Objectives:To analyze the trends in the disease burden of ischemic heart disease(IHD)attributable to kidney dysfunction globally and in China from 1990 to 2021,and to project the trend changes up to 2040.Methods:Based on the Global Burden of Disease Study 2021,the deaths and disability adjusted life years(DALY)of IHD attributable to kidney dysfunction,along with their corresponding age standardized rates were visualized and estimated annual percentage change(EAPC)were calculated.Spearman's rank correlation was employed to evaluate the correlation between the Socio-demographic Index(SDI)and disease burden indicators(age standardized death rate/DALY rate).Decomposition analysis based on the population-aging-epidemiology decomposition method was used to analyze related driving factors,and a Bayesian age-period-cohort model was applied to project future trends.Results:From 1990 to 2021,the age standardized death rates and DALY rates of IHD attributable to kidney dysfunction showed a decreasing trend globally.The EAPC of age standardized death rate was-1.45%(95%CI:-1.49%to-1.42%),and the EAPC of age standardized DALY rate was-1.29%(95%CI:-1.34%to-1.25%).In China,the age standardized death rates and DALY rates of IHD attributable to kidney dysfunction showed an upward trend from 1990 to 2021.The EAPC of age standardized death rate was 0.86%(95%CI:0.40%to 1.32%),and the EAPC of age standardized DALY rate was 0.45%(95%CI:0.06%to 0.84%).Compared with 1990,although the age standardized death rates and DALY rates of Chinese males and females showed an upward trend in 2021,but their age standardized death rates and DALY rates reached the peak in 2005 and then decreased year by year.The age standardized death rates and DALY rates of males were always higher than those of females globally and in China.The death rates and DALY rates of males and females increased gradually with age globally.The number of male deaths peaked at the age of 75-84,and the number of female deaths peaked at the age of 85-94;Male DALY peaked at the age of 65-74,and female DALY peaked at the age of 75-84.Similarly,the mortality rates and DALY rates of males and females in China also increased gradually with age.The number of deaths of males and females peaked at the age of 85-94;Male DALY peaked at the age of 65-74,and female DALY peaked at the age of 75-84.The growth of global mortality rates and DALY rates was mainly attributed to population growth and aging,while aging was the main driving factor in China.The global age standardized death rate(r=-0.169 4,P<0.000 1)and DALY rate(r=-0.278 4,P<0.000 1)were significantly negatively correlated with SDI.It is predicted that by 2040,the global and Chinese age standardized DALY rates would decrease to 543.71/100 000 and 333.64/100 000 respectively,and the age standardized DALY rate of males would continue to be higher than that of females.Conclusions:From 1990 to 2021,the age standardized death and DALY rates of IHD attributed to kidney dysfunction decreased significantly globally,while showed an upward trend in China.It is projected that by 2040,the disease burden of IHD attributable to kidney dysfunction would decline both globally and in China.In the future,interventions should focus on elderly populations and high-risk male groups to effectively control the disease burden of IHD attributable to kidney dysfunction.

Objectives:To analyze the trends in the disease burden of ischemic heart disease(IHD)attributable to kidney dysfunction globally and in China from 1990 to 2021,and to project the trend changes up to 2040.Methods:Based on the Global Burden of Disease Study 2021,the deaths and disability adjusted life years(DALY)of IHD attributable to kidney dysfunction,along with their corresponding age standardized rates were visualized and estimated annual percentage change(EAPC)were calculated.Spearman's rank correlation was employed to evaluate the correlation between the Socio-demographic Index(SDI)and disease burden indicators(age standardized death rate/DALY rate).Decomposition analysis based on the population-aging-epidemiology decomposition method was used to analyze related driving factors,and a Bayesian age-period-cohort model was applied to project future trends.Results:From 1990 to 2021,the age standardized death rates and DALY rates of IHD attributable to kidney dysfunction showed a decreasing trend globally.The EAPC of age standardized death rate was-1.45%(95%CI:-1.49%to-1.42%),and the EAPC of age standardized DALY rate was-1.29%(95%CI:-1.34%to-1.25%).In China,the age standardized death rates and DALY rates of IHD attributable to kidney dysfunction showed an upward trend from 1990 to 2021.The EAPC of age standardized death rate was 0.86%(95%CI:0.40%to 1.32%),and the EAPC of age standardized DALY rate was 0.45%(95%CI:0.06%to 0.84%).Compared with 1990,although the age standardized death rates and DALY rates of Chinese males and females showed an upward trend in 2021,but their age standardized death rates and DALY rates reached the peak in 2005 and then decreased year by year.The age standardized death rates and DALY rates of males were always higher than those of females globally and in China.The death rates and DALY rates of males and females increased gradually with age globally.The number of male deaths peaked at the age of 75-84,and the number of female deaths peaked at the age of 85-94;Male DALY peaked at the age of 65-74,and female DALY peaked at the age of 75-84.Similarly,the mortality rates and DALY rates of males and females in China also increased gradually with age.The number of deaths of males and females peaked at the age of 85-94;Male DALY peaked at the age of 65-74,and female DALY peaked at the age of 75-84.The growth of global mortality rates and DALY rates was mainly attributed to population growth and aging,while aging was the main driving factor in China.The global age standardized death rate(r=-0.169 4,P<0.000 1)and DALY rate(r=-0.278 4,P<0.000 1)were significantly negatively correlated with SDI.It is predicted that by 2040,the global and Chinese age standardized DALY rates would decrease to 543.71/100 000 and 333.64/100 000 respectively,and the age standardized DALY rate of males would continue to be higher than that of females.Conclusions:From 1990 to 2021,the age standardized death and DALY rates of IHD attributed to kidney dysfunction decreased significantly globally,while showed an upward trend in China.It is projected that by 2040,the disease burden of IHD attributable to kidney dysfunction would decline both globally and in China.In the future,interventions should focus on elderly populations and high-risk male groups to effectively control the disease burden of IHD attributable to kidney dysfunction.

Objective To investigate the application value of low-dose spiral CT(LDCT) scanning in high-risk population screening of lung cancer.Methods A total of 1 071 cases of LDCT lung scanning(observation group) and 350 cases of conventional dose CT lung scanning dose(control group) from October 2015 to May 2017 were performed the comparison on mean irradiation dose,lesion occurrence rate and diagnostic accuracy.Results The computed tomographic dose index(CTDI) in the observation group was(0.74±0.28)mSv;the excellent image quality rate was 95.42 ％;the positive detection rate was 43.60 ％ (467/1 071);13cases(1.21 ％)were confirmed as lung cancer by pathology.The average CTDI in the control group was(14.46 ± 4.21)mSv;the excellent image quality rate was 98.85 ％;the positive detection rate was 45.1 ％ (158/350);5 cases(1.43％) were confirmed as lung cancer by pathology.The average radiation dose and image quality showed statistically significant difference between the two groups (P＜0.05),and the positive detection rate and diagnostic rate of lung cancer had no statistical difference between the two groups (P＞0.05).Conclusion LDCT scan has good image quality,can significantly reduce the subject's irradiation dose without affecting the detection of lung lesions and lung cancer occurrence rate.