A series of mass mortalities of the cultured blood clam, Tegillarca granosa, occurred in the Yueqing Bay of China from 2005 to 2009. An obligate intracellular prokaryote, designated as rickettsia-like organism （RLO）...A series of mass mortalities of the cultured blood clam, Tegillarca granosa, occurred in the Yueqing Bay of China from 2005 to 2009. An obligate intracellular prokaryote, designated as rickettsia-like organism （RLO）, was frequently found in the moribund or dead blood clam sample during ultra- structural examination. These organisms were usually round, ellipsoid or occasionally dumbbell- shaped, ranged from approximately 0.28 to 0.71 #m in size and had a trilaminar cell wall. Two reproductive modes of organisms, transverse binary fission and budding, were observed. The or- ganisms were able to form eosinophilic inclusions. Most inclusions were found within epithelial and connective tissues of the mantle, gills and digestive tube. The biological and morphological char- acteristics indicate that these organisms may belong to the family Rickettsiaceae. RLOs exhibited significant pathogenicity. Cytopathological examinations revealed extensive necrosis and destruc- tion in the infected cell. The degree of tissue destruction was positively related to the number of RLO inclusions in the tissues, and the cytopathological effects were positively related to the number of intracellular RLO. RLOs and their inclusions were discovered throughout different disease areas and in different time periods. The infection intensity of the RLOs was positively correlated with the mortality rate of clams. Therefore, RLO infection might be associated with mass mortalities of cultured blood clams in the Yueqing Bay.展开更多
The growth parameters and mortalities of five species of Synodontis in the lower river Benue at Makurdi,Benue State were studied from January,2016 to December,2018.The asymptotic length(L∞)calculated for the five spe...The growth parameters and mortalities of five species of Synodontis in the lower river Benue at Makurdi,Benue State were studied from January,2016 to December,2018.The asymptotic length(L∞)calculated for the five species ranged from 18.80cm in S.clarias females to 37.04cm in S.membranaceus females.The t0 values were all negative in the combined sexes of S.clarias,S.omias,S.gambiensis and S.membranaceus.In both combined sexes of S.membranaceus and S.schall,the t0 values were positive.The growth rate(K)was low in S.clarias and S.omias(0.301-0.497,0.171-0.310)respectively and higher in S.membranaceus(0.310-0.640),S.schall females(0.430-0.580);S.schall males(0.573),S.gambiensis(0.500-0.571).Growth performance index(Ø’)was 2.212 in S.gambiensis and 2.946 in S.schall combined.Natural Mortality(M)ranged from 0.5422 in S.omias females to 1.3340 in S.membranaceus males.Fishing Mortality(F)was 0.8214 in S.omias combined and 3.0934 in S.membranaceus females.Total mortality(Z)ranged from 1.52 in S.omias combined to 4.078 in S.membranaceus combined.Mean Exploitation(E)ratios was 0.61 in S.clarias,0.64 in S.omias,0.53 in S.gambiences,0.70 in S.membranaceus,and 0.66 in S.schall.The rate at which these species survived in the River was low(from 0.147,in S.omias combined,to 1.482 in S.membranaceus combined).展开更多
Introduction: The National Central Cancer Registry(NCCR) of China collected population-based cancer registration data from all cancer registries in China. This study aimed to compile national cancer incidences and mor...Introduction: The National Central Cancer Registry(NCCR) of China collected population-based cancer registration data from all cancer registries in China. This study aimed to compile national cancer incidences and mortalities in 2011 and estimate cancer incident new cases and cancer deaths.Methods: In 2014, there were 234 cancer registries that submitted records of new cancer cases and cancer deaths that occurred in 2011 to the NCCR. All datasets were evaluated based on the criteria of data quality of the NCCR. The data of 177 registries was of suicient quality and was compiled to evaluate cancer statistics in 2011. The pooled data were stratiied by area, sex, age group, and cancer type. Cancer incident cases and deaths were estimated using age-standardized rates(ASR) and the Chinese population. All incidences and mortalities were age-standardized to the 2000 Chinese standard population and Segi's population.Results: The estimates of new cancer incident cases and cancer deaths were 3,372,175 and 2,113,048 in 2011, respectively. The crude incidence was 250.28/1,00,000(277.77/1,00,000 for males and 221.37/1,00,000 for females). The ASRs of incidence by the Chinese standard population(ASRIC) and by the world standard population(ASRIW) were 186.34/1,00,000 and 182.76/1,00,000, respectively, with a cumulative incidence(0–74 years old) of 21.20%. Cancers of the lung, female breast, stomach, liver, colorectum, esophagus, cervix, uterus, prostate, and ovary were the most common cancers, accounting for approximately 75% of all new cancer cases. Lung, liver, gastric, esophageal, colorectal, female breast, pancreatic, brain, and cervical cancers and leukemia were the leading causes of cancer death, accounting for approximately 80% of all cancer deaths. Cancer incidence, mortality, and spectrum were all diferent between urban and rural areas and between males and females.Conclusions: The population covered by the cancer registries greatly increased from 2010 to 2011. The data quality and representativeness of cancer registries have gradually improved. Cancer registries have an irreplaceable role in research on cancer prevention and control. The disease burden of cancer is increasing, and the health department must implement efective measures to contain the increased cancer burden in China.展开更多
Background: There are many reports from different parts of the world addressing different aspects of surgical mortality. However, none has been done in this centre as it relates to orthopaedics and trauma admissions. ...Background: There are many reports from different parts of the world addressing different aspects of surgical mortality. However, none has been done in this centre as it relates to orthopaedics and trauma admissions. Such data are invaluable to health planning and epidemiological monitoring. Objective: To retrospectively review all mortalities arising from orthopaedics and trauma admission as they present to Irrua specialist Teaching Hospital (ISTH) Irrua from Jan 2005-Dec 2014. Method: Medical records of case mortalities among orthopaedic and trauma admissions over ten years (Jan 2005-Dec 2014) were retrospectively reviewed. Results: Over this period, 2129 admissions and 45 deaths were recorded, with an overall crude mortality rate of 2.11%. No death was recorded among the paediatric age group. Thirty-four patients (75.56%) died from trauma (fracture) related diagnosis, majority of which were from head injury followed by infection 5 (11.11%), tumours 4, (8.89%) and disc herniation 2 (4.44%). Males were more affected 77.78% and median age at death was 44 years. Medical co-morbidities were found in 37.77% of the deceased patients. Conclusion: Patients with trauma related cases particularly head injuries, topped the list of mortalities. Young and middle aged adult males were most affected. Need for manpower development, investment in diagnostic and therapeutic facilities and preventive measures is emphasised.展开更多
Background: Studies have suggested epidemiological transition in the mortality pattern in Nigeria from communicable to non-communicable diseases of which Diseases of the cardiovascular system (DCVS) is prime. DCVS is?...Background: Studies have suggested epidemiological transition in the mortality pattern in Nigeria from communicable to non-communicable diseases of which Diseases of the cardiovascular system (DCVS) is prime. DCVS is?thus a growing public health concern but its mortality profile is under-studied?in Port Harcourt. This study was therefore designed to review the mortality profile of DCVS in Port Harcourt. Methodology: A retrospective case controlled study of deaths ascribed to DCVS at the University of Port Harcourt Teaching Hospital (UPTH) between January 2012 and December 2017. The composite diseases were grouped using the ICD10 scheme and analyzed using SPSS version 23. Minitab version 16 was used for trend analysis. Results: Of the overall 1902 deaths recorded within the period, 566 (29.8%) were cardiovascular system related. Of these, 301 (53.3%) were males and 265 (46.7%) were females. The elderly of 50 - 99 years were most commonly affected (65.5% of the mortalities). Cerebrovascular accidents (CVA) accounted for 322 deaths (56.9%);various types of shock caused 116 deaths (20.5%) while?congestive cardiac failure (CCF) accounted for 114 deaths (20.1%). Pulmonary?embolism, myocardial infarction, carotid aneurysm, and hypertensive encephalopathy caused 1.8%, 0.4%, 0.2%, and 0.2% deaths respectively. Peak annual mortality of 143 (25.3%) was recorded in 2013. Although the trend of mortality was undulating, there was an overall increase in annual incidence over the years.?Conclusion: DCVS constitute the commonest systemic cause?of death in Port Harcourt. Governmental and donor agencies involved in public health policy planning and implementation should scale-up strategies for the prevention and control of DCVS in order to stem the rising tide of associated mortalities.展开更多
A study on the evaluation of the effectiveness of three traditional methods of protecting guinea fowl from mortality was carried out at CRA-SS （Centre de Recherche Agronomique de la Savane S6che） in northem Togo. Gu...A study on the evaluation of the effectiveness of three traditional methods of protecting guinea fowl from mortality was carried out at CRA-SS （Centre de Recherche Agronomique de la Savane S6che） in northem Togo. Guinea fowl were divided into 5 batches, of which 3 batches received prophylactic medical treatment including plant decoctions, the 4th batch was followed by a medical prophylaxis program as a control group and the 5th batch considered as a negative control, has not received any prophylactic treatment. The results showed that a mortality rate of 25% for the reference lot and two other batches which received plant decoctions （Euphorbia poissonii or Khaya senegalensis） were recorded against a rate of 87.5% in the batch of guinea fowl which received the decoction of Pteleopsis suberosa. Meanwhile, regardless of weight growth, daily average gain （GMQ） or food consumption, no significant difference was observed （p 〉 0.05） between the guinea fowl that received a baseline health monitoring and those having taken the decoction orE. poissonii. On the other hand, the values recorded in these two batches of guinea fowl differed statistically from those in the guinea fowl that received the decoction of K. senegalensis. Although the decoction of K. senegalensis has a protective effect in guinea fowl, the growth of guinea fowl has been slowed down. On the basis of these results, it appears that two endogenous practices tested （K. senegalensis or E. poissonii） have positive effects. However, it would be desirable to carry out a toxicity test in order to determine the recommended doses.展开更多
Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical ca...Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical cancer as a major public health problem.Methods All data were extracted from the Global Cancer Observatory(GLOBOCAN)2022.Age-standardized incidence rate(ASIR)and mortality rates(ASMR)of cervical cancer were compared and linked to Human Development Index(HDI)between populations.The estimated annual percentage changes(EAPCs)were used to characterize the temporal trend in ASIR/ASMR,and demographic estimates were projected up to 2050.Results Globally,an estimated 662,044 cases(ASIR:14.12/100,000)and 348,709 deaths(ASMR:7.08/100,000)from cervical cancer occurred in 2022,corresponding to the fourth cause of cancer morbidity and mortality in women worldwide.Specifically,42%of cases and 39%of deaths occurred in China(23%and 16%)and India(19%and 23%).Both ASIR and ASMR of cervical cancer decreased with HDI,and similar decreasing links were observed for both early-onset(0–39 years)and late-onset(≥40 years)cervical cancer.Both ASIR and ASMR of overall cervical cancer showed decreasing trends during 2003–2012(EAPC:0.04%and-1.03%);however,upward trends were observed for early-onset cervical cancer(EAPC:1.16%and 0.57%).If national rates in 2022 remain stable,the estimated cases and deaths from cervical cancer are projected to increase by 56.8%and 80.7%up to 2050.Moreover,the projected increase of early-onset cervical cancer is mainly observed in transitioning countries,while decreased burden is expected in transitioned countries.Conclusions Cervical cancer remains a common cause of cancer death in many countries,especially in transitioning countries.Unless scaling-up preventive interventions,human papillomavirus(HPV)vaccination and cervical cancer screening,as well as systematic cooperation within government,civil societies,and private enterprises,the global burden of cervical cancer would be expected to increase in the future.展开更多
BACKGROUND: Sepsis, a common acute and critical disease, leads to 11 million deaths annually worldwide. Probiotics are living microorganisms that are beneficial to the host and may benefit sepsis outcomes, but their e...BACKGROUND: Sepsis, a common acute and critical disease, leads to 11 million deaths annually worldwide. Probiotics are living microorganisms that are beneficial to the host and may benefit sepsis outcomes, but their effects are stil inconclusive. This study aimed to evaluate the overal eff ect of probiotics on the prognosis of patients with sepsis.DATA RESOURCES: We searched several sources for published/presented studies, including Pub Med, EMBASE, Web of Science, the Cochrane Library and the US National Library of Medicine Clinical Trials Register(www.clinicaltrials.gov) updated through July 30, 2023, to identify all relevant randomized controlled trials(RCTs) or observational studies that assessed the effectiveness of probiotics or synbiotics in patients with sepsis and reported mortality. We focused primarily on mortality during the study period and analyzed secondary outcomes, including 28-day mortality, in-intensive care unit(ICU) mortality and other outcomes.RESULTS: Data from 405 patients in five RCTs and 108 patients in one cohort study were included in the analysis. The overall quality of the studies was satisfactory, but clinical heterogeneity existed. All adult studies reported a tendency for probiotics to reduce the mortality of patients with sepsis, and most studies reported a decreasing trend in the incidence of infectious complications, length of ICU stay and duration of antibiotic use. There was only one RCT involving children.CONCLUSION: Probiotics show promise for improving the prognosis of patients with sepsis, including reducing mortality and the incidence of infectious complications, particularly in adult patients. Despite the limited number of studies, especially in children, these findings will be encouraging for clinical practice in the treatment of sepsis and suggest that gut microbiota-targeted therapy may improve the prognosis of patients with sepsis.展开更多
Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze...Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year(DALY)rates for lower respiratory infections in the elderly population(aged 70 and above)in China from 1990 to 2050.It also discusses future trends in the burden of lower respiratory infections(LRI)in China under different scenarios.Results According to GBD predictions,the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average.The burden has been decreasing from 1990 to 2020,but is projected to increase from 2020 to 2050.Scenario-based predictions suggest that,under scenarios involving improvements in nutrition and vaccination,the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.Conclusion This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen.The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.展开更多
BACKGROUND Emphysematous pyelonephritis(EPN)is a life-threatening necrotizing renal parenchyma infection characterized by gas formation due to severe bacterial infection,predominantly affecting diabetic and immunocomp...BACKGROUND Emphysematous pyelonephritis(EPN)is a life-threatening necrotizing renal parenchyma infection characterized by gas formation due to severe bacterial infection,predominantly affecting diabetic and immunocompromised patients.It carries high morbidity and mortality,requiring early diagnosis and timely intervention.Various prognostic scoring systems help in triaging critically ill patients.The National Early Warning Score 2(NEWS 2)scoring system is a widely used physiological assessment tool that evaluates clinical deterioration based on vital parameters,but its standard form lacks specificity for risk stratification in EPN,necessitating modifications to improve treatment decisionmaking and prognostic accuracy in this critical condition.AIM To highlight the need to modify the NEWS 2 score to enable more intense monitoring and better treatment outcomes.METHODS This prospective study was done on all EPN patients admitted to our hospital over the past 12 years.A weighted average risk-stratification index was calculated for each of the three groups,mortality risk was calculated for each of the NEWS 2 scores,and the need for intervention for each of the three groups was calculated.The NEWS 2 score was subsequently modified with 0-6,7-14 and 15-20 scores included in groups 1,2 and 3,respectively.RESULTS A total of 171 patients with EPN were included in the study,with a predominant association with diabetes(90.6%)and a female-to-male ratio of 1.5:1.The combined prognostic scoring of the three groups was 10.7,13.0,and 21.9,respectively(P<0.01).All patients managed conservatively belonged to group 1(P<0.01).Eight patients underwent early nephrectomy,with six from group 3(P<0.01).Overall mortality was 8(4.7%),with seven from group 3(87.5%).The cutoff NEWS 2 score for mortality was identified to be 15,with a sensitivity of 87.5%,specificity of 96.9%,and an overall accuracy rate of 96.5%.The area under the curve to predict mortality based on the NEWS 2 score was 0.98,with a confidence interval of(0.97,1.0)and P<0.001.CONCLUSION Modified NEWS 2(mNEWS 2)score dramatically aids in the appropriate assessment of treatment-related outcomes.MNEWS 2 scores should become the practice standard to reduce the morbidity and mortality associated with this dreaded illness.展开更多
Background Breast cancer(BC)incidence and mortality vary significantly across countries,highlighting the need to update the global burden of female BC,including current trends and future projections.Methods Data were ...Background Breast cancer(BC)incidence and mortality vary significantly across countries,highlighting the need to update the global burden of female BC,including current trends and future projections.Methods Data were sourced from GLOBOCAN 2022,including estimated new cases and deaths from BC across 21 United Nation(UN)regions and 185 countries,the age-standardized incidence rate(ASIR)and mortality rate(ASMR),the estimated annual percentage changes(EAPC),and demographic projections through 2050.The region-specific and country-specific BC burden for women of all ages and for young women(<40 years old)was reorganized and re-plotted to highlight subgroup differences.Linear regression was used to explore the link between ASIR/ASMR and the human development index(HDI).Transitioning countries referred to those with low or medium HDI,while transitioned countries were those with high or very high HDI.Results In 2022,an estimated 2.3 million new BC cases and 666,000 BC-related deaths occurred globally,accounting for 23.8%and 15.4%of all cancer cases and deaths in women,respectively.Regionally,Eastern Asia reported the highest number of cases(480,019,ASIR:37.54/100,000),while South-Central Asia had the highest number of deaths(135,348,ASMR:13.41/100,000).At the country level,China had the highest number of cases due to its large population,whereas India reported the highest number of deaths.ASIR for both overall and early-onset BC increased with HDI,while ASMR for early-onset BC decreased with HDI(P<0.05).Overall BC showed an increasing trend in ASIR during 2003–2015(EAPC:0.92%)and a decreasing trend in ASMR during 2006–2016(EAPC:-1.06%).Early-onset BC showed a more significant rise in ASIR(EAPCs:1.4%)and a slight increase in ASMR(EAPCs:0.16%).If national rates remain stable,BC cases and deaths will increase by 54.7%and 70.9%,respectively,by 2050.Notably,increased early-onset BC cases are only observed in transitioning countries,while decreased cases are seen in transitioned countries.Conclusions Breast cancer remains the leading cancer burden in women,particularly in transitioning countries.Addressing this growing burden requires urgent integration of primary prevention,early detection and high-quality treatment through multi-sectoral collaboration.展开更多
Lung cancer, the leading cause of cancer deaths worldwide and in China, has a 19.7% five-year survival rate due to terminal-stage diagnosis^([1-3]).Although low-dose computed tomography(CT) screening can reduce mortal...Lung cancer, the leading cause of cancer deaths worldwide and in China, has a 19.7% five-year survival rate due to terminal-stage diagnosis^([1-3]).Although low-dose computed tomography(CT) screening can reduce mortality, high false positive rates can create economic and psychological burdens.展开更多
There exists a notion that there is an obesity paradox in the prognosis of community-acquired pneumonia.In other words,obese individuals with communityacquired pneumonia have a better prognosis.The study by Wang et al...There exists a notion that there is an obesity paradox in the prognosis of community-acquired pneumonia.In other words,obese individuals with communityacquired pneumonia have a better prognosis.The study by Wang et al supports this claim,but we believe that the obesity paradox should not be proposed hastily as it is influenced by numerous subjective and objective confounding factors.展开更多
BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related disorders.Recent evidence suggests associations between long-term...BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related disorders.Recent evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes,including greater mortality.AIM To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize bias.METHODS This retrospective cohort study used data from the TriNetX research network,with electronic health records from multiple healthcare organizations.The study employed a new-user,active comparator design,which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists(H2RA)users among adult cancer patients.Newly prescribed PPIs(esomeprazole,lansoprazole,omeprazole,pantoprazole,or rabeprazole)users were compared to non-users or newly prescribed H2RAs(cimetidine,famotidine,nizatidine,or ranitidine)users.The primary outcome was all-cause mortality.Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.Multivariable Cox regression models were used to estimate hazard ratios(HRs)and 95% confidence interval(CI).RESULTS During the follow-up period(median 5.4±1.8 years for PPI users and 6.5±1.0 years for non-users),PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year,2 years,and at the end of follow up(HRs:2.34-2.72).Compared with H2RA users,PPI users demonstrated a higher rate of all-cause mortality HR:1.51(95%CI:1.41-1.69).Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure,confirming the robustness of these findings.In a sensitivity analysis,we analyzed all-cause mortality outcomes between former PPI users and individuals who have never used PPIs,providing insights into the long-term effects of past PPI use.In addition,at 1-year follow-up,the analysis revealed a significant difference in mortality rates between former PPI users and non-users(HR:1.84;95%CI:1.82-1.96).CONCLUSION PPI use among cancer patients was associated with a higher risk of all-cause mortality compared to non-users or H2RA users.These findings emphasize the need for cautious use of PPIs in cancer patients and suggest that alternative treatments should be considered when clinically feasible.However,further studies are needed to corroborate our findings,given the significant adverse outcomes in cancer patients.展开更多
OBJECTIVE The emergence of evolving variants of Coronavirus disease 2019(COVID-19)has fostered the need for change of newer and adaptive treatments for these infections.During the COVID-19 pandemic and persists,tradit...OBJECTIVE The emergence of evolving variants of Coronavirus disease 2019(COVID-19)has fostered the need for change of newer and adaptive treatments for these infections.During the COVID-19 pandemic and persists,traditional Chinese medicine(TCM)herbs exhibit significant bioactivity and therapeutic effect.This study is aimed to evaluate the efficacy of four TCM preparations on 28-day mortality risk of patients and changes of the laboratory indicators.METHODS The retrospective cohort study included patients with COVID-19 who were admitted to the Jiangsu Province Hospital of Chinese Medicine from December 15,2022 to January 15,2023,and those died within 48 hours of admission or cannot be tracked for outcomes were excluded.The primary outcome was survival status in 28 days(death or survival)starting from the day of admission.The second outcomes were laboratory indicators,including absolute lymphocyte count,lactate dehydrogenase,creatinine,and blood urea nitrogen.Binary logistic regressions were used to estimate the effect of TCM preparations on the primary and secondary outcomes in main analysis.Meanwhile,heterogeneity and robustness of results from main analysis were assessed by subgroup analyses and multiple sensitivity analyses.RESULTS 1816 eligible patients were included in analysis dataset,including 573 patients received standard care(control group)and 1243 patients received TCM preparations(hospital preparation group).The 28-day mortality rate of hospital preparation group was lower than that of control group(4.75%vs.14.83%),and the difference was statistically significant(χ^(2)=54.666,P<0.001).The risk of 28-day mortality was 0.535 times lower in the hospital preparation group as compared with the control group(OR=0.46,95%CI:0.305-0.708,P<0.001)showed by multivariable binary logistic regressions.Subgroup analyses showed that taking TCM preparations reduced the 28-day mortality risk.Sensitivity analyses demonstrated that the results of the main analysis for primary outcomes were robust.For secondary outcomes,the risk of abnormal absolute lymphocyte counts at discharge in the hospital preparation group decreased by 0.284 times(OR=0.703,95%CI:0.515-0.961,P=0.027).CONCLUSION Compared with standard of care,taking four hospital preparations including Kanggan Heji,Feining Heji,Qishen Gubiao Keli,and Qianghuo Qushi Qingwen Heji decreased risk of 28-day mortality among hospitalized COVID-19 patients.TCM therapy achieves adequate therapeutic effects in COVID-19.展开更多
Rhabdomyolysis is a severe condition characterized by the breakdown of muscle tissue leading to the release of intracellular components into the bloodstream.This condition,when associated with acute kidney injury(AKI)...Rhabdomyolysis is a severe condition characterized by the breakdown of muscle tissue leading to the release of intracellular components into the bloodstream.This condition,when associated with acute kidney injury(AKI),can result in significant morbidity and mortality,particularly in the context of coronavirus disease 2019(COVID-19).This editorial discusses a retrospective study on patients with COVID-19 who developed rhabdomyolysis-related AKI.The study highlights that patients with rhabdomyolysis exhibited higher inflammatory markers,such as Creactive protein,ferritin,and procalcitonin,and experienced worse clinical outcomes compared to those with other causes of AKI.The findings underscore the importance of early recognition and management of rhabdomyolysis in COVID-19 patients to improve prognosis and reduce mortality rates.展开更多
BACKGROUND Solid organ transplantation(SOT)and hematopoietic stem cell transplantation(HSCT)revolutionized the survival and quality of life of patients with malignant diseases,various immunologic,and metabolic disorde...BACKGROUND Solid organ transplantation(SOT)and hematopoietic stem cell transplantation(HSCT)revolutionized the survival and quality of life of patients with malignant diseases,various immunologic,and metabolic disorders or those associated with a significant impairment in a patient's quality of life.AIM To investigate admission causes and treatment outcomes of patients after SOT or HSCT treated in a medical intensive care unit(ICU).METHODS We conducted a single-center,retrospective epidemiological study in the medical ICU at the University Hospital Centre Zagreb,Croatia covering the period from January 1,2018 to December 31,2023.RESULTS The study included 91 patients with either SOT[28 patients(30.8%)]or HSCT[63 patients(69.2%)].The median age was 56(43.2-64.7)years,and 60.4%of the patients were male.Patients with SOT had more comorbidities than patients after HSCT[χ^(2)(5,n=141)=18.513,P<0.001].Sepsis and septic shock were the most frequent reasons for admission,followed by acute respiratory insufficiency in patients following HSCT.Survival rate significantly differed between SOT and HSCT[χ^(2)(1,n=91)=21.767,P<0.001].ICU survival was 57%in the SOT and 12.7%in the HSCT group.The need for mechanical ventilation[χ^(2)(1,n=91)=17.081,P<0.001]and vasopressor therapy[χ^(2)(1,n=91)=36.803,P<0.001]was associated with survival.The necessity for acute renal replacement therapy did not influence patients'survival[χ^(2)(1,n=91)=0.376,P=0.54].In the subgroup of patients with infection,90%had septic shock,and the majority had positive microbiological samples,mostly Gram-negative bacteria.The ICU survival of patients with sepsis/septic shock cumulatively was 15%.The survival of SOT patients with sepsis/shock was 45%.CONCLUSION Patients with SOT or HSCT are frequently admitted to the ICU due to sepsis and septic shock.Despite advancements in critical care,the mortality rate of patients with refractory septic shock and multiorgan failure in this patient population is extremely high.Early recognition and timely ICU admittance might improve the outcome of patients,especially after HSCT.展开更多
This editorial comments on the article by Desai et al,which investigates the impact of coronavirus disease 2019(COVID-19)on in-hospital mortality among patients with recurrent stroke using data from the 2020 National ...This editorial comments on the article by Desai et al,which investigates the impact of coronavirus disease 2019(COVID-19)on in-hospital mortality among patients with recurrent stroke using data from the 2020 National Inpatient Sample.The findings reveal significantly higher mortality rates in COVID-19-positive patients compared to non-COVID-19 patients,particularly among middle-aged individuals,males,and ethnic minorities.This editorial explores the underlying mechanisms contributing to these outcomes and discusses the clinical implications for targeted management strategies in high-risk groups.The results emphasize the need for comprehensive approaches to mitigate the heightened risks faced by recurrent stroke patients during the COVID-19 pandemic.展开更多
BACKGROUND Liver transplantation aims to increase the survival of patients with end-stage liver diseases and improve their quality of life.The number of organs available for transplantation is lower than the demand.To...BACKGROUND Liver transplantation aims to increase the survival of patients with end-stage liver diseases and improve their quality of life.The number of organs available for transplantation is lower than the demand.To provide fair organ distribution,predictive mortality scores have been developed.AIM To compare the Acute Physiology and Chronic Health Evaluation IV(APACHE IV),balance of risk(BAR),and model for end-stage liver disease(MELD)scores as predictors of mortality.METHODS Retrospective cohort study,which included 283 adult patients in the postoperative period of deceased donor liver transplantation from 2014 to 2018.RESULTS The transplant recipients were mainly male,with a mean age of 58.1 years.Donors were mostly male,with a mean age of 41.6 years.The median cold ischemia time was 3.1 hours,and the median intensive care unit stay was 5 days.For APACHE IV,a mean of 59.6 was found,BAR 10.7,and MELD 24.2.The 28-day mortality rate was 9.5%,and at 90 days,it was 3.5%.The 28-day mortality prediction for APACHE IV was very good[area under the curve(AUC):0.85,P<0.001,95%CI:0.76-0.94],P<0.001,BAR(AUC:0.70,P<0.001,95%CI:0.58–0.81),and MELD(AUC:0.66,P<0.006,95%CI:0.55-0.78),P<0.008.At 90 days,the data for APACHE IV were very good(AUC:0.80,P<0.001,95%CI:0.71–0.90)and moderate for BAR and MELD,respectively,(AUC:0.66,P<0.004,95%CI:0.55–0.77),(AUC:0.62,P<0.026,95%CI:0.51–0.72).All showed good discrimination between deaths and survivors.As for the best value for liver transplantation,it was significant only for APACHE IV(P<0.001).CONCLUSION The APACHE IV assessment score was more accurate than BAR and MELD in predicting mortality in deceased donor liver transplant recipients.展开更多
BACKGROUND Ovarian carcinoma has the highest mortality rate among all gynecological cancers.Several reproductive and hormonal risk factors,including early menarche,late menopause,limited use of oral contraceptives,and...BACKGROUND Ovarian carcinoma has the highest mortality rate among all gynecological cancers.Several reproductive and hormonal risk factors,including early menarche,late menopause,limited use of oral contraceptives,and a low pregnancy rate,have been identified as contributors to the increased susceptibility to ovarian cancer.Advancements in cancer therapy over the past century,including the emergence of precision oncology,underscore the importance of early detection and tailored interventions,factors particularly critical in ovarian cancer,where late-stage diagnosis remains a persistent barrier to survival.This challenge is compounded by the lack of a universally endorsed screening program,resulting in late-stage identification and widespread metastasis.AIM To evaluate demographic differences in ovarian cancer-related mortality from 1999 to 2020 among adult females aged≥25 years within the United States.METHODS Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was used to collect de-identified death certificate data for malignant neoplasm of the ovaries related deaths in female adults aged 25 years and older from the year 1999 to 2020.Crude mortality rates and age-adjusted mortality rates(AAMRs)per 100000 people were calculated.Join point regression program was used to assess annual percent changes in mortality trends,with statistical significance set at P value<0.05.RESULTS Between 1999 and 2020,337619 deaths due to ovarian cancer occurred among United States females aged 25 to>85.The AAMR decreased from 14.62 in 1999 to 10.15 in 2020,with significant declines across various demographics.The AAMRs were highest among non-Hispanic White women,i.e.,13.53.Based on region,they were the highest in the Northeast(13.06)and Midwest(12.94).The steepest decline was observed in metropolitan areas as compared to nonmetropolitan ones.The study highlights significant progress in reducing ovarian cancer mortality across age,race/ethnicity,and geographic regions during this period.CONCLUSION The mortality trends for ovarian carcinoma patients showed an overall decrease,with the highest mortality rates observed among older individuals(65 to>85 years)and non-Hispanic Whites.These disparities underscore the need for equitable healthcare access and targeted policy interventions.展开更多
基金Scientific Projects of Zhejiang Province,China under contract Nos 2004C23041 and 20080123
文摘A series of mass mortalities of the cultured blood clam, Tegillarca granosa, occurred in the Yueqing Bay of China from 2005 to 2009. An obligate intracellular prokaryote, designated as rickettsia-like organism （RLO）, was frequently found in the moribund or dead blood clam sample during ultra- structural examination. These organisms were usually round, ellipsoid or occasionally dumbbell- shaped, ranged from approximately 0.28 to 0.71 #m in size and had a trilaminar cell wall. Two reproductive modes of organisms, transverse binary fission and budding, were observed. The or- ganisms were able to form eosinophilic inclusions. Most inclusions were found within epithelial and connective tissues of the mantle, gills and digestive tube. The biological and morphological char- acteristics indicate that these organisms may belong to the family Rickettsiaceae. RLOs exhibited significant pathogenicity. Cytopathological examinations revealed extensive necrosis and destruc- tion in the infected cell. The degree of tissue destruction was positively related to the number of RLO inclusions in the tissues, and the cytopathological effects were positively related to the number of intracellular RLO. RLOs and their inclusions were discovered throughout different disease areas and in different time periods. The infection intensity of the RLOs was positively correlated with the mortality rate of clams. Therefore, RLO infection might be associated with mass mortalities of cultured blood clams in the Yueqing Bay.
文摘The growth parameters and mortalities of five species of Synodontis in the lower river Benue at Makurdi,Benue State were studied from January,2016 to December,2018.The asymptotic length(L∞)calculated for the five species ranged from 18.80cm in S.clarias females to 37.04cm in S.membranaceus females.The t0 values were all negative in the combined sexes of S.clarias,S.omias,S.gambiensis and S.membranaceus.In both combined sexes of S.membranaceus and S.schall,the t0 values were positive.The growth rate(K)was low in S.clarias and S.omias(0.301-0.497,0.171-0.310)respectively and higher in S.membranaceus(0.310-0.640),S.schall females(0.430-0.580);S.schall males(0.573),S.gambiensis(0.500-0.571).Growth performance index(Ø’)was 2.212 in S.gambiensis and 2.946 in S.schall combined.Natural Mortality(M)ranged from 0.5422 in S.omias females to 1.3340 in S.membranaceus males.Fishing Mortality(F)was 0.8214 in S.omias combined and 3.0934 in S.membranaceus females.Total mortality(Z)ranged from 1.52 in S.omias combined to 4.078 in S.membranaceus combined.Mean Exploitation(E)ratios was 0.61 in S.clarias,0.64 in S.omias,0.53 in S.gambiences,0.70 in S.membranaceus,and 0.66 in S.schall.The rate at which these species survived in the River was low(from 0.147,in S.omias combined,to 1.482 in S.membranaceus combined).
文摘Introduction: The National Central Cancer Registry(NCCR) of China collected population-based cancer registration data from all cancer registries in China. This study aimed to compile national cancer incidences and mortalities in 2011 and estimate cancer incident new cases and cancer deaths.Methods: In 2014, there were 234 cancer registries that submitted records of new cancer cases and cancer deaths that occurred in 2011 to the NCCR. All datasets were evaluated based on the criteria of data quality of the NCCR. The data of 177 registries was of suicient quality and was compiled to evaluate cancer statistics in 2011. The pooled data were stratiied by area, sex, age group, and cancer type. Cancer incident cases and deaths were estimated using age-standardized rates(ASR) and the Chinese population. All incidences and mortalities were age-standardized to the 2000 Chinese standard population and Segi's population.Results: The estimates of new cancer incident cases and cancer deaths were 3,372,175 and 2,113,048 in 2011, respectively. The crude incidence was 250.28/1,00,000(277.77/1,00,000 for males and 221.37/1,00,000 for females). The ASRs of incidence by the Chinese standard population(ASRIC) and by the world standard population(ASRIW) were 186.34/1,00,000 and 182.76/1,00,000, respectively, with a cumulative incidence(0–74 years old) of 21.20%. Cancers of the lung, female breast, stomach, liver, colorectum, esophagus, cervix, uterus, prostate, and ovary were the most common cancers, accounting for approximately 75% of all new cancer cases. Lung, liver, gastric, esophageal, colorectal, female breast, pancreatic, brain, and cervical cancers and leukemia were the leading causes of cancer death, accounting for approximately 80% of all cancer deaths. Cancer incidence, mortality, and spectrum were all diferent between urban and rural areas and between males and females.Conclusions: The population covered by the cancer registries greatly increased from 2010 to 2011. The data quality and representativeness of cancer registries have gradually improved. Cancer registries have an irreplaceable role in research on cancer prevention and control. The disease burden of cancer is increasing, and the health department must implement efective measures to contain the increased cancer burden in China.
文摘Background: There are many reports from different parts of the world addressing different aspects of surgical mortality. However, none has been done in this centre as it relates to orthopaedics and trauma admissions. Such data are invaluable to health planning and epidemiological monitoring. Objective: To retrospectively review all mortalities arising from orthopaedics and trauma admission as they present to Irrua specialist Teaching Hospital (ISTH) Irrua from Jan 2005-Dec 2014. Method: Medical records of case mortalities among orthopaedic and trauma admissions over ten years (Jan 2005-Dec 2014) were retrospectively reviewed. Results: Over this period, 2129 admissions and 45 deaths were recorded, with an overall crude mortality rate of 2.11%. No death was recorded among the paediatric age group. Thirty-four patients (75.56%) died from trauma (fracture) related diagnosis, majority of which were from head injury followed by infection 5 (11.11%), tumours 4, (8.89%) and disc herniation 2 (4.44%). Males were more affected 77.78% and median age at death was 44 years. Medical co-morbidities were found in 37.77% of the deceased patients. Conclusion: Patients with trauma related cases particularly head injuries, topped the list of mortalities. Young and middle aged adult males were most affected. Need for manpower development, investment in diagnostic and therapeutic facilities and preventive measures is emphasised.
文摘Background: Studies have suggested epidemiological transition in the mortality pattern in Nigeria from communicable to non-communicable diseases of which Diseases of the cardiovascular system (DCVS) is prime. DCVS is?thus a growing public health concern but its mortality profile is under-studied?in Port Harcourt. This study was therefore designed to review the mortality profile of DCVS in Port Harcourt. Methodology: A retrospective case controlled study of deaths ascribed to DCVS at the University of Port Harcourt Teaching Hospital (UPTH) between January 2012 and December 2017. The composite diseases were grouped using the ICD10 scheme and analyzed using SPSS version 23. Minitab version 16 was used for trend analysis. Results: Of the overall 1902 deaths recorded within the period, 566 (29.8%) were cardiovascular system related. Of these, 301 (53.3%) were males and 265 (46.7%) were females. The elderly of 50 - 99 years were most commonly affected (65.5% of the mortalities). Cerebrovascular accidents (CVA) accounted for 322 deaths (56.9%);various types of shock caused 116 deaths (20.5%) while?congestive cardiac failure (CCF) accounted for 114 deaths (20.1%). Pulmonary?embolism, myocardial infarction, carotid aneurysm, and hypertensive encephalopathy caused 1.8%, 0.4%, 0.2%, and 0.2% deaths respectively. Peak annual mortality of 143 (25.3%) was recorded in 2013. Although the trend of mortality was undulating, there was an overall increase in annual incidence over the years.?Conclusion: DCVS constitute the commonest systemic cause?of death in Port Harcourt. Governmental and donor agencies involved in public health policy planning and implementation should scale-up strategies for the prevention and control of DCVS in order to stem the rising tide of associated mortalities.
文摘A study on the evaluation of the effectiveness of three traditional methods of protecting guinea fowl from mortality was carried out at CRA-SS （Centre de Recherche Agronomique de la Savane S6che） in northem Togo. Guinea fowl were divided into 5 batches, of which 3 batches received prophylactic medical treatment including plant decoctions, the 4th batch was followed by a medical prophylaxis program as a control group and the 5th batch considered as a negative control, has not received any prophylactic treatment. The results showed that a mortality rate of 25% for the reference lot and two other batches which received plant decoctions （Euphorbia poissonii or Khaya senegalensis） were recorded against a rate of 87.5% in the batch of guinea fowl which received the decoction of Pteleopsis suberosa. Meanwhile, regardless of weight growth, daily average gain （GMQ） or food consumption, no significant difference was observed （p 〉 0.05） between the guinea fowl that received a baseline health monitoring and those having taken the decoction orE. poissonii. On the other hand, the values recorded in these two batches of guinea fowl differed statistically from those in the guinea fowl that received the decoction of K. senegalensis. Although the decoction of K. senegalensis has a protective effect in guinea fowl, the growth of guinea fowl has been slowed down. On the basis of these results, it appears that two endogenous practices tested （K. senegalensis or E. poissonii） have positive effects. However, it would be desirable to carry out a toxicity test in order to determine the recommended doses.
基金supported by the National Key R&D Program of China(grant number:2021YFC2500400)National Natural Science Foundation of China(grant numbers:82172894,82073028,82204121)China Postdoctoral Science Foundation(grant number:2023M742617).
文摘Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical cancer as a major public health problem.Methods All data were extracted from the Global Cancer Observatory(GLOBOCAN)2022.Age-standardized incidence rate(ASIR)and mortality rates(ASMR)of cervical cancer were compared and linked to Human Development Index(HDI)between populations.The estimated annual percentage changes(EAPCs)were used to characterize the temporal trend in ASIR/ASMR,and demographic estimates were projected up to 2050.Results Globally,an estimated 662,044 cases(ASIR:14.12/100,000)and 348,709 deaths(ASMR:7.08/100,000)from cervical cancer occurred in 2022,corresponding to the fourth cause of cancer morbidity and mortality in women worldwide.Specifically,42%of cases and 39%of deaths occurred in China(23%and 16%)and India(19%and 23%).Both ASIR and ASMR of cervical cancer decreased with HDI,and similar decreasing links were observed for both early-onset(0–39 years)and late-onset(≥40 years)cervical cancer.Both ASIR and ASMR of overall cervical cancer showed decreasing trends during 2003–2012(EAPC:0.04%and-1.03%);however,upward trends were observed for early-onset cervical cancer(EAPC:1.16%and 0.57%).If national rates in 2022 remain stable,the estimated cases and deaths from cervical cancer are projected to increase by 56.8%and 80.7%up to 2050.Moreover,the projected increase of early-onset cervical cancer is mainly observed in transitioning countries,while decreased burden is expected in transitioned countries.Conclusions Cervical cancer remains a common cause of cancer death in many countries,especially in transitioning countries.Unless scaling-up preventive interventions,human papillomavirus(HPV)vaccination and cervical cancer screening,as well as systematic cooperation within government,civil societies,and private enterprises,the global burden of cervical cancer would be expected to increase in the future.
基金supported by the National High Level Hospital Clinical Research Funding (2022-PUMCH-B-109)Chinese Academy of Medical Science Innovation Fund for Medical Sciences (CIFMS)(2021-I2M-1-020)。
文摘BACKGROUND: Sepsis, a common acute and critical disease, leads to 11 million deaths annually worldwide. Probiotics are living microorganisms that are beneficial to the host and may benefit sepsis outcomes, but their effects are stil inconclusive. This study aimed to evaluate the overal eff ect of probiotics on the prognosis of patients with sepsis.DATA RESOURCES: We searched several sources for published/presented studies, including Pub Med, EMBASE, Web of Science, the Cochrane Library and the US National Library of Medicine Clinical Trials Register(www.clinicaltrials.gov) updated through July 30, 2023, to identify all relevant randomized controlled trials(RCTs) or observational studies that assessed the effectiveness of probiotics or synbiotics in patients with sepsis and reported mortality. We focused primarily on mortality during the study period and analyzed secondary outcomes, including 28-day mortality, in-intensive care unit(ICU) mortality and other outcomes.RESULTS: Data from 405 patients in five RCTs and 108 patients in one cohort study were included in the analysis. The overall quality of the studies was satisfactory, but clinical heterogeneity existed. All adult studies reported a tendency for probiotics to reduce the mortality of patients with sepsis, and most studies reported a decreasing trend in the incidence of infectious complications, length of ICU stay and duration of antibiotic use. There was only one RCT involving children.CONCLUSION: Probiotics show promise for improving the prognosis of patients with sepsis, including reducing mortality and the incidence of infectious complications, particularly in adult patients. Despite the limited number of studies, especially in children, these findings will be encouraging for clinical practice in the treatment of sepsis and suggest that gut microbiota-targeted therapy may improve the prognosis of patients with sepsis.
基金supported by the National High Level Hospital Clinical Research Funding(No.BJ-2023-066).
文摘Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year(DALY)rates for lower respiratory infections in the elderly population(aged 70 and above)in China from 1990 to 2050.It also discusses future trends in the burden of lower respiratory infections(LRI)in China under different scenarios.Results According to GBD predictions,the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average.The burden has been decreasing from 1990 to 2020,but is projected to increase from 2020 to 2050.Scenario-based predictions suggest that,under scenarios involving improvements in nutrition and vaccination,the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.Conclusion This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen.The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.
文摘BACKGROUND Emphysematous pyelonephritis(EPN)is a life-threatening necrotizing renal parenchyma infection characterized by gas formation due to severe bacterial infection,predominantly affecting diabetic and immunocompromised patients.It carries high morbidity and mortality,requiring early diagnosis and timely intervention.Various prognostic scoring systems help in triaging critically ill patients.The National Early Warning Score 2(NEWS 2)scoring system is a widely used physiological assessment tool that evaluates clinical deterioration based on vital parameters,but its standard form lacks specificity for risk stratification in EPN,necessitating modifications to improve treatment decisionmaking and prognostic accuracy in this critical condition.AIM To highlight the need to modify the NEWS 2 score to enable more intense monitoring and better treatment outcomes.METHODS This prospective study was done on all EPN patients admitted to our hospital over the past 12 years.A weighted average risk-stratification index was calculated for each of the three groups,mortality risk was calculated for each of the NEWS 2 scores,and the need for intervention for each of the three groups was calculated.The NEWS 2 score was subsequently modified with 0-6,7-14 and 15-20 scores included in groups 1,2 and 3,respectively.RESULTS A total of 171 patients with EPN were included in the study,with a predominant association with diabetes(90.6%)and a female-to-male ratio of 1.5:1.The combined prognostic scoring of the three groups was 10.7,13.0,and 21.9,respectively(P<0.01).All patients managed conservatively belonged to group 1(P<0.01).Eight patients underwent early nephrectomy,with six from group 3(P<0.01).Overall mortality was 8(4.7%),with seven from group 3(87.5%).The cutoff NEWS 2 score for mortality was identified to be 15,with a sensitivity of 87.5%,specificity of 96.9%,and an overall accuracy rate of 96.5%.The area under the curve to predict mortality based on the NEWS 2 score was 0.98,with a confidence interval of(0.97,1.0)and P<0.001.CONCLUSION Modified NEWS 2(mNEWS 2)score dramatically aids in the appropriate assessment of treatment-related outcomes.MNEWS 2 scores should become the practice standard to reduce the morbidity and mortality associated with this dreaded illness.
基金supported by the National Key R&D Program of China(grant number:2021YFC2500400)Tianjin Health Committee Foundation(grant number:TJWJ2021MS008).
文摘Background Breast cancer(BC)incidence and mortality vary significantly across countries,highlighting the need to update the global burden of female BC,including current trends and future projections.Methods Data were sourced from GLOBOCAN 2022,including estimated new cases and deaths from BC across 21 United Nation(UN)regions and 185 countries,the age-standardized incidence rate(ASIR)and mortality rate(ASMR),the estimated annual percentage changes(EAPC),and demographic projections through 2050.The region-specific and country-specific BC burden for women of all ages and for young women(<40 years old)was reorganized and re-plotted to highlight subgroup differences.Linear regression was used to explore the link between ASIR/ASMR and the human development index(HDI).Transitioning countries referred to those with low or medium HDI,while transitioned countries were those with high or very high HDI.Results In 2022,an estimated 2.3 million new BC cases and 666,000 BC-related deaths occurred globally,accounting for 23.8%and 15.4%of all cancer cases and deaths in women,respectively.Regionally,Eastern Asia reported the highest number of cases(480,019,ASIR:37.54/100,000),while South-Central Asia had the highest number of deaths(135,348,ASMR:13.41/100,000).At the country level,China had the highest number of cases due to its large population,whereas India reported the highest number of deaths.ASIR for both overall and early-onset BC increased with HDI,while ASMR for early-onset BC decreased with HDI(P<0.05).Overall BC showed an increasing trend in ASIR during 2003–2015(EAPC:0.92%)and a decreasing trend in ASMR during 2006–2016(EAPC:-1.06%).Early-onset BC showed a more significant rise in ASIR(EAPCs:1.4%)and a slight increase in ASMR(EAPCs:0.16%).If national rates remain stable,BC cases and deaths will increase by 54.7%and 70.9%,respectively,by 2050.Notably,increased early-onset BC cases are only observed in transitioning countries,while decreased cases are seen in transitioned countries.Conclusions Breast cancer remains the leading cancer burden in women,particularly in transitioning countries.Addressing this growing burden requires urgent integration of primary prevention,early detection and high-quality treatment through multi-sectoral collaboration.
基金supported by the National Natural Science Foundation of China(grant numbers 82204127 and 72204172)。
文摘Lung cancer, the leading cause of cancer deaths worldwide and in China, has a 19.7% five-year survival rate due to terminal-stage diagnosis^([1-3]).Although low-dose computed tomography(CT) screening can reduce mortality, high false positive rates can create economic and psychological burdens.
文摘There exists a notion that there is an obesity paradox in the prognosis of community-acquired pneumonia.In other words,obese individuals with communityacquired pneumonia have a better prognosis.The study by Wang et al supports this claim,but we believe that the obesity paradox should not be proposed hastily as it is influenced by numerous subjective and objective confounding factors.
文摘BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related disorders.Recent evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes,including greater mortality.AIM To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize bias.METHODS This retrospective cohort study used data from the TriNetX research network,with electronic health records from multiple healthcare organizations.The study employed a new-user,active comparator design,which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists(H2RA)users among adult cancer patients.Newly prescribed PPIs(esomeprazole,lansoprazole,omeprazole,pantoprazole,or rabeprazole)users were compared to non-users or newly prescribed H2RAs(cimetidine,famotidine,nizatidine,or ranitidine)users.The primary outcome was all-cause mortality.Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.Multivariable Cox regression models were used to estimate hazard ratios(HRs)and 95% confidence interval(CI).RESULTS During the follow-up period(median 5.4±1.8 years for PPI users and 6.5±1.0 years for non-users),PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year,2 years,and at the end of follow up(HRs:2.34-2.72).Compared with H2RA users,PPI users demonstrated a higher rate of all-cause mortality HR:1.51(95%CI:1.41-1.69).Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure,confirming the robustness of these findings.In a sensitivity analysis,we analyzed all-cause mortality outcomes between former PPI users and individuals who have never used PPIs,providing insights into the long-term effects of past PPI use.In addition,at 1-year follow-up,the analysis revealed a significant difference in mortality rates between former PPI users and non-users(HR:1.84;95%CI:1.82-1.96).CONCLUSION PPI use among cancer patients was associated with a higher risk of all-cause mortality compared to non-users or H2RA users.These findings emphasize the need for cautious use of PPIs in cancer patients and suggest that alternative treatments should be considered when clinically feasible.However,further studies are needed to corroborate our findings,given the significant adverse outcomes in cancer patients.
文摘OBJECTIVE The emergence of evolving variants of Coronavirus disease 2019(COVID-19)has fostered the need for change of newer and adaptive treatments for these infections.During the COVID-19 pandemic and persists,traditional Chinese medicine(TCM)herbs exhibit significant bioactivity and therapeutic effect.This study is aimed to evaluate the efficacy of four TCM preparations on 28-day mortality risk of patients and changes of the laboratory indicators.METHODS The retrospective cohort study included patients with COVID-19 who were admitted to the Jiangsu Province Hospital of Chinese Medicine from December 15,2022 to January 15,2023,and those died within 48 hours of admission or cannot be tracked for outcomes were excluded.The primary outcome was survival status in 28 days(death or survival)starting from the day of admission.The second outcomes were laboratory indicators,including absolute lymphocyte count,lactate dehydrogenase,creatinine,and blood urea nitrogen.Binary logistic regressions were used to estimate the effect of TCM preparations on the primary and secondary outcomes in main analysis.Meanwhile,heterogeneity and robustness of results from main analysis were assessed by subgroup analyses and multiple sensitivity analyses.RESULTS 1816 eligible patients were included in analysis dataset,including 573 patients received standard care(control group)and 1243 patients received TCM preparations(hospital preparation group).The 28-day mortality rate of hospital preparation group was lower than that of control group(4.75%vs.14.83%),and the difference was statistically significant(χ^(2)=54.666,P<0.001).The risk of 28-day mortality was 0.535 times lower in the hospital preparation group as compared with the control group(OR=0.46,95%CI:0.305-0.708,P<0.001)showed by multivariable binary logistic regressions.Subgroup analyses showed that taking TCM preparations reduced the 28-day mortality risk.Sensitivity analyses demonstrated that the results of the main analysis for primary outcomes were robust.For secondary outcomes,the risk of abnormal absolute lymphocyte counts at discharge in the hospital preparation group decreased by 0.284 times(OR=0.703,95%CI:0.515-0.961,P=0.027).CONCLUSION Compared with standard of care,taking four hospital preparations including Kanggan Heji,Feining Heji,Qishen Gubiao Keli,and Qianghuo Qushi Qingwen Heji decreased risk of 28-day mortality among hospitalized COVID-19 patients.TCM therapy achieves adequate therapeutic effects in COVID-19.
文摘Rhabdomyolysis is a severe condition characterized by the breakdown of muscle tissue leading to the release of intracellular components into the bloodstream.This condition,when associated with acute kidney injury(AKI),can result in significant morbidity and mortality,particularly in the context of coronavirus disease 2019(COVID-19).This editorial discusses a retrospective study on patients with COVID-19 who developed rhabdomyolysis-related AKI.The study highlights that patients with rhabdomyolysis exhibited higher inflammatory markers,such as Creactive protein,ferritin,and procalcitonin,and experienced worse clinical outcomes compared to those with other causes of AKI.The findings underscore the importance of early recognition and management of rhabdomyolysis in COVID-19 patients to improve prognosis and reduce mortality rates.
文摘BACKGROUND Solid organ transplantation(SOT)and hematopoietic stem cell transplantation(HSCT)revolutionized the survival and quality of life of patients with malignant diseases,various immunologic,and metabolic disorders or those associated with a significant impairment in a patient's quality of life.AIM To investigate admission causes and treatment outcomes of patients after SOT or HSCT treated in a medical intensive care unit(ICU).METHODS We conducted a single-center,retrospective epidemiological study in the medical ICU at the University Hospital Centre Zagreb,Croatia covering the period from January 1,2018 to December 31,2023.RESULTS The study included 91 patients with either SOT[28 patients(30.8%)]or HSCT[63 patients(69.2%)].The median age was 56(43.2-64.7)years,and 60.4%of the patients were male.Patients with SOT had more comorbidities than patients after HSCT[χ^(2)(5,n=141)=18.513,P<0.001].Sepsis and septic shock were the most frequent reasons for admission,followed by acute respiratory insufficiency in patients following HSCT.Survival rate significantly differed between SOT and HSCT[χ^(2)(1,n=91)=21.767,P<0.001].ICU survival was 57%in the SOT and 12.7%in the HSCT group.The need for mechanical ventilation[χ^(2)(1,n=91)=17.081,P<0.001]and vasopressor therapy[χ^(2)(1,n=91)=36.803,P<0.001]was associated with survival.The necessity for acute renal replacement therapy did not influence patients'survival[χ^(2)(1,n=91)=0.376,P=0.54].In the subgroup of patients with infection,90%had septic shock,and the majority had positive microbiological samples,mostly Gram-negative bacteria.The ICU survival of patients with sepsis/septic shock cumulatively was 15%.The survival of SOT patients with sepsis/shock was 45%.CONCLUSION Patients with SOT or HSCT are frequently admitted to the ICU due to sepsis and septic shock.Despite advancements in critical care,the mortality rate of patients with refractory septic shock and multiorgan failure in this patient population is extremely high.Early recognition and timely ICU admittance might improve the outcome of patients,especially after HSCT.
文摘This editorial comments on the article by Desai et al,which investigates the impact of coronavirus disease 2019(COVID-19)on in-hospital mortality among patients with recurrent stroke using data from the 2020 National Inpatient Sample.The findings reveal significantly higher mortality rates in COVID-19-positive patients compared to non-COVID-19 patients,particularly among middle-aged individuals,males,and ethnic minorities.This editorial explores the underlying mechanisms contributing to these outcomes and discusses the clinical implications for targeted management strategies in high-risk groups.The results emphasize the need for comprehensive approaches to mitigate the heightened risks faced by recurrent stroke patients during the COVID-19 pandemic.
文摘BACKGROUND Liver transplantation aims to increase the survival of patients with end-stage liver diseases and improve their quality of life.The number of organs available for transplantation is lower than the demand.To provide fair organ distribution,predictive mortality scores have been developed.AIM To compare the Acute Physiology and Chronic Health Evaluation IV(APACHE IV),balance of risk(BAR),and model for end-stage liver disease(MELD)scores as predictors of mortality.METHODS Retrospective cohort study,which included 283 adult patients in the postoperative period of deceased donor liver transplantation from 2014 to 2018.RESULTS The transplant recipients were mainly male,with a mean age of 58.1 years.Donors were mostly male,with a mean age of 41.6 years.The median cold ischemia time was 3.1 hours,and the median intensive care unit stay was 5 days.For APACHE IV,a mean of 59.6 was found,BAR 10.7,and MELD 24.2.The 28-day mortality rate was 9.5%,and at 90 days,it was 3.5%.The 28-day mortality prediction for APACHE IV was very good[area under the curve(AUC):0.85,P<0.001,95%CI:0.76-0.94],P<0.001,BAR(AUC:0.70,P<0.001,95%CI:0.58–0.81),and MELD(AUC:0.66,P<0.006,95%CI:0.55-0.78),P<0.008.At 90 days,the data for APACHE IV were very good(AUC:0.80,P<0.001,95%CI:0.71–0.90)and moderate for BAR and MELD,respectively,(AUC:0.66,P<0.004,95%CI:0.55–0.77),(AUC:0.62,P<0.026,95%CI:0.51–0.72).All showed good discrimination between deaths and survivors.As for the best value for liver transplantation,it was significant only for APACHE IV(P<0.001).CONCLUSION The APACHE IV assessment score was more accurate than BAR and MELD in predicting mortality in deceased donor liver transplant recipients.
文摘BACKGROUND Ovarian carcinoma has the highest mortality rate among all gynecological cancers.Several reproductive and hormonal risk factors,including early menarche,late menopause,limited use of oral contraceptives,and a low pregnancy rate,have been identified as contributors to the increased susceptibility to ovarian cancer.Advancements in cancer therapy over the past century,including the emergence of precision oncology,underscore the importance of early detection and tailored interventions,factors particularly critical in ovarian cancer,where late-stage diagnosis remains a persistent barrier to survival.This challenge is compounded by the lack of a universally endorsed screening program,resulting in late-stage identification and widespread metastasis.AIM To evaluate demographic differences in ovarian cancer-related mortality from 1999 to 2020 among adult females aged≥25 years within the United States.METHODS Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was used to collect de-identified death certificate data for malignant neoplasm of the ovaries related deaths in female adults aged 25 years and older from the year 1999 to 2020.Crude mortality rates and age-adjusted mortality rates(AAMRs)per 100000 people were calculated.Join point regression program was used to assess annual percent changes in mortality trends,with statistical significance set at P value<0.05.RESULTS Between 1999 and 2020,337619 deaths due to ovarian cancer occurred among United States females aged 25 to>85.The AAMR decreased from 14.62 in 1999 to 10.15 in 2020,with significant declines across various demographics.The AAMRs were highest among non-Hispanic White women,i.e.,13.53.Based on region,they were the highest in the Northeast(13.06)and Midwest(12.94).The steepest decline was observed in metropolitan areas as compared to nonmetropolitan ones.The study highlights significant progress in reducing ovarian cancer mortality across age,race/ethnicity,and geographic regions during this period.CONCLUSION The mortality trends for ovarian carcinoma patients showed an overall decrease,with the highest mortality rates observed among older individuals(65 to>85 years)and non-Hispanic Whites.These disparities underscore the need for equitable healthcare access and targeted policy interventions.
