[The effect of Ba Duan Jin on the balance of community-dwelling older adults: a cluster randomized control trial].

Objective: To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults. Methods: A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test. Results: A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95%CI: 2.23-3.88) points (P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95%CI: 4.03-5.37) points (P<0.001). Ba Duan Jin showed significant improvement (P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions: This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

[Prognostic factors of autologous hematopoietic stem cell transplantation in intermediate-risk acute myeloid leukemia patients with minimal residual disease negativity].

To explore prognostic factors in intermediate-risk acute myeloid leukemia (AML) patients with minimal residual disease (MRD) negativity (MRD<0.1%,MRD-)receiving autologous hematopoietic stem cell transplantation (auto-HSCT).A total of 59 intermediate-risk AML patients with MRD-were treated with auto-HSCT from January 2015 to September 2021 at Affiliated People's Hospital of Ningbo University. The clinical data and laboratory results were collected retrospectively. Efficacy, clinical outcome and prognostic factors were analyzed. Univariate analysis was conducted by using log-rank test, the multivariate analysis by Cox proportional risk model.Among 59 patients, there were 27 males and 32 females with median age of 55 (31-69) years old.The median follow-up was 761(317-1 861)days. The 2-year overall survival (OS) rate and event-free survival (EFS) rate were 76.1%±11.4% and 73.4%±11.6% respectively.The univariate analysis showed that age older than 50 years, TET2 gene mutation (TET2+), achieving MRD negativity over 30 days (MRD30+) were unfavorable factors of OS (χ2=6.20, 33.20, 7.18;P=0.013,<0.001, 0.007). TET2+, WT1 gene mutation (WT1+), CD34+cells<2×106/kg, MRD30+were negative factors of EFS (χ2=17.29, 4.47, 3.94, 9.393;P<0.001, 0.035, 0.047, 0.002).Multivariate analysis showed that MRD30+, TET2+ were independent prognostic factors of OS and EFS (OS:HR=9.251, 25.839, P=0.036, 0.001;EFS:HR=5.851, 9.199, P=0.043, 0.002). Intermediate-risk AML patients with MRD30+or TET2+ have very poor prognosis after auto-HSCT. Alternative regimens should be investigated.

[Objectives and strategies of unintentional injury prevention and control in 31 provincial Children's Development Outlines in China].

Objective: To landscape the contents, similarities, and differences of the objectives and strategies for unintentional injury prevention and control in the national and 31 provincial Children's Development Outlines from 2011 to 2020, and propose relevant suggestions. Methods: The content analysis method was used to extract, encode and classify the objective and strategy text of unintentional injury in all Children's Development Outlines and construct the theme of strategy text combined with the '5E' Injury Prevention Framework. Taking the national Children's Development Outline as the benchmark, the relevant contents of 31 provincial Children's Development Outlines in the same period were compared. Results: All Children's Development Outlines took child injury prevention and control as the primary objective set in health, environment, and safety. The national and most provincial Children's Development Outlines set this goal in health, while others put it in environment or safety. Reducing injury-induced death, disability and occurrence were designated as the main content in the objective of child injury prevention and control. However, there were no quantitative requirements for injury occurrence and disability in all the provincial outlines. The themes of unintentional injury prevention and control strategies in all Children's Development Outlines could be divided into the mechanism, law enforcement, education, environment, engineering, first aid, assessment, and economic strategies. Mechanism strategy was the primary domain, followed by law enforcement, education, environment, and engineering strategies, but less attention was put on first aid, assessment, and economic strategies. The unintentional injury prevention and control strategy in the provincial Children's Development Outlines was mainly based on the national outline. Still, it also varied with some emphasis and refinement in different items among all the provinces. Conclusions: Children's Development Outline is a vital policy guarantee for implementing child injury prevention and control work. Developing a system involving good primary data, mechanisms and strategies, law enforcement, and environmental and engineering-related strategies for more common types of child injuries has been attached to great importance. Actively carrying out assessments and encouraging the adoption of more economical strategies could further enrich and improve the unintentional injury prevention and control in Children's Development Outline and promote the progress of related work in China.

[Prevalence of injury among children in 28 counties of 6 provinces in China in 2017].

Objective: To investigate the incidence of injuries among children aged 0-17 years from 28 counties in six provinces. Methods: According to the earlier study on data in different local areas and the current work plan, we selected the survey objects for a general survey on child injury prevalence in the last 12 months. The subjects included guardians of children who did not attend kindergartens, children from kindergartens, and primary school grades 1-3. Children from grades 4-6 primary school, junior high school, and senior high school were also included. Results: The overall rate of injured children was 4.83%, with the incidence of injuries as 5.75% in the last 12 months before the survey. Both the rate of injured children and incidence of injuries were higher in boys than that in girls. Children whose primary caregivers were relatives, grandparents, minors, or with an education level below the primary school had a relatively higher rate of both injured children and incidence of injuries. The first cause of child injury was fall. The time of child injury was mainly from June to October, mainly at home, with the main activity as playing. The significant injuries in children were contusion and abrasion, and the main parts injured were lower limbs, upper limbs, and head. Most of the injuries were cured, and the primary treatment was outpatient and emergency treatment. Conclusions: Boys and children whose parents can not take care of are the priority population for child injury prevention and control. Targeted prevention and control measures should be implemented according to the characteristics of injuries among children of different ages.

[The epidemiological characteristics and influencing factors of animal injuries among children from 28 counties in 6 provinces, China].

Objective: To understand the epidemiological characteristic and influencing factors of animal injuries among children from 28 counties/districts in 6 provinces of China to provide evidence for formulating related prevention measures and strategies. Methods: Data was obtained from 'Children injury prevention project, 2016-2020'. Variables on the characteristics, including incidence, locations, related activities, time, and outcomes among children, were described. The negative binomial regression model analyzed animal injury frequency influencing factors. Results: There were 107 029 boys and 97 599 girls, with a gender ratio of 1.10, among the 204 628 children aged 0-17 in 28 counties/districts in 6 provinces of China. Per-person and per-time incidence rates of animal injuries were 0.70% and 0.72%, both higher in boys than in girls. Animal injuries among children mainly occurred in home (73.20%), road/street (7.51%), and open space of community/village (6.77%), during playing (63.15%), with the peak time between 12:01-18:00 (45.03%). Upper limbs (47.89%), lower limbs (35.31%), and head (8.44%) were the most injured body parts. Outpatient or emergency treatment (85.19%) had been carried out. The negative binomial regression showed that sex, grade, guardian educational level, urban or rural, and daily communication between guardians and children as influencing factors in the frequency of animal injuries among children. Conclusions: Special attention should be given to boys, at home, in projects on animal injury prevention and control. There were many influencing factors of animal injury frequency. Knowledge of injury prevention should be popularized to children and guardians. Related comprehensive intervention should be developed in families, schools, and social settings.

[Prevalence and prevention of traffic injury among children in 28 counties of 6 provinces in China, 2017].

Objective: To investigate the incidence of traffic injuries among children aged 0-17 years in 28 counties of 6 provinces and to provide prevention suggestions. Methods: Using the general survey method, a questionnaire survey was conducted on the road traffic injuries of children in 28 counties of 6 provinces in 2017. Results: A total of 204 628 students were surveyed, 908 of whom had experiences of road traffic injuries. Road traffic injuries were 0.44% among children in 28 counties of 6 provinces in China and 0.94% among children who did not attend kindergartens. July is a high incidence period of road traffic injuries among children (12.92%). When children suffer from road traffic injuries, the first three activities were playing (21.61%), riding an electric bicycle (20.40%), walking (20.07%). Most injuries appeared as contusion/abrasion, accounting for 42.26% of the total cases. The injured parts were mainly lower limbs, upper limbs, and heads, accounting for 38.85%, 23.29%, and 20.20%. Most children with road traffic injuries recovered after related treatments, accounting for 85.43% of all cases. The median length of hospital stay of children with road traffic injuries was seven days, and the median expense in hospitals was 3 000 Yuan (RMB). Conclusions: The incidence of road traffic injuries among males appeared higher than females, and the children who did not attend the kindergartens were the highest. During playing, riding an electric bicycle and walking were the top three activities prone to road traffic injuries.

[Analysis on epidemiologic characteristics of fall in old people: results from Chinese National Injury Surveillance System, 2015-2018].

Objective: To understand the epidemiologic characteristics of fall in people aged 60 years and above in China from 2015 to 2018, and provide basis for the prevention of fall in old people and the development of related policies. Methods: Descriptive analysis was conducted on general information, injury occurrence information and injury clinical characteristics of fall cases in people aged 60 years and above by using the data from Chinese National Injury Surveillance System(NISS). Results: A total of 205 670 fall cases were reported to NISS from 2015 to 2018 with the male to female ratio of 1.37. Falls mainly occurred during 10:00-10:59 am (11.91%). The top three places where fall might occur were home (56.41%), road (17.24%) and public residence (14.36%). Leisure activity(37.56%), housework (24.20%) and walk (15.07%) were top three activities in which fall occurred. Bruise/scrape (42.17%), fracture (31.79%) and sprain/strain (14.62%) were the major injuries. The most common body parts involved were low limbs (31.38%), head (22.46%) and truncus(20.71%). Moderate and severe injuries accounted for 37.21% of all cases, and 22.49% of the elderly seeking medical care due to fall required hospitalization. Conclusions: The number of fall in people aged 60 years and above increased from 2015 to 2018. The elderly is a key population in the prevention and control of fall.

[Disease burden on falls among 0-19 years old population in China, in 1990 and 2017].

Objective: To analyze and compare the disease burden of falls in Chinese population aged 0-19, in 1990 and 2017. Methods: Indicators including number of deaths, mortality rates, years of life lost due to premature mortality (YLL), years lived with disability (YLD) and disability-adjusted of life years (DALY), on falls, were gathered from the Global Burden of Disease (GBD) 2017 and used to describe the disease burden and corresponding parameters on falls, between 1990 and 2017, in China. Results: In 2017, number of death, YLLs, YLDs, DALYs caused by falls were 5 321, 0.43 million person years, 0.14 million person years and 0.57 million person years respectively, among aged 0-19 group. Rates on standardized mortality, YLLs, YLDs and DALYs on falls were 1.76/100 000, 141.49/100 000, 46.99/100 000, and 188.48/100 000, respectively. The burden of falls decreased with the increase of age. Compared with 1990, disease burden of falls decreased in all age groups, both in male and female, with more seen in the lower age groups. Compared with 1990, the number of deaths, rates on YLLs, YLDs and DALYs caused by falls decreased by 65.08%, 46.63%, 47.38% and 36.33% respectively, in 2017. However, the YLDs rate increased by 73.31% between 1990 and 2017. The ratio of YLLs to DALYs decreased from 90.84% in 1990 to 75.07% in 2017, with a proportion as 17.36%. Conclusion: Compared with 1990, although the disease burden of falls among aged 0-19 group showed a decreasing trend, falls still caused serious disease burden for the aged 0-19 group. Research that targeting prevention on falls, should be continued.

[Occurrence of injuries among left-behind children from 27 poor rural areas in 12 provinces of China, 2016].

Objective: To understand the injuries among 16 459 left-behind children from 27 poor rural areas in 12 provinces of China, 2016. Methods: Data were collected from the survey of 'Health Service Needs Assessment' (HSNA) program on left-behind children, from poor rural areas in the middle and western parts of China. Factors including causes, types, locations, related activities, ways of treatment and outcomes among left-behind children with injuries in 2016, were described and analyzed by gender and age groups. Results: In 2016, per-person and person-time incidence rates of injuries were 8.88% and 11.21%, among the 16 459 left-behind children from 27 poor rural areas in 12 provinces of China, both higher in boys, than in girls. Most injuries were unintentional with its proportion higher in older children. The main types of injuries were seen as falls, blunt and sharp injuries, with burns and animal injuries more common in younger children. Injuries among left-behind children mainly took place at home, kindergarten/school, and on the highways/streets/roads, during playing. Most common ways of treatment would include at the emergency settings, self-treated, with older children more likely to treat by themselves. Most injuries were cured. Conclusions: In programs on prevention and control of injuries targeting the left-behind children in poor rural areas, special attention should be given to older boys, on falls and blunt/sharp injuries, at home or kindergarten/school. Education programs should pinpoint on self-rescue skills and guidance on kids by the parents, with behavioral norms and social support included. Related comprehensive prevention and control mechanism should be developed in families, schools and communities, with medical resources and insurance mechanism explored to serve these population and districts, including those left-behind children.

[Trends of injury mortality among children in different stages of the China Children's Development Outlines].

Objective: To describe the trends and potential reasons responsible for injury mortality among children under 18 years old in different stages of the China Children's Development Outlines (CCDO) for children from 1990 to 2017, in China. Methods: Data derived from the Global Burden of Disease 2017 (GBD2017) were used to analyze the change of injury mortality, among children under 18 years old, by sex and provinces. Results: Since 1990, the Chinese government had formulated and implemented three CCDOs on Children. Each CCDO proposed corresponding main targets and strategic measures based on the development of children under current situation, in each area, accordingly. The first two CCDOs failed to set clear targets for child injury prevention and control, but the third one did propose a quantifiable target. The injury mortality rate of children under 18 years old showed a declining trend in all periods of the three CCDOs, by 26.07%, 40.68% and 26.48%, respectively. Both boys and girls showed significant downward trend in these three stages. Mortality rate on child injury differed in these three stages in all the 31 provinces. Conclusion: Thanks to the contribution of CCDO in different stages that providing important policies and impetus for the prevention and control of child injury, the number of deaths caused by child injury kept reducing, from 1990 to 2017, in China.

[Analysis on influence of the self-confidence, motivation and authoritative advice factors on the use of child restraint].

Objective: To establish the model of the self-confidence, motivation and authoritative advice factors influencing the use of child restraint and use structural equation model to test it to provide scientific basis for promoting the advocacy of use of child restraint. Methods: Using multi-stage cluster random sampling method, 9 112 parents from the family with one or more private cars and 0-6 years old children in Shanghai and Shenzhen were investigated about the use of child restraint. A theoretical model of the self-confidence, motivation and authoritative advice factors influencing the use of child restraint was constructed. The theoretical model was validated and quantitatively analyzed by structural equation model. Results: The overall model accords with the expected theoretical model, and the goodness of model fit was fine. The indicators had met the standard. RMSEA=0.03, CFI=0.97. The standardization coefficients of each route showed statistical significance (P<0.05). The standardization coefficients of the influence of authoritative suggestions and motives on self-confidence were 0.45 and 0.30 respectively, and the standardization coefficients of the influence of self-confidence on the use of child restraint was 0.40. The standardization coefficient of the influence of authoritative suggestions on motivation was 0.61. Conclusions: In the advocacy of the use of child restraint, we should attach importance to the use of recommendations from experts and organizations with professional authority, good credibility and public welfare. We should take the status of children's road traffic safety and the mechanism of the role of child restraint as one of the key points of propaganda.

[Road traffic injury happened on the way to school, among primary and secondary school students in Mengzi city, Honghe prefecture, Yunnan province in 2018].

Objective: To understand the current situation of road traffic injuries among primary and secondary school students in Mengzi city. Methods: Using the cluster random sampling method, more than 9 000 primary and secondary school students from 20 primary and secondary schools in Mengzi city, were randomly sampled. A questionnaire survey was conducted on the occurrence of road traffic injuries in school students. Results: A total of 9 197 students were surveyed, including 150 from road traffic injuries. The incidence rates of road traffic injuries was 1.63% among students in Mengzi city and 2.85% among junior high school students, with the high incidence in May. The leading places of injuries were village roads (38.00%), city roads (33.33%) and district roads (12.67%), respectively. 26.67% of the traffic injuries occurred on the way to or from schools, with riding on electric bicycle (52.00%) as the major cause and contusion/abrasion (75.33%) appeared as the major signs. Both lower and upper limbs plus multiple parts were accounting for 45.51%, 22.16% and 16.17%, respectively of all the injuries. 70.67% of all the cases with road traffic injuries in children, recovered after treatment. Children with road traffic injuries would stay in the hospital for up to 90 days but spent less than 30 000 Yuan. Conclusion: The incidence of road traffic injuries among students in Mengzi city seemed relatively high, with junior high school students reached the highest. Riding electric bicycle appeared as the leading cause for traffic injuries in children in Mengzi city of Yunnan province.

[Analysis on suicide mortality and self-inflicted injury/suicide hospital cases in China from 2006 to 2016].

Objective: To describe the epidemiological characteristics of suicide death and self-harm/suicide in China from 2006 to 2016. Methods: Data in this study are from the datasets of National Death Cause Surveillance from 2006 to 2016 and the National Injury Surveillance Dataset 2016. The age-standardized death rate based on the population census in 2000 was used to describe the trend of suicide over years. This study also described the epidemiological characteristics of suicide death and the demographic characteristics, suicide methods and severity of patients who sought medical help after committing suicide or self-inflicted injury in 2016. Results: Age-standardized suicide mortality had been declining from 9.23/100 000 in 2006 to 5.33/100 000 in 2016 by 42.25%. Suicide mortality increased with age. In 2016, the suicide mortality in China was 7.05/100 000, and among people over 85 years old was 49.49/100 000. In 2016, the dominant two suicide methods were poisoning (39.12%) and sharp injury (25.62%). The first leading method of suicide in rural population, urban population and young people aged 10-to 17-year-old was poisoning (65.13%), sharp injury (29.90%) and fall (25.47%), respectively. As age increased, the severity of suicide/self-inflicted injury increased. The proportions of serious cases among young people aged 10-to 17-year-old and older people aged 60 years old and above who sought medical help after committing suicide or self-inflicted injury were 4.88% and 26.86%, respectively. Conclusion: China's suicide mortality has been declining and special attention should be given to the suicide of old people.

[The death trend of children under 5 years old due to foreign body in airway in China from 1990 to 2017].

Objective: To analyze the current situation and the trend of the death due to foreign body in airway in children less than 5 years old in China from 1990 to 2017. Methods: Using the mortality data of foreign body in airway in China from 1990 to 2017 from the Global Disease Burden 2017 (data covered 31 provinces, autonomous regions, municipalities, as well as Hong Kong and Macau Special Administrative Regions, excluding Taiwan Province) to describe the death status of children under 5 years old due to foreign body in airway in China, and to calculate the relative change and 95% uncertainty interval (UI) of mortality rate and proportion of children under 5 years old due to foreign body in airway between 1990 and 2017. The robust linear regression was performed with the first-order lag of mortality, and the supremum Wald test was used to explore whether the mortality trend had obvious structural changes around a certain time point. Results: In 2017, the mortality rate of children under 5 years old due to foreign body in airway in China was 8.57/100 000 (95%UI: 7.41/100 000-9.57/100 000), and there was no significant difference between boys (9.05/100 000, 95%UI: 6.82/100 000-10.23/100 000) and girls (8.02/100 000, 95%UI: 7.02/100 000-9.12/100 000). The supremum Wald test showed that there was a structural change around the year of 2005 (P<0.001) in terms of the mortality rate of foreign body in the airway among children under 5 years old, which depicted a relatively stable trend before 2005 and a significant downward trend after 2005. Compared with 1990, the mortality rate of foreign body in airway among children, boys and girls under 5 years old in 2017 decreased by 49.32% (95%UI: 37.78%-65.41%), 41.22% (95%UI: 25.68%-68.26%) and 56.91% (95%UI: 44.78%-66.70%), respectively; the mortality proportion of foreign body in airway among increased by 153.33% (95%UI: 75.99%-204.56%), 171.05% (95%UI: 48.75%-239.63%) and 137.90% (95%UI: 86.62%-198.09%), respectively; the rank of foreign body in airway in all disease increased by 6 and became the first leading cause of injury from the second. Conclusion: From 1990 to 2017, the mortality rate of foreign body in airway among children, boys and girls under 5 years old in China generally showed a downward trend. Compared with 1990, the mortality proportion of foreign body in airway among these population increased by a relatively large extent in 2017.

[Disease burden of animal injury in China, 1990-2016].

Objective: To analyze the disease burden of animal injury in China between 1990 and 2016. Methods: Data obtained from the Global Burden of Disease 2016 were used to analyze the age and gender specific disease burden of animal injury in China, using the incidence and disability adjusted of life years (DALYs) rate. Relative and annual changes were evaluated. Results: In 2016, the age-standardized incidence and DALYs rate of animal injury in China showed as 245.05 per 100 000 people and 12.73 per 100 000. The age-standardized incidence of non-venomous animal injury was significantly higher than that of venomous animal injury, but the differences in age-standardized incidence and DALYs rate between venomous animal injury and non-venomous animal injury were not significant. Between 1990 and 2016, there was a significantly decreasing trend in the age-standardized incidence and DALYs rate of animal injury, and obvious decline could be seen in the incidence of non-venomous animal injury, compared with venomous animal injury. The incidence and DALYs rate of animal injury declined in both males and females and in different age groups. The obvious decline of incidence and DALYs rate could be found in children aged 5-14 years and aged <5 years. Conclusions: Between 1990 and 2016, there was a significant alleviation of the disease burden of animal injury in China. Young children were most prone to animal injury, resulting in serious disability and death, indicating more attention should be paid to this population at high risk and in animal injury prevention and control programs.

[The analysis of the trend of mortality rate of falls in China from 1990 to 2015].

Objective: To understand the status and trend of the mortality rate of falls in different gender, age groups and provinces in China from 1990 to 2015, to explore the number of subgroups of different trends in all provinces, and to determine the different trajectory of subgroups. Methods: Using the mortality rate of falls in China from 1990 to 2015 from the Global Disease Burden 2015 (data covers 31 provinces, autonomous regions, municipalities, as well as Hong Kong and Macau Special Administrative Regions, excluding Taiwan Province) to describe the status of the mortality rate of falls in different gender, age group and provinces in China 2015 and to calculate the corresponding relative change. Using log linear model to calculate the annual percent changes from 1990 to 2015. The number of subgroups and corresponding characteristics of different trajectories were analyzed by trajectory model to analyze with four indicators, P value of the coefficient of independent variables with different orders in all subgroups, Bayesian information criterion, log Bayes factor and average posterior probability. Results: In 2015, the age standardized mortality rate of falls in China was 8.38/100 000 (95%UI: 5.54/100 000-9.30/100 000), which was higher in men (10.81/100 000, 95%UI: 6.58/100 000-12.14/100 000) than that in women (5.84/100 000,95%UI: 3.41/100 000-6.62/100 000), and in the elderly aged 70-year-old and above (60.50/100 000, 95%UI: 38.36/100 000-67.75/100 000) than that in other age groups. From 1990 to 2015, there was no obvious change in the age standardized mortality rate of falls in total population, men and women with average percent change about 0.37 (95%UI: -0.08-0.83), 0.45 (95%UI: 0.05-0.84) and 0.31 (95%UI: -0.26-0.87) respectively, but a significant decrease and increase could be seen in children under 15-year-old, especially under 5-year-old with average percent change about -4.07 (95%UI: -5.62--2.51), and the elderly aged 70-year-old and above with average percent change about 1.89 (95%UI: 1.42-2.37) respectively. Four types of trajectories could be categorized for different trends of age standardized mortality rate of falls in all provinces. The first group had the lowest fall mortality with a downward trend. The fall mortality was close in the second and third group but with different change tendency, a decreasing propensity in the former and an increasing one in the latter. The fourth group had the highest fall morality with obvious fluctuation. Conclusion: There was no significant change in the age standardized mortality rate of falls in China from 1990 to 2015. However, the trend of age standardized mortality rate of falls varied in different age and provinces during the same period of time.

[Disease burden on drowning in the Chinese population, in 1990 and 2013].

Objective: To comprehensively analyze the disease burden of drowning in the Chinese population both at the national and provincial levels in 1990 and 2013, to provide reference for the development of strategies regarding drowning prevention. Methods: Both methods related to unified measurement framework and standardized estimation on Global Burden of Disease in 2013, were used. Data on deaths caused by injuries were from the following sources which include: Disease Surveillance Points, the National Maternal and Child Health Surveillance Network, the Death Registration Reporting System of Chinese Center for Disease Control and Prevention, Death Registration System and death information from Macau and Hong Kong areas of China. Injury-related incidence data was from the National Injury Surveillance System and literature review. Parameters as death/death rate, years of life lost due to premature mortality (YLL)/standardized YLL rate, years living with disability (YLD)/standardized YLD rate and disability-adjusted of life years (DALY)/standardized DALY were used to analyze the disease burden and changing trend on drowning at both the national and all the provincial levels. Results: In 2013, the number of deaths due to drowning was63 619 in China, with the standardized mortality rate as 5.29 per 100 000, accounting for 8.0% of the total injury deaths. Drowning was the fourth leading cause of injury death in the whole population and the first leading cause of injury death among children aged <5 and 5-14 years old in 2013, with YLL of drowning as 3.49 million person years, YLD as 0.04 million person years, and DALY as 3.53 million person years. Compared with data from 1990, the rates on standardized mortality, standardized YLL, standardized YLD and standardized DALY of drowning all declined in 2013. The five provinces/districts/cities with the highest rates of drowning were Xinjiang (10.08 per 100 000), Jiangxi (8.44 per 100 000), Anhui (7.92 per 100 000), Guizhou (7.77 per 100 000) and Sichuan (7.68 per 100 000). Standardized mortality of drowning reduced in all provinces in 2013. Conclusions: Disease burden of drowning in the Chinese population, especially in children, declined significantly in 2013, comparing to 1990. However, drowning remains a serious proble, with children and males in particular, in China. Research regarding prevention on drowning is in great need in the western and central areas where drowning mortalities appeared high.

[Disease burden caused by violence in the Chinese population, in 1990 and 2013].

Objective: To analyze the disease burden of violence in the Chinese population, in 1990 and 2013. Methods: Indicators including mortality rate, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted of life years (DALY) related to violence, were extracted from the Global Burden of Disease 2013 and used to describe the burden of disease caused by violence in the Chinese population. Data related to corresponding parameters on disease burden of violence in 1990 and 2013 were described. Results: In 2013, a total of 20 500 people died of violent events, with the death rate as 1.44 per 100 000, in China. DALY caused by violence was 1.08 million person years in 2013. DALY caused by sharp violence was 0.47 million person years, with 0.09 million person years lost due to firearm violence. Disease burden caused by violence appeared higher in males than in females. When comparing with data from the 1990s, reductions were seen by 67.35% on the standardized death rate of violence, by 68.07% on the DALY attributable to violence, and by 70.47% on the standardized DALY rate attributable to violence, respectively, in 2013. Disease burden of violence among young adults and elderly was among the highest. When comparing with data from the 1990, DALY in 2013 decreased among all the age groups except for the 70-year-old showed an increase of 9.36%. The standardized DALY rate in 2013 showed a declining trend in all the age groups, mostly in the 0-4-year-old group. The standardized DALY rates caused by sharp violence or firearm decreased by75.11% and 83.20% in the 0-4-year-old group. Conclusion: In recent years, the disease burden caused by violence showed a decreasing trend but appeared higher in males however with the increase of DALY in the elder population.

[Disease burden on road injury in the Chinese population, in 1990 and 2013].

Objective: To explore the disease burden of road injuries in China. Methods: The results of Global Burden of Disease 2013 including death rate, disability-adjusted of life years (DALY), years of life lost due to premature mortality (YLL), years lived with disability (YLD), were used to describe the burden caused by road injuries in 2013 and the trends from 1990 to 2013, in China. Results: In 2013, there were 313 676 deaths caused by traffic accidents in China. Death rate, rates on DALY, YLL and YLD were 22.52 per 100 000, 1 076.54 per 100 000, 971.21 per 100 000 and 105.34 per 100 000, respectively. Rates on deaths, YLL and YLD appeared higher in males, pedestrians than in females and other types of road travelers. Burden of injuries caused by traffic accidents was seen higher in those aged 15 to 49-year-old. From 1990 to 2013, the overall death rate on road injuries increased by 0.54 per 100 000 in China, with an increase of 2.34 per 100 000 and 0.81 per 100 000, respectively in males and pedestrians. The rates on DALY, YLL and YLD decreased by 164.21 per 100 000, 115.06 per 100 000 and 49.06 per 100 000, respectively. Conclusions: During the past 20 years, achievements had been made on road injury prevention and control, with the decrease of disease burden caused by road accidents. Males, young adults and pedestrians should be called for more attention to prevent road injuries.

[Disease burden caused by suicide in the Chinese population, in 1990 and 2013].

Objective: To provide basic suicide prevention strategy through analyzing the disease burden of suicide in the Chinese population, in 1990 and 2013. Methods: Indicators including mortality rate, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted of life years (DALY) on suicide, were from the results of Global Burden of Disease 2013 and used to describe the burden of disease caused by suicide in Chinese population. Data described the disease burden of suicide in China by comparing the corresponding parameters in 1990 and 2013. Results: In 2013, the standard mortality on suicide was 9.08 per 100 000, and 73.39 per 100 000 in the 80 and above year-old, with the highest rates on DALY and YLL seen in the 75-79-year-old. Each parameter related to suicide burden in males appeared higher than that in females. Compare to data in the 1990s, these parameters declined in 2013, especially seen in females. The rate of YLLs/YLDs on suicide was 90.03 in 2013, 89.83 in males and 89.00 in females. Conclusion: The disease burden of suicide decreased sharply between 1990 and 2013 but was still a serious issue in the elderly that called for more attention.