Epidemiological analysis reveals a surge in inflammatory bowel disease among children and adolescents: A global, regional, and national perspective from 1990 to 2019 - insights from the China study.

Background: The burden of inflammatory bowel disease (IBD) among children and adolescents is rising globally, with substantial variation in levels and trends of disease in different countries and regions, while data on the burden and trends were sparse in children and adolescents. We aimed to assess the trends and geographical differences in children and adolescents aged zero to 19 in 204 countries and territories over the past 30 years. Methods: Data on IBD among children and adolescents was collected from the Global Burden of Disease (GBD) 2019 database from 1990 to 2019. We used the GBD data and methodologies to describe the change in the burden of IBD among children and adolescents involving prevalence, incidence, disability-adjusted life years (DALYs), and mortality. Results: Globally, the IBD prevalence cases increased between 1990 and 2019. Annual percentage changes (AAPC) = 0.15; 95% confidence interval (CI) = 0.11-0.19, and incidence cases of IBD increased from 20 897.4 (95% CI = 17 008.6-25 520.2 in 1990 to 25 658.6 (95% CI = 21 268.5-31 075.6) in 2019, representing a 22.78% increase, DALYs cases decreased between 1990 and 2019 (AAPC = -3.02; 95% CI = -3.15 to -2.89), and mortality cases of IBD decreased from 2756.5 (95% CI = 1162.6-4484.9) in 1990 to 1208.0 (95% CI = 802.4-1651.4) in 2019, representing a 56.17% decrease. Decomposition analysis showed that IBD prevalence and incidence increased significantly, and a trend exhibited a decrease in underlying age and population-adjusted IBD DALYs and mortality rates. Correlation analysis showed that countries with high health care quality and access (HAQ) had relatively higher IBD age-standardised prevalence rate (ASPR) and age-standardised incidence rate (ASIR), but lower age-standardised DALYs rate (ASDR) and age-standardised mortality rate (ASMR). Conclusions: Global prevalence and incidence rate of IBD among children and adolescents have been increasing from 1990 to 2019, while the DALYs and mortality have been decreasing. Rising prevalence and rising incidence in areas with historically low rates will have crucial health and economic implications.

Synthesis and Cytotoxicity Assessment against Human Colorectal Cancer Cell Lines of Quaternary 8-Dichloromethyl Protoberberine Alkaloids.

Twenty-two quaternary 8-dichloromethylprotoberberine alkaloids were synthesized from unmodified quaternary protoberberine alkaloids (QPAs) to improve their physical and chemical properties and to obtain selectively anticancer derivatives. The synthesized derivatives showed more appropriate octanol/water partition coefficients by up to values 3-4 compared to unmodified QPA substrates. In addition, these compounds exhibited significant antiproliferative activity against colorectal cancer cells and lower toxicity on normal cells, resulting in more significant selectivity indices than unmodified QPA compounds in vitro. The IC50 values of antiproliferative activity of quaternary 8-dichloromethyl-pseudoberberine 4-chlorobenzenesulfonate and quaternary 8-dichloromethyl-pseudopalmatine methanesulfonate against colorectal cancer cells are 0.31 µM and 0.41 µM, respectively, significantly stronger than those of other compounds and positive control 5-fluorouracil. These findings suggest that 8-dichloromethylation can be used as one of the modification strategies to guide the structural modification and subsequent investigation of anticancer drugs for CRC based on QPAs.

[Research Progress on Risk Assessment of Secondary Transmission of Imported Malaria].

In 2015, WHO issued the Global Technical Strategy for Malaria 2016-2030, which sets the target of reducing global malaria incidence and mortality rates by at least 90% by 2030. Although many countries have successfully achieved malaria elimination, they are facing the risk of imported malaria. In China, despite the acceleration of malaria elimination, imported malaria has become a potential threat to achieving complete malaria elimination. This paper reviews the worldwide research progress on risk assessment of secondary transmission of imported malaria, in the aim of providing reference for risk assessment of imported malaria and preventing secondary transmission in China.

[Decision tree diagnostic model of Gan-dan damp-heat syndrome and Gan-stagnancy pi-deficiency syndrome in patients with chronic hepatitis B].

OBJECTIVE: To establish a clinical data based practical diagnostic model for Chinese medicine syndrome differentiation in patients with chronic hepatitis B (CHB), by way of seeking a combination of symptoms, signs and laboratory criteria associated with the typical syndromes of the disease. METHODS: A syndromatologic and laboratory investigation on 88 symptoms, 20 signs, and 14 laboratory indexes, was conducted in 1004 CHB patients. The clinical data of typical syndromes were selected and analyzed using Logistic regression analysis, decision tree and Bayesian network analysis in combination to establish a diagnostic model for effectively identifying the typical syndromes in CHB. RESULTS: The most typical syndromes revealed in the 1004 CHB patients were the Gan-dan damp-heat syndrome (340 patients, accounting for 33.86%) and the Gan-stagnancy with Pi-deficiency syndrome (366 patients, 36.45%). Based on the clinical data from patients with the two syndromes, 16 symptoms/signs and 3 laboratory indicators, provided with statistical significance, were selected using Logistic regression analysis. Then, a diagnostic model for differential the two syndromes, which was proved to have an accurate diagnosic rate of 74.36%, was formed by decision tree method. It was found that white tongue coating, light red tongue, yellow sclera, eye dryness, blood levels of alanine aminotransferase and HBeAg appeared to be the effective combination of indexes that may be helpful to differentiate the two syndromes. And the significance of the above-mentioned indexes was also verified by a Bayesian network approach. CONCLUSION: A decision tree model for diagnosing the two typical syndromes in CHB patients, the Gan-dan damp-heat syndrome and the Gan-stagnancy with Pi-deficiency syndrome, was established, which could be helpful for shifting the diagnosis of syndrome from experience-based to the data-model-based form, to make the syndrome diagnosis more objectively.