1.Trend in disease burden of gastric cancer in Wenzhou City from 2014 to 2023
WU Lihao ; YE Zhenmiao ; LIN Dewei ; CHEN Haidong
Journal of Preventive Medicine 2025;37(7):677-681
Objective:
To investigate the trend of gastric cancer disease burden in Wenzhou City, Zhijiang Province from 2014 to 2023, so as to providing evidence for prevention and control strategies.
Methods:
Data on incidence and mortality of gastric cancer among household registered residents in Wenzhou City from 2014 to 2023 were collected through the Wenzhou Chronic Disease Monitoring and Management Information System, and the crude incidence and crude mortality were calculated. The disease burden of gastric cancer was evaluated by calculating years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) using the World Health Organization's disease burden methodology. Trends in YLL rate, YLD rate and DALY rate of gastric cancer from 2014 to 2023 were analyzed using the average annual percent change (AAPC).
Results:
A total of 28 122 cases of gastric cancer and 17 080 deaths were reported in Wenzhou City from 2014 to 2023. The crude incidence and crude mortality were 34.13/105 and 20.73/105, respectively. The YYL, YLD and DALY caused by gastric cancer were 181 816.78, 53 198.41, and 235 015.198 person-years, and the YLL rate, YLD rate and DALY rate were 2.21, 0.64 and 2.85 person-years per 1 000 people, respectively. The YLL rate and DALY rate showed a downward trend (AAPC=-4.608% and -2.552%,both P<0.05), while the YLD rate showed an upward trend (AAPC=4.657%, P<0.05). The DALY rate of gastric cancer in men was 3.82 person-years per 1 000 people, and that in women was 1.83 person-years per 1 000 people, with a downward trend (AAPC=-2.924% and -1.647%, both P<0.05). The DALY rate of gastric cancer was relatively low in the 15 to <45 years age group, increased starting from the age of 45 years, and peaked in the ≥70 years age group, reaching 14.09 person-years per 1 000 peoples. The DALY rate of gastric cancer among residents aged 15 to <45 years, 45 to <70 years and ≥70 years showed a downward trend (AAPC=-3.626%, -5.450% and -4.404%, all P<0.05).
Conclusions
From 2014 to 2023, the DALY rate of gastric cancer in Wenzhou City demonstrated a sustained decline, primarily driven by a the loss of life years due to premature death. Males and older people continue had a heavier disease burden. It is recommended to implement targeted prevention and control measures to reduce the disease burden of gastric canceron among residents.
2.Flap combined with 3D printed microporous tianium(tantalum)prosthesis in the treatment of lower extremity soft tissue defect with large bone defect
Yongqing XU ; Xinyu FAN ; Teng WANG ; Shaoquan PU ; Chuan LI ; Xingbo CAI ; Yi CUI ; Xiaoqing HE ; Wei LIN ; Yipeng WU ; Jian SHI ; Xia LI ; Dewei ZHAO ; Baoyi LIU ; Qiang FENG
Chinese Journal of Microsurgery 2022;45(1):21-27
Objective:To investigate the effect of flap combined with 3D printed microporous titanium(tantalum)prosthesis in the treatment of lower extremity soft tissue defect with large bone defect.Methods:From January 2019 to December 2020, 2 patients with large soft tissue defects on dorsal foot together with large metatarsal bone defect and 4 patients with soft tissue defects of calf with large tibial bone defect were treated. The areas of soft tissue defect were 5.0 cm×8.0 cm-15.0 cm×10.0 cm. The length of the bone defect were 3.8 cm to 7.0 cm, 5.75 cm in average. In the first stage, metatarsal bone defect or tibial bone defect was filled with vancomycin blended bone cement, meanwhile, soft tissue defect was repaired with anterolateral femoral flap(ALTF) with vascular anastomosis in 2 cases of feet, and local fascia flap was trans-positioned in 4 cases of lower extremity defects. The sizes of repairing flap were 6.0 cm×8.5 cm-16.0 cm×11.0 cm. Two to 7 months after the initial surgery, the customer designed microporous titanium prostheses were used(5 cases with microporous titanium and 1 with microporous tantalum) to repair the bone defects. The wound healing, the integration of metatarsal and tibial fractures with 3D printed microporous titanium(tantalum) prostheses, and the walking condition were observed after surgery. The follow-up lasted from 6 to 25 months, with an average of 12.7 months.Results:The wound healing in 5 patients was good. The patients stood on the foot in 2 months after surgery, started to walk with the assistance of crutch in 3 months after surgery, and took walk without assistance in 5-6 months after surgery. Good osseous integration were achieved. One diabetic patient had infection of foot wound 3 months after surgery. After removal of microporous titanium prosthesis and replacement of vancomycin blended interstitial substance of bone cement, the wound healed and the patient resumed walking.Conclusion:It is an effective method to encourage the patients to take early ambulation after the surgery for lower extremity soft tissue defect with large bone defect that was repaired by a flap and 3D printed microporous titanium(tantalum)prosthesis. Further observations are required to investigate the long-term efficacy, and the reduction of prosthesis infection rate requires further exploration.
3. Clinical research of target guided treatment of patients with severe heart failure under the guidance of pulse indicator continuous cardiac output
Wei WU ; Yimin XUE ; Fenghui LIN ; Dewei CHEN
Chinese Critical Care Medicine 2019;31(12):1535-1537
Objective:
To investigate the value of pulse indicator continuous cardiac output (PiCCO) monitoring in the treatment management of patients with severe heart failure.
Methods:
Sixty patients of severe heart failure admitted to intensive care unit (ICU) of Fujian Provincial Hospital from August 2017 to February 2019 were enrolled, and they were divided into control group and treatment group according to random number table method, with 30 in each group. The treatment group used bedside PiCCO to carry out minimally invasive hemodynamics monitoring, according to the monitoring data target guidance for vasoactive drugs and liquid management. The control group was based only on traditional electrocardiogram (ECG) monitoring and lung sound, urine volume of vasoactive drugs and liquid management. The changes of cardiac index (CI), global end diastolic volume index (GEDVI), extravascular lung water index (EVLWI), systemic vascular resistance index (SVRI), invasive mean arterial pressure (MAP) and central venous pressure (CVP) were observed before and 72 hours after treatment in the treatment group. The 7-day total effective rate, the length of ICU stay and 28-day mortality were compared between the two groups.
Results:
Compared with before treatment, CI and MAP in the treatment group were significantly increased after treatment [CI (mL·s-1·m-2): 53.34±16.67 vs. 35.01±13.34, MAP (mmHg, 1 mmHg = 0.133 kPa): 72.6±10.6 vs. 62.5±10.3, both
4. A clinical study of the evaluation of hemodynamic status in mechanically ventilated critically ill patients by continuous non-invasive arterial pressure monitor
Yimin XUE ; Wei WU ; Mingguang CHEN ; Qian CHEN ; Dewei CHEN ; Fenghui LIN
Chinese Critical Care Medicine 2019;31(10):1231-1235
Objective:
To evaluate the difference and correlation between continuous non-invasive arterial pressure (CNAP) monitor and pulse indicated continuous cardiac output (PiCCO) monitor on determination of hemodynamic parameters in mechanically ventilated critically ill patients, and to assess the feasibility of non-invasive monitoring of hemodynamics with CNAP.
Methods:
A prospective observation self-control study was conducted.The critically ill patients with mechanical ventilation who needed hemodynamics monitoring, and admitted to the fourth department of intensive care unit (ICU) of Fujian Provincial Hospital from June 2018 to March 2019 were enrolled. PiCCO catheter were inserted immediately after admission, the hemodynamic indexes were measured by thermodilution method, and mean arterial pressure (MAPPiCCO), cardiac index (CIPiCCO), pulse pressure variation rate (PPVPiCCO) and systemic vascular resistance index (SVRIPiCCO) were obtained at 0 hour and 24 hours respectively. Meanwhile, the above indexes (MAPCNAP, CICNAP, PPVCNAP and SVRICNAP) were measured with CNAP. All measurements were repeated thrice and average values were reported. The differences in above parameters between the two methods were evaluated. Pearson test was used for the correlation analysis and Bland-Altman analysis method was used for consistency test.
Results:
Thirty-eight patients were enrolled into this study. One patient died within 24 hours was excluded, 2 patients were excluded due to withdrawing treatment within 24 hours, 2 patients were excluded because of atrial fibrillation, and 1 patient's data was lost due to technical problems. Thus, data from 32 patients were available for final analysis. There were 12 females and 20 males, aging 26-84 years old with the mean of (66.8±19.1) years old, body mass index (BMI) of (23.7±3.9) kg/m2, acute physiology and chronic health evaluationⅡ (APACHEⅡ) score of 19.5±5.3, sepsis-related organ failure assessment (SOFA) score of 9.7±4.1. There were no significant differences in CI or PPV between CNAP and PiCCO groups [CI (mL·s-1·m-2): 59.8±12.6 vs. 58.5±14.2, PPV: (14.7±6.8)% vs. (14.0±6.8)%, both
5.A clinical study of the evaluation of hemodynamic status in mechanically ventilated critically ill patients by continuous non-invasive arterial pressure monitor.
Yimin XUE ; Wei WU ; Mingguang CHEN ; Qian CHEN ; Dewei CHEN ; Fenghui LIN
Chinese Critical Care Medicine 2019;31(10):1231-1235
OBJECTIVE:
To evaluate the difference and correlation between continuous non-invasive arterial pressure (CNAP) monitor and pulse indicated continuous cardiac output (PiCCO) monitor on determination of hemodynamic parameters in mechanically ventilated critically ill patients, and to assess the feasibility of non-invasive monitoring of hemodynamics with CNAP.
METHODS:
A prospective observation self-control study was conducted.The critically ill patients with mechanical ventilation who needed hemodynamics monitoring, and admitted to the fourth department of intensive care unit (ICU) of Fujian Provincial Hospital from June 2018 to March 2019 were enrolled. PiCCO catheter were inserted immediately after admission, the hemodynamic indexes were measured by thermodilution method, and mean arterial pressure (MAPPiCCO), cardiac index (CIPiCCO), pulse pressure variation rate (PPVPiCCO) and systemic vascular resistance index (SVRIPiCCO) were obtained at 0 hour and 24 hours respectively. Meanwhile, the above indexes (MAPCNAP, CICNAP, PPVCNAP and SVRICNAP) were measured with CNAP. All measurements were repeated thrice and average values were reported. The differences in above parameters between the two methods were evaluated. Pearson test was used for the correlation analysis and Bland-Altman analysis method was used for consistency test.
RESULTS:
Thirty-eight patients were enrolled into this study. One patient died within 24 hours was excluded, 2 patients were excluded due to withdrawing treatment within 24 hours, 2 patients were excluded because of atrial fibrillation, and 1 patient's data was lost due to technical problems. Thus, data from 32 patients were available for final analysis. There were 12 females and 20 males, aging 26-84 years old with the mean of (66.8±19.1) years old, body mass index (BMI) of (23.7±3.9) kg/m2, acute physiology and chronic health evaluation II (APACHE II) score of 19.5±5.3, sepsis-related organ failure assessment (SOFA) score of 9.7±4.1. There were no significant differences in CI or PPV between CNAP and PiCCO groups [CI (mL×s-1×m-2): 59.8±12.6 vs. 58.5±14.2, PPV: (14.7±6.8)% vs. (14.0±6.8)%, both P > 0.05]. MAP and SVRI measured by CNAP were significantly higher than those measured by PiCCO [MAP (mmHg, 1 mmHg = 0.133 kPa): 65.6±9.4 vs. 60.1±9.2, SVRI (kPa×s×L-1×m-2): 206.2±53.9 vs. 179.5±57.8, both P < 0.01]. The correlation analysis showed that MAP, CI, PPV and SVRI measured by the two methods were significantly positively correlated (r value was 0.624, 0.864, 0.835 and 0.655 respectively, all P < 0.05). Bland-Altman analysis showed that CNAP and PiCCO had a good consistency for the measurement of CI and PPV, the average differences were 1.2 mL×s-1×m-2 and 0.5% respectively, while the 95% confidence interval (95%CI) were -12.8-15.3 mL×s-1×m-2 and -7.1%-8.2% respectively. However, the consistency of MAP and SVRI measured by those two methods was poor, the average differences were 5.5 mmHg and 26.8 kPa×s×L-1×m-2 respectively, while the 95%CI was -10.4-21.3 mmHg and -64.5-118.0 kPa×s×L-1×m-2 respectively.
CONCLUSIONS
CNAP was comparable with PiCCO when monitoring CI and PPV in mechanically ventilated critically ill patients; while the results of MAP and SVRI might be inaccurate, which should be interpreted correctly and carefully.
Adult
;
Aged
;
Aged, 80 and over
;
Arterial Pressure
;
Cardiac Output
;
Critical Illness
;
Female
;
Hemodynamics
;
Humans
;
Male
;
Middle Aged
;
Prospective Studies
;
Respiration, Artificial
6.Clinical research of target guided treatment of patients with severe heart failure under the guidance of pulse indicator continuous cardiac output.
Wei WU ; Yimin XUE ; Fenghui LIN ; Dewei CHEN
Chinese Critical Care Medicine 2019;31(12):1535-1537
OBJECTIVE:
To investigate the value of pulse indicator continuous cardiac output (PiCCO) monitoring in the treatment management of patients with severe heart failure.
METHODS:
Sixty patients of severe heart failure admitted to intensive care unit (ICU) of Fujian Provincial Hospital from August 2017 to February 2019 were enrolled, and they were divided into control group and treatment group according to random number table method, with 30 in each group. The treatment group used bedside PiCCO to carry out minimally invasive hemodynamics monitoring, according to the monitoring data target guidance for vasoactive drugs and liquid management. The control group was based only on traditional electrocardiogram (ECG) monitoring and lung sound, urine volume of vasoactive drugs and liquid management. The changes of cardiac index (CI), global end diastolic volume index (GEDVI), extravascular lung water index (EVLWI), systemic vascular resistance index (SVRI), invasive mean arterial pressure (MAP) and central venous pressure (CVP) were observed before and 72 hours after treatment in the treatment group. The 7-day total effective rate, the length of ICU stay and 28-day mortality were compared between the two groups.
RESULTS:
Compared with before treatment, CI and MAP in the treatment group were significantly increased after treatment [CI (mL×s-1×m-2): 53.34±16.67 vs. 35.01±13.34, MAP (mmHg, 1 mmHg = 0.133 kPa): 72.6±10.6 vs. 62.5±10.3, both P < 0.05], GEDVI, EVLWI, SVRI, CVP were significantly decreased [GEDVI (mL/m2): 760.3±90.2 vs. 960.2±110.3, EVLWI (mL/kg): 6.5±1.3 vs. 12.5±6.2, SVRI (kPa×s×L-1×m-2): 297.3±35.1 vs. 434.1±58.8, CVP (mmHg): 10.1±2.6 vs. 12.2±3.4, all P < 0.05]. Compared with the control group, the 7-day total effective rate of the treatment group was significantly higher (90.0% vs. 80.0%), the length of ICU stay was significantly shorter (days: 8.2±4.5 vs. 10.3±2.5), and the 28-day mortality was significantly lower, with statistically significant difference (all P < 0.05).
CONCLUSIONS
PiCCO monitoring is a goal-oriented treatment management for patients with severe heart failure, which is helpful to individualized accurate treatment, shorten the length of ICU stay and improve short-term prognosis.
Cardiac Output
;
Extravascular Lung Water
;
Heart Failure/therapy*
;
Heart Rate
;
Hemodynamics
;
Humans
;
Prospective Studies
7.Effect of expressive writing intervention on social support, resilience and school maladjustment in university freshman
Ya WEN ; Bo LIAN ; Dewei ZHENG ; Yanyu WANG ; Nengzhi JIANG ; Hongwei SUN ; Lin SUN
Chinese Journal of Behavioral Medicine and Brain Science 2018;27(2):183-188
Objective To explore the effect of expressive writing intervention on social support,resilience and school maladjustment in university freshman.Methods Selecting the freshmen volunteer of 600 university freshmen of Shandong,through the scale before the test recovery and comprehensive scoring chosen the part of low grade college students as the intervention object and were divided into writing expression(n=60) person and control group(n=60).The intervention group received a positive subject writing expression and the control group in the normal writing.Before and after the intervention tested the social support rating scale,the resilience scale for Chinese adolescents and the the student adaptation to college questionnaire were tested to evaluate the effect of active writing expression intervention.Results (1)After intervention,the intervention group and the control group had significant differences among the scales,objective support (t =-2.36,P<0.05),learning adaptation(t=-1.98,P<0.05) and subjective support (t=-2.56,P<0.05),target focus(t=-2.66,P<0.01),emotional control(t=-2.81,P<0.01),family support (t=-3.46,P<0.01),adaptation (t=-2.73,P<0.01),support utilization (t=-5.91,P<0.01) and social support score (t =-4.04,P< 0.01),positive cognition (t=-2.73,P<0.01),interpersonal assistance (t=-3.13,P<0.01),resilience score (t=-7.40,P<0.01),life adaptation (t=-3.83,P< 0.01),emotional state (t =-3.39,P< 0.01),and school adaptation score (t=-3.46,P<0.01).(2)There was no significant difference in objective support between the control group before intervention and after intervention.In addition,the remaining dimensions such as subjective support (20.72±2.46,22.96±2.81,t=4.54,P<0.01),support utilization (7.49± 1.40,9.86± 1.90,t =7.56,P<0.01) and social support score (36.79±4.24,41.89±5.18,t=5.76,P<0.01) were significantly increased.The intervention group had significant difference among target focus (15.98±2.86,17.89±3.35,t=3.28,P<0.01),emotional control (14.98±2.77,15.70±2.71,t=3.35,P<0.01),positive cognition (14.61 ± 2.04,16.26±3.09,t=3.36,P<0.01),interpersonal assistance (15.30±2.44,17.49±2.73,t=4.52,P<0.01),resilience score(77.65±6.01,88.25±5.74,t=9.63,P<0.01) and family support(16.77±2.28,19.58± 2.44,t =6.35,P< 0.01).In the intervention group of school adaptation scale,life adaptation (40.44± 6.36,45.12± 7.21,t=3.68,P<0.01),emotional state (34.04±6.99,38.84±5.95,t=3.95,P<0.01) and school adaptation score (145.21 ±22.86,160.51±21.78,t=3.66,P<0.01),interpersonal assistance (32.30±5.34,35.23±5.18,t=2.98,P<0.01),learning adaptation (38.44±7.06,41.32± 5.92,t=2.36,P<0.05) were significantly increased.Conclusion Written expression intervention has a positive effect on improving the low level of social support,the poor resilience and freshman's adaptation to college.
8. Experience of wound treatment on extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident
Beiming SHOU ; Qian TAN ; Bingwei SUN ; Lanjun NIE ; Yuming SHEN ; Guozhong LYU ; Yi ZHANG ; Wei LIN ; Zhixue WANG ; Ye YU ; Yaohua ZHAO ; Dewei WANG ; Jian YAO ; Erfan XIE ; Dongfeng ZHENG ; Shichu XIAO ; Hongwei ZHANG ; Zhijian HONG ; Lei WANG ; Wenzhong XIE
Chinese Journal of Burns 2018;34(6):339-342
Objective:
To explore experience of wound treatment of extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident.
Methods:
On August 2nd, 2014, 98 extremely severe burn mass patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to 20 hospitals in China. The patients with complete medical record were enrolled in the study and divided into microskin graft group with 56 patients and Meek skin graft group with 42 patients. Split-thickness skin in area of residual skin were resected to repair wounds of patients in microskin graft group and Meek skin graft group by microskin grafting and Meek miniature skin grafting, respectively. The residual wound size on 28 days post injury and wound infection after skin grafting of patients in the two groups, and position of donor site of all patients were retrospectively analyzed. Data were processed with
9. The effect of microRNA-21 on myocardial fibrosis in mice with chronic viral myocarditis
Yimin XUE ; Mingguang CHEN ; Dewei CHEN ; Weifeng WU ; Yanli LIU ; Fenghui LIN
Chinese Journal of Cardiology 2018;46(6):450-457
Objective:
To explore the effect of microRNA-21 (miR-21) on myocardial fibrosis in mice with chronic viral myocarditis (CVMC) and related mechanisms.
Methods:
Forty 4-week-old Balb/c male mice were randomly divided into 4 groups (
10.The feasibility study of repairment of articular cartilage defects with bone marrow-derived mesenchymal stem cells seeded on acellular amniotic membrane
Hao CHEN ; Zhijin ZHANG ; Dewei ZHAO ; Lin GUO
Chinese Journal of Microsurgery 2014;37(3):254-257
Objective To study the effect of repairment of articular cartilage defects in non weight-bearing area of rabbit with bone marrow-derived mesenchymal stem cells (BMSCs) seeded on human acellular amniotic membrane (HAAM).Methods From July 2012 to March 2013,bone marrow-derived mesenchymal stem cells were isolated and purified from rabbit in vitro.The cells were seeded on human acellular anniotic membrane at the concentration of 1.63 × l05/cm2.From 7 days to 8 days after cultured,the complexes of BMSC and HAAM were examined under electronmicroscope,light microscope and by HE stain.Full thickness empty defects measuring 4 mm in diameter by 3 mm depth were prepared in femoral intercondylar fossa of 24 rabbits.The rabbits were randomized into two groups:group A and group B with 12 each group.The defects of right knees were served as control and the left as experimental group.BMSCs/HAAM composite was cultured and then transplanted into the defect of left knee joint in group A as group BMSCs/HAAM and HAAM into group B as group HAAM.These rabbits were killed at 4 and 12 weeks after surgery in each group and the newly cartilage samples were evaluated grossly,histologically are graded.Results In the 4th and 12th week after the operation,the regenerated tissue were white,soft and smooth.Chondrocytes were found in the tissue In the 12th week,the morphology,distribution and arrangement of the regenerated tissues were similar to normal cartilage in the knees with HAAM-BMSCs transplantation.The regenerated tissues grew to be integrated with the surrounding normal cartilage with obscure boundary between them.Chondrocytes were found in all layer of the tissue,surrounding normal cartilage with obscure boundary between them.In the HAAM transplantation,the rough surface of regenerated tissue sunk obviously and the fibmblasts in all layer were found.While there were no regenerated tissue in the control side.Conclusion BMSCs seeded on HAAM could repair the articular cartilage defects of femoral intercondylar fossa from rabbits.


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