Objective:To analyze the long-term trends in cause-specific mortality across different sexes and age groups in China from 1990 to 2021, and quantitatively assess the impact of population aging on cause-specific deaths by sex.Methods:Based on data from the Global Burden of Disease Study 2021, this study extracted the number of deaths, crude mortality rates and age-standardized mortality rates (ASMRs) for all causes, Level 1 causes (communicable, maternal, neonatal, and nutritional diseases; non-communicable diseases; injuries) and Level 3 causes in China from 1990 to 2021, stratified by sex and age group. This study analyzed the current situation and long-term trends in mortality in China, applying decomposition analysis to quantify the impact of population aging on the number of deaths.Results:In 2021, the ASMRs of all-cause death and the three primary causes of death in Level 1 in China were 644.68, 26.59, 575.55, and 41.82 per 100 000, respectively. The ASMRs of the three primary causes continued to decline, with the smallest decrease observed in non-communicable diseases [EAPC=-1.79%, 95% CI (-1.92%, -1.66%)] and the largest in communicable, maternal, neonatal, and nutritional diseases (CMNND) [EAPC=-5.86%, 95% CI (-6.06%, -5.65%)]. The ASMRs were higher in males than females, with a smaller decline. Mortality was higher in the elderly. CMNND deaths mainly occurred in children under 5 and the elderly; non-communicable disease deaths were concentrated in the elderly; injury deaths were relatively evenly distributed across age groups. The proportion of CMNND deaths decreased annually, while the proportion of non-communicable disease deaths increased. From 1990 to 2021, population aging contributed to an increase of 8.11 million all-cause deaths, 167 464.42 CMNND deaths, 7.74 million non-communicable diseases deaths, and 196 287.78 injury deaths. The impact of population aging differed by sex and disease, with male and female aging-related deaths increasing by 4.47 million and 3.70 million, respectively. Compared to 1990, the age-specific mortality rate contributions in 2021 were -72.82% for males and -93.87% for females, with variations by sex and disease. Conclusion:The composition of disease-related deaths in China has changed notably. Population aging is linked to the sharp rise in deaths, with varying impacts across sexes and diseases. Reducing disease mortality can help lessen the negative effects of population aging.

Objective To externally validate a prediction model based on clinical and CT imaging features for the preoperative identification of high-grade patterns (HGP), such as micropapillary and solid subtypes, in early-stage lung adenocarcinoma, in order to guide clinical treatment decisions. Methods This study conducted an external validation of a previously developed prediction model using a cohort of patients with clinical stage ⅠA lung adenocarcinoma from the Fourth Hospital of Hebei Medical University. The model, which incorporated factors including tumor size, density, and lobulation, was assessed for its discrimination, calibration performance, and clinical impact. Results A total of 650 patients (293 males, 357 females; age range: 30-82 years) were included. The validation showed that the model demonstrated good performance in discriminating HGP (area under the curve>0.7). After recalibration, the model's calibration performance was improved. Decision curve analysis (DCA) indicated that at a threshold probability>0.6, the number of HGP patients predicted by the model closely approximated the actual number of cases. Conclusion This study confirms the effectiveness of a clinical and imaging feature-based prediction model for identifying HGP in stage ⅠA lung adenocarcinoma in a clinical setting. Successful application of this model may be significant for determining surgical strategies and improving patients' prognosis. Despite certain limitations, these findings provide new directions for future research.

OBJECTIVE: To explore the current status and changing trends of the disease burden of traumatic brain injury (TBI) in China from 1990 to 2023, and to quantitatively assess the impact of different influencing factors on this disease burden, thereby providing references for the prevention of TBI. METHODS: Based on the 2023 Global Burden of Disease Study (GBD), indicators including incidence and years lived with disability (YLDs) were used to analyze the status and changing trends of TBI disease burden in China from 1990 to 2023. Additionally, the decomposition method established by Gupta was adopted to quantify the effects of population growth, population aging, age-specific incidence rate, and disease severity on YLDs. RESULTS: From 1990 to 2023, the age-standardized incidence rate and YLDs rate of TBI in China showed an overall upward trend, with a significant downward trend between 2015 and 2020, followed by a resumption of upward trend after 2020. The disease burden of TBI in males was higher than that in females, with a larger increase amplitude. The elderly population had higher TBI incidence rate and YLDs rate, also with a larger upward amplitude. Falls were the main cause of TBI in China, and the changing trend of the disease burden caused by falls was consistent with the overall trend of TBI disease burden; meanwhile, the elderly population bore a relatively high disease burden from falls. Taking 1990 as the baseline, the growth rates of YLDs in males and females in 2023 were 101.54% and 101.40%, respectively. For males, the proportions of YLDs growth attributed to population growth, population aging, age-specific incidence rate, and disease severity were 26.91%, 49.62%, 37.74%, and -12.73%, respectively; for females, the corresponding proportions were 28.85%, 57.69%, 27.65%, and -12.79%. CONCLUSION From 1990 to 2023, population aging had a significant impact on the disease burden of TBI in China. Strengthening the prevention and control of falls and paying close attention to males and the elderly population should be the key focuses of TBI prevention and control work in China in the future.
Humans ; Brain Injuries, Traumatic/epidemiology* ; China/epidemiology* ; Male ; Female ; Incidence ; Middle Aged ; Aged ; Adult ; Cost of Illness ; Adolescent ; Young Adult ; Persons with Disabilities/statistics & numerical data* ; Child ; Global Burden of Disease ; Disability-Adjusted Life Years ; Child, Preschool ; Infant ; Aged, 80 and over

Objective:To analyze the long-term trends in cause-specific mortality across different sexes and age groups in China from 1990 to 2021, and quantitatively assess the impact of population aging on cause-specific deaths by sex.Methods:Based on data from the Global Burden of Disease Study 2021, this study extracted the number of deaths, crude mortality rates and age-standardized mortality rates (ASMRs) for all causes, Level 1 causes (communicable, maternal, neonatal, and nutritional diseases; non-communicable diseases; injuries) and Level 3 causes in China from 1990 to 2021, stratified by sex and age group. This study analyzed the current situation and long-term trends in mortality in China, applying decomposition analysis to quantify the impact of population aging on the number of deaths.Results:In 2021, the ASMRs of all-cause death and the three primary causes of death in Level 1 in China were 644.68, 26.59, 575.55, and 41.82 per 100 000, respectively. The ASMRs of the three primary causes continued to decline, with the smallest decrease observed in non-communicable diseases [EAPC=-1.79%, 95% CI (-1.92%, -1.66%)] and the largest in communicable, maternal, neonatal, and nutritional diseases (CMNND) [EAPC=-5.86%, 95% CI (-6.06%, -5.65%)]. The ASMRs were higher in males than females, with a smaller decline. Mortality was higher in the elderly. CMNND deaths mainly occurred in children under 5 and the elderly; non-communicable disease deaths were concentrated in the elderly; injury deaths were relatively evenly distributed across age groups. The proportion of CMNND deaths decreased annually, while the proportion of non-communicable disease deaths increased. From 1990 to 2021, population aging contributed to an increase of 8.11 million all-cause deaths, 167 464.42 CMNND deaths, 7.74 million non-communicable diseases deaths, and 196 287.78 injury deaths. The impact of population aging differed by sex and disease, with male and female aging-related deaths increasing by 4.47 million and 3.70 million, respectively. Compared to 1990, the age-specific mortality rate contributions in 2021 were -72.82% for males and -93.87% for females, with variations by sex and disease. Conclusion:The composition of disease-related deaths in China has changed notably. Population aging is linked to the sharp rise in deaths, with varying impacts across sexes and diseases. Reducing disease mortality can help lessen the negative effects of population aging.

Objective To observe changes of brain function synchronized activity and gray matter structure alterations in patients with chronic subjective tinnitus (ST) with MRI.Methods Resting-state fMRI and 3D T1WI were obtained in 21 chronic ST patients (case group) and 21 healthy volunteers (control group).The voxel-based morphometry and regional homogeneity (ReHo) were used to analyze changes of the gray matter structure and volume.Results Compared with control group,ReHo values of the right superior,middle and inferior temporal gyrus increased in case group (P＜0.05),ReHo values of the right middle orbital frontal gyrus/inferior triangle frontal gyrus,left middle frontal gyrus/angular gyrus and cerebellar vermis decreased (P＜0.05),and the gray matter volume of the right middle temporal gyrus,superior dorsolateral frontal gyrus and left superior medial frontal gyrus decreased in case group (P＜0.01).Furthermore,Re Ho values of the right middle temporal gyrus were positively correlated with tinnitus handicap inventory scores (r=0.604,P=0.005) in case group.Conclusion The neural function synchronized activity and gray matter volume changes in the auditory and non-auditory brain regions of patients with chronic ST,providing references for finding possible neuroimaging markers.