Objective Analyze the temporal trend of ischemic stroke(IS)mortality among the residents of Tengzhou City of Shandong Province during the period of hypertension control from 2013 to 2021.Methods On January 1,2013,Tengzhou City,Shandong Province,began its hypertension control program.The IS mortality rate was calculated using the mortality data from January 1,2013 to December 31,2021,and analyzed for its time trend among residents with different characteristics.The registered population was derived from the Public Security Bureau of Tengzhou City,Shandong Province,and the age and sex standardized mortality rate was calculated using the data of China's 7th population census in 2020.The Chi-square test was used to compare the differences in mortality rate,and Cochran-Armitage trend test was used to compare the time trend and age trend of mortality rate.Results The overall crude and standardized mortality rates of IS in Tengzhou showed a temporal trend from 2013 to 2021(Z values were 12.647,7.305,respectively;all P＜0.001),and decreased by 23.77％and 30.99％(Z values were-7.393,-9.975,respectively;all P＜0.001)respectively in 2021 compared with 2019.The crude mortality rate of IS in male increased by 13.27％in 2019 compared with 2017,while the crude and standardized mortality rate in female decreased by 16.39％and 19.49％in 2018 compared with 2017,respectively,with statistical significance(x2 values were 7.160,9.789,and 15.109,respectively;all P＜0.05).Except the crude mortality rates in 2013 and 2015,the crude mortality rates and standardized mortality rates for males in other years were all higher than those for females,with statistically significant differences(x2 values:25.816-124.040,all P＜0.001).The crude mortality rate for IS increased with age in all years(Z values:42.604-61.025,all P＜0.001).The proportion of IS deaths among those aged≥65 was 85.85％.The overall crude mortality rates of the age group of male 45-54 years old showed a temporal trend from 2013 to 2021(Z=3.035,P＜0.01),while females in the same age group did not show a temporal trend(P＞0.05).The IS mortality rate in urban areas decreased from 62.61 per 100 000 in 2013 to 54.00 per 100 000 in 2021(Z=-2.097,P＜0.05).The rural areas increased by 213.15％in 2019 compared with 2013 and decreased by 22.75％in 2021 compared with 2019(Z values were 19.074,-6.390,respectively;all P＜0.001).Conclusions The IS mortality rate in Tengzhou City showed a decreasing trend in urban areas from 2013 to 2021,and a decreasing trend in rural areas after 2019.Compared to females,there is a trend of younger mortality among males in the age range of 45-54.Males and rural IS patients should be given special attention.

Objective:To analyze the impact of hypertension prevention and control on the mortality rate of acute myocardial infarction (AMI) in Tengzhou City, Shandong Province from 2013 to 2021.Methods:This study was a cross-sectional study. The surveillance data of AMI deaths from January 1, 2013 (the time when hypertension prevention and control began in Tengzhou) to December 31, 2021 were collected in the coronary heart disease information management system, the mortality rate of AMI and its change trend were analyzed, and the distribution differences among residents with different characteristics were analyzed. The registered population information was obtained from Tengzhou Public Security Bureau, and the age and gender standardized mortality rate was calculated based on the data of the 7th national population census in 2020. The t test was used to compare the differences in blood pressure and laboratory items, chi-square test was used to compare the differences in mortality rate, and Cochran-Armitage trend test was used to compare the time trend and age trend of mortality rate, so as to analyze the impact of hypertension prevention and control on the mortality rate of AMI. Results:The overall crude and standardized AMI mortality rates in Tengzhou decreased from 50.87/100 000 and 63.82/100 000 to 41.08/100 000 and 38.70/100 000 from 2013 to 2021, respectively ( Z=-5.741, -10.884, both P<0.001), and double peaks were formed in 2014 and 2017. The first peak of crude and standardized mortality rate was formed in 2015 for males, which was 25.12% and 17.60% higher than that in 2013; and the first peak was formed in 2014 for females, which was 29.56% and 24.38% higher than that in 2013 ( χ2=13.200, 9.065, 14.862, 12.123) (all P<0.05). The second peaks of crude and standardized mortality were formed in 2017, with an increase of 18.17% and 17.17% for males and 25.73% and 22.34% for females from 2016 ( χ2=8.266, 9.182, 14.066, 11.105), the standardized mortality rate was 15.18%-29.01% higher in males than that in females ( χ2=6.239-19.326) (all P<0.05). The mortality rate of AMI increased with age ( Z=35.485-51.308) ( P<0.001). Compared with 2013, the mortality rate in males aged 55 to 64 years in 2015 increased by 64.29% from that in 2013, and that of females in 2017 increased by 108.48% from that in 2015; and that in females aged 35 to 44 years in 2016 increased by 373.51% from that in 2015 ( χ2=10.751, 12.805, 4.799); in 2021, the age group of male and female≥65 years decreased by 43.51% and 41.28% when compared with that in 2013, respectively ( Z=-7.333, -7.465) (all P<0.05). The mortality rate of AMI in urban areas decreased by 76.93% in 2021 when compared with that in 2016, and in rural areas it decreased by 30.28% than that in 2017. Both regions showed a downward trend ( Z=-7.560, -2.398) (both P<0.05). Conclusions:The mortality rate of AMI in Tengzhou City, Shandong Province from 2013 to 2021 shows a decreasing trend, and prevention and control of hypertension may be one of the reasons. The standardized mortality rate of males is higher than that of females, and the mortality rate decline rate in rural areas is lower than that in urban areas. The primary and secondary prevention of AMI in such populations should be strengthened.

Objective:To analyze the trends of coronary heart disease mortality in Tengzhou city of Shandong province from 2013 to 2021.Methods:The data of coronary heart disease (ICD-10: I20-I25) from January 2013 to December 2021 were obtained from the Chronic Disease Surveillance Information System-Coronary Heart Disease Management Module of Shandong province; the population data were provided by Tengzhou Public Security Bureau. The 95% confidence interval ( CI) of the rate was calculated using the binomial exact method. The age-standardized mortality rate (ASMR) was calculated based on 2020 National Population Census. The trends of mortality rate were analyzed using the Cochran-Armitage trend test. Results:During 2013 to 2021, there were 20 667 coronary heart disease deaths in Tengzhou city, with an average of 2 296 cases per year. The male-to-female ratio was 1.09∶1, and 80.98% (16 736/20 667) of the death cases were aged 65 years or older. The crude mortality rate and ASMR of coronary heart disease were 131.84/10 5 and 168.22/10 5 in 2013, respectively. The crude mortality rate increased by 13.67% from 2013 to 2021 ( P<0.001) with an average annual increase of 1.59%; while the ASMR decreased by 18.65% from 2013 to 2021 ( P<0.05) with an average annual decease of 2.34%. The crude mortality rate of coronary heart disease in men and women showed an upward trend, with the difference in the increase for women being statistically significant ( P<0.01); while the ASMR both in men and women showed a downward trend ( P<0.001). The crude death rates from 2013 to 2021 in age groups of 65 or older for men and women decreased by 22.40% and 19.73%, respectively (both P<0.001); while the crude death rate for age groups of 44 or younger in men showed an upward trend ( P<0.05). The crude death rate among urban residents decreased by 5.22% from 2013 to 2021 with an annual decrease of 0.67% ( P>0.05); while the crude death rate among rural residents increased by 19.29% with an annual increase of 2.18% ( P<0.001). The overall crude death rate among urban residents was higher than that among rural residents (all P<0.05). Conclusions:From 2013 to 2021, the crude mortality rate of coronary heart disease in Tengzhou city of Shandong province shows an increasing trend while the age-standardized mortality rate shows a decreasing trend. The crude mortality rate of coronary heart disease in people aged 65 and above shows a decreasing trend. In addition, the change trends are different between women and men, and between urban and rural areas.

The surveillance data of new cases of acute myocardial infarction (AMI) from January 1, 2013, to December 31, 2021, in Tengzhou City, Shandong Province, were used to analyze the incidence rate of AMI and its change trend among residents. The age and gender standardized incidence rate was calculated based on the 7th National Population Census 2020. The Cochran-Armitage trend test was used to analyze the trend of onset time and age. From 2013 to 2021, the crude and standardized incidence rate of total AMI in Tengzhou City declined from 130.07/100 000 and 161.12/100 000 to 76.15/100 000 and 72.77/100 000 ( Z=-13.785 and -20.822, both P<0.001). The crude and standardized incidence rates of males were higher than those of females. In 2016, males aged 45-54 years old and females aged 35-64 years old increased by 33.33%, 103.65%, 106.30%, and 95.75% compared to 2015, and the differences were statistically significant ( χ2=6.512, 4.965, 25.115, and 46.004, all P<0.05). The incidence rate of AMI in men aged<35 and 35-44 years old had an upward trend. From 2013 to 2021, the incidence rate of AMI decreased by 55.15% in urban areas and 36.59% in rural areas ( Z=-8.529 and -11.235, both P<0.001).

The surveillance data of new cases of acute myocardial infarction (AMI) from January 1, 2013, to December 31, 2021, in Tengzhou City, Shandong Province, were used to analyze the incidence rate of AMI and its change trend among residents. The age and gender standardized incidence rate was calculated based on the 7th National Population Census 2020. The Cochran-Armitage trend test was used to analyze the trend of onset time and age. From 2013 to 2021, the crude and standardized incidence rate of total AMI in Tengzhou City declined from 130.07/100 000 and 161.12/100 000 to 76.15/100 000 and 72.77/100 000 ( Z=-13.785 and -20.822, both P<0.001). The crude and standardized incidence rates of males were higher than those of females. In 2016, males aged 45-54 years old and females aged 35-64 years old increased by 33.33%, 103.65%, 106.30%, and 95.75% compared to 2015, and the differences were statistically significant ( χ2=6.512, 4.965, 25.115, and 46.004, all P<0.05). The incidence rate of AMI in men aged<35 and 35-44 years old had an upward trend. From 2013 to 2021, the incidence rate of AMI decreased by 55.15% in urban areas and 36.59% in rural areas ( Z=-8.529 and -11.235, both P<0.001).

Objective:To explore the causal associations of two blood pressure phenotype and four lipid fractions with type 2 diabetes mellitus(T2DM) in European and East Asian populations using Two-Sample Mendelian randomization analysis.Methods:Blood pressure phenotype, lipid fractions and T2DM genetic loci from two ethnics were matched and combined according to single nucleotide polymorphisms(SNPs) numbering. With SNPs closely related to the exposure phenotype as instrumental variables, the inverse variance weighting method was used to analyze the causal effects of blood pressure phenotype and lipid fractions on T2DM in different ethnic groups. The sensitivity analysis was conducted using MR-Egger regression model, Weighted Median method, MR-PRESSO, MR-robust Adjusted Profile Score, and leave-one-out method.Results:Among European populations, systolic blood pressure( OR=1.40, 95% CI 1.23-1.59, P<0.001) and diastolic blood pressure( OR =1.24, 95% CI 1.08-1.42, P=0.002)were associated with increased risk of T2DM while high density lipoprotein-cholesterol( OR=0.68, 95% CI 0.62-0.76, P<0.001) reduced the risk of T2DM. In East Asian ethnicity, elevated diastolic blood pressure( OR=0.75, 95% CI 0.59-0.95, P=0.007) reduced the risk of T2DM. Sensitivity analysis confirmed the results. Conclusion:There are differences in the effects of blood pressure phenotype and lipid composition on T2DM in different ethnic groups, which may be related to population heterogeneity and exposure sensitivity. It should be taken into consideration in extrapolation.

Objective:To analyze the changing trend of intracerebral hemorrhage (ICH) incidence among residents with different characteristics during 9 years of comprehensive hypertension prevention and control (hypertension prevention and control) in Tengzhou from 2013 to 2021.Methods:From January 1, 2013 to December 31, 2021, the new ICH cases collected by the Center for Disease Control and Prevention in Tengzhou City were analyzed to calculate the incidence of ICH, and the trend of its distribution was analyzed among residents with different ages, sexes, and between urban and rural areas. The registered population information came from Tengzhou Public Security Bureau. Age and sex standardized incidence was calculated based on the 7th National Population Census in 2020. The Cochran-Armitage test was used to analyze the time and age trends of the incidence.Results:The overall ICH crude and standardized incidence in Tengzhou City decreased from 97.30/100 000 to 52.13/100 000 ( Z=-9.93, P<0.001) and 119.30/100 000 to 50.69/100 000 ( Z=-15.40, P<0.001) from 2013 to 2021, and both elevated to form a single peak in 2020, with 22.58% ( χ 2=24.02, P<0.001) and 18.09% ( χ 2=17.08, P<0.001) higher than in 2019, respectively. The trends in male and female incidence over the same period were similar to the overall trends, and the incidence was higher in males than in females in all years. The incidence of ICH increased with age in all years. The difference of increase in male incidence rate in 2020 was statistically significant in three age groups ≥45 years compared with 2019 (36.29%, 23.57% and 16.18%, respectively, χ 2=6.73, 4.65, 4.00, P<0.001). The incidence of ICH decreased by 70.07% and 36.23% ( Z=18.44, 5.22, P<0.001) in urban and rural areas respectively from 2013 to 2021, whereas increased by 34.15% ( χ 2=10.88, P<0.01) and 22.08% ( χ 2=18.63, P<0.001) in 2020 compared with 2019 separately. Conclusions:The incidence of ICH in Tengzhou from 2013 to 2021 showed a significant downward trend, with the decrease in the incidence of ICH in women exceeding that in men. The decrease in the incidence of ICH in urban areas exceeded that in rural areas, and male morbidity seemingly had a younger trend.

Objective:To investigate the temporal trend of the mortality rate of intracerebral hemorrhage (ICH) among residents with different characteristics during the comprehensive prevention and control of hypertension in Tengzhou, Shandong Province from 2013 to 2021.Methods:Comprehensive prevention and control of hypertension was conducted in Tengzhou, Shandong Province from 2013 to 2021. ICH mortality rate was calculated from January 1, 2013 to December 31, 2021. ICH mortality monitoring data from Tengzhou, Shandong Province was used to analyze the temporal trend of ICH mortality among residents with different characteristics. The registered residence population came from the Public Security Bureau of Tengzhou, Shandong Province. The age and gender standardized mortality rate was calculated based on the data of China's seventh population census in 2020. The temporal and age trends of mortality were analyzed using Cochran Armitage Trend Tests.Results:From 2013 to 2021, the overall crude and standardized mortality rates of ICH in Tengzhou, Shandong Province decreased from 50.51/100 000 and 63.21/100 000 to 17.51/100 000 and 16.74/100 000, respectively ( Z=-11.013 and -15.426, P<0.001), with an average annual mortality rate decrease of 12.41% and 15.30%, respectively. The overall crude and standardized mortality rates in 2017 peaked compared to 2016, mainly due to an increase of 32.94% and 30.92% in male ICH crude and standardized mortality rates, respectively ( χ2=12.328 and 15.854, P<0.05). The mortality rate of ICH increased with age, and the decreasing trend over time became increasingly evident with age. The mortality rate of ICH in the ≥65 year old age group decreased by 77.94% over 9 years ( Z=-14.065, P<0.001). In 2017, the mortality rate of ICH in the male age group ≥65 years old and female 45-54 years old increased by 31.13% and 125.79% compared to 2016 respectively, there were statistically significant differences ( χ2=8.877 and 5.421, P<0.05). In 2021, the mortality rates of urban and rural ICH decreased by 93.22% and 46.40% compared to 2013, respectively ( Z=-13.279 and -5.393, P<0.001), with an average annual decrease of 28.56% and 7.50%, respectively. The ICH mortality rate in rural areas increased by 30.54% in 2017 compared to 2016 ( χ2=16.086, P<0.001); after 2018, the mortality rate of ICH began to be higher than that of urban areas ( χ2=33.400 and 67.305, P<0.001). Conclusions:The ICH mortality rate in Tengzhou, Shandong Province has shown a significant downward trend over time, with male mortality rate higher than female mortality rate and rural mortality rate higher than urban areas. This suggests that the key attention should be paid to both male and rural areas.

Objective To establish the norm of Sub-Health Measurement Scale for nurses in Shandong Province,so as to provide a basis for understanding the current situation of sub-health and provide a reference for promoting the health of nurses.Methods From December 2020 to February 2023,14,308 nurses from 23 public tertiary hospitals enrolled in the Nurse Health Cohort Study in Shandong Province were selected as participants by convenience sampling.The sub-health status was assessed by the Sub-Health Measurement Scale,and the sub-health norm of nurses was constructed by establishing the mean,percentile and demarcation norm.Results A total of 10669 nurses were included in the analysis.The total score of Sub-Health Measurement Scale of nurses in Shandong Province was(61.13±12.40),and the scores of physiological sub-health sub-scale,psychological sub-health sub-scale and social sub-health sub-scale were(58.35±11.86),(62.56±15.85)and(63.56±16.73),respectively.The mean norm of sub-health assessment scale was established by gender and age.Based on the results of univariate analysis,we selected the characteristics with differences,namely gender,age,marital status,working department,years of working,professional title and employment type to establish a classification norm.P5,P25,P50,P75 and P95 were select to establish percentile norm.Taking(x-s),(x-0.5s),(x+0.5s),(x+s)as the cut-off points,the demarcation norm of the Sub-Health Measurement Scale and sub-scales was established,which was divided into 5 categories,including disease,severe sub-health,moderate sub-health,mild sub-health and healthy states.Conclusion This study established the Sub-Health Measurement Scale norm of nurses,which provided a basis for effectively evaluating and identifying the sub-health status of nurses.

Objective:To analyze the characteristics of adverse events of active medical devices in Shandong province, as well as the impact of device use duration on the risk rate of adverse events, for reference in improving the monitoring system of active medical device adverse events in China and the level of hospital medical quality management.Methods:The data came from the adverse event reporting data of active medical devices collected by Shandong Adverse Drug Reaction Monitoring Center from January 2019 to October 2021. The R software was used to analyze the distribution, cause and severity of adverse events, and a linear regression model of adverse event risk rate(Y) and adverse event time point(X) was established.Results:A total of 35 254 adverse events of active devices were included, of which 3 059 were serious injuries. The province/municipality with the largest number of reported adverse events was Shanghai(8 006 cases), and the least was Hainan province(4 cases); The majority of adverse events were reported by hospitals, with 34 056(96.60%). The medical devices reporting a higher number of adverse events were ventilators(688 cases), monitors(4 623 cases), infusion pumps(1 079 cases), syringe infusion pumps(1 995 cases), medical electron accelerators(529 cases)and infant incubators(513 cases). In the linear regression model, the risk rate of adverse events increased with the useduration of the device when 0.00%≤ X<14.14%; the risk rate of adverse events decreased with the increase of service time when 14.14%≤ X<100.00%. Conclusions:The number of adverse events reported in each province is different, and hospitals are the main reporting units.The causes of adverse events of different medical devices indicate different correlation strengths with the product itself. The use duration of medical devices poses a great impact on the risk rate of adverse events.