Objective To evaluate the accuracy of different methods for estimating blood loss during burn wound excixion and skin grafting in pediatric patients with severe burn. Methods Twenty pediatric patients of both sexes aged 7 days-8 yr weighing 4-22 kg undergoing burn wound excision and skin grafting were enrolled in this clinical study. Two methods were used for estimating blood loss during operation: Method Ⅰ: surgical surface area (SSA). MethodⅡ: the product of SSA and blood volume (BV). Total blood loss was calculated: total blood loss = BV ( Hct0 - Hctx ) ÷ Hct0 + Tx. Hct0 =Hct before operation. Hctx =Hct at the end of operation. Tx =total amount of blood transfusion. Results The correlation between the total blood loss and SSA was 0.776. The correlation between the total blood loss and the product of SSA and BV was 0.889. The difference was statistically significant. Conclusion The product of SSA and BV is more accurate in estimating blood loss during burn wound excision and skin grafting in children with severe burn.

Objective To evaluate the reliability of gas sampling from the distal end of the tracheal tube for partial pressure of end-tidal CO2 (PETCO2) monitoring in neonates.Methods A total of 50 fullterm neonates,scheduled for elective abdominal surgery under general anesthesia,aged 1-28 days,weighing 2.55-4.00 kg,of ASA physical status Ⅰ or Ⅱ,were randomly divided into 2 groups (n =25 each) using a random number table:gas samples collected from proximal end of tracheal tube group (group P) and gas samples collected from distal end of tracheal tube group (group D).Epidural catheters of 1 mm in external diameter were used.One end of the catheter was connected to a tube for carbon dioxide sampling,and the other end was inserted into the endotracheal tube and advanced toward the distal hole of the tube.At 15 min of mechanical ventilation,blood samples were collected from the radial artery for record of PETCO2 and for blood gas analysis.Consistency test was performed between PETCO2 and partial pressure of arterial CO2 (PaCO2).Results PET CO2 was significantly lower than PaCO2 in the two groups.There was no significant difference in PaCO2between the two groups.PETCO2 was significantly higher in group D than in group P.Kappa was significantly higher in group D than in group P.Conclusion Gas sampling from the distal end of the tracheal tube is more reliable than gas sampling from the proximal end in monitoring PETCO2 in the neonates.

OBJECTIVETo analyze and compare burden of disease caused by malignant tumor in China, 1990 and 2010.

METHODSThe indicators including prevalence, death, years of life lost (YLL), years lived with disability (YLD), and disability adjusted of life years (DALY) of malignant tumor from the results of Global Burden of Disease (GBD) 2010 were used to calculate the standardized prevalence rate, mortality rate, YLL rate, YLD rate and DALY rate with the 2010 national census data. The research described the prevalence, death, and burden of disease caused by malignant tumor and analyze the trend of these indicators in 1990 and 2010 in China.

RESULTSIn China from 1990 to 2010, the standardized prevalence rate of malignant tumor increased from 529.76/100 000 to 749.57/100 000 (increased by 41.49%); the standardized mortality rate decreased from 196.57/100 000 to 169.88/100 000 (decreased by 13.58%); the standardized DALY rate decreased from 5 206.56/100 000 to 4 150.86/100 000. In 2010, the top five standardized DALY rate of malignant tumor were lung cancer, liver cancer, gastric cancer, esophageal cancer, and colorectal cancer. Their standardized DALY rate were 892.21/100 000, 787.40/100 000, 521.36/100 000, 303.95/100 000, and 269.94/100 000, respectively. In all kind of malignant tumors, the burden of disease of lung cancer had the fastest-growing rate. The standardized mortality rate of lung cancer increased from 34.78/100 000 in 1990 to 41.09/100 000 in 2010; the standardized DALY rate increased from 830.77/100 000 in 1990 to 892.21/100 000 in 2010. The burden of disease of gastric cancer had the fastest-falling rate. The standardized mortality rate of gastric cancer decreased from 39.65/100 000 in 1990 to 23.79/100 000 in 2010; the standardized DALY rate decreased from 968.96/100 000 in 1990 to 521.36/100 000 in 2010.

CONCLUSIONThe burden of disease caused by malignant tumor in China remained at high levels in 2010. The top five burden of disease of malignant tumor were lung cancer, liver cancer, gastric cancer, esophageal cancer, and colorectal cancer. The burden of disease of lung cancer had the fastest-growing rate and gastric cancer had the fastest-falling rate from 1990 to 2010 in China. Prevention and control of malignant tumor was still difficult.

China ; Colorectal Neoplasms ; Cost of Illness ; Esophageal Neoplasms ; Humans ; Liver Neoplasms ; Lung Neoplasms ; Mortality ; Neoplasms ; Prevalence ; Quality-Adjusted Life Years ; Stomach Neoplasms

Objective: To understand the causes of death and long-term prognosis of lymphoma patients. Methods: Data from 6 200 patients with lymphoma admitted to the Department of Lymphoma, Peking University Cancer Hospital, from January 1995 to Decem-ber 2017, were collected. Those who had died and whose causes of death were known were selected. Clinical records and information on death were collected. Results: A total of 1,173 patients were selected, 742 of whom were male (63.3% ), and 431 were female (36.7%). The median age was 56 (8-92) years. There were 77 cases (6.6%) of Hodgkin's lymphoma, 1,095 cases (93.4%) of non-Hodg-kin's lymphoma, and 1 case of unclear pathological classification. Overall population survival was 0-253 months, with a median surviv-al rate of 20 months. The direct causes of death included lymphoma in 688 (58.7%), various infectious diseases in 119 (10.1%), cardio-vascular diseases in 96 (8.2%), secondary primary tumors in 68 (5.8%), and other diseases in 202 cases (17.2%). The underlying causes of death included lymphoma in 936 (79.8%), secondary primary tumors in 94 (8.0%), cardiovascular diseases in 75 (6.4%), respiratory diseases in 32 (2.7%) and other diseases in 36 cases (3.1%). The underlying causes of death in cases wherein survival time exceeded 5 years included lymphoma in 129 (59.4%), secondary primary tumors in 38 (17.5%), cardiovascular diseases in 35 (16.1%), and other dis-eases in 15 cases (6.9%). The underlying causes of death in cases wherein survival time exceeded 10 years included lymphoma in 28 (46.7%), secondary primary tumors in 17 (28.3%), cardiovascular diseases in 7 (11.7%), and other diseases in 8 cases (13.3%). Conclu-sions: Primary tumors remain the main cause of death in patients with lymphoma. After primary tumors, secondary primary tumors and cardiovascular diseases are the most common causes of death, and with the prolongation of survival, the risk of death caused by these factors increases significantly.

Objective: To assess the disease burden attributable to household air pollution in 1990 and 2013 in China. Methods: Based on data from the Global Burden of Disease Study 2013 in China (GBD 2013), we used population attributable fractions (PAF) to analyze the burden of different diseases attributable to solid-fuel household pollution in 2013 in China(not inclnding HongKang, Macao, Taiwan). We compared PAF, mortality, and disability-adjusted life years (DALY) for diseases attributable to solid-fuel household pollution in 31 provinces in mainland China in 1990 and 2013, and stratified the burden by age group. The estimated world average population during 2000- 2025 was used to calculate age-standardized mortality and DALY rates. Results: In 2013, 14.9% of lower respiratory infections in children <5, 32.5% of chronic obstructive pulmonary disease (COPD), 12.0% of ischemic stroke, 14.2% of hemorrhagic stroke, 10.9% of ischemic heart disease, and 13.7% of lung cancer were attributable to solid-fuel household pollution. In addition, 807 000 deaths were attributable to solid-fuel household pollution, including 296 000 from COPD, 169 000 from hemorrhagic stroke, 152 000 from ischemic heart disease, 88 000 from ischemic stroke, 75 000 from lung cancer, and 28 000 from lower respiratory infections in children <5. The age-standardized mortality rate from solid-fuel household pollution decreased by 59.3% from 158.8/100 000 in 1990 to 64.6/100 000 in 2013. The age-standardized mortality rate from solid-fuel household pollution decreased in all 31 provinces, with the highest decline observed in Shanghai (96.3%), and lowest in Xinjiang (39.9%). In 2013, the age-standardized DALY rate from solid-fuel household pollution was highest in Guizhou (2 233.0/100 000) and lowest in Shanghai (27.0/100 000). The DALY rate was the highest for the >70 age group (7 006.0/100 000). Compared with 1990, the 2013 mortality rate and DALY rate from solid-fuel household pollution decreased in all age groups, with the highest decline observed in the <5 age group (91.9% and 91.8% , respectively). Conclusion Although the disease burden attributable to household air pollution decreased notably between 1990 and 2013, household pollution caused a high number of deaths and DALY loss in certain western provinces.

Objective: To investigate the current status, temporal trend and achieving Health China 2030 reduction target of probability of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, tumour, diabetes, and chronic respiratory disease in China both at national and provincial level during 1990 to 2015. Methods: Using the results of Global Burden of Disease study 2015 (GBD 2015), according to the method of calculating premature mortality probability recommended by WHO, the current status and temporal trend by different gender from 1990 to 2015 were calculated, analyzed, and compared. Referring to " Health China 2030" target of reduction 30% of probability of premature mortality caused by major NCDs, we evaluated the difficulty of achieving the reduction target among provinces (not including Taiwan). Results: From 1990 to 2015, the probabilities of premature mortality in cardiovascular and cerebrovascular diseases, tumour, and chronic respiratory disease were all declined consistently for both men and women in China, the total of four main NCDs decreased from 30.69% to 18.54% with higher decreasing in women (from 25.97% to 12.40%) than that in men (from 34.94% to 24.19%). In 2015, the top five provinces in terms of probability of premature mortality caused by four main NCDs were Qinghai (28.81%), Tibet (25.88%), Guizhou (24.67%), Guangxi (23.56%), and Xinjiang (23.21%) in turn, while the top five provinces with the lowest probability were Shanghai (8.40%), Beijing (9.39%), Hong Kong (10.10%), Macao (10.31%), and Zhejiang (11.70%). If achieving the " Health China 2030" target, the probabilities of premature mortality in Qinghai and Tibet with the highest probability should decline to about 20.17%, and 18.12%, respectively in 2030, while 5.88%, and 6.57% in Shanghai and Beijing, respectively. From 1990 to 2015, the probability of premature mortality of four main NCDs declined by 2.00% a year on average, the top five provinces with the fastest decline were Beijing (3.48%), Shanghai (3.24%), Zhejiang (2.81%), Fujian (2.75%), and Guangdong (2.67%), and 11 provinces including these five provinces could achieve the " Health China 2030" target by the usual rate of decline, while other 22 provinces could not achieve the target, they need greater rate of decline in order to achieve the target. Conclusion From 1990 to 2015, the probabilities of premature mortality of four main NCDs were declined consistently in China both at national and provincial level, compared with women, the men had higher probabilities and declined slower, there were significant different in probabilities of premature mortality and their change speed among provinces. Based on the results from 1990 to 2015, there were about two thirds of the provinces, which the task of achieving the Health China 2030 target will be daunting.

Objective To analyze the death attributable to smoking and impact of life expectancy in China in 2013.Methods According to the characteristics of different diseases,we calculated the population attributable fractions of different diseases,death and impact of life expectancy which caused by smoking,using direct method (current smoking rate as exposure levels)and indirect method (smoking impact ratio as exposure levels),based on data from both programs of death surveillance and Chinese chronic disease risk factor surveillance of 2013.Results In 2013,smoking caused around 1.59 million deaths which accounted for 17.38％ of all deaths in China.Constituent ratio of death caused by smoking in males (23.66％) was much higher than that in females (8.30％).However,in urban areas (17.24％),it was slightly lower than that in rural areas (17.51％).Constituent ratio of death caused by smoking in the eastern regions appeared the lowest (16.81％),with western regions the highest (17.91％).In 2013,lung cancer,COPD and ischemia heart disease were the top three diseases causing deaths that related to smoking,but the top three population attributable fractions were lung cancer,COPD and nasopharyngeal carcinoma in China.In 2013,smoking caused a reduction of 2.04 years of life expectancy loss in China,with males in the western regions the highest (3.05 years).Conclusion Smoking is still an important public health problem in China.Tobacco-control-targeted programs in the heavily involved areas could reduce the number of deaths from related diseases that caused by smoking.

Objective To quantitatively estimate the deaths and life expectancy losses attributable to diet high in sodium in China,and examine the gains and shifts under different control scenarios of sodium consumption.Methods Based on data from the cause-of-death through the National Mortality Surveillance System,and 24 hours urinary sodium values from Global Burden of Disease study on Chinese's estimates,population attributable fractions with the framework of comparative risk assessment were used to analyze the deaths and life expectancy losses due to diet high in sodium.The same methods were followed to examine the gains and shifts under different control scenarios of sodium consumption.Results In 2013,1 430 (940 for men and 490 for women)thousand deaths were attributable to diet high in sodium,accounting for 15.6％ (17.4％ for men and 13.0％ for women) of all-cause deaths in China,which causing 2.17 (2.49 for men and 1.71 for women) years of life expectancy loss.Diet with high sodium in 2013 caused 1 200,50 and 180 thousand deaths from cardiovascular disease,chronic kidney disease and stomach cancer respectively,accounting for 31.5％,30.8％ and 64.8％ of those specific causes.Comparing to the baseline in 2013,if the targets of 10％ decrease of sodium consumption by 2020 and 15％ by 2030 for Chinese chronic disease prevention and treatment planning,and 30％ decrease by 2030 for WHO non-communicable disease monitoring framework are achieved,220,340 and 730 thousand deaths will be averted,which may gain 0.30,0.45 and 0.95 years of life expectancy,respectively.Conclusions As one of the leading risk factors,diet high in sodium had caused heavy burden of disease from cardiovascular disease,chronic kidney disease and stomach cancer on Chinese residents.Intervention programs on sodium-reductionare urgently needed in China and related cost-effectiveness is highly expected.

Objective To analyze the attribution of mortality and impact on life expectancy caused by insufficient physical activity in different gender and areas in adults aged ≥25 years among Chinese people.Methods Data from the programs related to Chinese death surveillence,risk factors of chronic survey,health outcomes of physical activity as well as relative risk (RR) on Global Burden of Disease (GBD) study were used.Population attributable fraction (PAF) of different health outcomes attributable to deaths that caused physical activity and the influence of life expectancy in adults aged ≥25 years in Chinese people were calculated.Results The overall PAF for all cause of death due to physical activity in adults aged ≥25 years was 4.24％,with 4.86％ in females and 3.82％ in males.The health outcomes of inadequate physical activity would include breast cancer,colorectal cancer,ischemic heart disease,ischemic stroke and diabetes with relative PAFs as 9.04％,13.96％,14.96％,17.80％ and 16.92％,respectively.The attribution of death on Physical activity was 388 954.The most attributed death was ischemic heart disease,followed by ischemic stroke.With the elimination of physical inactivity,the total life expectancy was expected to lose by 0.43 years,with 0.47 years in women,and 0.39 years in men.Conclusion The increase of physical activity may benefit on health condition so to reduce the burden of chronic diseases and increase the life expectancy.

Objective To assess the mortality attributable to low fruit intake among people over 25 years old in China,2013,and its effect on life expectancy.Methods Based on data collected from China Chronic Disease and Risk Factor Surveillance in 2013,the average fruit intake in different genders and areas were calculated.Potential impact fraction (PIF) was used to examine the impact on deaths,mortality and life expectancy.Results The average daily fruit intake was (113.3 ± 168.9)g among people over 25 years old,with (103.6± 160.1) g for men and (122.7± 176.6) g for women,in China in 2013.Fruit intake for urban residents was significantly higher than that in rural residents and higher in eastern regions than that in central or western regions.Scores that attributable to low fruit intake accounted for 15.21％ of the total deaths and the population attributable fraction of inadequate intake of fruits to associated diseases was 35.00％.PIF for all the deaths in rural residents (16.50％)appeared higher than that of the urban residents (13.88％),and higher in the residents living in the eastern region (15.48％) than that in the central (16.27％) or western (13.75％) regions.Number of deaths that attributable to low fruit intake was 1.348 4 million.Deaths caused by related diseases appeared as:ischemic heart disease (472.5 thousands),hemorrhagic stroke (338.8 thousands),ischemic stroke (259.0 thousands),lung cancer (208.4 thousands),esophageal cancer (60.7 thousands),laryngeal cancer (5.4 thousands) and oral cancer (3.6 thousands).Numbers of all deaths and related diseases for urban residents were lower than that of the rural residents,with central regions (452.7 thousands) higher than that in the eastern (531.1 thousands) or western (364.6 thousands) regions.The average life expectancy loss caused by low fruit intake was 1.73 years,1.80 years for men and 1.58 years for women,in this country.Loss of life expectancy in the rural residents was higher than that of the urban residents,and higher in central regions than that in the eastern or western regions.Conclusions The intake of fruit was far lower than the recommended standard set for the Chinese people.Population attributable fraction was related to the associated diseases caused by inadequate intake of fruits which also made serious impact on life expectancy.