Temporal trends of sepsis-related mortality in China, 2006-2020: a population-based study.

BACKGROUND: The scarcity of sepsis epidemiologic data from most low- and middle-income countries (LMICs) hampered estimation of regional and global burden of the disease, and provided limited guidance for policy makers. We aimed to characterize and analyze the temporal trends of sepsis-related mortality in China, by population groups, underlying causes of death, geographic regions, and sociodemographic index (SDI) levels. METHODS: Sepsis-related deaths were identified from the National Mortality Surveillance System (NMSS) of China from 2006 to 2020. Trends of sepsis-related mortality and years of life lost (YLLs), stratified by age, sex, underlying diseases, and regions were analyzed using the Jointpoint regression analysis. We investigated the association of SDI with trends of sepsis-related mortality. RESULTS: In 2020, sepsis was estimated to be responsible for 986,929 deaths and 17.1 million YLLs in China. Age-standardized sepsis-related mortality significantly declined from 130.2 (95%CI, 129.4-131) per 100,000 population in 2006 to 76.6 (76.3-76.9) in 2020. Age-standardized YLLs decreased from 2172.7 (2169.4-2176) per 100,000 population in 2006 to 1271 (1269.8-1272.2) in 2020. Substantial variations of sepsis-related mortality and YLLs were observed between population groups and regions, with higher burden in males, the elderly, and western China. An inverse relation was noted between SDI and sepsis-related mortality or YLLs. CONCLUSIONS: Despite declining trends of age-standardized mortality and YLLs of sepsis in China, significant disparities between population groups and regions highlight a need for targeted policies and measures to close the gaps and improve the outcome of sepsis.

An Epidemiological Study of Chinese Children with Developmental Dyslexia.

OBJECTIVE: The epidemiological studies of Chinese developmental dyslexia (DD) in China are still limited. The current study aimed to investigate the prevalence rate, risk factors, and psychiatric comorbidities of Chinese DD in Guangzhou, a city in South China. METHOD: A total of 1661 students from second to fifth grades were recruited. The dyslexic students were identified by evaluating learning disability through the Pupil Rating Scale-Revised Screening for Learning Disability (PRS) scale by the head teachers and word recognition through the standard test. Students with a PRS score of <65 received the Raven's test, and those with intelligence quotient scores below 80 in the Raven's test were excluded. Psychiatric comorbidities were assessed by the Strength and Difficulties Questionnaire completed by parents. RESULTS: The prevalence rate of Chinese DD was 4.9% in Guangzhou city. There were significant differences in gender, the paternal educational level, and reading experience before the age of 6 years between the DD group and the non-DD group. Male gender (odds ratio [OR] = 4.17), low paternal educational level (p = 0.045), and lack of reading experience before the age of 6 years (OR = 1.99) were the risk factors for DD. The DD cases had a higher risk of hyperactivity and inattention (OR = 3.21). CONCLUSION: This study showed that the prevalence rate of DD was 4.9% in Guangzhou city. Male gender, low paternal educational level, and lack of reading experience before the age of 6 years were the risk factors for Chinese DD. The high comorbidity rate of hyperactivity and inattention in the Chinese DD population needs further evaluation.

Loss of microRNA-22 prevents high-fat diet induced dyslipidemia and increases energy expenditure without affecting cardiac hypertrophy.

Obesity is associated with development of diverse diseases, including cardiovascular diseases and dyslipidemia. MiRNA-22 (miR-22) is a critical regulator of cardiac function and targets genes involved in metabolic processes. Previously, we generated miR-22 null mice and we showed that loss of miR-22 blunted cardiac hypertrophy induced by mechanohormornal stress. In the present study, we examined the role of miR-22 in the cardiac and metabolic alterations promoted by high-fat (HF) diet. We found that loss of miR-22 attenuated the gain of fat mass and prevented dyslipidemia induced by HF diet, although the body weight gain, or glucose intolerance and insulin resistance did not seem to be affected. Mechanistically, loss of miR-22 attenuated the increased expression of genes involved in lipogenesis and inflammation mediated by HF diet. Similarly, we found that miR-22 mediates metabolic alterations and inflammation induced by obesity in the liver. However, loss of miR-22 did not appear to alter HF diet induced cardiac hypertrophy or fibrosis in the heart. Our study therefore establishes miR-22 as an important regulator of dyslipidemia and suggests it may serve as a potential candidate in the treatment of dyslipidemia associated with obesity.

Practical value of intravenous urography combined with add-on CT in diagnosing ureteral abnormalities.

BACKGROUND: Intravenous urography (IVU) combined with add-on CT (IVU-CT) can help to provide more diagnostic information for determining the localization and nature of ureteral abnormalities with less irradiation dose. This study aimed to determine the value of IVU-CT for diagnosis of ureteral diseases, where IVU is insufficient to determine the diagnosis. METHODS: Two hundred and eighty patients underwent IVU for suspected ureteral disorders, which identified a definite diagnosis in 184 cases and was insufficient for definite diagnosis in 96 cases designated as indeterminate diagnosis. Subsequently 90 patients (six patients declined CT) with indeterminate diagnosis consented to undergo immediate or delayed helical CT scan. The CT data were transferred to the workstation for post-processing, and the cost and mean effective dose for each imaging method were calculated and compared indirectly. RESULTS: Of the 90 indeterminate diagnosis cases, diagnosis was determined in 86 cases by IVU-CT with a diagnostic accordance rate of 95.6%, while 184/280 (65.7%) had diagnosis determined by IVU alone. There was a significant difference between IVU and IVU-CT in the determination of the diagnosis of ureteral diseases (c(2) = 36.4, P < 0.05). The cost of IVU equals to 1/8 - 1/9 of that for CT urography (CTU), and the cost of IVU-CT is as much as 1/3 of CTU. CTU results in the highest mean effective dose, approximately nine times that for IVU and three times that for IVU-CT. CONCLUSION: IVU-CT provides valuable information for the localization and diagnosis of ureteral abnormalities and may be considered as an efficient, cost-effective and low-dose diagnostic technique in this setting.

Unenhanced helical CT following excretory urography in the diagnosis of upper urinary tract disease: a little more cost, a lot more value.

The objective of the study is to evaluate unenhanced CT following intravenous urography (IVU) for the detection of upper urinary tract (UUT) abnormalities, when IVU fails to provide the qualitative diagnosis. Helical CT scan was performed on patients with suspected disorders of UUT, after the completion of IVU for further diagnoses. In total, 124 cases of definite diagnosis and 71 cases of uncertain diagnosis via IVU were collected from 195 patients with suspected UUT disorders. Among the 71 uncertain cases, 65 patients were consent to undergo immediate or delayed CT scan. CT data were transferred to the workstation for postprocessing. Of all the 65 cases, the major CT diagnoses were the following: stone disease (n = 41), urinary tract infections (n = 4), UUT tumors (n = 7), neighboring invasion or metastasis (n = 2), congenital anomalies (n = 2), and compressed stenosis (n = 6). Among all the results, 62 cases were confirmed by surgery, pathology or clinical follow-up, while three cases (4.6%) left were still uncertain. The diagnose accordance rate of IVU + CT achieved to 95.4%. There was significant difference between IVU and IVU + CT in the determinate diagnosis of UUT diseases (chi (2) = 30.4, P < 0.05). In conclusion, IVU + CT provides more valuable information for the localization and qualitative diagnosis of UUT abnormalities. It is recommended as a cost-effective and time-saving complemental means for IVU.