[Correlation among age, sex, and liver diseases-related mortality risk in patients with hepatitis B virus-related liver cirrhosis].

Objective: To understand and compare the differences between age, sex and liver diseases-related mortality risk in patients with hepatitis B virus-related liver cirrhosis. Methods: Based on the front-page inpatient medical record database and the death registration system of Beijing patients with hepatitis B-related liver cirrhosis from 2008 to 2015 were included. The survival information of all patients were traced up to the occurrence of liver disease-related mortality event or until December 31, 2019. Kaplan-Meier method was used to calculate the cumulative incidence of liver disease-related mortality in patients with liver cirrhosis. Cox regression model was used to analyze the effect of age-gender interaction on liver disease-related mortality risk. Results: A total of 16 738 patients with hepatitis B-related liver cirrhosis were included, of which 13 969 cases (83.46%) were in compensated stage and 2 769 cases (16.54%) were in decompensated stage. Liver cirrhosis complications mortality risk in patients with compensated stage cirrhosis at 3, 5, and 8 years were 10.84%, 12.70%, and 14.37%, respectively; while in decompensated stage patients, the mortality risk was 16.70%, 19.02%, and 20.73%, respectively. The 3, 5, and 8-year liver cancer mortality rates of patients with compensated stage liver cirrhosis were 5.24%, 7.49%, and 10.25%, respectively; while those with decompensated stage liver cancer mortality rates were 9.01%, 11.16%, and 13.50%, respectively. Liver disease-related mortality risk was increased with age in patients with liver cirrhosis. Liver cirrhosis complications mortality risk in female patients with liver cirrhosis at age < 60 years was lower than that of male patients. Liver cirrhosis complications mortality risk in male and female patients aged 60-69 years were similar. Liver cirrhosis complications mortality risk in female patients aged ≥70 years was higher than that of male patients. However, female patients had a lower risk of liver cancer mortality than male patients in utmost age groups. Conclusion: Age is positively correlated with liver diseases-related mortality risk in patients with hepatitis B-related liver cirrhosis. Female sex is a protective factor for liver cancer mortality in patients with liver cirrhosis, and the protective effect on liver cirrhosis complications mortality risk gradually disappears with age.

[Comparative analysis of comprehensive health status among 31 provinces in China and 134 countries (regions) in 2015].

Objective: To evaluate comprehensive health status of 31 provinces in China and compare with other countries (regions). Methods: Social-demographic index, life expectancy and healthy life expectancy in 134 countries (regions) and 31 provinces in China were collected from the Global Burden of Disease Study 2015. K-means clustering method was used to classify comprehensive health status of various countries (regions) in the world. HemI 1.0.3 software was applied to draw distribution heat maps of social-demographic index, life expectancy and healthy life expectancy in different provinces of Mainland China. Discriminant analysis was used to evaluate comprehensive health status of different provinces in Mainland China. Results: Comprehensive health status of 134 countries (regions) was grouped into category 1-8 from good to poor, and Mainland China was in the category 4. The comprehensive health status of provinces in Mainland China is better in the east coast and poorer in the west inland, among which Shanghai and Beijing were grouped into the category 1, Zhejiang, Jiangsu, Guangdong and Tianjin into the category 2, Fujian, Liaoning and Shandong into the category 3, Yunnan, Guangxi, Xinjiang and Guizhou into the category 5, Qinghai and Tibet into the category 6, and the rest 16 provinces into the category 4. Conclusion: Comprehensive health status of Mainland China ranked middle to upper level in the world, and health status disparities were observed among different provinces in Mainland China.

[Probability of premature mortality caused by non-communicable diseases in Beijing, 2010-2015].

Objective: To understand the probability of premature mortality caused by non-communicable diseases (NCD) in Beijing from 2010 to 2015. Methods: The data of deaths from Beijing vital registration system were used to analyze age-standardized NCD mortality rates, proportion of NCD deaths in age group <70 years and premature NCD mortality. Results: NCD deaths accounted for 90% of the total deaths in Beijing. Age-standardized NCD death rate decreased from 332.43/100 000 in 2010 to 280.02/100 000 in 2015. Meanwhile, the probability of deaths from four NCDs between in age group 30-70 years (premature NCD mortality) decreased from 12.81% to 11.11% in Beijing. The premature mortality of four NCDs in men was 14.63%, and compared with 2015 baseline, it would decrease by 16.4% to reach 2025 goal (12.23%), and the probability of premature mortality four NCDs in women was 7.54%, and compared with 2015 baseline, it would decrease by 6.8% to reach the 2025 goal (7.03%). People living in suburb areas had a higher probability of premature NCD mortality (13.67%) than those living in urban areas (9.72%) in Beijing in 2015. Conclusions: The premature NCD mortality was much higher in men than in women in Beijing. More attention should be paid to the control of risk factors for NCD premature deaths, especially in men and in suburb residents, to reach the 25×25 goal.

[Analysis on causes of death of residents in Beijing, 1965-1974].

OBJECTIVE: To fill up the absence of data on causes of death of urban residents in Beijing during 1965-1974 and provide evidence for the similar study in other areas. METHODS: All possible sources for death data during 1965-1974 were identified through expert consultations and record search. Stratified sampling was conducted to collect the death data of urban residents during this period in Beijing. The mortality rate, death cause constituent and rank of death causes were used in this descriptive analysis. RESULTS: A total of 11 668 records of deaths from 1965 to 1974 were collected from 10 local police stations in urban area of Beijing. The top 10 death causes in the urban residents were heart disease, tumor, cerebrovascular disease, accidental injury, respiratory system disease, digestive system disease, communicable disease and parasitic disease, nervous system disease, urogenital and reproductive system disease, endocrine and nutrition metabolic diseases. The deaths caused by these diseases accounted for 84.19% of the total deaths. Accidental injury accounted for 13.22% of the total deaths, which was significantly higher than that in either 1964 or 1975, two years before and after this period(P<0.01). Suicide accounted for 54.47% of the total accidental injury deaths. For men, accidental injury was the leading death cause, followed by cancer and heart disease; for women, heart disease, cancer and cerebrovascular disease were the top three death causes. CONCLUSION: The major death cause in urban residents changed from infectious diseases to chronic and non-communicable diseases during 1965-1974. A remarkable high proportion of deaths caused by accidental injury was due to the historical background during that period in Beijing, China.

[Analysis on the consistency and timeliness of death data gathered from different sources in the residents of Beijing].

Objective: To further improve the quality of mortality data for Beijing residents, through describing and analyzing the current death data gathered from different sources in Beijing. Methods: Data on death of the Beijing residents from Beijing Public Security Bureau, Beijing Civil Affairs Bureau and Beijing Centers for Disease Control and Prevention (BJCDC) were collated and compared. Timeliness of related data from the three different sources were described and analyzed. The overall consistency and reported timeliness of data from the three sources appear good, but the consistency on the causes of death needs to be improved. Result: Numbers of deaths from the three different sources were 95 318, 130 906 and 160 779 respectively, with 387 003 in total. Data from the Beijing Public Security Bureau and BJCDC seemed better in terms of integrity and accuracy. Data from the Beijing Public Security Bureau had the highest filling rate of ID card number while data from the Beijing Civil Affairs Bureau had the best timeliness. The most informative source of data was from the BJCDC. Conclusion: The overall quality of the exchanged death data from Beijing Public Security Bureau, Beijing Civil Affairs Bureau and BJCDC appeared good but remained some areas for improvement.

[Influencing factors on healthy life expectancy in adults in Beijing].

OBJECTIVE: To understand the main influencing factors related to healthy life expectancy (HALE) among adults in Beijing. METHODS: The calculation on health-adjusted life expectancy was performed by Sullivan METHODS. Data from the self-reported health survey program on adults in Beijing 2012 was gathered. Hierarchical ordered probit model was used to estimate the severity-weighted prevalence of disability and then combined with the period life table to obtain the HALE. Factors associated with the severity-adjusted prevalence of the disabled were analyzed under the generalized additive models (GAM). RESULTS: The main influencing factors of HALE would include age (t=40.351, P<0.001), sex (t=9.689, P<0.001), levels of education (t=5.021, P< 0.001), exercise (t=5.487, P<0.001) and alcohol intake (t=-2.380, P=0.017) etc. The influence of per capita monthly income (χ(2) =3.949, P=0.044) showed as non-linear. CONCLUSIONS: Levels of income would directly influence the severity-weighted prevalence of the disability, which also affecting the HALE. Programs on improving healthy life style and health care in women should be promoted.

Bony morbidity in children treated for acute lymphoblastic leukemia.

PURPOSE: Corticosteroids are widely used in the treatment of acute lymphoblastic leukemia (ALL). To determine the frequency of corticosteroid-associated bony morbidity in children with ALL, we retrospectively evaluated the incidence of fractures and osteonecrosis (ON) on two consecutive pediatric ALL protocols. PATIENTS AND METHODS: One hundred seventy-six consecutive children were treated for ALL between 1987 and 1995 at the Dana-Farber Cancer Institute and Children's Hospital. Prednisone was used as the corticosteroid during postremission therapy from 1987 to 1991, and dexamethasone was used from 1991 to 1995. Medical records for all patients were reviewed to assess the occurrence of fractures and ON. RESULTS: With a median follow-up of 7.6 years, the 5-year cumulative incidence (CI) +/- SE of any bony morbidity for the 176 patients was 30% +/- 4%, with a 5-year CI of fractures of 28% +/- 3% and of ON of 7% +/- 2%. With multivariate analysis, independent predictors of bony morbidity included age 9 to 18 years at diagnosis (P <.01), male sex (P <.01), and treatment with dexamethasone (P =.01). Dexamethasone was associated with a higher risk of fractures (5-year CI, 36% +/- 5% v 20% +/- 4% with prednisone; P =.04), but not ON (P =.40). The 5-year event-free survival for the 176 patients was 79% +/- 3%. CONCLUSION: Children treated for ALL had a high incidence of fractures and ON. Older children, boys, and patients receiving dexamethasone were at increased risk for the development of bony morbidity. Future studies should attempt to minimize corticosteroid-associated bony morbidity without compromising clinical efficacy.

Extraperitoneal laparoscopic radical prostatectomy.

A total of 28 patients with clinically localized prostate cancer (PCa) underwent extraperitoneal laparoscopic radical prostatectomy (EP-LRP). The mean operative duration was 309 (287-600) minutes. Estimated blood loss ranged from 380 to 1000 (mean 480) ml. At 3 to 5 days postoperatively, the catheter was removed. No open conversion was required and no patient presented postoperative complications. PSA level was less than 0.1 ng/ml at 3 months after surgery in all patients. At a mean follow-up of 10 (6-16) months, there were no biochemical failures. The extraperitoneal technique potentially decreased the risk of intra-abdominal complications and better approximated than open retropubic radical prostatectomy. In conclusion, EP-LRP is an effective, safe and precise technique.

A comparison of the effects of different degrees of zona pellucida damage followed by cryopreservation on the postthaw development of mouse embryos.

PURPOSE: The totally intact zona pellucida is not essential for the development of embryos. It is still unclear how much effect the degree of damages to the zona pellucida will have on the developmental potential of postthaw embryos after cryopreservation. We compared the developmental potential of cryopreserved mouse embryos after induction of two degrees of mechanical damage to the zonae pellucidae by micromanipulation. METHODS: In experiment I, the development of 124 cryopreserved ICR mouse embryos to the blastocyst stage after zona pellucida penetration of two-cell embryos as in the procedures of subzonal sperm insertion (SUZI) was compared with the development of zona-intact cryopreserved embryos. In experiment II, the zonae pellucidae of 93 two-cell mouse embryos were dissected as in the procedures of partial zonal dissection (PZD), following which the embryos were frozen. This postthaw development was also compared with that of zona-intact two-cell cryopreserved embryos. All the embryos were thawed and cultured to the blastocyst stage. Additional controls were provided by culturing zona-intact and zona-penetrated or zona-dissected embryos without cryopreservation. RESULTS: The development of unfrozen mouse embryos was not affected by either zona penetration (P = 0.433) or zona dissection (P = 0.659). The developmental potential of cryopreserved mouse embryos was significantly affected after zona dissection (blastocyst rate, 31% ZD vs 72%, control; P < 0.001) but not after zona penetration (blastocyst rate, 59% ZP vs 64% control; P = 0.441). CONCLUSIONS: The quality of cryopreserved embryos was affected by a large hole on the zona pellucida created by zona dissection but not by simple zona penetration.

The effects of brief gamete co-incubation in human in vitro fertilization.

PURPOSE: To investigate whether very short exposure of mature oocytes to sperm in vitro may affect the fertilization rates, embryo cleavage rates, and embryo quality between sibling oocytes in the same patient. METHODS: Sibling oocytes of the same patient from 23 oocyte collection cycles were randomly allocated to the study group, with a 1-hr or 3-hr sperm-oocyte incubation, or the control group with the standard overnight gamete co-incubation. The fertilization rates, cleavage rates, and subsequent embryo quality were evaluated. RESULTS: Our results showed no statistically significant differences in fertilization rates, embryo cleavage rates, and quality of the embryos between the study group and the control group. CONCLUSIONS: Since the present study showed that long exposure of the oocyte to sperm has no advantage over short exposure, we prefer shortening the oocyte-sperm incubation period for reducing the negative effect induced by nonphysiologically high concentrations of spermatozoa.

Development of hatching blastocysts from immature human oocytes following in-vitro maturation and fertilization using a co-culture system.

Recently, in-vitro maturation (IVM) of immature human oocytes recovered from non-stimulated follicles has been applied in the treatment of infertility. However, in previous reports, very few embryos cultured in conventional medium have reached the expanded blastocyst stage following in-vitro maturation and fertilization (IVM/IVF). The objective of this study was to investigate whether the developmental competence of human embryos following IVM/IVF could be enhanced by the use of a human ampullary cell co-culture system. Immature human oocytes were aspirated from small follicles at Caesarean section and then cultured in medium containing human menopausal gonadotrophin for 36 to 48 h, followed by insemination. Zygotes were randomly cultured either in conventional culture medium alone or in the co-culture system. Of 48 embryos cultured in conventional medium alone, all arrested at the 2-16-cell stage on day 3 after insemination. Of 46 embryos cultured in the co-culture system, 26 embryos (56.5%) arrested at the 2-16-cell stage. Six embryos (13%) developed to the morula stage. Fourteen embryos (30.4%) developed to expanded blastocysts and two blastocysts were hatching on day 7 after insemination. We conclude that co-culture significantly enhances the development of blastocysts in embryos resulting from IVM/IVF.