Multi-centric Study on Clinical Epidemiology Is the Key Link in Treating Hypertension with Integrative Chinese and Western Medicine

General survey ofhypertension has beencarried out in our coun—try for three times.Thelast time was in 1999,with the result showingthat in our country theincidence of hyperten-sion among people over15 years old was11.26％.The incidencehas been raised by 25％

Clinical epidemiology and disease burden of bronchiolitis in hospitalized children in China:a national cross-sectional study

Background Bronchiolitis is a common acute lower respiratory tract infection(ALRTI)and the most frequent cause of hospitalization of infants and young children with ALRTI.Respiratory syncytial virus is the main pathogen that leads to severe bronchiolitis.The disease burden is relatively high.To date,few descriptions of the clinical epidemiology and disease burden of children hospitalized for bronchiolitis are available.This study reports the general clinical epidemiological characteristics and disease burden of bronchiolitis in hospitalized children in China.Methods This study included the face sheet of discharge medical records collected from 27 tertiary children’s hospitals from January 2016 to December 2020 that were aggregated into the FUTang Update medical REcords(FUTURE)database.The sociodemographic variables,length of stay(LOS)and disease burden of children with bronchiolitis were analyzed and compared using appropriate statistical tests.Results In total,42,928 children aged 0–3 years were hospitalized due to bronchiolitis from January 2016 to December 2020,accounting for 1.5%of the total number of hospitalized children of the same age in the database during the period and 5.31%of the hospitalizations for ALRTI.The male to female ratio was 2.01:1.Meanwhile,more boys than girls were observed in different regions,age groups,years,and residences.The 1–2 year age group had the greatest number of hospitalizations for bronchiolitis,while the 29 days–6 months group had the largest proportion of the total inpatients and inpatients with ALRTI in the same age group.In terms of region,the hospitalization rate of bronchiolitis was the highest in East China.Overall,the number of hospitalizations from 2017 to 2020 showed a decreasing trend from that in 2016.Seasonally,the peak hospitalizations for bronchiolitis occurred in winter.Hospitalization rates in North China in autumn and winter were higher than those in South China,while hospitalization rates in South China were higher in spring and summer.Approximately,half of the patients with bronchiolitis had no complications.Among the complications,myocardial injury,abnormal liver function and diarrhea were more common.The median LOS was 6 days[interquartile range(IQR)=5–8],and the median hospitalization cost was 758 United States dollars(IQR=601.96–1029.53).Conclusions Bronchiolitis is a common respiratory disease in infants and young children in China,and it accounts for a higher proportion of both total hospitalizations and hospitalizations due to ALRTI in children.Among them,children aged 29 days–2 years are the main hospitalized population,and the hospitalization rate of boys is significantly higher than that of girls.The peak season for bronchiolitis is winter.Bronchiolitis causes few complications and has a low mortality rate,but the burden of this disease is heavy.

Radical Hysterectomy in Cervical Cancer: Patients’ Epidemiological and Clinical Profiles and Perioperative Outcome in Two Referral Hospitals in Cameroon

Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on screening and awareness of early symptoms can reverse the situation.

Adult Kidney Cancer in Mauritania: Clinical and Therapeutic Aspects

Introduction: since its creation, our urology department has taken care of tumor pathologies in particular kidney cancer in adults;our goal is to study the clinical and therapeutic epidemiological profiles of adult kidney cancer in Mauritania. Materials and Methods: We carried out a retrospective study over a period of six years, from January 1, 2012 to December 31, 2017, including all cases of adult kidney cancer registered in the urology-andrology departments of the Cheikh Zayed Hospital and Pathological Anatomy of the National Hospital of Nouakchott (Mauritania). Results: we collected 50 cases of kidney cancer. The average annual incidence was 8.3 cases. The average age of the patients was 52.98 years with extremes of 18 and 84 years. There was a female predominance (52%) or 29 women for 21 men. Lumbar pain was the most frequent clinical expression, more than half of the patients had symptoms over a period of at least 12 months before the first consultation. The left kidney was the most frequently affected. The right localization was demonstrated in 23 patients, the extension assessment was made with thoraco-abdomino-pelvic CT in 40 patients. Twelve patients had a tumor localized in the kidney. The extension assessment had made it possible to objectify the existence of metastases in 17 of our patients (37%). The preferred locations of these metastases were pulmonary and hepatic. Surgical intervention was performed in 44 patients (88%), of whom 36 underwent radical nephrectomy (72%), and two patients underwent partial nephrectomy (4.5%). Surgical abstention was decided from the outset in 6 patients (13.6%). None of our patients had received treatment with anti-angiogenics. The histological type most observed in our patients was renal cell carcinoma, observed in 34 patients, or 77.72%. At the time of the study, more than a third of the patients had died. The mortality rate in our series had reached 24%. A specific survival rate could not be assessed due to lack of information in the files and significant numbers of patients lost to follow-up at the time of the study. Conclusion: adult kidney cancer in Mauritania is characterized by its low incidence, its occurrence in a relatively young population, its female predominance, its often late diagnosis at locally advanced and metastatic stages, and the treatment is the most often surgical.

Epidemiological and Clinical Aspects of Bladder Tumours at the Nianankoro Fomba Hospital in Segou in the Urology Department

Objectives: To study the epidemiological, diagnostic and prognostic aspects of bladder tumours in Segou Hospital. Patients and Methods: We conducted a descriptive cross-sectional study of bladder tumours over the period from 1 April 2012 to 1 April 2017, in the urology department of the Nianankoro Fomba Hospital in Segou. The first three years were used for patient recruitment, and the last two years for follow-up of the patients in the series. Results: Over a period of three years, we collected 165 cases of bladder tumours hospitalised out of 1308 hospitalisations from 7007 consultations, i.e. 12.6% of hospitalisations and 2.3% of consultations. The sex ratio was 1.2 in favour of men. A history of treated bilharzia was reported in 78.8% of cases and untreated bilharzia in 9.1% of cases. Haematuria was the most common reason for consultation. The majority of our patients were at stage T4 and T3 at the time of diagnosis, i.e. 53.3% and 44.3% respectively. Most patients consulted within 13 to 24 months after the first sign, i.e. 44.8%. Conclusion: The prognosis is still clouded by the delay in management. All the patients diagnosed had a bladder tumour infiltrating the muscle.

Diagnosis and Prevention of Avian Leukosis

This paper introduced the characteristics of avian leukosis from the aspects of pathogen,epidemiology,clinical symptoms,and anatomical symptoms,and puts forward clinical comprehensive diagnosis and laboratory diagnostic methods.Besides,the disease is also differentiated from similar diseases of chicken such as Marek's disease,infectious bursal disease and reticuloendothelial hyperplasia.Finally,the prevention and control measures against the disease were proposed.

Multicausality in fatty liver disease:Is there a rationale to distinguish between alcoholic and non-alcoholic origin?

Apart from alcohol,there are other factors that may induce complications,which resemble alcohol-related liver disorders.In particular,obesity has been brought into focus as a risk factor for fatty liver disease.The term "non-alcoholic" fatty liver disease is commonly used to distinguish between obesity-related and alcohol-related hepatic steatosis.This review uses the epidemiological perspective to critically assess whether it is necessary and useful to differentiate between alcoholic and "nonalcoholic" fatty liver disease.The MEDLINE database was searched using the PubMed search engine,and a review of reference lists from original research and review articles was conducted.The concept to distinguish between alcoholic and "non-alcoholic" fatty liver disease is mainly based on specific pathomechanisms.This concept has,however,several limitations including the common overlap between alcohol misuse and obesityrelated metabolic disorders and the non-consideration of additional causal factors.Both entities share similar histopathological patterns.Studies demonstrating differences in clinical presentation and outcome are often biased by selection.Risk factor reduction is the main principle of prevention and treatment of both disease forms.In conclusion,alcoholic and "non-alcoholic" fatty liver diseases are one and the same disease caused by different risk factors.A shift from artificial categories to a more general approach to fatty liver disease as a multicausal disorder may optimize preventive strategies and help clinicians more effectively treat patients at the individual level.

Detailed analysis of the impact of age on the QT interval

Objective To analyze the effect of age on the ECG QT interval, an important predictor of cardiovascular mortality and drug-induced cardiac arrhythmias, and determine whether QT-heart rate correction formulae （QTc） have differential relationships with age and sex. Methods Data were examined from the US National Health and Nutrition Examination Survey （NHANES） II and III, civilian population aged 25 to 90 years. QT weighted means and standard deviations were calculated for all ages. The QTc were evaluated for six QTc： proposed by Bazett （QTcBZT）, Fridericia （QTcFRD）, Hodges （QTcHDG）, Dmitrienko （QTcDMT）, Rautaharju （QTcRTHa） and Framingham （QTcFRM）. Results QTc was strongly related to age and gender, for all formulae except for QTcBZT for women. The relationship between QTc and age was significant regardless of whether the relationship was approximated by a linear or non-linear （quadratic or cubic spline） model. QTc increased more dramatically with age in men. There was a significant （P 〈 0.001） positive relationship between QTc variance and age for each QTc formula for both men and women. There were a greater proportion of individuals with longer QTc with older ages especially age 80 years and above. Conclusion QTc and its variance increase with age. Prolonged QTc is more prevalent in older individuals, especially men.

ENDOMYOCARDIAL FIBROSIS IN CHINA

To introduce the epidemical, pathological, and clinical characteristics as well as the diagnostic and therapeutical experiences of endomyocardial fibrosis(EMF) in China. [WT5”BX] Data sources.[WT5”BZ]A CMBdisc search was done of the Chinese language literature published from January 1983 through June 1997 about EMF and/or restrictive cardiomyopathy. A manual search was then done for other contributions, including abstracts, between January 1965 and June 1997. [WT5”BX] Results. [WT5”BZ]Eighty seven Chinese cases of EMF were collected in this paper. There were 49 men and 38 women, with a mean age of 28±13 years(range, 8 to 68 years). The distribution of the cases is mainly in the south of China. Combined right and left ventricular disease occurs in 48 percent of cases, with pure right ventricular involvement occurring in 42 percent and pure left ventricular involvement in the remaining 10 percent of patients who are examined postmortem. The diagnosis of EMF was confirmed in 21 cases at autopsy, and in 66 cases by echocardiography, angiocardiography, and/or endomyocardial biopsy which showed the characteristic changes. Clinically, right sided disease is the commonest variety. Endocardiectomy and tricuspid(n=7) or mitral(n=1) valves replacement have been performed in 8 patients. There were 2 operative deaths. Six patients had a satisfactory recovery postoperatively and living well in the follow up duration. [WT5”BX] Conclusion.

Epidemiological Aspects of Cervicofacial Cellulitis Due to Dental Origin in the City of Ouagadougou (Burkina Faso)

Background: Head and neck cellulitis of dental origin are polymicrobial bacterial infections involving the cellulo-adipose spaces of the face and neck. The objective of this work was to describe the epidemiological and clinical profile of patients with head and neck cellulitis. Methods: This was a cross-sectional study conducted from 1 January to 30 June 2020. All patients consulting for cervico-facial cellulitis of dental origin in 2 university hospitals in Ouagadougou were included in the study. The usual parameters of descriptive statistics were estimated for each variable. Results: Two hundred and ninety-two cases (184 men and 108 women), aged 3 to 85 years were collected. The 25 - 35 years old were the most affected (33%). Decay was the leading dental cause (95.6%). The delay in consultation was included within 7 days in 74.66% of cases. Ninety-one-point forty-four percent of patients had poor oral hygiene. Diffuse cellulitis was the most common (64.04%) and peri-mandibular regions were the most invaded (42.81%). Conclusion: The frequencies observed in our study allow us to conclude that cervicofacial cellulitis of dental origin is still frequent and affects a young and disadvantaged population.

Prevalence of gastroesophageal reflux disease:a population-based cross-sectional study in southern Chile

Background This study assessed the prevalence of gastroesophageal reflux disease(GERD)in a general adult population from Temuco in southern Chile.The association of GERD with demographic variables was also examined.Methods A cross-sectional study among the general population of Temuco in southern Chile was conducted in 2017,using a validated and reliable questionnaire for detecting GERD.The urban area of Temuco,with a population of 245,317 inhabitants(2002 census),was divided into four zones,which were representative of the socioeconomic sectors of the city.The sample size was estimated assuming a prevalence of 52.8%,an accuracy of 3.0%,a confidence level of 95.0%,and a design effect of 1.15.Area sampling was used to build clusters.The prevalence of GERD was determined and associated factors were studied by means of bivariate and multivariate analyses.Results A total of 1,069 subjects(47.9%women,median age 40 years)from the selected subareas were interviewed.The prevalence of GERD was 44.8%.The most frequently reported symptom was regurgitation(54.8%).One-third of subjects took medication to control symptoms and was considered‘sick’by the instrument,although>68%of them had never sought medical consultation.There was a significant association between GERD and age(P<0.001)and female gender(P=0.001).Conclusions In this population-based study,the prevalence of GERD was high(44.8%).GERD was associated with age and female gender.

Translating evidence into policy in China:opportunities and challenges

Research and evidence are critical for the formulation of policies and practices in support of health care.In the past two decades,the Chinese Clinical Epidemiology Network has been promoting evidence-based policy making in China.Evidence-based policy has become a major part of the government’s approach to policy making.The current article addresses the translation of evidence into health policies based on the expansion of evidence-based medicine in China.It also discusses the opportunities and challenges for certain evidence to be considered in policy making and practice in the future.