BACKGROUND: In China, stroke burden remains severe as it is a major cause of mortality and disability. Detailed analyses across different subtypes will help optimize intervention strategies, enhance resource allocation efficiency, and ultimately reduce the overall disease burden. METHODS: We conducted a descriptive analysis of the incidence, prevalence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) of stroke and its subtypes using data (1990-2021) from the Global Burden of Disease (GBD) database. A Joinpoint regression model was applied to quantitatively analyze the indicators and calculate the annual percentage change (APC) and average annual percentage change (AAPC). We applied the Bayesian age-period-cohort (BAPC) model to project trends for 2022-2040. RESULTS: Incidence of stroke increased by 100.64% from 1990 to 2021, with ischemic stroke (IS) exhibiting the largest increase (201.13%) among all the subtypes, and the incidence being consistently higher in males than in females. The YLL/YLD ratio for stroke and its subtypes has decreased, with the YLL/YLD ratio falling from 20.13 to 9.48 in 1990-2021, indicating an increase in non-fatal burden. After adjusting for age, the age-standardized incidence rates (ASIRs) of stroke and its subtypes declined, except for IS. The age-standardized mortality rate (ASMR) for subarachnoid hemorrhage (SAH) decreased significantly (APC: -15.31%; 2000-2004), with the largest reduction in the age-standardized DALY rate (ASDR) also occurring during this period (APC: -14.22%). Furthermore, BAPC projections (2022-2040) indicate that stroke ASIRs in males will slightly decline but increase in females. Meanwhile, the ASIR of IS is expected to continue to rise. Overall, the ASMR and ASDR are projected to decline. CONCLUSIONS Although China has made some progress in stroke prevention and control, several challenges remain. Controlling IS must be prioritized, especially due to the high stroke burden among males.

Objective To analyze and compare the change of disease burden attributed to high temperature in the Chinese population in 2019 compared with 1990. Methods Based on the global burden of disease study data in 2019, the number of deaths, mortality, disability-adjusted life years (DALY) and DALY rate attributable to high temperature in Chinese population of different ages and genders in 1990 and 2019 were extracted to analyze the changing trend of disease burden attributable to high temperature exposure in Chinese population and its main causes. The Joinpoint regression model was used to analyze the trend of changes in standardized attributable DALY rates. Results Compared with 1990, the number of disease deaths attributable to high temperature in China in 2019 increased from 10 700 to 13 900, and the attributable DALY decreased from 532,200 to 276 100 person-years. The standardized mortality and DALY rates decreased by 35.25% and 65.20%, respectively. The burden attributable to high temperature was higher in males than in females, and the burden was relatively heavier in the population aged 70 and above. In 2019, chronic non-communicable diseases were the main cause of the attributable burden of high temperature exposure, and ischemic heart disease had the highest DALY burden, with an age-standardized DALY rate of 4.64/100 000. Conclusion The absolute death burden attributable to high temperature exposure in Chinese population is still increasing. It is necessary to pay more attention to high-risk groups such as men and the elderly, continue to strengthen environmental protection, and formulate relevant interventions in a targeted way to further reduce the disease burden caused by high temperature exposure.

Objective To evaluate the impact of particulate matter (PM) pollution on the hospitalization for respiratory diseases (RD), to estimate the avoidable economic loss by reducing the level of PM pollution, and to provide a basis for evaluating the cost-effectiveness of air pollution control. Methods The data of RD inpatients in two class-A tertiary hospitals in Wuhan from 2015 to 2019, PM concentration and meteorological data in Wuhan in the same period were collected. The generalized additive model (GAM) was used to estimate the impact of PM on the number of RD inpatients, and the cost of illness approach (COI) was used to estimate the avoidable economic loss caused by the reduction of PM concentration. Results PM pollution caused an increase in the number of RD inpatients. Each 10 g/m³ increase in PM_2.5 and PM₁₀ concentrations resulted in an increase of 1.71% and 0.71% in the number of RD inpatients, respectively. Among them, men and children aged 0-14 years were more affected. For every 10 g/m³ increase in PM_2.5 concentration, the number of hospitalized men and children aged 0-14 years increased by 1.97% and 2.65%, respectively. For every 10 g/m³ increase in PM₁₀ concentration, the number of hospitalized men and children aged 0-14 years increased by 0.87% and 0.88%, respectively. PM pollution caused 63 300 hospitalizations and 1.214 billion yuan of economic losses in 2015-2019,Wuhan. If the PM concentration is reduced to the recommended value of the World Health Organization in the same period, 194 million yuan of economic loss and 10100 hospitalizations could be avoided every year in Wuhan. Conclusion PM exposure can lead to heavy disease burden and economic loss. Taking effective measures to control PM concentration will bring great economic benefits.

Objective To retrospectively analyze the distribution and drug resistance of pathogenic bacteria in urinary tract infection in Xiangyang Central Hospital from 2017-2019, so as to provide a basis for clinical treatment of urinary tract infection and rational use of antibiotics. Methods The pathogenic bacteria isolated from clinical urine culture in Xiangyang Central Hospital from January 2017 to December 2019 were collected, and BD Phoenix^TM 100 was used for the identification of pathogens and antimicrobial sensitivity test. The WHONET 5.6 and GraphPad Prism 5.0 software were used for data analysis. Results A total of 3 056 strains of pathogens were isolated from 15 672 urine specimens (19.50%). Gram-negative bacteria accounted for 77.95%, of which E. coli was the most common (52.45%). Gram-positive bacteria accounted for 12.63%, including E. faecalis (4.80%) and E. faecium (4.80%). Fungi accounted for 9.50%. The clinical departments with the highest rates of urinary culture submission and positive detection were Urology (26.20%) and Endocrinology (41.90%), respectively. E. coli and K. pneumoniae had high resistance rates to piperacillin, compound trimethoprim, cefuroxime, ceftriaxone and cefazolin, all exceeding 50.00%, while P. aeruginosa was relatively sensitive to various antibiotics. The resistance rates of these three gram-negative bacteria to carbapenem antibiotics increased year by year. The isolated gram-positive cocci were mainly enterococcus faecalis and enterococcus faecalis. They were highly sensitive to linazolamide, vancomycin and teicoplanin, but the resistance rates to other types of antibiotics were quite different. The average detection rates of ESBLs-producing E. coli and K. pneumoniae were 52.90% and 59.00%, respectively. Conclusion The pathogens of urinary tract infections in Xiangyang Central Hospital from 2017 to 2019 are mainly gram-negative bacteria, and the resistance rate to carbapenem drugs is increasing year by year. The ESBLs-producing strains of E. coli and K. pneumoniae are highon should be strengthened in patients with high DOB value and smoking.

Objective To analyze the epidemic trends and risk factors of cardiovascular disease (CVD) burden in China from 1990 to 2019, based on the Global Burden of Disease (GBD) study 2019, by comparing with the world, the USA, Japan and India. Methods Data were obtained from the Global Health Data Exchange (GHDx) database, and the prevalence, incidence, mortality, disability adjusted life years (DALY) rate and main risk factors of CVD in China in 2019 were analyzed by gender and age. Age-standardized rates were used to compare the trends of CVD burden in the world and other four countries. Results In 2019, the number of CVD patients, incidences and deaths in China was 120.33 million, 12.34 million, and 4.58 million, respectively. The prevalence, morbidity, mortality and DALY rate increased from 4 235.43/100 000, 447.81/100 000, 204.75/100 000 and 5 091.03/100 000 in 1990 to 8 460.08/100 000, 867.65/100 000, 322.30/100 000, and 6 463.47/100 000 in 2019, respectively, all of which were increasing with age. The burden of CVD in males was higher than that in females. After eliminating the influence of population aging, the age-standardized mortality rate of CVD in China decreased from 381.21/100 000 in 1990 to 276.93/100 000 in 2019, and the age-standardized DALY rate decreased from 7 412.81/100 000 to 4 938.38/100 000. However, they were still slightly higher than those in the world and significantly higher than those in the USA and Japan. In addition, the leading four risk factors of CVD in China in 2019 were hypertension, dietary risks, air pollution and tobacco. A higher burden of CVD caused by all these factors in China were above the global average level. Conclusion Due to hypertension, dietary factors, air pollution, tobacco and other reasons, coupled with the rapid aging of the population, the burden of CVD in China is still very serious, and relevant departments need to pay more attention to it.

Objective:To evaluate the effect of combined teaching of optical laryngoscope and general laryngoscope on anesthesia undergraduate practice.Methods:A total of 40 anesthesia undergraduate students were randomly divided into group A (using the optical laryngocope only in the first month and the general laryngoscope only in the second month, n=20), and group B (using the general laryngocope only in the first month and the optical laryngoscope only in the second month, n=20). The teaching effect was evaluated through the first month and the second month of tracheal intubation assessment and questionnaire survey results. SPSS 23.0 was used for t test and chi-square test. Results:In the first month, the success rate was 90% in group A and 60% in group B, which showed that the success rate of group B was lower, with significant differences ( P < 0.05). The time for tracheal intubation in group A was (61.8±5.0) s, and that in the group B was (83.0±4.9) s, showing that the time of group B was longer, with significant differences ( P < 0.05). The complications in group A was 5%, and that in group B was 14%, showing that the group B had more cases of implications, with significant differences ( P < 0.05). In the second month, there was no significant difference in the one-time success rate, the time for tracheal intubation, and complications between the two groups ( P > 0.05). There was no significant difference in one-time success rate and complications between groups. Both groups showed that the time for general laryngoscope intubation was longer, with significant differences ( P < 0.05). All of the students believed that applying optical laryngoscope teaching was beneficial and could enhance the interest of learning, and the combination of the two methods was better. Conclusion:Using the optical laryngoscope first and then the general laryngoscope teaching is more beneficial for students to master the two methods of tracheal intubation, improve the success rate, reduce complications, and cultivates their self-confidence.

Objective Analyze the distribution and influencing factors of inpatients with extra-long hospital stay in Hubei Province. Methods Length of stay≥30 days was defined as the extra-long hospital stay, and logistic regression was used to determine the risk factors. Results There were 26 043 cases with extra-long hospital stay, which accounting for 2.88% of the total cases. Proportion of extra-long hospital stay was increased with age, the proportion of the group aged 65 and above was the highest (3.25%), and which were higher in males than that of females, the sex ratio was 1.58. Patients with extra-long hospital stay mainly had injury/poisoning and certain other consequences of external causes (16.88%), circulatory system disease (12.72%), neoplasms (11.23%), genitourinary system diseases (8.13%), mental and behavioral disorders (6.27%), and the proportion totaled up to 52.23%. Multivariate logistic regression analysis indicated that gender, age, type of disease, surgery or not and hospital grade were the influencing factors of extra-long hospital stay. Conclusions There are differences in the distribution of extra-long hospital stay in different individuals, diseases and medical treatment, targeted measures should be taken to shorten the length of stay.

Objective To analyze and forecast the epidemic of the new coronavirus pneumonia (COVID-19) in Hubei Province. Methods Exponential Smoothing Model was applied to fit the tendency of the number of confirmed cases, discharged cases, death cases, severe cases and critical cases. Results The epidemic of COVID-19 in Hubei province has been gradually alleviated, the rapid remission period and slow remission period were occurred after February 18th and March 21st, respectively. The Exponential Smoothing Model was significantly fit well and the fitting values were basically consistent with the actual values. Predicted results indicated that the number of existing confirmed cases was expected to reduce to less than 1 000 on April 2nd, and was mainly consist of severe and critical cases. Conclusions The prevention and control measures of COVID-19 in Hubei province were effective, and the Exponential Smoothing Model was applicable to predicate the epidemic of COVID-19.

PURPOSE: . The aim of this study was to evaluate the clinical performance and reliability of plasma sprayed nanostructured zirconia (NSZ) coating. MATERIALS AND METHODS: . This study consisted of three areas of analysis: (1) Mechanical property: surface roughness of NSZ coating and bond strength between NSZ coating and titanium specimens were measured, and the microstructure of bonding interface was also observed by scanning election microscope (SEM). (2) Biocompatibility: hemolysis tests, cell proliferation tests, and rat subcutaneous implant test were conducted to evaluate the biocompatibility of NSZ coating. (3) Mechanical compatibility: fracture and artificial aging tests were performed to measure the mechanical compatibility of NSZcoated titanium abutments. RESULTS: . In the mechanical study, 400 μm thick NSZ coatings had the highest bond strength (71.22 ± 1.02 MPa), and a compact transition layer could be observed. In addition, NSZ coating showed excellent biocompatibility in both hemolysis tests and cell proliferation tests. In subcutaneous implant test, NSZcoated plates showed similar inflammation elimination and fibrous tissue formation processes with that of titanium specimens. Regarding fatigue tests, all NSZ-coated abutments survived in the five-year fatigue test and showed sufficient fracture strength (407.65-663.7 N) for incisor teeth. CONCLUSION . In this study, the plasmasprayed NSZ-coated titanium abutments presented sufficient fracture strength and biocompatibility, and it was demonstrated that plasma spray was a reliable method to prepare high-quality zirconia coating.

Objective:To analyze the current situation for the mortality of Chinese female breast cancer and the trend of change in the past thirty years,and to provide scientific basis for prevention and control of breast cancer in China.Methods:The mortality data of breast cancer in Chinese female from 1987 to 2014 were collected,the trends of age-standardized rates and age-adjusted rates were described,and the variations via Joinpoint regression models were analyzed.Results:From 1987 to 2014,the mortality for the urban female breast cancer was greater than that for the rural females.There was a downward trend for urban women with an average decrease of 0.3％ for each year (P=0.06).While the average annual change for rural females showed an upward trend (AAPC=l.26％,P＜0.01).The gap between urban and rural females is narrowing gradually.The 40-59 age-adjusted rate for urban females decreased first and then it was increased with time moving forward.The mortality for rural females was continuously increased.Conclusion:From 1987 to 2014,the breast cancer mortality for urban females was overall higher than that for rural females.The mortality for rural females was continuously increased in the past years.The gap between urban and rural females is narrowing.We should pay specific attention to the prevention and treatment of breast cancer for the rural females.