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 analyze the status of protection facilities for key occupational disease hazards in Sichuan Province from 2020 to 2023. Methods Data on protection facilities for occupational disease hazard in enterprises in Sichuan Province from 2020 to 2023 were collected through the "Workplace Occupational Disease Hazard Monitoring System" within the "Occupational Disease Hazard Project Declaration System". A total of 13 081 enterprise reports involving occupational disease hazard factors were analyzed for the implementation of protection facilities for three key hazards: dust, chemical toxins, and noise. Results The overall installation rate of occupational hazard protection facilities among the 13 081 enterprise reports was 68.9%, with a compliance rate of 80.4%. Installation rates for protection facilities for the four occupational hazard factors including dust, organic toxicants, metallic toxicants, and noise were 81.0%, 79.9%, 57.0%, and 57.6%, with compliance rates of 81.9%, 82.1%, 78.7%, and 78.4%, respectively. Significant differences were observed in installation and compliance rates of these protection facilities among the four occupational hazard factors and across different industries (all P<0.01). Both the installation and compliance rates of protection facilities in enterprises improved in each year from 2021 to 2023 compared with 2020 (all P<0.05). Conclusion From 2021 to 2023, the installation and compliance rates of protection facilities for dust, toxic substances, and noise in enterprises in Sichuan Province showed some improvement compared with 2020. However, efforts to enhance engineering controls and protective measures should be strengthened for operations involving dust, metallic toxicants, and noise.

With the change of infectious disease incidence pattern and the development of related technologies, progresses have been made in the research of infectious disease epidemiology. In recent years, due to the change in the requirements of infectious disease prevention and control, the research focus has expanded from common infectious diseases to diseases which have been eliminated or might be eliminated, as well as emerging and re-emerging infectious diseases. Infectious disease data has been characterized by multiple sources and modalities. Along with the rapid development of pathogen detection methods, infectious disease surveillance has shifted from a single disease-targted one to a comprehensive one. Moreover, novel technologies such as multi-omics and artificial intelligence have been applied in infectious disease epidemiology research. The international cooperation in this field has become increasingly crucial, and the revision of the International Health Regulations and the negotiation of pandemic agreement will have a profound impact. In the future, infectious disease epidemiology research will develop with more powerful tools to improve its capabilities.

With the change of infectious disease incidence pattern and the development of related technologies, progresses have been made in the research of infectious disease epidemiology. In recent years, due to the change in the requirements of infectious disease prevention and control, the research focus has expanded from common infectious diseases to diseases which have been eliminated or might be eliminated, as well as emerging and re-emerging infectious diseases. Infectious disease data has been characterized by multiple sources and modalities. Along with the rapid development of pathogen detection methods, infectious disease surveillance has shifted from a single disease-targted one to a comprehensive one. Moreover, novel technologies such as multi-omics and artificial intelligence have been applied in infectious disease epidemiology research. The international cooperation in this field has become increasingly crucial, and the revision of the International Health Regulations and the negotiation of pandemic agreement will have a profound impact. In the future, infectious disease epidemiology research will develop with more powerful tools to improve its capabilities.

Objective To investigate preliminary clinical effects of three-dimensional(3D)printing combined with minimally invasive percutaneous plate osteosynthesis(MIPPO)in the treatment of anterior pelvic ring injuries.Methods Between December 2017 and July 2023,we treated 15 patients with anterior pelvic ring injuries by using 3D printing combined with MIPPO.Before surgery,a 3D model was printed to establish the actual structure,and a steel plate was pre-bent outside the body to simulate the surgery,as well as the design of number,direction,and length of screws.Then,the pre-bent internal fixation device was inserted through the bone membrane tunnel in the anterior pelvic ring,and the screws were fixed through both sides of the incision according to the preoperative planning.Results All the 15 patients underwent surgery successfully without complications such as nerve and vascular injury.The operation time was(162.9±63.1)min,the total length of incision was(13.5±2.2)cm,the number of fluoroscopic examinations during the surgery was(5.5±1.0)times,and the amount of blood loss was(456.7±272.5)ml.The fracture healing time was(17.5±1.8)weeks.The 15 patients were followed up for(15.2±3.9)months.The Majeed functional score increased significantly from(18.3±2.3)points before surgery to(86.3±6.0)points at 6 months postoperatively(t=-47.313,P=0.000).The fracture reduction according to the Matta standards showed excellent in 14 patients,fair in one patient,the excellent and good rate being 93.3％(14/15).Conclusion Combination of 3D printing and MIPPO treatment for anterior pelvic ring injuries can achieve good clinical effects.

Objective To comparatively observe the value of TIPS combined with catheter-directed thrombolysis and percutaneous transhepatic portal vein catheterization thrombolysis for acute non-cirrhotic non-neoplastic portal vein thrombosis(PVT).Methods Twenty-five patients with acute non-cirrhotic non-neoplastic PVT were retrospectively enrolled and clustered into TIPS group(n=17,underwent TIPS combined with catheter-directed thrombolysis)and liver puncture group(n=8,underwent percutaneous transhepatic portal vein catheterization thrombolysis)according to the access of thrombolysis.The technical success rate,duration of catheter-directed thrombolysis,complications within 7 days,as well as portal vein patency 3 months after treatment,Child-Pugh grading of liver function and occurrence of hepatic encephalopathy(HE)were recorded and compared between groups.Results The technical success rates were both 100%in 2 groups.There was no significant difference of the duration of catheter-directed thrombolysis between groups(P＞0.05).The thrombolytic effect in TIPS group was better than that in liver puncture group(P＜0.05).No significant difference of the occurrence of bleeding within 7 days was found between groups(P＞0.05).After 3 months'follow-up,the degree of portal vein patency in TIPS group was higher than that in liver puncture group(P＜0.05).No significant difference of Child-Pugh grading of liver function nor occurrence of HE was found between groups(both P＞0.05).Conclusion Both TIPS combined with catheter-directed thrombolysis and percutaneous transhepatic portal vein catheterization thrombolysis were effective for treating acute non-cirrhotic non-neoplastic PVT,and the thrombolytic effect of the former was better than the latter.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

Objective To investigate preliminary clinical effects of three-dimensional(3D)printing combined with minimally invasive percutaneous plate osteosynthesis(MIPPO)in the treatment of anterior pelvic ring injuries.Methods Between December 2017 and July 2023,we treated 15 patients with anterior pelvic ring injuries by using 3D printing combined with MIPPO.Before surgery,a 3D model was printed to establish the actual structure,and a steel plate was pre-bent outside the body to simulate the surgery,as well as the design of number,direction,and length of screws.Then,the pre-bent internal fixation device was inserted through the bone membrane tunnel in the anterior pelvic ring,and the screws were fixed through both sides of the incision according to the preoperative planning.Results All the 15 patients underwent surgery successfully without complications such as nerve and vascular injury.The operation time was(162.9±63.1)min,the total length of incision was(13.5±2.2)cm,the number of fluoroscopic examinations during the surgery was(5.5±1.0)times,and the amount of blood loss was(456.7±272.5)ml.The fracture healing time was(17.5±1.8)weeks.The 15 patients were followed up for(15.2±3.9)months.The Majeed functional score increased significantly from(18.3±2.3)points before surgery to(86.3±6.0)points at 6 months postoperatively(t=-47.313,P=0.000).The fracture reduction according to the Matta standards showed excellent in 14 patients,fair in one patient,the excellent and good rate being 93.3％(14/15).Conclusion Combination of 3D printing and MIPPO treatment for anterior pelvic ring injuries can achieve good clinical effects.

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

OBJECTIVES: This study aims to explore the clinical and pathological characteristics of congenital granular cell tumors and provide some references for clinical diagnosis, differential diagnosis, and treatment. METHODS: Nine ca-ses of congenital granular cell tumors who visited the Children's Hospital of Zhejiang University School of Medicine from February 2008 to March 2022 were retrospectively analyzed. Herein, its clinical characteristics, pathological characteristics, treatment, and prognosis were summarized and analyzed. RESULTS: We found that nine patients were all female, aged 1‑38 days when they saw the doctor. Three of them were attached in maxillary and the other six were attached in mandible. Meanwhile, six tumors were found during the mother's pregnancy at 28-39 weeks and three tumors were found at the baby's birth. One case was excised surgically under local anesthesia, and the other cases were excised surgically under general anesthesia. After 1 month to 12 years of follow-up, patients have no recurrence, however, two cases emerged new teeth from the tumor resection site. Histopathology of all excised lesions was congenital granular cell lesion. CONCLUSIONS Congenital granular cell tumor is a benign tumor and the prognosis is good. Therefore, surgical resection of the tumor can be done without extensive resection, and it generally does not relapse. Thus, ultrasonography during pregnancy is an important method for the early detection of congenital granular cell epulis.
Infant ; Child ; Pregnancy ; Humans ; Female ; Granular Cell Tumor/surgery* ; Retrospective Studies ; Neoplasm Recurrence, Local ; Anesthesia, General ; Diagnosis, Differential