Burden of digestive system diseases in China and its provinces during 1990-2019: Results of the 2019 Global Disease Burden Study.

BACKGROUND: Evaluating the impact of digestive system diseases is vital for devising effective prevention strategies. However, comprehensive reports on the burden of digestive system diseases in China are lacking. Our study aimed to provide an overview of the burden and trends of digestive system diseases from 1990 to 2019 in China and its provinces. METHODS: This cross-sectional study utilized the Global Disease Burden Study 2019 to estimate the incidence, mortality rate, disability-adjusted life years (DALYs), years of life disability, years of life lost, and changes in the burden of digestive diseases across 31 Chinese provinces from 1990 to 2019. The analysis of disease burden primarily examines the characteristics of sub-disease distribution, time trends, age distribution, and sex distribution. Additionally, we compared provincial age-standardized DALYs for digestive diseases with the expected rates based on the socio-demographic index (SDI). RESULTS: In 2019, there were 499.2 million cases of digestive system diseases in China, resulting in 1,557,310 deaths. Stomach cancer, colon and rectal cancer, and esophageal cancer are the top three diseases associated with mortality and DALY related to digestive system diseases. Meanwhile, cirrhosis and other chronic liver diseases, gastroesophageal reflux disease, and gallbladder and biliary diseases are the top three kinds of diseases with the highest prevalence among digestive system diseases. The risk of gastric cancer sharply increases among men after the age of 40 years, leading to a significant disparity in burden between men and women. As the SDI increased, the DALYs associated with digestive system diseases in China and its provinces showed a downward trend. CONCLUSION: Our study highlights the inverse correlation between DALYs associated with digestive system diseases and the SDI, providing valuable insights that can assist public health officials in the estimation of the disease burden in this area.

National age-specific mortality trends for cervical and breast cancers in urban-rural areas of China from 2009 to 2021: a population-based analysis.

BACKGROUND: Cervical and breast cancers are among the top 4 leading causes of cancer-related mortality in women. This study aimed to examine age-specific temporal trends in mortality for cervical and breast cancers in urban and rural areas of China from 2009 to 2021. METHODS: Age-specific mortality data for cervical and breast cancers among Chinese women aged 20-84 years were obtained from China's National Disease Surveillance Points system spanning the years 2009 to 2021. Negative binomial regression models were utilized to assess urban-rural differences in mortality rate ratios, while Joinpoint models with estimated average annual percent changes (AAPC) and slopes were employed to compare temporal trends and the acceleration of mortality rates within different age groups. RESULTS: From 2009 to 2021, there was a relative increase in age-specific mortality associated with the two cancers observed in rural areas compared with urban areas. A rising trend in the screening age of 35-64 [AAPC: 4.0%, 95% confidence interval (CI) 0.5-7.6%, P = 0.026] for cervical cancer was noted in rural areas, while a stable trend (AAPC: - 0.7%, 95% CI - 5.8 to 4.6%, P = 0.78) was observed in urban areas. As for breast cancer, a stable trend (AAPC: 0.3%, 95% CI - 0.3 to 0.9%, P = 0.28) was observed in rural areas compared to a decreasing trend (AAPC: - 2.7%, 95% CI - 4.6 to - 0.7%, P = 0.007) in urban areas. Urban-rural differences in mortality rates increased over time for cervical cancer but decreased for breast cancer. Mortality trends for both cervical and breast cancers showed an increase with age across 4 segments, with the most significant surge in mortality observed among the 35-54 age group across urban and rural areas, periods, and regions in China. CONCLUSIONS: Special attention should be given to women aged 35-54 years due to mortality trends and rural-urban disparities. Focusing on vulnerable age groups and addressing rural-urban differences in the delivery of cancer control programs can enhance resource efficiency and promote health equity.

Burden of non-communicable diseases in China and its provinces, 1990-2021: Results from the Global Burden of Disease Study 2021.

BACKGROUND: Non-communicable diseases (NCDs) are the primary causes of disability and death. The aim of this study is to analyze the disease burden of NCDs in China from 1990 to 2021. METHODS: This study used data on NCDs in China and its provinces from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The study analyzed the disease burden of NCDs in 2021 and its changes from 1990 to 2021 using indicators including deaths and disability-adjusted life years (DALYs). RESULTS: Between 1990 and 2021, the NCD burden in China exhibited an upward trend. In 2021, China had 10.6 (95% uncertainty interval [UI]: 9.0-12.2) million deaths and 349.3 (95% UI: 301.5-401.2) million DALYs due to NCDs, accounting for 91.0% (95% UI: 90.4-91.7%) of all deaths and 86.7% (95% UI: 86.0-87.4%) of all DALYs. NCDs caused a lower disease burden in females than in males. Cardiovascular diseases and neoplasms were the main NCD level 2 causes of deaths and DALYs, resulting in 5.1 (95% UI: 4.3-5.9) and 2.8 (95% UI: 2.3-3.4) million deaths and 100.2 (95% UI: 84.6-116.6) million and 71.2 (95% UI: 59.3-85.2) million DALYs in 2021, respectively. Chronic respiratory diseases were the third leading cause of NCD deaths, while musculoskeletal disorders were the third leading cause of NCD DALYs. Qinghai, Xizang, and Heilongjiang had the highest age-standardized mortality rates and age-standardized DALY rates (per 100,000) for NCDs, while Hong Kong Special Administration Region (SAR), Macao SAR, and Shanghai recorded the lowest age-standardized mortality rates and age-standardized DALY rates. CONCLUSIONS: NCDs disease burden in China and exhibited heterogeneity across sexes provinces. China needs to focus on addressing key NCDs and implement intervention measures tailored to the disease distribution characteristics to reduce the NCD burden.

Ambient fine particulate matter and Life's essential 8 and mortality in adults in China: A Nationwide retrospective cohort study.

BACKGROUND: Enhanced cardiovascular health (CVH) is linked to reduced mortality risks, whereas long-term exposure to fine particulate matter (PM2.5), elevates these risks. Whether long-term exposure to PM2.5 counteracts the health benefits of high CVH is unknown. The study aims to evaluate whether the association of CVH assessed by Life's Essential 8 (LE8) with death was consistent between participants with different PM2.5 exposures. METHODS: We included 134,727 participants in the field survey of China Chronic Disease and Risk Factor Surveillance which was conducted from August 2013 to June 2014. The deaths of participants were obtained by linking to the National Mortality Surveillance System (2013-2018). The environmental data is obtained by satellite inversion. The participants' CVH scores were calculated using the LE8 method. Hazard ratio (HR) and 95% confidence intervals (95%CI) for mortality were calculated using Cox regression models. RESULTS: A total of 2,936 all-cause deaths and 1,158 cardiovascular disease (CVD) deaths were recorded. Compared to those with low CVH, adults with high CVH demonstrated a reduced risk of all-cause mortality, irrespective of their PM2.5 exposure levels (P < 0.05, all P for interaction >0.05). Furthermore, in comparison to those with low CVH and highest PM2.5 exposure, adults with high CVH and lowest PM2.5 exposure exhibited HR of 0.18 (95%CI, 0.12-0.25) for all-cause mortality and 0.13 (95%CI, 0.08-0.22) for CVD mortality. CONCLUSIONS: High CVH is associated with reduced all-cause mortality risk, regardless of PM2.5 exposure levels. For Chinese adults, sustaining high CVH is advisable, irrespective of their residential location.

National and subnational mortality trends of multiple myeloma in China, 2013-2020: Empirical evidence from national mortality.

The incidence of multiple myeloma (MM) has increased over time in China. Despite this increase, comprehensive and up-to-date statistics on its mortality at national and provincial scales are lacking. To bridge this gap, we used mortality data from the disease surveillance points system operated by the Chinese Center for Disease Control and Prevention. Mortality rates were standardized against the 2010 census population of China (ASMRC) and Segi's world population (ASMRW). Joinpoint regression models were used to analyze temporal trends. Our findings indicated an estimated 14,568 MM-related deaths in China. The observed crude mortality rates ASMRC, and ASMRW were 1.04, 0.80, and 0.62 per 100,000 individuals, respectively. A notable sex-related difference in mortality rates was evident, with male mortalities (8,319) surpassing female mortalities (6,249) by a factor of 1.33. Age-wise, mortality rates tended to increase after 55 years, reaching a maximum in those over 85 years (7.09 per 100,000 individuals). Provincial data revealed that the highest ASMRCs were in Zhejiang, Beijing, and Jiangxi, whereas the lowest were in Tibet, Qinghai, and Hainan. The period from 2013 to 2020 exhibited a significant increase of 58.09 % in MM mortality, with urban and rural areas exhibiting a 44.97 % and 70.94 % increase, respectively. This analysis highlights the growing mortality burden of MM across various demographics and regions, emphasizing the need for tailored disease management and preventive measures.

The temporal variation in the effects of extreme temperature on respiratory mortality: Evidence from 136 cities in China, 2006-2019.

BACKGROUND: In the context of climate change and urbanization, the temporal variation of the adverse health effect of extreme temperature has attracted increasing attention. METHODS: The meteorological data and the daily death records of mortality from respiratory diseases of 136 Chinese cities were from 2006 to 2019. Heat wave and cold spell were selected as the indicator events of extreme high temperature and extreme low temperature, respectively. The generalized linear model and time-varying distributed lag model were used to perform a two-stage time-series analysis to evaluate the temporal variation of the mortality risk associated with extreme temperature in the total population, sub-populations (sex- and age- specific) and different regions (climatic zone and relative humidity level). RESULTS: During the study period, relative risk (RR) of respiratory mortality associated with heat wave decreased from 1.22 (95 %CI: 1.07-1.39) to 1.13 (95 %CI: 1.01-1.26) in the total population, and RR of respiratory mortality associated with cold spell decreased from 1.30 (95 %CI: 1.14-1.49) to 1.17 (95 %CI: 1.08-1.26). The impact of heat wave reduced in the males (P = 0.044) and in the females as with cold spell (P < 0.001). The respiratory mortality risk of people over 65 associated with cold spell decreased (P = 0.040 for people aged 65-74 and P < 0.001 for people over 75). The effect of cold spell reduced in cities from tropical or arid zone (P = 0.035). The effects of both heat wave and cold spell decreased in cities with the relative humidity in the first quartile (P = 0.046 and 0.010, respectively). CONCLUSION: The impact of heat wave on mortality of respiratory diseases decreased mainly in males and cities with the lowest relative humidity, while the impact of cold spell reduced in females, people over 65 and tropical and arid zone, suggesting adaptation to extreme temperature of Chinese residents to some extent.

Mortality Burden of Liver Cancer in China: An Observational Study From 2008 to 2020.

Background and Aims: China accounts for nearly half of liver cancer deaths globally. A better understanding of the current liver cancer mortality will be helpful to establishing priorities for intervention and to decreasing the disease burden of liver cancer. The study aimed to explore and predict the mortality burden of liver cancer in China. Methods: Data were extracted from the Disease Surveillance Point system of the Chinese Center for Disease Control and Prevention from 2008 to 2020. Crude and age-standardized liver cancer mortality rates were reported by sex, urban or rural residence, and region. Trends in liver cancer mortality rates from 2008 to 2020 were estimated as average annual percentage change (AAPC). The changing trend of live cancer mortality in the future is also predicted. Results: In 2020, the crude mortality of liver cancer was 25.57/100,000, and males and people lived in rural areas had higher age-standardized liver cancer mortality rates than females and people lived in people in urban areas. Crude mortality and age-standardized mortality rates in southwest provinces (Guangxi, Sichuan, Tibet) and in a northeast province (Heilongjiang) were higher than that in other provinces, and age-specific mortality rates increased with age. From 2008 to 2020, liver cancer mortality rates decreased, but people under 50 years of age had a higher AAPC than those over 50 years of age, possibly because of the adoption of hepatitis B virus vaccination in newborns and children. Furthermore, the mortality of liver cancer in 2021-2030 is predicted to have a downward trend. Conclusions: Liver cancer mortality rates declined in China from 2008 to 2020. Future interventions to control liver cancer mortality need to focus on people of male sex, older age, and living in rural areas or less developed provinces.

Trends in Mortality of Cirrhosis in China: An Analysis of the China Death Surveillance Database from 2008 to 2020.

Background and Aims: China accounts for 14.9% of total cirrhosis deaths worldwide. A detailed and comprehensive understanding of the contemporary status of cirrhosis mortality in China is crucial for establishing strategies for intervention and decreasing the disease burden of cirrhosis worldwide. The study aimed to report the cirrhosis mortality rates in our whole country or province over time. Methods: Mortality data from 2008 to 2020 were retrieved from the Disease Surveillance Point System (DSPs) of the Chinese Center for Disease Control and Prevention. The crude mortality rate and age-standardized mortality rate of patients with cirrhosis were stratified by sex, residential location, and region. The average annual percentage change (AAPC) in cirrhosis mortality rates from 2008 to 2020 was also calculated. Results: The crude mortality rate of cirrhosis was 4.57/100,000 people in 2020. Compared with females and individuals living in urban areas, males and people living in rural areas had greater age-standardized mortality. The crude mortality rate and age-standardized mortality rate in provinces in Southwest China (Guangxi, Yunnan, Guizhou, and Qinghai) were greater than those in other provinces. Moreover, with increasing age, the age-specific mortality rate increased significantly. From 2008 to 2020, the mortality rate of cirrhosis in China decreased except for in males aged 50-59 years, females aged 45-49 years and females aged 80-84 years. Conclusions: The mortality rate of patients with cirrhosis in China decreased from 2008 to 2020. In the future, interventions of cirrhosis mortality control need to pay more attention to all males, females aged 45-49 and 80-84 years, and people living in rural areas and in provinces in Southwest China.

Evaluation of three decades of the burden of low back pain in China before COVID-19: Estimates from the Global Burden of Disease Database 2019.

Background: Low back pain (LBP) is reported as an urgent public-health concern globally because it occurs in all age groups and is now the leading cause of disability, with health systems unable to cope with this burden. We present China's burden of LBP by estimating its prevalence and years lived with disability (YLDs) from 1990 to 2019. Methods: We obtained the data relating to LBP from the Global Burden of Disease Database (GBD) 2019. Then we calculated years lived with disability caused by LBP by multiplying the prevalence of LBP sequelae by their corresponding disability weights. We performed an analysis of the age-, sex-, and province-specific prevalence and YLDs of 33 provinces/regions in China, as well as their relationship with the sociodemographic index (SDI). Results: China has the largest numbers of people with LBP (91.3 million) and YLDs (8.6 million) globally, and LBP is the leading cause of YLDs. The age-standardised prevalence was 7.25% in 1990, and this decreased to 5.13% in 2019. The age-standardised YLD rate was 579/100 000 in 2019, having decreased by 28.97%. Both measurements increased with age, being higher in women and varying across the 33 provinces/regions. For the 5-to-14-year age group, the prevalence (4.50%) and YLD rate (4.51%) increased in 2019 from 1990 (3.21% and 3.21%, respectively) when compared to the elderly group. Age-standardised YLD rates experienced decreases with increasing SDI, while there was an increasing tendency as SDI increased further; the changes for women were more obvious. Conclusions: Over the three decades considered, China has continued to have the largest number of people with LBP in the world, even though the age-standardised prevalence has decreased. YLDs were found to decrease as SDI increased, but they subsequently increased again. LBP still presents a burden, particularly for children and postmenopausal women.

Robust Low-Friction and Low-Wear TiNbMoTaCr High-Entropy Film Enabled by Periodically Inserting Curved MoS2 Sheets.

The well-known integration of physical, chemical, and mechanical properties enables high-entropy alloys (HEAs) to be applied in various fields; however, refractory HEAs are brittle and susceptible to abrasive wear at high coefficients of friction (COF), resulting in insufficient mechanical durability against abrasion. Herein, curved MoS2 nanosheets are periodically introduced into the TiNbMoTaCr film for triggering the self-assembly mixed metal oxides @MoS2 nanoscrolls, which contain hard mixed metal oxides cores and the low-shearing lubricant MoS2 shells, during the friction in the air environment; such mixed metal oxides@MoS2 nanoscrolls in the friction interfaces can contribute to the robust low friction and low wear. Compared to the pure TiNbMoTaCr film (with high COF of ∼0.78, low abrasive durability identified by worn-out event), the periodic incorporation of 10 nm thickness curved MoS2 sheets can successfully achieve a low COF of ∼0.08 and low wear rate of ∼9.561 × 10-8 mm3/ Nm, much lower than the pure MoS2 film (COF = ∼ 0.21, wear rate = ∼ 1.03 × 10-6 mm3/ Nm). Such superior tribological properties originate from the cooperative interaction of TiNbMoTaCr nanolayers and curved MoS2 nanosheets, accompanied by the self-assembly of mixed metal oxides@MoS2 nanoscrolls. In these nanoscrolls, TiNbMoTaCr can act as an 'air-absorbing agent' to form high-loading mixed metal oxide cores and serve as an 'oxygen sacrificer,' preventing the low-shearing lubricant curved MoS2 nanosheets from oxidation. In addition, even with the soft MoS2, the hardness of the TiNbMoTaCr/MoS2 nanomultilayers can still be well maintained and increased above the calculated values by mixing law, further favoring superior mechanical durability. The synergetic effect of TiNbMoTaCr and curved MoS2 nanosheets during the friction in air can provide a route to design HEA films with enhanced tribological properties for better mechanical durability and broader application prospects.

National and subnational trends in cancer burden in China, 2005-20: an analysis of national mortality surveillance data.

BACKGROUND: Cancer has been the leading cause of death since 2010 in China, with increasing incidence, mortality, and burden. We aimed to assess national and subnational changes in the cancer burden from 2005 to 2020 in China using data from the National Mortality Surveillance System. METHODS: We extracted data on cancer-related deaths from the National Mortality Surveillance System, which accounts for 24·3% of the country's population with national and provincial representativeness. Data for the surveillance population stratified by age and sex were extracted from the National Bureau of Statistics of China. We estimated mortality and years of life lost (YLLs) for all cancers and for 23 cancer groups by age and sex, nationally, and for 31 provinces in China between 2005 and 2020. We calculated age-standardised mortality and YLL rates using the China 2020 census as the reference population. Average annual percent changes in age-standardised rates for mortality and YLLs were calculated to assess trends over the study period. Decomposition analysis was used to assess the drivers of changes in cancer-related death due to three explanatory components: population growth, population ageing, and age-specific mortality rates in China. FINDINGS: The total number of cancer-related deaths increased by 21·6% to 2 397 772 and YLLs increased by 5·0% to 56 598 975 between 2005 and 2020. The three leading fatal cancer types remained stable for both sexes over the study period: tracheal, bronchus, and lung cancer; liver cancer; and stomach cancer. The fourth and fifth leading cancers also remained stable among males (oesophageal, and colon and rectum), while colon and rectum cancer replaced oesophageal cancer as the fourth and breast cancer replaced colon and rectum cancer as the fifth leading cause of cancer-related death among females. Age-standardised mortality rates and age-standardised YLL rates for almost all cancer types (except for prostate for male and multiple myeloma for female) decreased significantly in both sexes in urban areas. Age-standardised YLL rates increased for about half of all cancers for both sexes in rural areas. Leading fatal types were leukaemia and brain and nervous system cancer in younger groups (aged 0-19 years); liver, tracheal, bronchus, and lung, or breast cancers in middle-aged groups (aged 40-59 years); and tracheal, bronchus, and lung, liver, or stomach cancers in older adults (aged ≥60 years) in 2020. The leading causes of cancer-related mortality varied for each province, with tracheal, bronchus, and lung or liver cancer at the top in 30 provinces. INTERPRETATION: The cancer burden in China appeared to be shifting towards that in high-income countries from 2005 to 2020. Adjustments to existing health plans and actions are needed to reduce the burdens of tracheal, bronchus, and lung cancer or other leading and emerging cancers. FUNDING: National Key Research and Development Program of China.

Trends and determinants of place of death among Chinese lymphoma patients: a population-based study from 2013-2021.

Limited research exists on factors influencing the place of death (POD) or hospital deaths among lymphoma patients in China, despite the country's significant burden of lymphoid neoplasms. This study aimed to describe the distribution of POD among lymphoma patients and identify the factors associated with hospital lymphoma deaths to provide evidence for developing targeted healthcare policies. Data in this study were obtained from the National Mortality Surveillance System (NMSS). The distribution of POD among individuals who died from lymphoma was analyzed, and factors influencing the choice of dying in the hospital were examined. Chi-square test was employed to analyze the differences in characteristic distributions. Multilevel logistic regression analysis was identify the relationship between hospital deaths due to lymphoma and individual factors, as well as socioeconomic contextual variables. During 2013-2021, there were 66772 lymphoma deaths reported by the NMSS, including 44327 patients (66.39%) who died at home and 21211 (31.77%) died in the hospital. Female patients, those had a higher level of educational attainment, retired individuals, those died of non-Hodgkin lymphoma, residents of urban areas, patients between the ages of 0 and 14, and unmarried individuals had a higher probability of dying in hospitals. Improving health care providers' understanding of palliative care for cancer patients and prioritizing accessible services are essential to enhance the quality of end-of-life care. These approaches ensure the equitable allocation of healthcare resources and provide diverse options for minorities with specific preferences regarding end-of-life care.

Pulmonary Heart Disease Associated Mortality - China, 2014-2021.

Introduction: Over the latter half of the previous century, pulmonary heart disease (PHD) emerged as a significant public health issue in China. However, the current mortality rate is unknown. Utilizing the Multiple Cause of Death database, the present study aims to investigate the current state and progression of PHD-associated death in China. Methods: Data from the China National Mortality Surveillance System were used to analyze progression in mortality rates attributable to PHD from 2014 to 2021. To standardize population structure for each year during the investigation period, demographic information from the 2020 census was employed as the reference population. Age-standardized mortality rates (ASMR) were determined based on sex, urban-rural area, and region. To identify trends in ASMR, a joinpoint regression analysis was executed. Results: The ASMR of PHD exhibited a marked decrease, falling from 61.68 per 100,000 in 2014 to 28.53 per 100,000 in 2021. This downward trend was observable in both genders, all regions, and both urban and rural settings. The greatest ASMR values were documented in the western region. Comparative observations revealed a higher ASMR in rural areas versus urban ones and in males versus females. PHD-associated deaths predominantly occurred among older individuals, particularly those aged 80 and above. Chronic obstructive pulmonary disease (COPD) emerged as the principal underlying cause of death PHD-associated mortalities, accounting for between 87.41% and 93.42% of cases throughout the period 2014-2021. Conclusions: There was a declining trend in PHD mortality in China from 2014 to 2021, with COPD accounting for a significant proportion of these deaths. Given the high prevalence of COPD and the escalating population aging in China, PHD remains a significant health concern that warrants further attention.

Trends of Mortality in End-Stage Liver Disease - China, 2008-2020.

Introduction: Liver cancer and cirrhosis represent the most prevalent forms of end-stage liver diseases (ESLDs). Notably, in China, deaths attributed to ESLDs contribute significantly to the global mortality rate of these disorders. Enhanced comprehension of the mortality profile associated with ESLDs in China could provide crucial insights into intervention prioritization, which could in turn help reduce the overall global burden of these diseases. Methods: Data were obtained from China's Disease Surveillance Points system. The presentation includes both crude and age-standardized mortality rates, stratified by sex, residential location, and region. Using Joinpoint Regression, trends in annual mortality rates were estimated from the period of 2008 to 2020 and expressed as the average annual percentage change (AAPC). Results: In 2020, the gross mortality rate of ESLD stood at 30.08 cases per 100,000 individuals. A higher age-standardized ESLD mortality rate was observed in males and rural populations in comparison to their female and urban counterparts, respectively. Noticeably, the highest mortality rates associated with liver cancer and cirrhosis were reported in South and Southwest China, respectively. A positive correlation was noticed between age-specific ESLD mortality rates and advancing age. Interestingly, an annual decrease in the ESLD mortality rate was observed from 2008 to 2020. In urban contexts, the AAPC of cirrhosis was noted to be higher than that of liver cancer. Conclusions: The mortality rate associated with ESLDs in China decreased between 2008 and 2020. Nevertheless, the death burden attributable to ESLD continues to be alarmingly high. Future initiatives should prioritize the reduction of ESLD mortality in particular populations: males, elderly individuals, and those residing in rural regions of South and Southwest China. The emphasis of future interventions should be placed on antiviral therapy for adults diagnosed with viral hepatitis, and on the prevention of hepatitis B virus (HBV) infection across all demographics.

Can global or national disability weights represent provincial level?

BACKGROUND: A universal set of disability weights(DWs) is mainly based on the survey of North America, Australia and Europe, whereas the participants in Asia was limited. The debate hasn't yet settled whether a universal DW is desirable or useful.The focus of the debate is its representativenes-s.After all, the DWs come from people's subjective evaluation of pain, and they may vary according to cultural background.The differences of the DWs could have implications for the magnitude or ranking of disease burdens.The DWs of Anhui Province has not been completely presented.This paper aims to obtain the DWs suitable for the general population of Anhui Province of China, and attempts to explore the differences between different DWs by comparing the DWs with the similar-cultural background and the DWs with cross-cultural background. METHODS: A web-based survey was conducted to estimate the DWs for 206 health states of Anhui province in 2020. Paired comparison (PC) data were analyzed and anchored by probit regression and fitting loess model. We compared the DWs in Anhui with other provinces in China and those in Global burden of disease (GBD) and Japan. RESULTS: Compared with Anhui province, the proportion of health states which showed 2 times or more differences ranged from 1.94% (Henan) to 11.17% (Sichuan) in China and domestic provinces. It was 19.88% in Japan and 21.51% in GBD 2013 respectively. In Asian countries or regions, most of the health states with top 15 DWs belonged to the category of mental, behavioral, and substance use disorders. But in GBD, most were infectious diseases and cancer. The differences of DWs in neighboring provinces were smaller than other geographically distant provinces or countries. CONCLUSION: PC responses were largely consistent across very distinct settings,but the exceptions do need to be faced squarely.The differences of DWs among similar-cultural regions were smaller than cross-cultural regions. There is an urgent need for relevant gold standards.

The burden of hepatitis C virus in the world, China, India, and the United States from 1990 to 2019.

Background and aim: Hepatitis C virus infection can lead to an enormous health burden worldwide. Investigating the changes in HCV-related burden between different countries could provide inferences for disease management. Hence, we aim to explore the temporal tendency of the disease burden associated with HCV infection in China, India, the United States, and the world. Methods: Detailed data on the total burden of disease related to HCV infection were collected from the Global Burden of Disease (GBD) 2019 database. Joinpoint regression models were used to simulate the optimal joinpoints of annual percent changes (APCs). Further analysis of the age composition of each index over time and the relationship between ASRs and the socio-demographic Index (SDI) were explored. Finally, three factors (population growth, population aging, and age-specific changes) were deconstructed for the changes in the number of incidences, deaths, and DALYs. Results: It was estimated that 6.2 million new HCV infections, 0.54 million HCV-related deaths, and 15.3 million DALYs worldwide in 2019, with an increase of 25.4, 59.1, and 43.6%, respectively, from 1990, are mainly due to population growth and aging. China experienced a sharp drop in age-standardized rates in 2019, the United States showed an upward trend, and India exhibited a fluctuating tendency in the burden of disease. The incidence was increasing in all locations recently. Conclusion: HCV remains a global health concern despite tremendous progress being made. The disease burden in China improved significantly, while the burden in the United States was deteriorating, with new infections increasing recently, suggesting more targeted interventions to be established to realize the 2030 elimination goals.

Burden of liver complications related to non-alcoholic fatty liver disease in China from 2005 to 2019: Observations from the Global Burden of Disease Study, 2019.

AIM: To assess the burden of liver complications related to non-alcoholic fatty liver disease (LC-NAFLD) from 2005 to 2019 in China. MATERIALS AND METHODS: We used data from the Global Burden of Disease, Injuries, and Risk Factors Study, 2019, to present contemporary and varying profiles of China's LC-NAFLD burden. The Joinpoint Regression model and Gaussian process regression were, respectively, used to estimate the annual percentage change in prevalence rates and disability-adjusted life-year (DALY) rates, and the relationship between the sociodemographic index (SDI) and age-standardized rates of LC-NAFLD. RESULTS: In 2019, China had 293.42 million (95% uncertainty interval [UI]: 263.69-328.44) LC-NAFLD cases with a prevalence rate and DALYs of 20.63 (95% UI: 23.09-18.54) per 1000 people and 591.03 thousand (95% UI: 451.25-737.33), respectively. North China had the highest prevalence but the lowest DALYs of LC-NAFLD, whereas Southwest China had the lowest prevalence but the highest DALYs. LC-NAFLD were more common in men than in women (male: female ratio, 1.27) in 2019. From 2005 to 2019, the prevalence of NAFLD cases increased by 68.32% (from 174.32 million in 2005 to 293.42 million in 2019), mainly because of an age-specific prevalence rate increase. CONCLUSION: The LC-NAFLD burden in China is substantial and has increased markedly over the past 15 years. Effective measures for low SDI regions and men are needed to address the rapidly increasing NAFLD burden.

Pt-induced atomic-level tailoring towards paracrystalline high-entropy alloy.

Paracrystalline state achieved in the diamond system guides a direction to explore the missing link between amorphous and crystalline states. However, such a state is still challenging to reach in alloy systems in a controlled manner. Here, based on the vast composition space and the complex atomic interactions in the high-entropy alloys (HEAs), we present an "atomic-level tailoring" strategy to create the paracrystalline HEA. The addition of atomic-level Pt with the large and negative mixing enthalpy induces the local atomic reshuffling around Pt atoms for the well-targeted local amorphization, which separates severe-distorted crystalline Zr-Nb-Hf-Ta-Mo HEA into the high-density crystalline MRO motifs on atomic-level. The paracrystalline HEA exhibits high hardness (16.6 GPa) and high yield strength (8.37 GPa) and deforms by nanoscale shear-banding and nanocrystallization modes. Such an enthalpy-guided strategy in HEAs can provide the atomic-level tailoring ability to purposefully regulate structural characteristics and desirable properties.

Projecting the excess mortality related to diurnal temperature range: A nationwide analysis in China.

The projection of excess mortality due to diurnal temperature range (DTR) in future has not been evaluated yet in China. Based on daily cause-specific mortality data from 266 cities in China, this study aimed to examine the association between DTR and mortality, which help project the future mortality burden attributable to DTR by considering the modification effects of altitude and population migration. We first found that every 10 °C increase in the DTR would result in a 3.3 % (95 % confidence interval: 2.6 %-4.1 %) excess risk of non-accidental mortality. The unit risk of DTR-associated cause-specific mortality at moderate or high altitudes was significantly lower than at lower altitudes, especially for cardiovascular disease. Subsequently, DTR-associated excess mortality in 2017 in China was 233,154 deaths (with a population-weighted attributable fraction of 2.9 %). Furthermore, we projected DTR-attributable additional mortality in the future, with the associated mortalities to be 221,860 deaths in 2050-2059 (2050s) and 132,305 deaths in 2090-2099 (2090s), under the SSP1-2.6 scenario. Meanwhile, the regional inequalities were exacerbated by 18 % in 2050s and 13 % in 2090s when considering the modification effects of city altitude. Future population migration would increase excess mortality in most areas in central and southern China, and reduce the disease burden in most areas in eastern, western, and northern China. Our findings underpinned that regional strategies should be adopted to mitigate excess mortality attributable to global climate change.