Objective: To investigate the mortality and disease burden of diabetes in Hangzhou City from 2013 to 2021, so as to provide insights into improving diabetes prevention and control strategies. Methods: Data on morbidity and mortality of diabetes in Hangzhou City from 2013 to 2021 were collected through the Chronic Disease and Death Cause Monitoring System of Hangzhou Center for Disease Control and Prevention, and the crude and age-standardized mortality (standardized by the population of the Seventh National Population Census in China in 2020) were calculated. Data on the prevalence of diabetes were collected from the China Chronic Disease and Risk Factors Surveillance (CCDRFS), and the burden of disease was evaluated by calculating years of life lost (YLL), years lived with disability (YLD) and disability-adjusted years (DALY) with reference to the methodology of the Global Burden of Disease Study (GBD). The trends in mortality and disease burden of diabetes were evaluated with the average annual percent change (AAPC). Results: There were 8 686 deaths of diabetes in Hangzhou City from 2013 to 2021, with the average annual crude mortality of 13.17/105 and age-standardized mortality of 10.89/105. The crude mortality of diabetes showed a tendency towards a rise (AAPC=2.62%, P<0.05), while the trend in age-standardized mortality was not significant (P>0.05). The crude and age-standardized mortality of diabetes were higher in women than in men (14.11/105 vs. 12.21/105, 12.16/105 vs. 9.71/105; both P<0.05); however, the crude mortality in men increased more rapidly (men: AAPC=4.46%, P<0.05; women: AAPC=1.09%, P>0.05). The YLL, YLD and DALY of diabetes were 155.42, 1 246.73 and 1 402.15 thousand person-years, and the rates of YLL, YLD and DALY were 2.36, 18.90 and 21.25 person-years per thousand, respectively. The rates of YLL, YLD and DALY appeared a tendency towards a rise (AAPC=1.57%, 6.03% and 7.11%, all P<0.05). Higher rates of DALY and more remarkable increase were seen in men than in women (P<0.05; AAPC=8.37%, 5.54%, both P<0.05). Conclusions The mortality of diabetes in Hangzhou City from 2013 to 2021 is high, and the burden of disease, especially disability, is growing rapidly, with the burden of disease being more serious in men.

Objective    To evaluate the mid-term safety, efficacy and feasibility of perventricular device closure for subarterial ventricular septal defect. Methods    Clinical data of 97 patients diagnosed with subarterial ventricular septal defect through echocardiography in West China Hospital from September 2013 to December 2015 were retrospectively analyzed. There were 66 males and 31 females aged 3 (1.8, 5.9) years. All the patients underwent perventricular device closure under the guidance of transesophageal echocardiography using eccentric occlusion device. Possible complications such as residual shunt, valvular regurgitation, atrioventricular conduction block and arrhythmias were recorded during the 1-year, 3-year and 5-year follow-up. Results    All the patients received perventricular device closure successfully except that 1 patient underwent open surgical repair under cardiopulmonary bypass 3 months later because of the migration of device. So the rate of complete closure was 99.0%. No residual shunt, moderate or severe valvular regurgitation, atrioventricular conduction block or arrhythmias were observed 5 years later. Conclusion    Treating subarterial ventricular septal defect through perventricular device closure exhibits remarkable mid-term efficacy, safety and feasibility with high success rate.

Objective    To explore the mechanism of volume-related mitral regurgitation (MR) from the anatomy of mitral valve. Methods    A total of 32 patients with ventricular septal defect (VSD) combined MR meeting inclusion criteria in West China Hospital from September 2018 to November 2019 were enrolled in this study. The direction relative to the cardiac axis: the deviation of the MR bundle along the left atrial wall was eccentric, otherwises it was central. There were 23 patients of VSD and eccentric MR (EMR, a VSD-EMR group), including 10 males and 13 females aged 21 (10, 56) months, and 9 patients of VSD and central MR (CMR, a VSD-CMR group), including 4 males and 5 females aged 26 (12, 87) months. Besides, 9 healthy children were enrolled in a control group, including 4 males and 5 females aged 49 (15, 72) months. All patients underwent transthoracic echocardiography (TTE) examination at 2 weeks before surgery and 6 months after surgery, respectively, The MR degree, end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), antero-posterior diameter (AP), annulus circumference (AC), commissural diameter (CD) were assessed. Results    Before operation, EDV, ESV, SV, AP, AC and CD in the VSD-EMR and VSD-CMR groups were significantly larger or longer than those in the control group (P<0.05); after operation, EDV, ESV, SV, AP and CD decreased compared with those before operation (P<0.05), but there was no significant difference compared with the control group (P>0.05). Compared with the control group, AC was slightly decreased (P<0.05). There was no significant difference in EF between and within groups before and after operation (P>0.05). The improvement rate of MR was 78.9%(15/19) in the VSD-EMR group and 100.0% (9/9) in the VSD-CMR group. Conclusion    After unloading of volume, the valve structure is back to normal except AC. The improvement rate of MR in the VSD-EMR group is lower than that in the VSD-CMR group, which may indicate that the mechanism of VSD-EMR is more complicated.