BACKGROUND: Pulmonary arterial hypertension (PAH) presents a significant health burden in Asia and remains a critical challenge. This study aims to delineate the PAH burden in Asia from 1990 to 2021. METHODS: Using the latest data from the Global Burden of Disease 2021, we evaluated and analyzed the distributions and patterns of PAH disease burden among various age groups, sexes, regions, and countries in Asia. Additionally, we examined the associations between PAH disease burden and key health system indicators, including the socio-demographic index (SDI) and the universal health coverage (UHC) index. RESULTS: In 2021, there were 25,989 new PAH cases, 103,382 existing cases, 13,909 PAH-associated deaths, and 385,755 DALYs attributed to PAH in Asia, which accounted for approximately 60% of global PAH cases. The age-standardized rates (ASRs) for prevalence and deaths were 2.05 (95% uncertainty interval [UI]: 1.66-2.52) per 100,000 population and 0.31 (95% UI: 0.23-0.38) per 100,000 population, respectively. From 1990 to 2021, Asia reported the lowest ASRs for PAH prevalence but the highest ASRs for deaths compared to other continents. While the ASRs for prevalence increased slightly, ASRs for mortality and DALYs decreased over time. This increasing burden of PAH was primarily driven by population growth and aging. The burden was especially pronounced among individuals aged ≥60 years and <9 years, who collectively accounted for the majority of deaths and DALYs. Moreover, higher SDI and UHC levels were linked to reduced incidence, but higher prevalence rates. CONCLUSIONS Although progress has been made in reducing PAH-related mortality and DALYs, the disease continues to impose a substantial burden in Asia, particularly among older adults and young children. Region-specific health policies should focus on improving early diagnosis, expanding access to treatment, and effectively addressing the growing PAH burden in the region.
Humans ; Global Burden of Disease ; Male ; Female ; Middle Aged ; Adult ; Asia/epidemiology* ; Prevalence ; Aged ; Pulmonary Arterial Hypertension/mortality* ; Adolescent ; Young Adult ; Child ; Child, Preschool ; Infant ; Hypertension, Pulmonary/epidemiology*

Objective To analyze the advantages and surgical experience of laparoscopic anatomical surgery for adrenal tumors.Methods A total of 156 patients with benign or malignant adrenal tumors admitted to our hospital from April 2012 to September 2016 were enrolled and underwent laparoscopic anatomical surgery in the study.The curative effect and advantages of the operation were analyzed,and surgical experiences of laparoscopic anatomical surgery for adrenal tumors were summarized.Results Laparoscopic adrenalectomy was successfully completed in 155 of the 156(99.4％)patients and 1 patient with pheochromocytoma underwent open surgery due to pneumothorax caused by an accidental diaphragm injury.Postoperative pulmonary embolism occurred in 1 case and hematoma in right adrenal region in 6 cases,all of whom were completely relieved after intervention.Postoperative surgical specimen of adrenal glands in 54 patients were histopathologically examined,the results of which showed the negative boundaries in all patients.Patients were followed up for a mean of 11.6 months(range,4 to 26 months).All patients had a good recovery after surgery without recurrence of malignant tumor in local or trocar site.Conclusions As compared with open surgery,the transperitoneal laparoscopic adrenal surgery provides a larger operation area for good orientation and vision,and has such advantages as shorter hospital stay,fewer postoperative complications and better prognosis in patients with malignant adrenal tumors,which is worthy of clinical selection.

Objective To explore the effect of laparoscopic radical prostatectomy for prostate cancer combined with endocrine adjuvant therapy on the treatment of patients with high-risk prostate cancer.Methods A total of 50 patients with local advanced high-risk prostate cancer were treated with laparoscopic radical treatment for prostate cancer.According to application of postoperative adjuvant endocrine therapy (AHT),the patients were divided into the observation group and control group.General surgery condition and 2-year survival rate were compared between two groups.Results All the 50 patients finished operation successfully.The 2-year total biochemical recurrence rate was 76% in observation group,and the control group was 52.00%.The patients received AHT therapy in the observation group were able to tolerate treatment during follow-up.Conclusion Laparoscopic radical prostatectomy for prostate cancer combined with endocrine adjuvant therapy can significantly improve 2-year non-biochemical recurrence rate and control the disease progression.

Objective To explore the effect of laparoscopic radical prostatectomy for prostate cancer combined with endocrine adjuvant therapy on the treatment of patients with high-risk prostate cancer.Methods A total of 50 patients with local advanced high-risk prostate cancer were treated with laparoscopic radical treatment for prostate cancer.According to application of postoperative adjuvant endocrine therapy (AHT),the patients were divided into the observation group and control group.General surgery condition and 2-year survival rate were compared between two groups.Results All the 50 patients finished operation successfully.The 2-year total biochemical recurrence rate was 76% in observation group,and the control group was 52.00%.The patients received AHT therapy in the observation group were able to tolerate treatment during follow-up.Conclusion Laparoscopic radical prostatectomy for prostate cancer combined with endocrine adjuvant therapy can significantly improve 2-year non-biochemical recurrence rate and control the disease progression.

Objective To studying the MR findings and pathology of peripheral small intrahepatic cholangiocarcinoma and improving the understanding of peripheral small cholangiocarcinoma with no-bile duct dilatation. Methods A retrospective analysis of 12 patients with intrahepatic peripheral cholangiocarcinoma which were confirmed by surgery and pathology, all patients were examined by abdominal MRI without and with contrast. Correlation was made with gross pathology and surgical pathological specimen. Results On T1WI, there were 4 cases of complex low signal intensity and 8 cases of low signal intensity. On T2WI, there were 8 cases of high signal intensity and 4 cases of complex high signal intensity. Enhanced MRI showed: marked nidus enhancement on arterial phase in 1 case, and the pathological diagnosis was poorly differentiated adenocarcinoma. Inhomogeneous enhancement or annular enhancement were seen in 10 cases on arterial phase, 3 of these cases showed thin annular enhancement on arterial phase, low signalintensity on portal venous phase and isointensity on delayed phase. One case showed delayed enhancement. Thick circular enhancement correlated with pathological changes of survival of tumor cells, center areas correlated with fibrous connective tissue, and a small amount of necrotic tissue. Island-like enhancement or inhomogeneous enhancement were seen in 3 cases. Corresponding pathological changes consisted of tumor tissue and a small amount of fibrous connective tissue, as well as somenecrotic tissue. In 1 case, no enhancement was seen on all three phases and pathological changes showed cystic changes, hemorrhage, necrosis, with survival tumor cells seen between cyst and normal liver tissue. Conclusions MRI scanning of peripheral small cholangiocarcinoma lacked characteristic features, but dynamic contrast-enhanced MR had certain specific findings. Due to different pathology, the fibrous tissue, necrotic tissue and survival tumor tissue components were exhibited different imaging findings.

Objective To compare the efficacy of MRI and multi-slice CT(MSCT) for characterization of liver isolation nodular lesions in cirrhosis patients .Methods A total of 64 patients with 64 lesions ,underwent MSCT and MRI .Chi-square tests were used to compare the performances of MSCT and MRI in characterization of lesions .Results The detection rate ,accuracy ,sensitivity ,spe-cificity ,positive predictive and negative predictie of MSCT and MRI were 76 .56% ,65 .31% ,37 .50% ,78 .79% ,72 .22% ,46 .15%and 87 .50% ,85 .71% ,66 .67% ,97 .14% ,82 .93% ,93 .33% respectively .There were statistical difference in accuracy ,specificity , positie predictie between MSCT and MRI (P< 0 .05) .Conclusion MRI is superior to MSCT in accuracy ,specificity ,and positive predictive for characterization of liver isolation noduler lesions .