Objective To evaluate the trend of notified incidence of pulmonary tuberculosis(PTB)in China at different periods by population and region and to explore the effect of TB prevention and control in recent years.Methods...Objective To evaluate the trend of notified incidence of pulmonary tuberculosis(PTB)in China at different periods by population and region and to explore the effect of TB prevention and control in recent years.Methods Using pooled data on TB cases reported by the TB Information Management Reporting System(TBIMS)from 2005 to 2020,we calculated the annual percentage change(APC)using the Joinpoint regression model.Results From 2005 to 2020,a total of 16.2 million cases of PTB were reported in China,with an average notified incidence of 75.5 per 100,000 population.The age standardization rate(ASR)continued to decline from 116.9(/100,000)in 2005 to 47.6(/100,000)in 2020,with an average annual decrease of5.6%[APC=-5.6,95%confidence interval(CI):-7.0 to-4.2].The smallest decline occurred in2011–2018(APC=-3.4,95%CI:-4.6 to-2.3)and the largest decrease in 2018–2020(APC=-9.2,95%CI:-16.4 to-1.3).From 2005 to 2020,the ASR in males(159.8 per 100,000 in 2005,72.0 per 100,000 in2020)was higher than that in females(62.2 per 100,000 in 2005,32.3 per 100,000 in 2020),with an average annual decline of 6.0%for male and 4.9%for female.The average notified incidence was the highest among older adults(65 years and over)(182.3/100,000),with an average annual decline of6.4%;children(0–14 years)were the lowest(4.8/100,000),with an average annual decline of 7.3%,but a significant increase of 3.3%between 2014 and 2020(APC=3.3,95%CI:1.4 to 5.2);middle-aged(35–64years)decreased by 5.8%;and youth(15–34 years)decreased by an average annual rate of 4.2%.The average ASR in rural areas(81.3/100,000)is higher than that in urban areas(76.1/100,000).The average annual decline in rural areas was 4.5%and 6.3%in urban areas.South China had the highest average ASR(103.2/100,000),with an average annual decline of 5.9%,while North China had the lowest(56.5/100,000),with an average annual decline of 5.9%.The average ASR in the southwest was 95.3(/100,000),with the smallest annual decline(APC=-4.5,95%CI:-5.5 to-3.5);the average ASR in the Northwest China was 100.1(/100,000),with the largest annual decline(APC=-6.4,95%CI:-10.0 to-2.7);Central,Northeastern,and Eastern China declined by an average of 5.2%,6.2%,and 6.1%per year,respectively.Conclusions From 2005 to 2020,the notified incidence of PTB in China continued to decline,falling by55%.For high-risk groups such as males,older adults,high-burden areas in South,Southwest,and Northwest China,and rural regions,proactive screening should be strengthened to provide timely and effective anti-TB treatment and patient management services for confirmed cases.There is also a necessity to be vigilant about the upward trend of children in recent years,the specific reasons for which need to be further studied.展开更多
OBJECTIVE To conduct meta-regression for the identification of clinically meaningful characteristics that can predict successful treatment of intracranial aneurysms(IAs)with the Pipeline Embolization Device(PED).METHO...OBJECTIVE To conduct meta-regression for the identification of clinically meaningful characteristics that can predict successful treatment of intracranial aneurysms(IAs)with the Pipeline Embolization Device(PED).METHODS Using the keyword"Pipeline Embolization Device"and pre-specified eligibility criteria,we searched PubM ed and EMBASE and identified 105 original research articles(10,813 patients)published or in press(April 6,2011-December 31,2016)focused on safety and/or effectiveness of PED.We constructed meta-regression models to identify predictors of three measures of PED treatment success,specifically rates of aneurysm occlusion,modified Rankin score(mRS)and death.Rates were loge-transformed and the adjusted R2 statistic was reported for each model.RESULTS Aneurysm morphology and type accounted for substantial variation in 1-year aneurysm occlusion rate(14 studies with 689 patients;Radj2=88.91%).By contrast,predictors of 6-months aneurysm occlusion rate(aneurysm location,aneurysm type)(24 studies with 1,321 patients;Radj2=31.67%)and aneurysm occlusion rate at unspecified follow-up time(year of publication,mean duration of angiographic follow-up)(34 studies with 1,663 patients,Radj2=42.82%)accounted for less variability.Few predictors were identified for death rate(number of patients,aneurysm morphology;34 studies with 6,463 patients,Radj2=50.69%)or mRS≤2(year of publication,mean age,aneurysm morphology;14 studies with 556 patients,Radj2=100%).CONCLUSIONS:Few clinically meaningful characteristics appear to be relevant as predictors of the selected measures of PED treatment success.Future studies should attempt to identify additional predictors while focusing on aneurysm morphology as a key predictor of PED outcomes.展开更多
Objective To examine increases in average height among Chinese children and adolescents.Methods The data were obtained from the China Health and Nutrition Survey conducted during the period 1989–2015. A stratified mu...Objective To examine increases in average height among Chinese children and adolescents.Methods The data were obtained from the China Health and Nutrition Survey conducted during the period 1989–2015. A stratified multistage cluster sampling method was utilized to select participants aged 2–22 years in each province. Linear regression was used to examine the effects of age, birth cohort, and survey period on height.Results A total of 15,227 males and 13,737 females were included in the final analysis. Age(A) showed a continuous effect on height. The average heights of the investigated groups increased continuously during the investigation period. By 2015, the average height of the overall group increased by 7.87 cm compared to the average height during the 1989 survey. Moreover, birth year(cohort, C) also had a stable effect on height. Using the height of individuals born in or before 1975 as a reference, the average height of each birth cohort increased in comparison to the previous birth cohort.Conclusions The height of Chinese children and adolescents was affected by age, period, and cohort effects, and this effect is governed by certain rules. The age-period-cohort model can be used to analyze the trends of children’s and adolescent’s heights. The findings provide a scientific basis for the formulation of children’s and adolescents’ growth and development policies in China.展开更多
Background Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus （T2DM）. We retrospectively analyzed the efficacy and safety...Background Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus （T2DM）. We retrospectively analyzed the efficacy and safety of two intensive insulin therapy regimens administered to bone fracture patients with T2DM in the perioperative period, to explore the best method of achieving perioperative glycemic control. Methods A number of 159 bone fracture patients with T2DM were divided into two groups. One group （n=81） received multiple subcutaneous insulin injections （MSII group） and the other （n=78） received continuous subcutaneous insulin infusion （CSII group）. Blood glucose （BG） levels, time to achieve glycemic target, insulin dosage, and the incidence of hypoglycemia and complications were compared between groups. Results Both regimens reduced BG to desired levels before surgery. The time to reach glycemic target in CSII group （2.5 days） was significantly shorter than that in the MSII group （7.3 days; P〈0.001）. Mean insulin dosage in the CSII group （0.66 IU·kg^-1·d^-1） was significantly lower than that in the MSII group （0.74 IU·kg^-1·d^-1; P=0.005）, as were the incidences of hypoglycemia （15.4% vs 32.1%） and infection （6.4% vs. 23.5%）. Multiple regression analysis showed that the time to reach glycemia target was associated with the insulin therapy regimen and dosage. The insulin dosage on reaching glycemia target was positively associated with body mass index （BMI）, diabetes mellitus course, glycated hemoglobin Alc （HbAlc）, and β-hydroxybutyric acid, and was negatively associated with age. Conclusion The efficacy and safety of CSII was superior to that achieved with MSII, suggesting that CSII should be considered as initial therapy to control perioperative BG in bone fracture patients with T2DM.展开更多
Background Diabetes has been associated with increased risk of fracture and impaired fracture healing. The aim of this study was to examine the influence of diabetes on perioperative complications, length of stay and ...Background Diabetes has been associated with increased risk of fracture and impaired fracture healing. The aim of this study was to examine the influence of diabetes on perioperative complications, length of stay and ambulatory ability recovery in individuals with hip fracture, and to determine whether changes could be made to improve treatment outcome. Methods The study included 707 hip fracture patients treated at Beijing Jishuitan Hospital between July 2009 and December 2010. The medical history and perioperative complications were compared between non-diabetic and diabetic groups. Length of stay, days awaiting surgery, and days of hospitalization after surgery were also analyzed. Ambulatory ability was compared at 1-year follow-up using the Chi-square test and Fisher＇s exact test. An independent Student＇s t-test was used to compare normally distributed continuous data. Results Patients with diabetes were more likely than non-diabetic patients to develop cardiac perioperative complications （8.9% vs. 3.0%, P=0.021）, urinary tract infections （12.0% vs. 2.8%, P 〈0.001）, and gastrointestinal symptoms （15.0% vs. 6.8%, P=0.003）. No difference in perioperative complications was observed between the groups. Days awaiting surgery and length of hospital stay were both longer in the diabetic group （（8.0＋5.1） vs. （6.2＋3.7） days and （16.5＋3.8） vs. （13.3＋3.8） days, P 〈0.001, respectively）. Before the occurrence of fracture, patients with diabetes were less likely to be ambulatory outdoors （71.9% vs. 85.9%, P 〈0.001） and had more restricted walking ability. After at least 1-year follow-up, similar proportions of patients in the non-diabetic and diabetic groups （16.1% and 15.9%, respectively）, who were able to ambulate outdoors before the fracture, became housebound till the final follow-up. Conclusions Diabetics are at increased risk of specific complications and have a longer time to surgery and longer in-hospital stay, but generally have similar recovery to non-diabetics thereafter.展开更多
What is already known on this topic?The incidence of diabetes is on the rise in the world,and it is increasingly affecting young people.The American Diabetes Association(ADA)has published the 2020 Diabetes Medical Sta...What is already known on this topic?The incidence of diabetes is on the rise in the world,and it is increasingly affecting young people.The American Diabetes Association(ADA)has published the 2020 Diabetes Medical Standard,but there is no blood glucose standard for teenagers by age and sex.What is added by this report?In this study,quantile regression was used to analyze the data of National Health and Nutrition Examination Survey(NHANES)and found that blood glucose varied significantly based on demographics.What are the implications for public health practice?This study provides reference for formulating the normal ranges of adolescent blood glucose and helping to screen out high-risk groups at an early stage for key interventions.The quantile regression method can give a set of curves,which could better describe the situation.展开更多
Background Appropriate planning and staffing for medical services at large-scale athletic events is essential to provide for a safe and successful competition. There are few well-documented accounts describing the dem...Background Appropriate planning and staffing for medical services at large-scale athletic events is essential to provide for a safe and successful competition. There are few well-documented accounts describing the demand for such services. The present study provided the data from the Beijing 2008 Olympics and Paralympics, with a view to provide the guidance for planning future events.展开更多
基金supported by China CDC's Public Health and Emergency Response Mechanism Programme[131031001000150001]FIDELIS-Hubei TB Program[No.2004-fid-4-034].
文摘Objective To evaluate the trend of notified incidence of pulmonary tuberculosis(PTB)in China at different periods by population and region and to explore the effect of TB prevention and control in recent years.Methods Using pooled data on TB cases reported by the TB Information Management Reporting System(TBIMS)from 2005 to 2020,we calculated the annual percentage change(APC)using the Joinpoint regression model.Results From 2005 to 2020,a total of 16.2 million cases of PTB were reported in China,with an average notified incidence of 75.5 per 100,000 population.The age standardization rate(ASR)continued to decline from 116.9(/100,000)in 2005 to 47.6(/100,000)in 2020,with an average annual decrease of5.6%[APC=-5.6,95%confidence interval(CI):-7.0 to-4.2].The smallest decline occurred in2011–2018(APC=-3.4,95%CI:-4.6 to-2.3)and the largest decrease in 2018–2020(APC=-9.2,95%CI:-16.4 to-1.3).From 2005 to 2020,the ASR in males(159.8 per 100,000 in 2005,72.0 per 100,000 in2020)was higher than that in females(62.2 per 100,000 in 2005,32.3 per 100,000 in 2020),with an average annual decline of 6.0%for male and 4.9%for female.The average notified incidence was the highest among older adults(65 years and over)(182.3/100,000),with an average annual decline of6.4%;children(0–14 years)were the lowest(4.8/100,000),with an average annual decline of 7.3%,but a significant increase of 3.3%between 2014 and 2020(APC=3.3,95%CI:1.4 to 5.2);middle-aged(35–64years)decreased by 5.8%;and youth(15–34 years)decreased by an average annual rate of 4.2%.The average ASR in rural areas(81.3/100,000)is higher than that in urban areas(76.1/100,000).The average annual decline in rural areas was 4.5%and 6.3%in urban areas.South China had the highest average ASR(103.2/100,000),with an average annual decline of 5.9%,while North China had the lowest(56.5/100,000),with an average annual decline of 5.9%.The average ASR in the southwest was 95.3(/100,000),with the smallest annual decline(APC=-4.5,95%CI:-5.5 to-3.5);the average ASR in the Northwest China was 100.1(/100,000),with the largest annual decline(APC=-6.4,95%CI:-10.0 to-2.7);Central,Northeastern,and Eastern China declined by an average of 5.2%,6.2%,and 6.1%per year,respectively.Conclusions From 2005 to 2020,the notified incidence of PTB in China continued to decline,falling by55%.For high-risk groups such as males,older adults,high-burden areas in South,Southwest,and Northwest China,and rural regions,proactive screening should be strengthened to provide timely and effective anti-TB treatment and patient management services for confirmed cases.There is also a necessity to be vigilant about the upward trend of children in recent years,the specific reasons for which need to be further studied.
文摘OBJECTIVE To conduct meta-regression for the identification of clinically meaningful characteristics that can predict successful treatment of intracranial aneurysms(IAs)with the Pipeline Embolization Device(PED).METHODS Using the keyword"Pipeline Embolization Device"and pre-specified eligibility criteria,we searched PubM ed and EMBASE and identified 105 original research articles(10,813 patients)published or in press(April 6,2011-December 31,2016)focused on safety and/or effectiveness of PED.We constructed meta-regression models to identify predictors of three measures of PED treatment success,specifically rates of aneurysm occlusion,modified Rankin score(mRS)and death.Rates were loge-transformed and the adjusted R2 statistic was reported for each model.RESULTS Aneurysm morphology and type accounted for substantial variation in 1-year aneurysm occlusion rate(14 studies with 689 patients;Radj2=88.91%).By contrast,predictors of 6-months aneurysm occlusion rate(aneurysm location,aneurysm type)(24 studies with 1,321 patients;Radj2=31.67%)and aneurysm occlusion rate at unspecified follow-up time(year of publication,mean duration of angiographic follow-up)(34 studies with 1,663 patients,Radj2=42.82%)accounted for less variability.Few predictors were identified for death rate(number of patients,aneurysm morphology;34 studies with 6,463 patients,Radj2=50.69%)or mRS≤2(year of publication,mean age,aneurysm morphology;14 studies with 556 patients,Radj2=100%).CONCLUSIONS:Few clinically meaningful characteristics appear to be relevant as predictors of the selected measures of PED treatment success.Future studies should attempt to identify additional predictors while focusing on aneurysm morphology as a key predictor of PED outcomes.
基金supported by 2020 Beijing Natural Science Foundation-Haidian Original Innovation Joint Fund Key research topicThe research of varicella disease burden and economic evaluation of vaccination [L202008]+2 种基金Beihang University & Capital Medical University Advanced Innovation Center for Big Data-Based Precision Medicine Plan [BHME-201801]Study on the current situation, change trend, nutrition and related factors of diabetes in children and adolescents,National Key R&D Program of China [2016YFC1305201]Study on the influencing factors of herpes zoster, Chinese Center for Disease Control and Prevention surplus project [59911917]。
文摘Objective To examine increases in average height among Chinese children and adolescents.Methods The data were obtained from the China Health and Nutrition Survey conducted during the period 1989–2015. A stratified multistage cluster sampling method was utilized to select participants aged 2–22 years in each province. Linear regression was used to examine the effects of age, birth cohort, and survey period on height.Results A total of 15,227 males and 13,737 females were included in the final analysis. Age(A) showed a continuous effect on height. The average heights of the investigated groups increased continuously during the investigation period. By 2015, the average height of the overall group increased by 7.87 cm compared to the average height during the 1989 survey. Moreover, birth year(cohort, C) also had a stable effect on height. Using the height of individuals born in or before 1975 as a reference, the average height of each birth cohort increased in comparison to the previous birth cohort.Conclusions The height of Chinese children and adolescents was affected by age, period, and cohort effects, and this effect is governed by certain rules. The age-period-cohort model can be used to analyze the trends of children’s and adolescent’s heights. The findings provide a scientific basis for the formulation of children’s and adolescents’ growth and development policies in China.
文摘Background Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus （T2DM）. We retrospectively analyzed the efficacy and safety of two intensive insulin therapy regimens administered to bone fracture patients with T2DM in the perioperative period, to explore the best method of achieving perioperative glycemic control. Methods A number of 159 bone fracture patients with T2DM were divided into two groups. One group （n=81） received multiple subcutaneous insulin injections （MSII group） and the other （n=78） received continuous subcutaneous insulin infusion （CSII group）. Blood glucose （BG） levels, time to achieve glycemic target, insulin dosage, and the incidence of hypoglycemia and complications were compared between groups. Results Both regimens reduced BG to desired levels before surgery. The time to reach glycemic target in CSII group （2.5 days） was significantly shorter than that in the MSII group （7.3 days; P〈0.001）. Mean insulin dosage in the CSII group （0.66 IU·kg^-1·d^-1） was significantly lower than that in the MSII group （0.74 IU·kg^-1·d^-1; P=0.005）, as were the incidences of hypoglycemia （15.4% vs 32.1%） and infection （6.4% vs. 23.5%）. Multiple regression analysis showed that the time to reach glycemia target was associated with the insulin therapy regimen and dosage. The insulin dosage on reaching glycemia target was positively associated with body mass index （BMI）, diabetes mellitus course, glycated hemoglobin Alc （HbAlc）, and β-hydroxybutyric acid, and was negatively associated with age. Conclusion The efficacy and safety of CSII was superior to that achieved with MSII, suggesting that CSII should be considered as initial therapy to control perioperative BG in bone fracture patients with T2DM.
文摘Background Diabetes has been associated with increased risk of fracture and impaired fracture healing. The aim of this study was to examine the influence of diabetes on perioperative complications, length of stay and ambulatory ability recovery in individuals with hip fracture, and to determine whether changes could be made to improve treatment outcome. Methods The study included 707 hip fracture patients treated at Beijing Jishuitan Hospital between July 2009 and December 2010. The medical history and perioperative complications were compared between non-diabetic and diabetic groups. Length of stay, days awaiting surgery, and days of hospitalization after surgery were also analyzed. Ambulatory ability was compared at 1-year follow-up using the Chi-square test and Fisher＇s exact test. An independent Student＇s t-test was used to compare normally distributed continuous data. Results Patients with diabetes were more likely than non-diabetic patients to develop cardiac perioperative complications （8.9% vs. 3.0%, P=0.021）, urinary tract infections （12.0% vs. 2.8%, P 〈0.001）, and gastrointestinal symptoms （15.0% vs. 6.8%, P=0.003）. No difference in perioperative complications was observed between the groups. Days awaiting surgery and length of hospital stay were both longer in the diabetic group （（8.0＋5.1） vs. （6.2＋3.7） days and （16.5＋3.8） vs. （13.3＋3.8） days, P 〈0.001, respectively）. Before the occurrence of fracture, patients with diabetes were less likely to be ambulatory outdoors （71.9% vs. 85.9%, P 〈0.001） and had more restricted walking ability. After at least 1-year follow-up, similar proportions of patients in the non-diabetic and diabetic groups （16.1% and 15.9%, respectively）, who were able to ambulate outdoors before the fracture, became housebound till the final follow-up. Conclusions Diabetics are at increased risk of specific complications and have a longer time to surgery and longer in-hospital stay, but generally have similar recovery to non-diabetics thereafter.
基金Study on the current situation,change trend,nutrition and related factors of diabetes in children and adolescents,National Key R&D Program of China(2016YFC1305201)Beihang University&Capital Medical University Advanced Innovation Center for Big Data-Based Precision Medicine Plan(BHME-201801)Study on the influencing factors of herpes zoster,Chinese Center for Disease Control and Prevention surplus project(59911917).
文摘What is already known on this topic?The incidence of diabetes is on the rise in the world,and it is increasingly affecting young people.The American Diabetes Association(ADA)has published the 2020 Diabetes Medical Standard,but there is no blood glucose standard for teenagers by age and sex.What is added by this report?In this study,quantile regression was used to analyze the data of National Health and Nutrition Examination Survey(NHANES)and found that blood glucose varied significantly based on demographics.What are the implications for public health practice?This study provides reference for formulating the normal ranges of adolescent blood glucose and helping to screen out high-risk groups at an early stage for key interventions.The quantile regression method can give a set of curves,which could better describe the situation.
文摘Background Appropriate planning and staffing for medical services at large-scale athletic events is essential to provide for a safe and successful competition. There are few well-documented accounts describing the demand for such services. The present study provided the data from the Beijing 2008 Olympics and Paralympics, with a view to provide the guidance for planning future events.
