Background::China is one of the countries with the largest burden of gastrointestinal and liver diseases (GILD) in the world. The GILD constitutes various causes of mortality and disability. The study aimed to investigate the trend of GILD in China using the Global Burden of Diseases Study 2019 (GBD 2019) data resources from 1990 to 2019.Methods::The data on the age-standardized mortality rates (ASMR) and disability-adjusted life years (DALYs) for GILD in China from 1990 to 2019 were collected from the GBD 2019 data resources. Furthermore, the ranking of the main causes of deaths and DALYs, as well as the trends of ASMR, DALYs, years of life lost (YLLs), and years of life lost due to disability (YLDs) per 1,000,000 in GILD were reported.Results::The ASMR and DALYs for stomach cancer, liver cancer, and esophageal cancer, which ranked top three among the GILDs from 1990 to 2019, were gradually decreasing. Significant decreases in the ASMR and DALYs were found in diarrheal diseases and acute hepatitis (A, E, and C). However, noteworthy increases were found in those of colon and rectum cancer (CRC) and pancreatic cancer. Trend of DALYs, mortality, and YLLs rates for most of GILD were decreasing from 1990 to 2019, except the burden of CRC and pancreatic cancer with an increasing trend. The DALYs, mortality and YLLs of most GILD diseases showed decreasing trends from 1990 to 2019, except the burden of CRC and pancreatic cancer with an increasing trends.Conclusions::The result of the GBD 2019 showed that the rates of most GILDs decreased in China; however, gastrointestinal and liver cancer, such as stomach cancer still held the top ranking. Furthermore, the shift from infectious diseases to non-communicable causes among GILD burden is occurring.

Objective:To analyze the risk factors of stress perception in patients with systemic lupus erythematosus (SLE) , and construct and validate a risk prediction model for health risk stress perception in SLE patients.Methods:This study is a cross-sectional study. From October 2020 to March 2021, totals of 310 SLE inpatients and outpatients in the Department of Rheumatology and Immunology from 4 general hospitals in Anhui Province were selected as the modeling object. According to the patients' stress perception score, they were divided into the group with health risk stress ( n=132) and the group without health risk stress ( n=178) . The general data, SLE disease activity, general self-efficacy, emotional intelligence, resilience, sleep disturbance, anxiety, depression were compared between the two groups, and independent risk factors were screened out and Logistic regression was used to construct a risk prediction model. Hosmer-Lemeshow and receiver operator characteristic curve (ROC) area were used to test the fit and prediction effect of the model, respectively, and 206 patients were included for model validation. Results:Binary Logistic regression analysis showed that SLE disease activity, resilience, anxiety, payment type, and family monthly income were the influencing factors of stress perception in SLE patients, and the difference was statistically significant ( P<0.05) . Hosmer-Lemeshow fit test showed χ 2=6.123, P=0.633. Besides, the area under the ROC, maximum Youden index, predictive critical value, sensitivity and specificity were 0.903, 0.660, 0.497, 0.795 and 0.865 respectively. Conclusions:This study is based on five independent risk factors of SLE patients' stress perception, namely SLE disease activity, resilience, anxiety, payment type, and family monthly income. The risk prediction model has good sensitivity and specificity, which can provide a reference for clinical assessment of health risk stress perception in SLE patients.

Objective: To evaluate the diagnostic value of the endoscopic biopsy operation to the lesions of the skull base in the patients with nasopharyngealcarcinoma after radiotherapy. Methods: From February 2006 to February 2010, 84 patients with nasopharyngeal carcinoma suffered from the lesions of the skull base after radiotherapy were included in this study. The relationship between the pathologic results of endoscopic biopsies from the skull base and the imaging results by Magnetic Resonance Imaging(MRI) was compared and discussed. The relationship between the pathologic results and more than 2-years′ follow-up was also investigated. Results: There were 71 cases with clivus, 5 cases with pterygopalatine fossa and infratemporal fossa, 4 cases with parapharyngeal space, and 4 cases with cavernous sinus. The pathologic results of endoscopic biopsies indicated that 35 cases with recurrence including 30 case with poorly differentiated squamous cell carcinomas, 5 cases with cancer nests, 49 cases with non-tumor. Chi-square test showed that there was close relationship between MRI and pathologic results (P<0.05). In the patients followed up over 2 years, the pathologic results showed 28 cases with recurrence, 48 cases with non-tumor. MRI showed 36 cases with recurrence, 40 cases with non-tumor. But during follow-up, 30 cases were proved to be recurrent and 46 cases had non-tumor. However, Chi-square test showed that there was no statistically significance between the pathological results and follow-up(P=0.62). The sensitivity, specificity and diagnostic accuracy of the endoscopic diagnosis were 90.0%, 97.8% and 95.0%. Chi-square test also showed that there was no statistically significance between MRI and follow-up (P=0.24). The sensitivity, specificity and diagnostic accuracy of MRI were 80.0%, 73.9% and 76.0%. Conclusions The endoscopic method is a specific, sensitive, safe, effective and minimally invasive in diagnosis of lesions of the skull base in postradiotherapeutic patients with nasopharyngeal carcinoma.

Objective:To understand the awareness of chronic obstructive pulmonary disease (COPD) status and awareness of COPD-related knowledge and its influencing factors in COPD patients aged ≥40 years in China in 2014-2015.Methods:The study subjects were selected through multi-stage stratified cluster sampling from 125 COPD surveillance points in 31 provinces (autonomous regions, municipalities) in China. The number of the subjects was 75 107. The relevant variables about COPD diagnosis and COPD-related knowledge awareness were collected by electronic questionnaire in face to face interviews. A total of 9 134 participates with post-bronchodilator FEV 1/FVC<70% were diagnosed with COPD. Based on the complex sampling design, the awareness rate of COPD status and related knowledge were estimated, and the influencing factors were analyzed. Results:A total of 9 132 COPD patients were included in the analysis. Among COPD patients aged ≥40 years in China, 0.9% were aware of their COPD status (95 %CI: 0.6%-1.1%), and 5.7% were aware of COPD related knowledge (95 %CI: 4.8%-6.6%), and 3.4% were aware of pulmonary function test (95 %CI: 2.8%-4.0%). The COPD status awareness rate was 3.9% in the patients with history of chronic respiratory disease (95 %CI: 2.9%-4.8%), 2.4% in the patients with respiratory symptoms (95 %CI: 1.7%-3.1%), and 7.1% in the patients with COPD related knowledge awareness (95 %CI: 4.5%-9.8%) respectively. The results of multivariate logistic regression analysis showed that chronic respiratory disease history, respiratory symptoms, occupational dust and/or harmful gas exposure and COPD related knowledge awareness had influences on the awareness rate of COPD status. Educational level and chronic respiratory disease history had influences on the awareness rate of COPD related knowledge. And ethnic groups, educational level and history of chronic respiratory diseases had influences on the awareness rate of pulmonary function test. Conclusions:The awareness rates of COPD status, COPD-related knowledge and pulmonary function test in COPD patients in China were low. The comprehensive intervention of COPD should be carried out to improve the level of diagnosis and the awareness COPD status of COPD patients.