BACKGROUND: Tracheal, bronchus, and lung cancer (TBL) is a major cause of mortality and top contributor to productivity loss in large emerging economies such as the BRICS (Brazil, Russia, India, China, and South Africa). We examined the time trends of TBL mortality across the BRICS to better understand the disease burden in these countries and inform public health and healthcare resource allocation. METHODS: TBL mortality-related data between 1990 and 2019 were obtained from the Global Burden of Disease Study 2019 and analyzed using age-period-cohort models. Net drift (local drift) was used to describe the expected age-adjusted TBL mortality rate over time overall (each age group); the longitudinal age curve was used to reflect the age effect; the period rate ratios (RRs) were used to reflect the period effect; and the cohort RR was used to reflect the cohort effect. RESULTS: In 2019, there were 958.3 thousand TBL deaths across the BRICS, representing 46.9% of the global TBL deaths. From 1990 to 2019, the age-standardized mortality rate (ASMR) of TBL decreased in Russia, Brazil, and South Africa while increased in China and India, with the largest reduction reported in Russia (-29.6%) and the largest increase in China (+22.4%). India showed an overall increase (+15.7%) in TBL mortality but the mortality risk decreased among individuals born after 1990 (men) and 1995 (women). Although South Africa and Brazil experienced an overall decline in TBL mortality, their recent birth cohorts, such as Brazilian individuals born after 1985 (men) and 1980 (women), and South African men born after 1995, had an increasing TBL mortality risk. China has experienced an overall increase in TBL mortality, with the mortality risk rising among individuals born after 1995 for both men and women. Russia, which had the highest TBL mortality among the BRICS countries in 1990, has demonstrated significant improvement over the past three decades. CONCLUSIONS Over the past 30 years, the BRICS accounted for an increasing proportion of global TBL mortality. TBL mortality increased in older women in all the BRICS countries except Russia. Among the recent birth cohort, the risk of TBL mortality increased in Brazil, China, and South Africa. More effective efforts are needed in the BRICS to reduce the burden of TBL and help achieve the United Nation's Sustainable Development Goals.
Humans ; Lung Neoplasms/mortality* ; Male ; Female ; China/epidemiology* ; Middle Aged ; Global Burden of Disease ; Aged ; India/epidemiology* ; Adult ; South Africa/epidemiology* ; Cohort Studies ; Russia/epidemiology* ; Brazil/epidemiology* ; Tracheal Neoplasms/mortality* ; Bronchial Neoplasms/mortality* ; Adolescent ; Young Adult ; Aged, 80 and over ; Child

Objective By analyzing the clinical data from 88 infants or young children with allergic rhini-tis(AR),we explore the clinical characteristics of AR in those pediatric patients as well as the improvement in symptoms after drug treatment.Methods A retrospective analysis was conducted on 88 infants or young children initially diagnosed with AR who visited the pediatric respiratory clinic of the first affiliated hospital of Guangzhou medical university from February 1,2020 to August 1,2020.Telephone follow-ups were conducted from 6 to 12 months after the first visit.Based on the follow-up results,we summarized the clinical characteristics,complications,and efficacy of therapies of AR in infants and young children.Results Among 88 infants or young children aged 3 to 36 months with AR,34(38.6%)had mild AR and 54(61.4%)had moderate to severe AR.Runny nose and nasal congestion were the most common clinical symptom(87.5%,77/88),followed by sneezing(47.7%,42/88)and nasal itching(37.5%,33/88).Coughing(56.8%,50/88)was the most common complications,followed by snoring(52.3%,46/88),wheezing(27.3%,24/88)and mouth breathing(12.5%,11/88).The top three positive rates of serum specific IgE testing were 53.4%(47/88)in milk,46.6%(41/88)in dust mites and 36.4%(32/88)in eggs.After 2 to 8 weeks of medication uses,the remission rate of rhinitis symptoms was significantly higher in mild AR than in moderate to severe AR[94.1%(32/34)vs.75.9%(41/54),χ2 = 4.883,P = 0.027].24.1%of patients with moderate to severe AR still had recurrent symptoms at follow-up visits,which was significantly higher than 5.9%in the mild AR group(χ2 = 4.883,P = 0.027).Conclusion The main symptoms of AR in infants and young children are runny nose and nasal congestion,and the main complications include cough and snoring.The main allergens are dust mites,milk,and eggs.The symptom relief rate is better in mild AR than in moderate to severe AR after treatment.The symptoms in moderate to severe AR are prone to relapse.

Objective:To explore the spatial distribution and clustering in birth defects from 2010 to 2013 in Shaanxi Province.Methods:Spatial distribution was used to describe the birth defects,while ordinary Kriging method was used to predict the status of birth defects in Shaanxi province.The spatial characteristics for the birth defects at the county/district level were analyzed by spatial autocorrelation.Results:The overall incidence of birth defects was 219.196/10 000;Birth defect did not appear to be a random distribution but show a significant spatial aggregation.Spatial interpolation predicted the geographic distribution for occurrence of birth defects in Shaanxi Province.Local autocorrelation analysis showed nine hot spot areas for birth defects,such as Qian County,Liquan County,Yongshou County,Bin County,Fufeng County,Jingyang County,Chunhua County,Wugong County and Xingping City,and seven cold spot areas including Jia County,Yuyang District,Mizhi County,Suide County,Wubu County,Qingjian County and Zizhou District.Conclusion:There are spatial clustering in birth defects from 2010 to 2013 in Shaanxi Province.Spatial interpolation and spatial autocorrelation can be used to predict the spatial features of birthdefects in the whole province and provide evidence for the further intervention.

Objective To analyze the temperature modification effect on emergency room visits for circulatory and respiratory diseases caused by air pollution,in Beijing,Methods Data on both circulatory and respiratory diseases in 2010 and 2011 were collected,Both meteorological and air pollutants related data were obtained from the National Scientific Data Sharing Platform for Population and Health.By using the stratified time-series models,we analyzed the effects of air pollution on emergency room visits for circulatory and respiratory diseases under different temperature zones,from 2010 to 2011,in Beijing.Results Low temperature (daily average temperature ＜-4.9 ℃) seemed to have obviously enhanced the effect of air pollution index (API) on emergency room visits for circulatory diseases,Under 10 units of API,the relative risks and confidence interval appeared as 1.067 (1.054-1.080).However,high (daily average temperature between 24.4 ℃ and 28.5 ℃) and extra-high temperature (daily average temperature ＞28.5 ℃) could enhance the effect of API on emergency room visits for respiratory diseases,Under 10 units of API,the relative risks and confidence interval were 1.021 (1.015-1.028) and 1.006 (1.003-1.008),respectively.Conclusion Temperature seemed to have modified the association between air pollution and both circulatory and respiratory diseases.

Objective To investigate the effect of folic acid supplementation in childbearing aged women during pregnancy on the birth weight of newborns in Shaanxi province.Methods A questionnaire survey was conducted among the childbearing aged women selected through multistage stratified random sampling in Shaanxi during 2010-2013,all of these childbearing aged women were in pregnancy or had definite pregnancy outcomes.The birth weight of newborns and folic acid supplementation during pregnancy were used as the dependent variables and independent variables respectively in multiple linear regression model and quantile regression model and confounding factors were controlled.Results Multiple linear regression analysis showed that the birth weight of newborns whose mothers had folic acid supplementation during pregnancy were significantly higher than those whose mothers had no folic acid supplementation during pregnancy,an average increase of 29.56 g (B=29.56,t=4.69 and P＜0.01).Quantile regression analysis showed from very low to higher percentiles (q=0-0.55,q=0.65,q=0.75-0.80),the birth weights of newborns whose mothers supplemented folic acid were higher than those whose mother did not supplement folic acid,the difference was significant,but the increase varied.As the increase of the percentiles of birth weight,the body weight increase declined gradually in those whose mothers had folic acid supplementation compared with those whose mothers had no folic acid supplementation.Conclusion Folic acid supplementation during pregnancy can increase the birth weight of newborns,the influence was greater in newborns with lower body weight than in newborns with higher body weight.

Objective To analyze the incidence and influencing factors on fetal macrosomia among single live birth neonates in Xi'an.Methods A questionnaire survey was conducted among women at the childbearing age who were selected through multi stage stratified random sampling in Xi'an during 2010-2013.All the childbearing aged women involved,were in pregnancy or having definite pregnancy outcomes.Results A total of 4 970 women at childbearing age and their infants were investigated.The overall incidence of fetal macrosomia weight among the single live birth neonates under study,was 9.7％ during 2010-2013 (8.9％ in 2010,8.1％ in 2011,10.0％ in 2012 and 10.1％ in 2013,respectively).The incidence rates of fetal macrosomia appeared 10.5％ in the central district and,8.6％ in the rural-urban area of Xi'an.There were statistically significant differences (P＜0.05) seen between the two areas.Results of logistic regression analysis suggested that factors as:having male newborn (OR=1.717,95％ CI:1.402-2.102),drinking during pregnancy (OR=2.174,95％ CI:1.042-4.533),gestational diabetes (OR=1.680,95％CI:1.100-2.568) gestational age≥42 (compared with 37-41,OR=2.565,95％CI:1.306-5.039),being multipara (OR=1.874,95％CI:1.492-2.354)were risk factors for the fetal macrosomia.Conclusion The incidence of fetal macrosomia in Xi'an was higher than the national figures.The incidence of fetal macrosomia was higher in the central district than in rural-urban area.Having male neonate,postmature birth,gestational diabetes,being multipara,drinking during pregnancy were the risk factors related to fetal macrosomia.

Objective To understand the incidence and epidemiological characteristics of adverse pregnancy outcome in Shaanxi province.Methods General information of the study was derived from the prevalence and risk factors of birth defects in Shaanxi province in 2010-2013.Descriptive epidemiological method was used to analyze the data of adverse pregnancy outcome.Results The overall incidence of adverse pregnancy outcome was 25.45％ during 2010-2013 (26.84％ in 2010,26.11％ in 2011,24.96％ in 2012 and 24.80％ in 2013,respectively).Fetal macrosomia and low birth weight accounted for 31.91％ and 23.42％,spontaneous abortion and premature delivery accounted for 18.94％ and 16.65％,while birth defects and embryo death in the palace accounted for 7.38％ and 1.70％,respectively.There were significant differences in distribution of adverse pregnancy outcome among different age groups (P＜0.001) and different years (P＜0.05).Age was positively associated with risk on adverse pregnancy outcomes (P＜0.001).The incidence of adverse pregnancy outcome were high in Liquan (37.49％),Wugong (35.50％) and Qianxian counties (35.13％).Conclusions The overall incidence of adverse pregnancy outcome was 25.45％ in Shaanxi.Fetal macrosomia,low birth weight and spontaneous abortion were the three major types of adverse pregnancy outcome,while age and area were related factors.Targeted strategies should be taken to reduce the incidence of adverse pregnancy outcome in Shaanxi.

Objective To compare the differences in the incidence of adverse pregnancy outcome in different area,and confirm if the incidence of adverse pregnancy outcomes is closely associated with air pollution.Methods A cross-sectional study was conducted in the central urban area and the rural-urban area of Xi'an through a questionnaire survey conducted among the local reproductive women selected through multistage stratified random sampling during 2010-2013,all the reproductive women surveyed were in pregnancy or had definite pregnancy outcomes.Results The annual average of SO2 concentration in the central urban area was 38-54 μg/m3,higher than that in the rural-urban area (29-43 μg/m3).The annual average NO2 concentration in the central urban area was 29-87 μg/m3,higher than that in the rural-urban area (22-42 μg/m3).The incidence of birth defects was higher in the central urban area than in the rural-urban area (2.1％ vs.1.0％),the difference was significant (P＜0.05).After adjusting for confounding factors,logistic regression analysis showed the incidence of birth defects in the central urban area was still significantly higher than that in the rural-urban area,the difference was significant (P＜0.05).Conclusion The incidence of adverse pregnancy was closely associated with the level of air pollution.

Objective To investigate effects of changes in body composition and pancreas islet β-cell function on bone mineral density(BMD)in obese women with normal glucose metabolism at child-bearing age.Methods Ninety-five obese women with normal blood glucose at child-bearing age were recruited for the study,20 in non-obese group with body mass index(BMI)less than 23,20 in overweightgroup with BMI equal to or more than 23 and less than 25.28 in obesity Ⅰ group with BMI equal to or more than 25 and less than 30.and 27 in obesity Ⅱ group with BMI equal to or more than 30.Their BMD,body fat and lean mass were measured with by dual energy X-ray absorptiometer(DEXA),and intravenous -glucose tolerance test(IVGTT)was performed.Area under the Curve of insulin(AUCins)and acute jnsulin response(AIR)phase were calculated to assess their early insulin secretion.Homeostasis model assessment β-cell function index(HOMA2-%B)and homeostasis model insulin resistance index(HOMA2-IR)were used to assess their β-cell function and insulin resistance.Results Fat and lean mass in the upper and lower extremities.trunk and whole body and BMD in those women increased with increasing of their BMI(P＜0.05),particularly in fat mass.as well as their otller parameters including plasma insulin level at zerominute of IVGTT(IVGTTins0),AUCins.HOMA2-%B and HOMA2.IR(all P＜0.01).BMD in the upper and lower extremities,trunk and whole body showed a positive correlation with BMI,FPG,lean mass and/or fat mass.respectively(P＜0.05).BMD of the trunk and whole body also had a positive correlation with TVGTTins0,AIR,AUCins and HOMA2-IR.respectively(P＜0.05).Results of multivariate linear regression analysis showed that HOMA2-%B and HOMA2-IR correlated with BMD in a linear pattern.As the vailable body composition was added to the regression model.HOMA2 parameters would be removed from the model.Results of partial correlation analysis showed that islet β-cell function did not correlate with BMD after controlling body composition factors.Conclusions Insulin resistance or islet β-cell function compensation accompanied in obese women with main increase in fat mass have little benefit for their BMD,which may reflect indirectly their change in body compositions.Body composition,especially lean nlass,is the most important determinants of BMD in obese women.

Objective To explore the relationship between body composition and β-cell function in obese females with normal glucose metabolism. Methods Seventy-five obese women with normal blood glucose and without family history of diabetes were investigated. They were assigned to 4 groups based on body mass index (BMI). Body fat content was measured by dual-energy X-ray absorptiometry (DEXA), and intravenous glucose tolerance test (IVGTT) was performed. The acute insulin response (AIR), the area under the curve (AUC) of insulin (AUCins) and homeostasis model assessment (HOMA) for β-cell function (HOMA2-% B) were calculated. Insulin resistance index(HOMA2-IR) and the ratio of AUCins to AUC of glucose (AUCins/AUCglu) were calculated to assess insulin resistance. Results Women with higher BMI appeared to have more total body fat content and trunk fat content. The similar distribution was also found in other parameters, including the plasma glucose levels at 0 and 10 min, AUCins, AIR, AUCins/AUCglu and the difference of insulin level between 0 and 10 min [INS (10-0)] during IVGTF. AUCins, AIR, AUCins/AUCglu and [INS (10-0)] were positively correlated with the age, BMI,total body fat content and trunk fat content. After adjustment of age, the trunk fat content was independently associated with the AIR in a good linear manner. Conclusion The obese females show change in body composition with more trunk fat content. They show significant insulin resistance with compensated elevation of insulin secretion. Body composition assessment is a valid and more accurate method than BMI and waist circumference in predicting early damaged β-cell function in obese patients.