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ObjectiveTo investigate the epidemiological characteristics of respiratory disease mortality in Baoshan residents during the period of 2009‒2020. MethodsRespiratory disease deaths of Baoshan residents from 2009‒2020 were collected. ICD-10 codes were used to classify the causes of death， and R-4.2.1 was applied for statistical analysis. The average annual percent change （AAPC） of standardized mortality rates of different respiratory diseases were analyzed by using Joinpoint 4.9.0.0. ResultsThe average annual mortality rate of respiratory diseases in Baoshan from 2009 to 2020 was 58.86/105， and the standardized mortality rate was 35.62/105， which was the 3rd leading cause of mortality. The mortality rate of respiratory diseases was higher in men than in women （χ2=46.70， P<0.001）. COPD ranked first among respiratory diseases in Baoshan from 2009 to 2020， followed by pneumonia， asthma and pneumoconiosis in that order. The standardized mortality rate for COPD decreased from 38.66/105 in 2009 to 19.88/105 in 2020 （AAPC=-6.6%， 95%CI： -8.2% to -4.9%， P<0.001）. The standardized mortality rate of asthma decreased from 2.86/105 in 2009 to 1.43/105 in 2020 （AAPC=-5.8%， 95%CI： -8.8% to -2.8%， P<0.01）. The standardized mortality rate of pneumoconiosis decreased from 0.64/105 in 2009 to 0.12/105 in 2020 （AAPC=-7.4%， 95%CI： -13.0% to -1.5%， P<0.05）. The standardized mortality rate for pneumonia decreased from 2.63/105 in 2009 to 0.70/105 in 2020 （AAPC=-6.2%， 95%CI： -12.2% to 0.2%， P=0.056）， but not statistically significant. The annual average mortality rates of COPD， pneumonia and asthma were all highest in January. Crude mortality rates for COPD （χ2=2 669.01， P<0.001）， pneumonia （χ2=217.82， P<0.001）， asthma （χ2=100.09， P<0.001）， pneumoconiosis （χ2=26.46， P<0.001） and all categories of respiratory diseases （χ2=2 995.84， P<0.001） increased with age showed an increasing trend. The crude mortality rates for COPD （χ2=101.69， P<0.001）， pneumonia （χ2=7.39， P<0.01） and asthma （χ2=7.41， P<0.01） were higher in the central than in the northern part of Baoshan District， while the crude mortality rate for COPD （χ2=19.97， P<0.001） was higher in the central than in the southern part. ConclusionThe attention should be focused on COPD； increased detection in males and the elderly， especially in winter and spring； and a good balance between environmental and economic when planning the regional development.
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ObjectiveTo investigate the mortality and years of life lost of pancreatic cancer in Baoshan District of Shanghai，from 2009 to 2021， and to provide scientific evidence for the prevention and control of pancreatic cancer in the future. MethodsThe death surveillance data of Baoshan District from 2009 to 2021 were collected from the Shanghai chronic disease surveillance information management system. Crude mortality， standardized mortality，potential years of life lost （PYLL）， potential years of life lost rate （PYLLR） ， average years of potential life lost （AYLL） ， annual percentage change （APC） were calculated to analyze the trend of mortality and life loss of pancreatic cancer. ResultsFrom 2009 to 2021， a total of 2117 deaths of pancreatic cancer were reported in Baoshan District， accounting for 7.05% of all cancer deaths. The average age of the death cases was （71.18±10.97）years. The youngest was 3 years old and the oldest was 96 years old. The death component ratio of pancreatic cancer increased with time （P<0.05）， and the average death age of women was higher than that of men （P<0.05）. The crude mortality of pancreatic cancer was 17.38/105 in Baoshan District from 2009 to 2021， showing a rising tendency （P<0.05） with APC of 3.74%. The standardized mortality of pancreatic cancer was 7.84/105. The crude mortality of pancreatic cancer was 19.71/105 in men and 14.89/105 in women， both showed a tendency towards a rise （P<0.05 ） with APC of 4.44% and 2. 89%， respectively. The crude mortality of pancreatic cancer showed a tendency towards a decline in residents at ages of 45 to 60 years （ P<0.05 ）， with APC of 4.74%. The PYLL and PYLLR of pancreatic cancer were 8 115 person-years and 0.67‰ in Baoshan District from 2009 to 2021， while the AYLL of pancreatic cancer was 3.83 years per person. The PYLL was higher in men than in women. ConclusionThe mortality rate of pancreatic cancer in Baoshan District shows an increasing trend. The healthy life of elderly and men is affected largely by pancreatic cancer. It is necessary to strengthen the health education on the prevention/control of pancreatic cancer and healthy life style， thereby improving the tertiary prevention system of pancreatic cancer.
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Objective@#To study the therapeutic value of endoscopic ultrasonography-guided hepaticogastrostomy(EUS-HG) for patients with high malignant biliary obstructive jaundice.@*Methods@#A total of 56 patients with high malignant obstructive jaundice hospitalized at the Second Affiliated Hospital of Nanjing Medical University and the Second Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2017 were included in the study. There were 29 males and 27 females with median age of 72 (60-82) years. Patients were randomized into two groups according to the random number table, the EUS-HG group (n=20) treated with EUS-HG and the percuteneous transhepatic cholangiodrainge(PTCD) group (n=36) treated with PTCD. The operative success rate, curative effect, complications and operation cost were compared between the two groups, and the median unblock period of plastic double pig tail stent was observed.@*Results@#(1)The success rates were 100% in both groups. (2) Preoperative and one-month postoperative levels of the following were tested and compared. Levels of total bilirubin were 362.15±138.27 μmol/L, 56.85±28.57 μmol/L in the EUS-HG group and 356.47±130.69 μmol/L, 60.93±25.79 μmol/L in the PTCD group, respectively. Levels of alkaline phosphatase were 896.57±357.29 U/L, 146.59±48.63 U/L in the EUS-HG group and 883.65±364.32 U/L, 151.57±49.73 U/L in the PTCD group, respectively. Levels of alanine aminotransferase were 252.36±38.77 U/L, 60.29±31.57 U/L in the EUS-HG group and 246.26±32.57 U/L, 62.56±32.87 U/L in the PTCD group. Levels of aspartate aminotransferase were 259.37±30.64 U/L, 62.28±26.58 U/L in the EUS-HG group and 242.37±29.52 U/L, 60.28±29.57 U/L in the PTCD group, and there was no significant difference between the two groups (P>0. 05). CRP levels were 52.57±31.95 mg/L, 16.95±8.77 mg/L in the EUS-HG group and 53.42±35.79 mg/L, 25.13±14.77 mg/L in the PTCD group (P<0.05). (3)There was significant difference in remission rate of anorexia and abdominal distension between the two groups [80.0%(16/20) VS 52.8%(19/36), P<0.05]. There was no significant difference in symptom relief of jaundice, pruritus or abdominal pain between the two groups [90.0%(18 /20)VS 91.7%(33/36), P>0.05]. (4) The incidence of total complications in the EUS-HG group (20.0%, 4/20) was significantly lower than that in the PTCD group (47.2%, 17/36, P<0.05). (5)The cost of operation in the EUS-HG group (22 685.26±2 356.16 yuan) was slightly higher than that in the PTCD group (20 529.57±4 135.63 yuan, P>0.05). (6) The median unblock period of double pig tail plastic stents in EUS-HG group patients was 102 days.@*Conclusion@#EUS-HG is a safe and effective method for the treatment of high malignant biliary obstructive jaundice. It can be used as the first choice for treatment after failure of conventional ERCP.
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Objective To study the therapeutic value of endoscopic ultrasonography-guided hepaticogastrostomy( EUS-HG) for patients with high malignant biliary obstructive jaundice. Methods A total of 56 patients with high malignant obstructive jaundice hospitalized at the Second Affiliated Hospital of Nanjing Medical University and the Second Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2017 were included in the study. There were 29 males and 27 females with median age of 72 (60-82) years. Patients were randomized into two groups according to the random number table, the EUS-HG group ( n=20) treated with EUS-HG and the percuteneous transhepatic cholangiodrainge( PTCD) group (n=36) treated with PTCD. The operative success rate, curative effect, complications and operation cost were compared between the two groups, and the median unblock period of plastic double pig tail stent was observed. Results (1) The success rates were 100％ in both groups. (2) Preoperative and one-month postoperative levels of the following were tested and compared. Levels of total bilirubin were 362. 15 ± 138. 27 μmol/L, 56. 85 ± 28. 57 μmol/L in the EUS-HG group and 356. 47 ± 130. 69 μmol/L, 60. 93 ± 25. 79 μmol/L in the PTCD group, respectively. Levels of alkaline phosphatase were 896. 57±357. 29 U/L, 146. 59±48. 63 U/L in the EUS-HG group and 883. 65 ± 364. 32 U/L, 151. 57 ± 49. 73 U/L in the PTCD group, respectively. Levels of alanine aminotransferase were 252. 36±38. 77 U/L, 60. 29±31. 57 U/L in the EUS-HG group and 246. 26 ± 32. 57 U/L, 62. 56 ± 32. 87 U/L in the PTCD group. Levels of aspartate aminotransferase were 259. 37 ± 30. 64 U/L, 62. 28 ± 26. 58 U/L in the EUS-HG group and 242. 37 ± 29. 52 U/L, 60. 28±29. 57 U/L in the PTCD group, and there was no significant difference between the two groups (P>0. 05). CRP levels were 52. 57±31. 95 mg/L, 16. 95±8. 77 mg/L in the EUS-HG group and 53. 42± 35. 79 mg/L, 25. 13 ± 14. 77 mg/L in the PTCD group ( P<0. 05) . ( 3 ) There was significant difference in remission rate of anorexia and abdominal distension between the two groups [ 80. 0％( 16/20) VS 52. 8％( 19/36) , P<0. 05] . There was no significant difference in symptom relief of jaundice, pruritus or abdominal pain between the two groups [ 90. 0％( 18 /20) VS 91. 7％( 33/36) ,P>0. 05] . ( 4) The incidence of total complications in the EUS-HG group ( 20. 0％,4/20) was significantly lower than that in the PTCD group (47. 2％,17/36, P<0. 05). (5)The cost of operation in the EUS-HG group (22685. 26±2356. 16 yuan) was slightly higher than that in the PTCD group (20529. 57±4135. 63 yuan, P>0. 05). (6) The median unblock period of double pig tail plastic stents in EUS-HG group patients was 102 days. Conclusion EUS-HG is a safe and effective method for the treatment of high malignant biliary obstructive jaundice. It can be used as the first choice for treatment after failure of conventional ERCP.
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Objective To assess the use of hospitalization services by urban and rural residents of Dongying City and its influencing factors. Methods A survey on health services in the whole city was conducted in 2002 and on the basis of a descriptive analysis of the data, an analysis of the influencing factors of hospitalization probability was made by means of logistic regression. Results The hospitalization ratio of urban and rural residents of Dongying averaged 57‰ whereas the ratio of nonhospitalization averaged 42‰, both being higher than the average national levels. The hospitalization ratio of urban residents was 76‰ whereas that of rural residents was 46‰, the former being significantly higher than the latter. Factors influencing hospitalization probability chiefly included sex, age, income, and medical insurance system. Conclusion It is suggested that the process of regional health planning be accelerated and systems of medical security and medical aid be adopted.