Objective To evaluate the effect of vitamin A (Vit A) supplementation on the morbidity and mortality in children with infectious diseases. Methods We searched Cochrane Library (Issue 1, 2004), MEDLINE (1966-2004.3) and The PedsCCM Evidence-Based Journal Club (1992-2002). Relevant systematic reviews and randomized controlled trials (RCTs) of Vit A supplementation on morbidity and mortality in children with infectious diseases were obtained. Results We collected 107 studies and identified 13 systematic reviews or RCTs. The evidence showed that the effect of Vit A supplementation on morbidity and mortality was affected by the nutritional status of the children. Vit A supplementation given to Vit A deficient children could reduce the morbidity of diarrhea and mortality of measles. However, Vit A supplementation would increase the morbidity of diarrhoea and respiratory infections in children with sufficient nutrition. Conclusions The nutritional status of children correlates with morbidity and mortality of some infectious diseases, and the nutritional status and serum Vit A level should be evaluated before Vit A supplementation applied.
Objective To compare surgical outcomes of Stanford type A acute aortic dissection between operations at midnight and daytime. Methods From January 2004 to March 2013，195 patients with Stanford type A acute aortic dissection received surgical treatment in Nanjing Hospital Affiliated to Nanjing Medical University （Nanjing Cardiovascular Disease Hospital）. Patients with identical or similar propensity scores were matched from 127 patients who underwent emergency operation at daytime and 68 patients who underwent emergency operation at midnight. A total of 58 pairs of matched patients which had the same or similar propensity score were selected in daytime surgery group （n=58，43 males and 15 females，47.7±14.6 years） and midnight surgery group （n=58，45 males and 13 females，48.3±14.6 years）. Operation time，postoperative chest drainage，mechanical ventilation time，postoperative incidence of dialysis and tracheostomy，length of ICU stay and in-hospital mortality were compared between the daytime group and midnight group. Results A total of 58 pair of patients were matched in this study. There was no statistical difference in postoperative incidence of tracheostomy ［19.0% （11/58） vs. 6.9% （4/58），P=0.053］ or in-hospital mortality ［8.6% （5/58） vs. 6.9%（4/58），P=0.729］ between the midnight group and daytime group. Operation time （485.7±93.5 minutes vs. 428.5±123.3 minutes，P=0.048），postoperative chest drainage （979.5±235.7 ml vs. 756.6±185.9 ml，P=0.031），mechanical ventilation time （67.9±13.8 hours vs. 55.7±11.9 hours，P=0.025），postoperative incidence of dialysis ［17.2% （10/58） vs. 5.2%（3/58），P=0.039］ and length of ICU stay （89.4±16.2 hours vs. 74.8±12.5 hours，P=0.023） of the midnight group weresignificantly longer or higher than those of the daytime group. A total of 107 patients were followed up for 4-6 months after discharge. During follow-up，there was no late death. Among the 13 patients who required postoperative dialysis，12 patientsno longer needed regular dialysis. Conclusion Emergency operation at midnight does not increase in-hospital mortalitybut increase some postoperative morbidity in patients with Stanford type A acute aortic dissection. Whether at midnight or daytime，better preoperative preparation and surgeons’ vigor are needed for timely surgical treatment for patients with Stanford type A acute aortic dissection.
Objective To retrospectively analyze the morbidity, mortality, epidemiologic trends and distribution characteristic of top-three malignant tumors in Chengdu from 1990 to 2010, and to be aware of the incidence risk factors, and types and syn-position of main tumors, so as to provide evidence for the policy-making of tumor prevention and control. Methods ICD-10 coding method was used to categorize diseases and analyze the morbidity and mortality of malignant tumors seen in different ages, genders, areas and types, based on the surveillance data in Chengdu collected since 1990. Results The morbidity reports of top-three malignant tumors in Chengdu from 1999 to 2010 were lung cancer, liver cancer and colorectal cancer, the same as the mortality reports from 1999 to 2005, But the mortality of gastric cancer exceeded that of colorectal cancer and ranked as the third from 2005 to 2010. The mortality of top-three malignant tumors in male patients was higher than those in female patients. No difference was observed between urban and rural areas. The mortality of main malignant tumors rose along with the age growth. Conclusion Lung cancer, liver cancer and gastric cancer have become the main malignant tumors threatening Chengdu civilians, and their morbidity and mortality are rising yearly, which suggests that the prevention and control measures such as early diagnosis and treatment should be implemented aiming directly at those main tumors.
Objective To investigate the constituent ratio and clinical features of diffuse interstitial lung disease（DILD） in Chongqing city.Methods Data was collected from all patients diagnosed as DILD in five comprehensive teaching hospitals in Chongqing from 2002 to 2006.The disease constituent ratio of DILD in the respiratory department or in the whole hospital was analysised.Meanwhile the clinical manifestation and the laboratory examination such as lung function and biopsy were also analysised.Results Mean age of DILD patients is （61.65±13.31）years with a ratio male to female of 1.83.The constituent ratio of DILD were 2.83‰ in respiratory department and 0.30‰ in hospital in 2002，and increased to 8.29‰ and 0.48‰ respectively in 2006.Graticule（62.20%）and honeycombing（24.50%） were predominant imaging manifestations.47.55% patients had restrictive lung function impairment，and 51.05% had mixed lung function impairment.Pathologic examination revealed UIP as the most common type，however，81.82% cases could not be classified to any category pathologically.Conclusions The prevalence of DILD increased progressively from 2002 to 2006.A definite diagnosis of DILD demands cooperation of physicians，radiologists and pathologists.
ObjectiveTo summarize clinical outcomes of different end-to-end anastomotic methods for surgical treatment of acute Stanford type A aortic dissection (AD). MethodsBetween January 2012 and May 2013, 95 patients with acute Stanford type A AD received surgical treatment in Nanjing Hospital Affiliated to Nanjing Medical University. According to different end-to-end anastomotic methods, 72 patients were divided into 3 groups (23 patients undergoing Bentall procedure were excluded from this study). In group A, there were 23 patients including 18 males and 5 females with their age of 48.67±9.23 years, who received 'sandwich' anastomotic technique strengthening both the inner and outer layers of the aortic wall. In group B, there were 11 patients including 8 males and 3 females with their age of 48.00±9.17 years, who received pericardium strengthening only inner layer of the aortic wall. In group C, there were 38 patients including 29 males and 9 females with their age of 49.20±8.57 years, who received artificial graft that was anastomosed directly to the aortic wall without any reinforcement. Postoperative outcomes were compared among the 3 groups. ResultsEight patients (11.11%)died postoperatively including 1 patient in group A (1/23, 4.35%)and 7 patients in group C (7/38, 18.42%). One patient in group A died of persistent wound errhysis and later disseminated intravascular coagulation. Three patients in group C died of persistent anastomotic incision errhysis and circulatory failure. Four patients in group C died of postopera-tive severe tricuspid regurgitation, secondary severe low cardiac output syndrome and multiple organ dysfunction syndrome. Severe postoperative complications included renal failure in 5 patients, respiratory failure in 7 patients, severe cerebral infarction and paralysis in 1 patient, paresis in 3 patients, delayed recovery of consciousness in 2 patients, and ischemic necrosis of the lower limb in 1 patient. Postoperative thoracic drainage amount in group C was significantly larger than that of the other 2 groups, and there was no statistical difference in thoracic drainage amount between group A and group B. Sixty-four patients were followed up for 1 to 6 months, and there was no late death during follow-up. Among the 5 patients with postoperative renal failure, only 1 patient needed regular hemodialysis, and renal function of the other 4 patients returned to normal. One patient with cerebral infarction recovered partial limb function and was able to walk with crutches. All the 3 patients with paresis recovered their limb function. ConclusionsAnastomotic quality of end-to-end anastomosis is of crucial importance for surgical treatment of acute Stanford type A AD. Appropriate reinforcement methods can be chosen according to individual intraoperative findings. 'sandwich' anastomotic technique can significantly reduce incision errhysis, prevent acute myocardial infarction caused by aortic anastomotic tear, and decrease postoperative mortality. If coronary ostia are involved in AD, concomitant coronary artery bypass grafting is needed.
Objective To investigate the morbidity and mortality of malignant tumors in Chengdu, and get to know their epidemiological characteristics and trends, so as to provide evidence for the policy-making of tumor prevention and control. Methods The ICD-10 coding method was used to analyze the morbidity and mortality of malignant tumors in different ages, genders, areas and types, based on the surveillance data in Chengdu collected from 1990 to 2010. Results The reporting morbidity rose from 32.29/100 000 in 1990 to 171.63/100 000 in 2010, while the reporting mortality rose from 87.03/100 000 in 1990 to 177.51/100 000 in 2010. Liver cancer was seen with the highest morbidity and mortality rate in Chengdu in 2010. The mortality of cancer was higher in male than in female (233.49/100 000 vs. 121.12/100 000). No significant differences were observed between city and rural areas (177.84/100 000 vs. 176.95/100 000). Conclusion The morbidity and mortality rates of tumor are rising year by year, and tumor has become the main disease threatening people’s health. It is suggested that earlier prevention and control measures should be implemented as soon as possible.
Objective To get known about the disease burden and quality of life (QOL) of rheumatoid arthritis (RA) in China by conducting a systematic review. Methods The observational studies about the disease burden and QOL of RA in China were systematically searched in the following databases: CNKI, CBM, VIP, WanFang Data, MEDLINE/Pub Med, EMbase, and Science Citation Index. The retrieval time was from January 1st, 1990 to July 31st, 2010. According to the inclusion and exclusion criteria, the literature was screened, the data were extracted, and the methodological quality of the included studies was assessed. The morbidity of RA was pooled by adopting generic inverse variance model, the meta-analyses on 8 dimensions of SF-36 life quality score (LQS) was conducted by suing RevMan5.0 software, the weighted mean difference (WMD) was regarded as the indicator of intervention effect, and the impact of studies’ quality on the results was assessed by sensitivity analysis. Results A total of 20 studies with medium quality in general were included. The morbidity of RA was 14.7/100 000. The disability adjusted of life years (DALYs) per capita were 4.92. If excluding the cost resulted from DALY, the overall economic cost was RMB 1 250.45 yuan per capita per year; While considering DALY, the cost was RMB 15 717.91 yuan per capita per year. The average cost of outpatient medications was RMB 8 018±17 238 yuan per capita per year. The weighted morbidity was 0.42% (95%CI 0.39% to 0.45%), and it was higher in female than male (Plt;0.05). There was no secular trend and difference between southern and northern (Pgt;0.05), but there were statistical significances in the WMD of 8 dimensions of SF-36 LQS. Sensitivity analyses revealed that the weighted pooled results were stable. Conclusion The epidemiological and economic burden of rheumatoid arthritis are heavier in China, which needs to be concerned by both government and society.
Objective To assess the trend of prevalence, awareness, treatment and control rate of diabetes among elderly residents (≥45 years old) of Shunqin District in Nanchong City, and provide scientific references for the prevention and control of diabetes. Methods From February 2013 to August 2015, a cross-sectional survey was conducted in 9 sub-district offices of Shunqing District of Nanchong City. Households as a unit, the questionnaires and blood tests were investigated by clustering sampling in residents aged ≥45 years old. Results A total of 82 225 residents with complete information were enrolled in this study. Among them, 11 857 were with diabetes, in whom 6 260 had been diagnosed as diabetes before, only 5 054 were under treatment, and only 1 986 could control blood glucose to target level. The prevalence of diabetes was 14.4% among the participants. The rate of awareness, treatment, and control of diabetes in the 11 857 diabetes patients identified was 52.8%, 42.6%, and 16.7%, respectively. Conclusions The prevalence rate of diabetes is high, but the rate of awareness, treatment, and control of diabetes is low. It is necessary to popularize the knowledge and the cognition of diabetes, and it is urgent to make efficient measures to prevent and control diabetes in Nanchong City.
ObjectivesTo systematically review the epidemiological characteristics of post-stroke shoulder pain (PSSP).MethodsPubMed, WanFang Data, CNKI, EMbase, The Cochrane Library and SinoMed databases were electronically searched to collect studies on the morbidity of PSSP from inception to November 30th, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using Stata 15.0 software.ResultsA total of 13 studies were included. The total sample size was 3 514, including 1 357 patients with PSSP. The results of meta-analysis showed that the total morbidity of PSSP was 45.0% with 95%CI 32.0% to 58.0%. The results of subgroup analysis showed that the morbidity of PSSP was 55.5% (95%CI 48.1% to 63.0%) prior to 2010 and 40.6% (95%CI 28.3% to 52.9%) after 2010, respectively. The morbidity of PSSP in Asia was 61.2% (95%CI 51.3% to 71.1%), and in Europe and America was 18.4% (95%CI 9.9% to 26.9%), respectively.ConclusionsCurrent evidence suggests that PSSP has high morbidity, and it may be affected by regional factors. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo analyze the trend of disease burden changes in congenital birth defects in China from 1990 to 2019. MethodsUsing the global burden of disease study 2019 (GBD 2019), we analyzed the morbidity, mortality, and disability-adjusted life years (DALYs) of congenital birth defect diseases and their corresponding age-standardized rates and average annual percentage change (AAPC) to analyze the changes in the disease burden of congenital birth defects in China and compared them with global data from 1990 to 2019. ResultsIn 2019, the age-standardized incidence, mortality, and DALY in China were 147.41/100 000, 4.62/100 000, 480.95/100 000, respectively. Compared with 1990, the age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALY rate increased by 12.08% and decreased by 70.38% and 66.82%, respectively. In recent years, although the age-standardized incidence of congenital birth defect disease in China is on the rise and higher than the global level, the disease burden is roughly on the decline and lower than the global level, which is closely related to earlier intervention and treatment of the disease resulting in a lower standardized mortality rate. ConclusionThe age-standardized mortality rate of children with congenital birth defects in China showed a decreasing trend from 1990 to 2019, and the burden of disease ranged from slightly higher than global to lower than global levels, but the age-standardized incidence rate was significantly higher, but the age-specific incidence rate has increased significantly.