their responses to natural and socioeconomic conditions in the hinterland of the CTP.Findings reveal that the scale of human settlements on the CTP is extremely small,and density is very sparse.Settlements on the CTP primarily consist of several households,with some containing more than a dozen households,or are sub-village scale.Socioeconomic development is low and socioeconomic factors have a weak influence on the settlement layout on the CTP.Natural factors are the core elements affecting the layout of human settlements on the CTP.Settlements tend to occur on low mountains,gentle slopes,and areas with high average annual temperatures.Careful settlement site selection can help to mitigate the impact of natural disasters.To meet the needs of grazing,settlement layouts must typically have a high-quality grassland orientation.Riverbanks are key settlement areas,and settlement sites are often far away from alpine salt lakes.The characteristics of settlements on the CTP and their responses to environmental conditions significantly differ from those of human settlements in low-altitude inland areas.

Activity Pattern and Habitat Use of Shorebirds in an Artificial Wetland Complex:A Case Study of Breeding Pied Avocet in the Yellow River Delta,China

With the loss of substantial natural wetlands in coastal zones,artificial wetlands provide alternative habitats for many shorebirds.Scientific management of artificial wetlands used by shorebirds plays an important role in maintaining the stability of shorebird population.Satellite tracking technique can obtain high-precision location information of individuals day and night,providing a good technical support for the study of quantitative relationship between waterfowls and their habitats.In this study,satellite tracking method,Remote Sensing(RS)and Geographic Information System(GIS)technology were used to analyze the activity pattern and habitat utilization characteristics of Pied Avocet during breeding period in an artificial wetland complex in the Yellow River Delta(YRD),China.The results showed that the breeding Pied Avocets had a small range of activity,with a total core and main home range of 33.10 km^(2) and 216.30 km^(2),respectively.This species tended to forage in the pond and salt pan during the day and night,respectively,with an unfixed staying time in the breeding ground.The distance between breeding ground and feeding ground was less than 6 km.It is emphasized that in addition to improving the conditions of the remaining natural habitats,effective managing artificial habitats is a priority for shorebird conservation.This research could provide reference for the management of artificial wetlands in coastal zones and supply technique support for the protection of shorebirds and their habitats,and alleviate human-bird conflicts and sustainable development of coastal zones.

Predicting changes in the suitable habitats of six halophytic plant species in the arid areas of Northwest China

In the context of changes in global climate and land uses,biodiversity patterns and plant species distributions have been significantly affected.Soil salinization is a growing problem,particularly in the arid areas of Northwest China.Halophytes are ideal for restoring soil salinization because of their adaptability to salt stress.In this study,we collected the current and future bioclimatic data released by the WorldClim database,along with soil data from the Harmonized World Soil Database(v1.2)and A Big Earth Data Platform for Three Poles.Using the maximum entropy(MaxEnt)model,the potential suitable habitats of six halophytic plant species(Halostachys caspica(Bieb.)C.A.Mey.,Halogeton glomeratus(Bieb.)C.A.Mey.,Kalidium foliatum(Pall.)Moq.,Halocnemum strobilaceum(Pall.)Bieb.,Salicornia europaea L.,and Suaeda salsa(L.)Pall.)were assessed under the current climate conditions(average for 1970-2000)and future(2050s,2070s,and 2090s)climate scenarios(SSP245 and SSP585,where SSP is the Shared Socio-economic Pathway).The results revealed that all six halophytic plant species exhibited the area under the receiver operating characteristic curve values higher than 0.80 based on the MaxEnt model,indicating the excellent performance of the MaxEnt model.The suitability of the six halophytic plant species significantly varied across regions in the arid areas of Northwest China.Under different future climate change scenarios,the suitable habitat areas for the six halophytic plant species are expected to increase or decrease to varying degrees.As global warming progresses,the suitable habitat areas of K.foliatum,S.salsa,and H.strobilaceum exhibited an increasing trend.In contrast,the suitable habitat areas of H.glomeratus,S.europaea,and H.caspica showed an opposite trend.Furthermore,considering the ongoing global warming trend,the centroids of the suitable habitat areas for various halophytic plant species would migrate to different degrees,and four halophytic plant species,namely,S.salsa,H.strobilaceum,H.glomeratus,and H.capsica,would migrate to higher latitudes.Temperature,precipitation,and soil factors affected the possible distribution ranges of these six halophytic plant species.Among them,precipitation seasonality(coefficient of variation),precipitation of the warmest quarter,mean temperature of the warmest quarter,and exchangeable Na+significantly affected the distribution of halophytic plant species.Our findings are critical to comprehending and predicting the impact of climate change on ecosystems.The findings of this study hold significant theoretical and practical implications for the management of soil salinization and for the utilization,protection,and management of halophytes in the arid areas of Northwest China.

Influence of Human Activity Intensity on Habitat Quality in Hainan Tropical Rainforest National Park,China

Due to long-term human activity interference,the Hainan Tropical Rainforest National Park(HTRNP)of China has experienced ecological problems such as habitat fragmentation and biodiversity loss,and with the expanding scope and intensity of human activity impact,the regional ecological security is facing serious challenges.A scientific assessment of the interrelationship between human activity intensity and habitat quality in the HTRNP is a prerequisite for achieving effective management of ecological disturbances caused by human activities and can also provide scientific strategies for the sustainable development of the region.Based on the land use change data in 2000,2010,and 2020,the spatial and temporal variations and the relationship between habitat quality(HQ)and human activity intensity(HAI)in the HTRNP were explored using the integrated valuation of ecosystem services and trade-offs(InVEST)model.System dynamics and land use simulation models were also combined to conduct multi-scenario simulations of their relationships.The results showed that during 2000–2020,the habitat quality of the HTRNP improved,the intensity of human activities decreased each year,and there was a negative correlation between the two.Second,the system dynamic model could be well coupled with the land use simulation model by combining socio-economic and natural factors.The simulation scenarios of the coupling model showed that the harmonious development(HD)scenario is effective in curbing the increasing trend of human activity intensity and decreasing trend of habitat quality,with a weaker trade-off between the two compared with the baseline development(BD)and investment priority oriented(IPO)scenarios.To maintain the authenticity and integrity of the HTRNP,effective measures such as ecological corridor construction,ecological restoration,and the implementation of ecological compensation policies need to be strengthened.

中国戏曲对外传播中的媒介形象建构——基于China Daily相关英文报道的分析

本研究收集China Daily2019至2022年有关中国戏曲的英文报道,自建英文语料库,从语篇层面进行分析发现,China Daily建构的中国戏曲形象主要表现为历史悠久、种类丰富、底蕴深厚、认可广泛、官方重视、传播主体多元化、受众年轻化、传播形式创新化、“戏曲+旅游”融合发展、戏曲助力乡村振兴等特征,为对外展示真实、立体、全面的中国发挥了积极作用。

主流媒体短视频传播中的国家形象建构研究——以中国网短视频节目《中国三分钟(China Mosaic)》为例

以中国网账号发布在境外社交媒体平台Facebook上的节目《中国三分钟(China Mosaic)》为例,使用Python工具软件抓取得到评论数据样本,能很好地分析海外受众对主题类型的关注偏向和态度取向。从整体上看,海外受众对我国国家形象呈现出积极认可的态度,主要表现为:高度肯定我国的经济实力和科教发展成果,赞许我大国外交所起到的作用和经济建设成就,向往中华优秀传统文化等。但由于意识形态、东西方认知的差异,在海外受众的评论中也存在一些杂音,需要我们理性对待、主动消弭。在对外传播中,要用海外受众乐于接受的话语表达方式、共通的符号,从大处着眼、小处入手讲述中国故事,掌握议题设置的主动权,传播好中国声音。

Prediction of Suitable Habitat for Lycophytes and Ferns in Northeast China: A Case Study on Athyrium brevifrons

Suitable habitat is vital for the survival and restoration of a species.Understanding the suitable habitat range for lycophytes and ferns is prerequisite for effective species resource conservation and recovery efforts.In this study, we took Athyrium brevifrons as an example, predicted its suitable habitat using a Maxent model with 67 occurrence data and nine environmental variables in Northeast China.The area under the curve(AUC) value of independent test data, as well as the comparison with specimen county areal distribution of A.brevifrons exhibited excellent predictive performance.The type of environmental variables showed that precipitation contributed the most to the distribution prediction, followed by temperature and topography.Percentage contribution and permutation importance both indicated that precipitation of driest quarter(Bio17) was the key factor in determining the natural distribution of A.brevifrons, the reason could be proved by the fern gametophyte biology.The analysis of high habitat suitability areas also showed the habitat preference of A.brevifrons: comparatively more precipitation and less fluctuation in the driest quarter.Changbai Mountains, covering almost all the high and medium habitat suitability areas, provide the best ecological conditions for the survival of A.brevifrons, and should be considered as priority areas for protection and restoration of the wild resource.The potential habitat suitability distribution map could provide a reference for the sustainable development and utilisation of A.brevifrons resource, and Maxent modelling could be valuable for conservation management planning for lycophytes and ferns in Northeast China.

CONSERVATION OF WETLANDS ESPECIALLY AS WATERFOWL HABITAT IN NORTHEAST CHINA

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A New Species of Odorrana Inhabiting Complete Darkness in a Karst Cave in Guangxi, China

A new species of the genusOdorrana is described from a completely dark karst cave of northeastern Guangxi, southern China. The new species,Odorranalipuensissp. nov., can be distinguished from its congeners by a combination of the following characters： medium size （SVL： 40.7–47.7 mm in males, 51.1–55.4 mm in females）;tips of all but ifrst ifnger expanded with circummarginal grooves; smooth, grass-green dorsum with irregular brown mottling; pineal body invisible; throat to upper abdomen with gray mottling; dorsal surfaces of limbs with brown bands; dorsolateral fold absent; tiny spinules on lateral body, temporal region, and anterior and posterior edge of tympanum;white nuptial pad present on ifnger I; males lacking vocal sacs; females having creamy yellow eggs, without black poles. Uncorrected sequence divergences betweenO.lipuensissp. nov. and all homologous 16S rRNA sequences ofOdorrana available on GenBank is equal to or greater than 4.9%. Currently, the new species is only known from the type locality.

Preliminary Estimation of Paleoproductivity via TOC and Habitat Types:Which Method Is More Reliable?—A Case Study on the Ordovician-Silurian Transitional Black Shales of the Upper Yangtze Platform, South China

New total organic carbon （TOC） data from the two Ordovician-Silurian transitional graptolite-bearing black shale intervals, the Wufeng （五峰） Formation and the Longmaxi （龙马溪） Formation in Central Guizhou （贵州） and West Hubei （湖北）, respectively, as well as previously reported TOC data from the same intervals in other places on the Yangtze platform of South China, have been used to produce an initial estimate of the primary paleoproductivity via a conventional inverse method （i.e., Rpp.inverse）. The values of the Rpp.inverse are estimated to be 32 （43-21） gC/（m^2·a）（Wufeng Formation） and 21 （27-16） gC/（m^2·a） （Longmaxi Formation）. Also, simultaneously, the habitat types （i.e., HT; cf., BA： benthic assemblage） and their temporal and spatial changes have been documented from the same succession, and an initial estimate of the primary paleoproductivity has been produced using a forward method （i.e., Rpp-forward） Beingbounded mainly by the peritidal to inner-shelf environment shelly-facies or mixed-facies successions with BA1 to BA3 faunas both at the top and the base, which indicates the habitat types from HT Ⅱ to HT Ⅲ2, the biohabitat type of the two graptolite-bearing black shale intervals can be limited to HT III to HT IV, corresponding to the inner shelf to the outer shelf, with depths from roughly 60 m to 200-300 m. Based on the current data from the South China Sea and the southern part of the East China Sea, values of Rpp-forward should be about 100 to 400 gC/（m^2·a）. The difference in the results via the two methods suggests that paleoproductivity estimates from the geological strata need to be made cautiously, with particular attention paid to the paleogeographic setting, oxic-anoxic conditions, as also the preservation factor of organic carbon.

Two New Free-Living Marine Nematode Species of the Genus Anoplostoma(Anoplostomatidae) from the Mangrove Habitats of Xiamen Bay,East China Sea

Two new species of free-living marine nematode from mangrove habitats in Xiamen Bay are identified.Anoplostoma tumidum sp.nov.is characterized by relatively short outer labial setae(0.86–1.00 h.d.),long tail(c 7.2–8.9,c' 8.3–10.5),an instinct swollen distal portion of slender spicule(Sc 94–101 μm),and well developed copulatory bursae without bursal papillae.A.tumidum sp.nov.differs from all valid species of genus Anoplostoma in copulatory apparatus of males with a distinct swollen distal portion of spicule,and a relatively obvious constriction of head.A.paraviviparum sp.nov.is characterized by relatively long outer labial setae(1.11–1.22 h.d.),and tail(c 6.6–8.5,c' 8.6–10.2);elongated spicules with distinct knob-like proximal and pointed distal ends(Sc 46–69 μm);distinct strip-like gubernaculum(length with 11–15μm);well developed copulatory bursae with precloacal papillae and post-cloacal papillae;and a distinct constriction of head.A.paraviviparum sp.nov.is similar to A.viviparum Bastian,1865,but differs in the reproductive mode of female and the constriction of head.

Scale-dependent effects of habitat fragmentation on the genetic diversity of Actinidia chinensis populations in China

Spatial scale partly explains the differentiated effects of habitat fragmentation on plant biodiversity,but the mechanisms remain unclear.To investigate the effects of habitat fragmentation on genetic diversity at different scales,we sampled Actinidia chinensis Planch.at broad and fine scales,China.The broad-scale sampling included five mountain populations and one oceanic island population(Zhoushan Archipelago),and the fine-scale sampling covered 11 lake islands and three neighboring land populations in Thousand-Island Lake(TIL).These populations were genotyped at 30 microsatellite loci,and genetic diversity,gene flow,and genetic differentiation were evaluated.Genetic differentiation was positively related to geographical distance at the broad scale,indicating an isolation-bydistance effect of habitat fragmentation on genetic diversity.The oceanic population differed from the mainland populations and experienced recent bottleneck events,but it showed high gene flow with low genetic differentiation from a mountain population connected by the Yangtze River.At the fine scale,no negative genetic effects of habitat fragmentation were found because seed dispersal with water facilitates gene flow between islands.The population size of A.chinensis was positively correlated with the area of TIL islands,supporting island biogeography theory,but no correlation was found between genetic diversity and island area.Our results highlight the scale-dependent effects of habitat fragmentation on genetic diversity and the importance of connectivity between island-like isolated habitats at both the broad and fine scales.

Assessment of Habitat Suitability in the Upper Reaches of the Min River in China

HabRat richness influences and even determines biological diversity. Plant habitat suitability assessment can provide technical guidance and information support for ecological restoration. Thirteen factors in three categories of terrain, meteorology and soil were chosen to build a habitat suitability assessment index framework in the Upper Reaches of the Min River, based on the local natural environment and the actual influencing factors of vegetative growth. Combined with the Analytic Hierarchy Process （AHP） and entropy method, which were used to calculate weights of indexes, habitat suitability was studied by using a multi-objective linear weighting model and geographic information systems （GIS） spatial analysis techniques. The assessment results are as follows： Altitude, soil stability, aspect and slope have more important effects on plant habitat suitability in the Upper Reaches of the Min River, and their weights are o.311, 0.260, o.198 and o.125, respectively. Suitable and sub-suitable habitats cover 4431.8o km2 and 6171.12 km2, respectively; most of which are distributed along both sides of rivers and have higher suitability. Unsuitable habitats cover the largest area （6679.76 km2）, accounting for 29.83% of the whole area; and the worst unsuitable habitats are 5107.23 km2 （22.81%）; they account for more than half of the study area. These results indicate that the plant habitat in the Upper Reaches of the Min River is poor and ecological restoration is both urgent and difficult. Therefore, based on the principle of taking measures suitable to the habitat in ecological restoration projects, ecological and engineering measures should be combined to have better effects, while increasing the strength of ecological protection.

Investigation of children’s habits of smartphone usage and parental awareness of myopia control in underdeveloped areas of China

AIM: To investigate the behaviors of smartphone usage and parental knowledge of vision health among primary students in the rural areas of China. METHODS: In this school-based, cross-sectional study, a total of 52 606 parents of students from 30 primary schools in the Xingguo County were investigated through an online questionnaire from July 2020 to August 2020. The self-designed questionnaire contained three parts: the demographic factors of both children and parents, parental knowledge and attitude toward myopia, and the preventive treatment of myopia.RESULTS: A total of 52 485 appropriately answered questionnaires were received, showing an effective response rate of 95.1%. The average age of the primary students was 10.1±0.98 y and the prevalence of myopia among the primary students was 40.3%. The age of myopia occurrence in elementary students was significantly correlated with the parents’ educational level(95%CI: 0.82-0.98, P=0.013), children’s gender(95%CI: 1.08-1.20, P<0.001), school location(county or countryside)(95%CI: 0.59-0.66, P<0.001), children’s smartphone ownership(95%CI: 1.09-1.26, P<0.001), and the average time spent on smartphone per day(95%CI: 0.78-0.88, P<0.001). School location in the county town, high family income, and high parents’educational level significantly affected both parents’ myopia awareness and children’s vision-threatening behaviors(P<0.01). Left-behind children showed a higher incidence of vision-threatening habits than those who lived with their parents(P<0.01).CONCLUSION: The results reveal the current situation of myopia development among rural primary school students and their parents. This survey will serve as a guidance for designing myopic prevention policies in the rural areas of China.

Effects of Climate Variability on Habitat Range and Distribution of Chub Mackerel in the East China Sea

Spatio-temporal distribution of chub mackerel Scomber japonicus is strongly susceptible to climate variability.In this study,a weighting-based habitat suitability index(HSI)model was established to assess the impacts of Pacific Decadal Oscillation(PDO)on habitat range and distribution of S.japonicus in the East China Sea(ECS)using vertical water temperature at depths of 2.5 m,25 m and 50 m.Results showed that the optimal HSI model selected from ten weighting scenarios can yield reliable predictions.Correlation analysis revealed a significant negative relationship between the PDO index and water temperature anomaly at different depths.The water temperatures at three different layers on the fishing ground of S.japonicus tended to be low in the warm PDO phase and high in the cold PDO phase,respectively.The range of suitable habitats and its spatial distribution exhibited large differences between the warm and cold PDO regimes.During a warm PDO phase,vertical water temperature became cool,and the monthly preferred water temperature at each depth for S.japonicus shifted southeastward.Consequently,habitat quality dramatically decreased,and suitable habitat ranges also reduced and moved southeastward.Conversely,in a cool PDO phase,with the warmer vertical water temperature and northwestward shift of the preferred water temperature,the suitable habitats enlarged and migrated in the same direction.Our findings indicate that the PDO produced significant impacts on habitat range and distribution of S.japonicus in the East China Sea.

Relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China

AIM:To study the relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China, which is a unique Littoral high-risk area of esophageal carcinoma in China. The poor communication and transportation in the past has made Chaoshan a relatively closed area and kept its culture and custure of old China thousand years ago. METHODS: Data on age, sex, ABO blood type and X-ray or pathological diagnose of the patients with carcinoma of esophagus or cardia were collected from the Tumor Hospital. First Affiliated Hospital, Second Affiliated Hospital of Shantou University Medical College; and the Central Hospital of Shantou and the Central Hospital of Jieyang. A total of 6685 patients with esophageal carcinoma (EC) and 2955 patients with cardiac cancer (CC) in Chaoshan district were retrospectively assessed for their association with ABO blood groups. RESULTS: The distribution of ABO blood groups in patients with EC or CC was similar to the normal local population in Chaoshan. However, blood group B in male patients with CC and in the patients with carcinoma in the upper third esophagus was 2.3% and 4.7% higher than the corresponding controls. The relative risk B O was 1.1415 (P【0.05) and 1.2696 (P【0.05), respectively. No relationship was found between ABO blood groups and tumor differentiation. CONCLUSION: ABO blood group B is associated with the incidence of CC in male individuals and carcinoma in the upper third esophagus. The distribution of ABO blood groups varies in the different geographical and ethnic groups. As a result, proper controls are very important for such studies.

How do the landslide and non-landslide sampling strategies impact landslide susceptibility assessment? d A catchment-scale case study from China

The aim of this study is to investigate the impacts of the sampling strategy of landslide and non-landslide on the performance of landslide susceptibility assessment(LSA).The study area is the Feiyun catchment in Wenzhou City,Southeast China.Two types of landslides samples,combined with seven non-landslide sampling strategies,resulted in a total of 14 scenarios.The corresponding landslide susceptibility map(LSM)for each scenario was generated using the random forest model.The receiver operating characteristic(ROC)curve and statistical indicators were calculated and used to assess the impact of the dataset sampling strategy.The results showed that higher accuracies were achieved when using the landslide core as positive samples,combined with non-landslide sampling from the very low zone or buffer zone.The results reveal the influence of landslide and non-landslide sampling strategies on the accuracy of LSA,which provides a reference for subsequent researchers aiming to obtain a more reasonable LSM.

Cancer incidence and mortality in China,2022

Background:The National Cancer Center(NCC)of China regularly reports the nationwide statistics on cancer incidence and mortality in China.The International Agency for Research on Cancer(IARC)calculates and publishes the cancer burden of countries around the world every two years.To ensure consistency between the actual surveillance data in China and the data published by IARC,NCC has received approval from the National Health Commission and IARC to simultaneously release the cancer burden data for China in GLOBOCAN 2022.Methods:There were a total of 700 registries reporting high-quality data on cancer incidence and mortality across China in 2018,of which 106 registries with continuous monitoring from 2010 to 2018 were used to establish an age-period-cohort model to simulate the trend of cancer incidence and mortality and to estimate the incidence and mortality in China in 2022.In addition,we analyzed the temporal trends of age-standardized cancer incidence and mortality from 2000 to 2018 using data from 22 continuous cancer registries.Results:It was estimated about 4,824,700 new cancer cases and 2,574,200 new cancer deaths occurred in China in 2022.Cancers of the lung,colon-rectum,thyroid,liver and stomach were the top five cancer types,accounting for 57.42%of new cancer cases.Cancers of the lung,liver,stomach,colon-rectum and esophagus were the five leading causes of cancer deaths,accounting for 67.50%of total cancer deaths.The crude rate and age-standardized incidence rate(ASIR)were 341.75 per 100,000 and 201.61 per 100,000,respectively.The crude mortality rate was 182.34 per 100,000 and the age-standardized mortality rate(ASMR)was 96.47 per 100,000.The ASIR of all cancers combined increased by approximately 1.4%per year during 2000–2018,while the ASMR decreased by approximately 1.3%per year.We observed decreasing trends in ASIR and ASMR for cancers of the esophagus,stomach,and liver,whereas the ASIR increased significantly for cancers of the thyroid,prostate,and cervix.Conclusions:Cancer remains a major public health concern in China,with a cancer profile that reflects the coexistence of developed and developing regions.Sustained implementation of prevention and control measures has resulted in significant reductions in the incidence and mortality rates of certain historically high incidence cancers,such as esophageal,stomach and liver cancers.Adherence to the guidelines of the Healthy China Action Plan and the Cancer Prevention and Control Action Plan,along with continued efforts in comprehensive risk factor control,cancer screening,early diagnosis and treatment,and standardization of diagnostic and therapeutic protocols,are key strategies to effectively mitigate the increasing cancer burden by 2030.

Epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China:a hospital-based retrospective study

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.