OBJECTIVE:  To estimate the population attributable disease burden (PAD) of low bone mineral density (LBMD) related fractures (fragility fractures) among Chinese people over 50 years old from 1990 to 2023, using data from the Global Burden of Disease Study 2023 (GBD 2023), and to provide evidence for prevention strategies and health resource allocation. METHODS:   Based on the GBD 2023, the LBMD summary exposure values (SEV), fracture incidence, years lived with disability (YLDs), and LBMD-related falls YLDs of Chinese people over 50 years old from 1990 to 2023 were extracted. PAD was calculated with population attributable fraction (PAF), and an entropy-weight method was applied to evaluate the contribution of individual fracture sites. Temporal trends and sex differences were examined with Joinpoint regression. RESULTS:  From 1990 to 2023, the age-standardized SEV of LBMD in people over 50 years old showed an overall decline [average annual percent change (AAPC)=-0.564%]. Age-standardized fracture incidence, fracture YLDs rate, and LBMD-related falls YLDs rate all exhibited W-shaped upward trends (AAPC=1.045%, 0.296%, and 0.724%, respectively). PAF-based estimates indicated that LBMD-attributable fracture incidence likewise increased in a "W-shaped" manner (AAPC=0.558%), whereas the corresponding YLDs rate showed an overall W-shaped decline (AAPC=-0.193%). In international comparison, China and the global average displayed broadly concordant directions of change, with greater volatility in China and a progressive narrowing of the gap after 2015. Regarding sex differences, fracture YLDs rates were consistently higher in the males, whereas the other burden indicators were higher in the females; the temporal patterns were similar in both sexes. Entropy weight method identified hip fractures as contributing most to incidence (weight 0.133), and pelvic fractures as the largest contributor to YLDs rate (weight 0.115). CONCLUSION Since 1990, the LBMD attributable fracture burden in China's older population has risen, with female and hip or pelvic fractures bearing the heaviest load. Strengthened osteoporosis screening, improved insurance coverage, and targeted health education are urgently needed to curb further increases in disease burden.
Humans ; China/epidemiology* ; Middle Aged ; Female ; Male ; Bone Density ; Aged ; Incidence ; Osteoporotic Fractures/epidemiology* ; Aged, 80 and over ; Accidental Falls/statistics & numerical data* ; Cost of Illness ; Global Burden of Disease ; Osteoporosis/complications* ; Disability-Adjusted Life Years ; Fractures, Bone/epidemiology*

Objective:To investigate the clinical significance of intraoperative prepositioning of dual mediastinal drains in elderly patients developing anastomotic leakage(AL)after a total endoscopic Ivor-Lewis procedure.Methods:This retrospective case-control study analyzed the clinical data of 500 elderly patients who underwent total endoscopic Ivor-Lewis surgery for esophageal or cardia cancer from January 2020 to December 2022.In the control group, one mediastinal drainage tube was placed intraoperatively, while in the study group, two mediastinal drainage tubes were placed.Both groups had a chest tube placed conventionally.The study compared the incidence of anastomotic leak(AL)at 1 month postoperatively, inflammatory indexes in patients with AL, grading of AL, rate of nasal fistula placement, incision infection, anastomotic stenosis, and incidence of hoarseness.Additionally, it compared ICU occupancy, ventilator use, and ICU length of stay between the two groups.Results:The analysis included clinical data from 455 elderly patients.Among the patients who developed AL, the study group had significantly lower peak body temperature[(39.58±1.03)℃ vs.(38.05±0.56)℃, t=4.298, P<0.05], white blood cell count[(18.63±3.35)×10 9/L vs.(14.28±2.78)×10 9/L, t=3.450, P<0.05], and C-reactive protein(CRP)levels[(154.66±41.64)mg/L vs.(122.19±31.29)mg/L, t=2.131, P<0.05]. The study group also had a significantly lower grading of AL and rate of nasal fistula placement(82.4% vs.30.0%, P<0.05). In terms of ICU indicators, the study group had a significantly lower ICU admission rate(64.7% vs.10.0%, P<0.05), shorter period of ventilator use[(6.47±8.15)days vs.(0.90±2.23)days, t=2.62, P<0.05], and shorter ICU stay[(11.70±8.89)days vs.(4.70±6.27)days, t=2.184, P<0.05]. Conclusions:Double mediastinal drainage tubes, have been found to significantly alleviate inflammation, decrease the rate of nasal fistula placement and ICU admission, and shorten the length of ICU stay in elderly patients.Therefore, they are considered safe and deserving of clinical promotion.

The peroxisome proliferator-activated receptor gamma(peroxisome proliferator-activated receptor gamma,coactivator 1 beta,PPARGC1B)gene is an intranuclear receptor transcription fac-tor responsible for regulating the expression of target genes.To comprehend the characteristics and mutations of the PPARGC1B gene within the Sichuan yak population,the SNP loci of the PPARGC1B gene were identified through direct sequencing of PCR products.Additionally,the cod-ing region of the PPARGC1B gene was obtained via PCR amplification and sequencing.Bioinforma-tics analyses were conducted to predict protein-coding and mRNA secondary structure.This study identified four exon SNP mutation sites(E9-189A→C,E9-387G→A,E9-542C→T,and E9-554T→C)based on the single nucleotide polymorphism analysis of the PPARGC1B gene in Sichuan yaks.Notably,the E9-387G→A and E9-554T→C loci exhibited significant correlations with shear force and backfat thickness in Sichuan yaks.Subsequently,bioinformatics analysis of the four mutation sites revealed that the PPARGC1B protein is an acidic,unstable,non-transmembrane,and non-secretory hydrophilic protein with a coiled helix structure.It lacks a signal peptide and transmembrane region,predominantly functions in the nucleus,and features 106 phosphorylation sites,one glycosylation site,and one conserved RRM structure.The secondary structure comprises mainly α-helix and random coils.Although the protein structure of the PPARGC1B gene remained unchanged post-mutation,there were significant differences in mRNA secondary structure.These findings suggest that the polymorphic loci of the PPARGC1B gene in Sichuan yaks could serve as a theoretical basis for enhancing meat quality traits through molecular biological methods,presen-ting practical applications in breeding.

Vaccination is an effective public health measure to prevent and control vaccine-preventable diseases for individual and society. However, China currently confronts significant challenges, including a dearth of skilled professionals in the field of vaccination and disparities in the capacity for immunization services. This review introduced the experiences of four prime international vaccinology education models, including London School of Hygiene & Tropical Medicine, Johns Hopkins University, Leading International Vaccinology Education, and the Bill & Melinda Gates Foundation, in the aspect of personnel development, academic research and communication platforms establishment. It is supposed to give some insights and feasible suggestions on the establishment and advancement of vaccinology as a sub-discipline within high-level public health school in China, with the aim of development of a robust vaccinology education framework in China, which is essential for nurturing the next generation of public health leaders and practitioners for our country.

Vaccination is an effective public health measure to prevent and control vaccine-preventable diseases for individual and society. However, China currently confronts significant challenges, including a dearth of skilled professionals in the field of vaccination and disparities in the capacity for immunization services. This review introduced the experiences of four prime international vaccinology education models, including London School of Hygiene & Tropical Medicine, Johns Hopkins University, Leading International Vaccinology Education, and the Bill & Melinda Gates Foundation, in the aspect of personnel development, academic research and communication platforms establishment. It is supposed to give some insights and feasible suggestions on the establishment and advancement of vaccinology as a sub-discipline within high-level public health school in China, with the aim of development of a robust vaccinology education framework in China, which is essential for nurturing the next generation of public health leaders and practitioners for our country.

Humans ; Cross-Sectional Studies ; SARS-CoV-2 ; COVID-19 Vaccines/therapeutic use* ; Pandemics ; COVID-19/prevention & control* ; China/epidemiology* ; Attitude ; Vaccination

BACKGROUND: World Health Organization recommends that influenza vaccines should benefit as much of the population as possible, especially where resources are limited. Corona virus disease 2019 (COVID-19) has become one of the greatest threats to health systems worldwide. The present study aimed to extend the evidence of the association between influenza vaccination and COVID-19 to promote the former. METHODS: In this systematic review, four electronic databases, including the Cochrane Library, PubMed, Embase, and Web of Science, were searched for related studies published up to May 2022. All odds ratios (ORs) with 95% confidence intervals (CIs) were pooled by meta-analysis. RESULTS: A total of 36 studies, encompassing 55,996,841 subjects, were included in this study. The meta-analysis for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection provided an OR of 0.80 (95% CI: 0.73-0.87). The statistically significant estimates for clinical outcomes were 0.83 (95% CI: 0.72-0.96) for intensive care unit admission, 0.69 (95% CI: 0.57-0.84) for ventilator support, and 0.69 (95% CI: 0.52-0.93) for fatal infection, while no effect seen in hospitalization with an OR of 0.87 (95% CI: 0.68-1.10). CONCLUSION: Influenza vaccination helps limit SARS-CoV-2 infection and severe outcomes, but further studies are needed. REGISTRATION PROSPERO, CRD42022333747.
Humans ; COVID-19/epidemiology* ; SARS-CoV-2 ; Influenza, Human ; Intensive Care Units ; Vaccination

Objective:To explore the epidemic situation and brucellosis in key occupational populations of brucellosis monitoring sites in Jiangsu Province, and provide a basis for development of prevention and control strategies against brucellosis.Methods:From 2013 to 2017, according to the requirements of the "National Brucella Surveillance Programme", two brucellosis monitoring sites in Yixing City of Wuxi and Huaiyin District of Huai'an, Jiangsu Province were established to monitor brucellosis. Brucellosis epidemic data were collected and analyzed of the two monitoring sites in Yixing City and Huaiyin District from 2013 to 2017 (data were from Jiangsu Provincial Legal Infectious Disease Reporting System). Blood samples were collected from the general occupational populations (health check-up population) and the key occupational populations (people engaged in livestock trading, livestock slaughtering, and the fur, milk and meat processing) in the monitoring sites. Tiger red plate agglutination test (RBPT) and serum tube agglutination test (SAT) were used for serological examination. Results:From 2013 to 2017, a total of 18 cases of brucellosis were reported at the two monitoring sites in Yixing City and Huaiyin District, Jiangsu Province, including 13 males and 5 females, with a male to female sex ratio of 2.6∶1.0; the age of onset was mainly 35 - 64 years, accounting for 72.22% (13/18); the time of onset was mainly from January to June, accounting for 94.44% (17/18); and the occupational distribution was mainly farmers, accounting for 77.78% (14/18); there was no epidemic and outbreaks of brucellosis. A general occupational populations survey was conducted in 17 743 cases, serological tests were negative, no infection and no signs and symptoms were found in the two monitoring sites. In 2013 - 2017, a total of 113 cases of serological tests were positive in the key occupational populations of brucellosis in Jiangsu Province, with a positive rate of 7.83% (113/1 444), and the overall trend was downward year by year ( t = 6.463, P < 0.05). Among them, the positive rates in Yixing City and Huaiyin District were 11.79% (106/899) and 1.28% (7/545), respectively. The difference between different regions was statistically significant (χ 2 = 51.926, P < 0.01). The positive rates of occupational groups engaged in livestock trading, livestock slaughtering, and the fur, milk and meat processing were 5.10% (20/392), 9.74% (49/503), and 8.01% (44/549), respectively. The differences were statistically significant between different occupations (χ 2 = 6.618, P < 0.05); and the positive rates of livestock slaughtering occupations and the fur, milk and meat processing occupations were higher than that of livestock trading occupations ( P < 0.05). Conclusions:The positive rate of brucellosis in key occupational populations has showed a general downward trend, the livestock slaughtering occupations and the fur, milk and meat processing occupations are more susceptible to Brucella infection. It is still necessary to strengthen the health education for the key occupational populations of brucellosis and inspection and quarantine work for prevention of the epidemic of brucellosis in humans.

Objective To investigate the effects of the number of harvested lymph nodes in neoadjuvant chemoradiotherapy (nCRT) combined with surgery on prognosis of middle-low rectal cancer.Methods The retrospective case-control study was conducted.The clinicopathological data of 373 patients with middle-low rectal cancer who underwent nCRT combined with surgery in the Fujian Medical University Union Hospital from January 2009 to December 2013 were collected.There were 241 males and 132 females,aged from 26 to 81 years,with the age of (55 ± 11) years.Observation indicators:(1) treatment situations;(2) follow-up and survival;(3)influencing factors for the number of harvested lymph nodes;(4) prognostic analysis of the different number of harvested lymph nodes as cut-off for grouping;(5) stratified analysis.Follow-up using telephone interview and outpatient examination was performed to detect postoperative survival of patients once every three months within postoperative 2 years and once every 6 months during the postoperative third year up to March 2016.The endpoint of follow-up was tumor recurrence,retastasis or death.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was done using the independent sample t test.Measurement data with skewed distribution were represented as M (range),and comparison between groups was done using the Kruska1-Wallis H test.Count data was described as absolute numbers.Univariate and multivariate analyses were done by the multiple linear regression model.Survival rate was calculated by the Kaplan-Meier method,and Logrank test was used for survival analysis.Results (l) Treatment situations:373 patients underwent nCRT combined with surgery,including 329 combined with sphincter-sparing rectal resection and 44 combined with abdominoperineal rectal resection.The number of harvested lymph nodes was 12 ± 6 in 373 patients.There were 185 patients with the number of harvested lymph nodes ＜ 12 and 188 with the number of harvested lymph nodes ≥ 12.(2) Follow-up and survival:373 patients were followed up for 5-77 months,with a median follow-up time of 43 months.During the follow-up,the 1-,3-,5-year disease-free survival rates were respectively 90.4％,76.3％,and 67.5％ in the 373 patients.(3) Influencing factors for the number of harvested lymph nodes:univariate analysis showed that distance between the tumor and anal verge,tumor diameter,tumor pathological N staging,and regression grade of rectal cancer were associated factors for the number of harvested lymph nodes (t =3.156,2.992,x2=8.183,10.839,P＜0.05).Multivariate analysis showed that distance between the tumor and anal verge,regression grade of rectal cancer,and tumor pathological N staging were independent factors for the number of harvested lymph nodes (t=3.308,2.690,2.584,95％ confidence interval:0.808-3.180,0.446-2.873,0.332-2.448,P＜0.05).(4) Prognostic analysis of the different number of harvested lymph nodes as cut-off for grouping:with the number of harvested lymph nodes of 6,7,8,9,10,11,12,13,14,15,and 16 as cut-off for grouping,there was no significant difference in the 3-year disease-free survival rate,cumulative local recurrence rate,and cumulative distant metastasis rate between ＜6 group and ≥6 group,between ＜7 group and ≥7 group,between＜8 group and ≥8 group,between ＜9 group and ≥9 group,between ＜10 group and ≥ 10 group,between ＜11 group and ≥ll group,between ＜12 group and ≥12 group,between ＜13 group and ≥13 group,between ＜ 14 group and ≥ 14 group,between ＜ 15 group and ≥ 15 group,between ＜ 16 group and ≥ 16 group,respectively (P＞0.05).(5) Stratified analysis:with the number of harvested lymph nodes of 7,8,9,and 10 as cut-off for grouping in 45 of 373 patients with Ⅱ-Ⅲ regression grade of rectal cancer and negative lymph nodes (NO staging),there was no significant difference in the 3-year disease-free survival rate between ＜7 group and ≥ 7group,between ＜8 group and ≥8 group,between ＜9 group and ≥9 group,between＜10 group and ≥ 10 group,respetively (x2 =3.946,5.346,6.375,4.297,P＜0.05).Conclusions The number of lymph nodes as 12 is not the independent factor for prognosis of patients with middle-low rectal cancer after nCRT combined with surgery.The number of harvested lymph nodes as 7 to 10 is the important factor for evaluating the prognosis of middle-low rectal cancer patients with Ⅱ-Ⅲ regression grade of rectal cancer and negative lymph nodes after nCRT combined with surgery.