ObjectiveTo analyze the impact of diabetes-related deaths on the probability of premature mortality and life expectancy in Minhang District of Shanghai from 2004 to 2023, and to provide reference data for the optimization of targeted prevention and control strategies. MethodsAll death cases involving diabetes among the registered residents of Minhang District from 2004 to 2023 were collected. The probability of premature mortality and life expectancy was computed using the abridged life table method. The average annual percent change (AAPC) was calculated with Joinpoint 4.9.0.0. The Arriaga decomposition method was employed for statistical analyses of the influence of cause-specific and age-specific mortality related to diabetes on life expectancy. ResultsThe total number of diabetes-related mortality, crude mortality, and standardized mortality for both males and females in Minhang District from 2004 to 2023 exhibited an increasing trend (P<0.001). The primary causes of death among diabetes-related cases were cardiovascular disease (37.68%), diabetes mellitus (31.95%), and malignant tumor (17.80%). From 2004 to 2023, probability of premature mortality to diabetes-related diseases demonstrated a rising trend (P<0.001), contrasting with the declining trend observed in the overall population (P=0.001). Males showed a significant upward trajectory (P<0.001), while females displayed a stable pattern. Among the diseases exerting considerable influence, cardiovascular disease and malignant tumor revealed a marked increase over time (P<0.001), whereas diabetes mellitus maintained a stable trend; both factors negatively impacted the reduction in probability of premature mortality. From 2004 to 2023, diabetes-related mortality reduced life expectancy among residents by an average of 1.22 years (-49.89%), indicating a negative impact; the reduction was 1.41 years in males and 0.90 years in females. The age groups exhibiting greater negative contributions differed by genders, namely males aged 50‒54 years and females aged 70‒74 years. Cardiovascular disease, diabetes mellitus, and malignant tumor contributed significantly to this decline (-0.46 years, -0.42 years, -0.20 years, respectively), with male experiencing higher negative contributions than females. ConclusionIn Minhang District, the rising mortality associated with diabetes-related diseases negatively impact both the reduction of the probability of premature mortality and the increase in life expectancy. This trend is primarily attributed to the rapid escalation of mortality and younger age demographic of male residents, which warrants significant attention. It is recommended that, based on the enhancement of case management, efforts should be directed towards the targeted prevention and control of risk factors and high-risk populations.

Objective:To analyze the survival and influencing factors of HIV infections and AIDS cases (HIV/AIDS) aged 15 years and over who had received antiretroviral treatment (ART) for more than 10 years in Henan Province.Methods:In this retrospective cohort study, data of HIV infections and AIDS cases in Henan province were collected from the AIDS Prevention and Control System between January 1, 2002 and December 31, 2020. This study included 20 256 participants alive after 10-year ART with complete baseline and follow-up information, such as demographic characteristics, CD4 +T lymphocyte count and viral load. Cox proportional risk regression model was used to analyze influencing factors of HIV/AIDS survival. Results:A total of 20 256 participants were followed up for 82 738.2 person-years, with an average follow-up of 4.1 person-years, of which most cases were blood transmission (85.5%) and married (71.2%). The male to female ratio was 1∶1.06 and the age at 10 years of ART was (51.2±8.7) years old. About 88.5% of HIV/AIDS patients received ART in village/township treatment institutions. Overall, there were 2 030 deaths during this period, among which 1 897 were due to AIDS-related diseases (93.5%) and the case fatality rate was 9.4% (1 897/20 256). Cox proportional risk regression model showed that participants aged 40-54, 55-69, and ≥70 years had a higher risk of death compared to those aged 25-39, with adjusted HRs (95% CI) of 1.57 (1.19-2.08), 3.78 (2.86-4.99), and 6.17 (4.33-8.79), respectively. Participants with the initial CD4 +T lymphocyte count about 200-349/μl and<200/μl had a higher risk of death compared to those with initial CD4 +T lymphocyte count ≥350/μl, with adjusted HRs (95% CI) of 1.81 (1.61-2.04) and 3.64 (3.20-4.15), respectively. Participants with the initial viral load outcome ≥1 000 copies/ml had a higher risk of death compared to those with the initial viral load outcome<1 000 copies/ml, with adjusted HRs (95% CI) of 1.73 (1.52-1.97). Participants receiving the second-line ART had a lower risk of death compared to those receiving the first-line ART, with adjusted HRs (95% CI) of 0.12 (0.11-0.14). Conclusion:From 2002 to 2020, the survival rate of HIV/AIDS treated with ART for more than 10 years is high in Henan Province. Age, CD4 +T lymphocyte count and viral load are influencing factors of HIV/AIDS survival.

ObjectiveTo analyze the changing trend of cerebrovascular disease burden in Minhang District of Shanghai from 1996 to 2021， and to provide scientific evidence for government to formulate targeted cerebrovascular disease prevention and control strategies. MethodsMortality， years of life lost（YLL）， years of lived with disability（YLD） and disability⁃adjusted life years（DALY） were used to evaluate the burden of cerebrovascular diseases in Minhang District. Joinpoint linear regression was used to analyze the trend of disease burden. ResultsFrom 1996 to 2021， the YLL rate of cerebrovascular diseases in Minhang District showed a downward trend （whole population： APC=-1.69%， t=-6.9， P<0.05）， The YLD rate of cerebrovascular diseases showed a slow upward trend （whole population： APC=1.17%， t=3.5， P<0.05）， The DALY rate of cerebrovascular diseases showed a downward trend， and fluctuated since 2003 （whole population： APC= -1.43%， t=-5.6， P<0.05）. The YLL rate of cerebrovascular diseases in men was higher than that in women， and the YLD rate of cerebrovascular diseases in women was higher than that in men. After 2014， the DALY of cerebrovascular diseases in men was higher than that in women. With the increase of age， the burden of cerebrovascular diseases increased， and the burden of disease increased significantly in the age group above 70. ConclusionThe burden of cerebrovascular diseases in Minhang District is at a high level， and there are differences in age， gender and other aspects. Measures such as screening， intervention and rehabilitation need to be improved to reduce disability and premature death caused by cerebrovascular diseases and to reduce the burden of cerebrovascular diseases on individuals， families and society.

Objective:To analyze the survival and influencing factors of HIV infections and AIDS cases (HIV/AIDS) aged 15 years and over who had received antiretroviral treatment (ART) for more than 10 years in Henan Province.Methods:In this retrospective cohort study, data of HIV infections and AIDS cases in Henan province were collected from the AIDS Prevention and Control System between January 1, 2002 and December 31, 2020. This study included 20 256 participants alive after 10-year ART with complete baseline and follow-up information, such as demographic characteristics, CD4 +T lymphocyte count and viral load. Cox proportional risk regression model was used to analyze influencing factors of HIV/AIDS survival. Results:A total of 20 256 participants were followed up for 82 738.2 person-years, with an average follow-up of 4.1 person-years, of which most cases were blood transmission (85.5%) and married (71.2%). The male to female ratio was 1∶1.06 and the age at 10 years of ART was (51.2±8.7) years old. About 88.5% of HIV/AIDS patients received ART in village/township treatment institutions. Overall, there were 2 030 deaths during this period, among which 1 897 were due to AIDS-related diseases (93.5%) and the case fatality rate was 9.4% (1 897/20 256). Cox proportional risk regression model showed that participants aged 40-54, 55-69, and ≥70 years had a higher risk of death compared to those aged 25-39, with adjusted HRs (95% CI) of 1.57 (1.19-2.08), 3.78 (2.86-4.99), and 6.17 (4.33-8.79), respectively. Participants with the initial CD4 +T lymphocyte count about 200-349/μl and<200/μl had a higher risk of death compared to those with initial CD4 +T lymphocyte count ≥350/μl, with adjusted HRs (95% CI) of 1.81 (1.61-2.04) and 3.64 (3.20-4.15), respectively. Participants with the initial viral load outcome ≥1 000 copies/ml had a higher risk of death compared to those with the initial viral load outcome<1 000 copies/ml, with adjusted HRs (95% CI) of 1.73 (1.52-1.97). Participants receiving the second-line ART had a lower risk of death compared to those receiving the first-line ART, with adjusted HRs (95% CI) of 0.12 (0.11-0.14). Conclusion:From 2002 to 2020, the survival rate of HIV/AIDS treated with ART for more than 10 years is high in Henan Province. Age, CD4 +T lymphocyte count and viral load are influencing factors of HIV/AIDS survival.