Background Lung cancer, one of the most common malignant tumors worldwide, has long ranked first in cancer incidence and mortality, posing a severe challenge to public health systems. Objective To analyze the trends in incidence, mortality, and disability-adjusted life years (DALYs) of lung cancer among residents in Jing'an District, Shanghai, from 2002 to 2021, explore the impacts of population aging, population growth, and age-specific prevalence on disease burden, and provide a scientific basis for optimizing regional lung cancer prevention and control strategies. Methods Based on the cancer registration and cause-of-death surveillance data of registered residents in Jing'an District, Shanghai, from 2002 to 2021, Joinpoint regression models were used to analyze the annual change trends (APC) and average annual change trends (AAPC) of lung cancer incidence, mortality, DALY rate, and their age-standardized rates. Decomposition analysis was applied to quantify the contribution of population aging, population growth, and age-specific prevalence to changes in the number of new cases, deaths, and DALYs. Results From 2002 to 2021, the crude incidence rate of lung cancer in Jing'an District increased from 68.00 per 100000 to 144.36 per 100000 (AAPC=4.86%, P<0.001), and the age-standardized incidence rate rose from 43.09 per 100000 to 61.46 per 100000 (AAPC=2.89%, P<0.001). The growth rate of incidence was significantly higher in females (AAPC=6.73%) than in males (AAPC=3.62%). The crude mortality rate increased from 58.08 per 100000 to 66.11 per 100000 (AAPC=1.10%, P<0.001), while the age-standardized mortality rate decreased (AAPC=−1.54%, P<0.001). The crude DALY rate showed an upward trend (AAPC=0.94%, P=0.002), whereas the age-standardized DALY rate declined (AAPC=−1.63%, P<0.001). Significant differences were observed across genders and age groups: the mortality and DALY rates increased in males aged 60-64 years, while the fastest incidence growth occurred in females aged 45-64 years. The results of decomposition analysis indicated that the increase in new cases was primarily attributed to age-specific incidence (38.15%) and aging (37.31%); the growth in deaths and DALYs was driven by aging, while age-specific mortality and population growth showed offsetting effects. From 2002 to 2021, the probability of premature death from lung cancer among males (2.04%-2.52%) in Jing'an District showed no statistically significant trend (AAPC=−0.28%, P=0.440), while it presented a decreasing trend in the total population (1.37%-1.89%) and females (0.72%-1.26%) (AAPC=−0.80% and −2.23%, respectively; P=0.029 and <0.001, respectively). Conclusion From 2002 to 2021, the risk of lung cancer incidence in Jing’an District, Shanghai, continue to increase, with a disease burden exhibiting significant heterogeneity by gender and age: key features include a rapid increase in new cases and a trend toward younger onset among females, alongside rising mortality risk among males aged 60–64 years. Population aging and increasing age-specific incidence rates are primary drivers of the growing number of cases, while declining age-specific mortality rates mitigate the rise in mortality burden.

Objective:To explore the structural equation model to explore the levels of work-related musculoskeletal disorders (WMSDs) and various risk factors in the feet and ankle of China's occupational population, providing scientific basis for for preventing WMSDs in feet and ankles.Methods:Data of 73497 national occupational epidemiological cases were selected from June 2018 to December 2023 used the Chinese version of the Electronic Questionnaire on Musculoskeletal Disorders. The adverse ergonomic factors and their source classification standard and confirmatory factor analysis were used to investigate foot and ankle WMSDs and their related risk factors (including individual factors, work organization, work posture, work type, fatigue, etc.) in key occupational groups in China, and structural equation model hypothesis, fitting, verification, and path and intermediary effect analysis were carried out. The model fit evaluation indexes included Chi-square specific degrees of freedom ( χ2/ df), gauge fit index (NFI), Tucker Lewis index (TLI), goodness of Fit index (GFI), adjusted Goodness of Fit index (AGFI) and approximate root mean square error (RMSEA) . Results:A total of 73497 occupational workers were surveyed, with local muscle fatigue and WMSDs incidence rates in the feet and ankles being 17.17% and 12.06%, respectively. The fitting index of the adjusted structural equation model basically meets the standard (GFI=1, AGFI=1, RMESA=0.042, NFI=0.716, TLI=0.663). The top three factors affecting feet and ankle WMSDs are feet and ankle muscle fatigue, work type, and work organization, with standardized path coefficients of 0.221, 0.105, and 0.095, respectively. The top two factors affecting feet and ankle muscle fatigue are work organization and work type, with standardized path coefficients of 0.548 and 0.383, respectively. Feet and ankle muscle fatigue, work type, work organization, and work posture have a direct effect on feet and ankle WMSDs, with effect values of 0.221, 0.105, 0.095, and 0.077, respectively. The organization and type of work can also have indirect effects through feet and ankle muscle fatigue, with effect values of 0.121 and 0.084, respectively.Conclusion:Feet and ankle muscle fatigue has a direct impact on WMSDs, and plays a mediating role between ankle and ankle WMSDs caused by work organization and work type. Feet and ankle muscle fatigue is an important pathway leading to feet and ankle WMSDs. It is recommended that employers and managers detect job fatigue early and take corresponding prevention and intervention measures, which can play a key role in preventing feet and ankle WMSDs.

Objective:To analyze the trends of preterm birth among women of advanced maternal age in Haidian District, Beijing from 2013 to 2022.Methods:A retrospective analysis was conducted on the birth registration data in Haidian District, Beijing, from January 2013 to December 2022, focusing on the records of women aged ≥35 who delivered between 22 and 44 weeks of gestation. The Joinpoint regression model was used to analyze the time trends of preterm birth rates among women of advanced maternal age in the Haidian District. Interrupted time series (ITS) analysis was applied to quantitatively evaluate the transient and long-term effects of China's universal two-child policy on the preterm birth rate among women of advanced maternal age.Results:(1) A total of 70 640 birth registration records from 68 587 women were finally included. The number of women giving birth peaked between 2016 and 2018 (8 158, 9 906, and 8 914 cases, respectively). The proportion of permanent residents in Beijing gradually decreased from 53.7% (2 175/4 049) in 2013 to 42.0% (4 160/9 906) in 2017 and then increased to over 98% between 2019 and 2022 [98.8% (7 828/7 925), 99.1% (6 283/6 340), 99.3% (5 970/6 014), and 99.5% (6 371/6 404), respectively]. (2) Among the 68 587 women, 57 339 (83.6%) were delivered at tertiary hospitals, and 35 496 (51.8%) were delivered by cesarean section. The proportion of multiple births increased slowly from 2.4% (236/9 906) in 2017 to 3.5% (225/6 404) in 2022. From 2013 to 2015, primiparous women accounted for the majority. Subsequently, the proportion of multiparous women increased annually, reaching 71.6% (6 385/8 914) in 2018 before gradually decreasing to 56.2% (3 600/6 404) in 2022. (3) A total of 70 640 live births were delivered. The highest number of deliveries was in 2017, with 10 139 cases. From 2013 to 2022, 36 995 male infants and 33 645 female infants were born, with preterm birth rates of 10.6% (3 914/36 995) and 9.4% (3 123/33 645), respectively. (4) Among the 70 640 infants, there were 124 extremely preterm infants (0.2%), 773 very preterm infants (1.1%), and 6 140 late preterm infants (8.7%), accounting for 1.8%, 11.0%, and 87.3% of all preterm infants (7 037 cases), respectively. (5) The optimal fitting results of Joinpoint regression indicated that the preterm birth rate showed a declining trend from 2013 to 2017 ( APC=－4.4%, 95% CI: -13.0% to -0.2%); with 2017 as the turning point, the preterm birth rate exhibited an upward trend from 2017 to 2022 ( APC=4.5%, 95% CI: 1.6% to 13.0%). (6) The results of ITS analysis revealed that the preterm birth rate instantly decreased by 0.79% ( β2=－0.79, P=0.026) in the month when the universal two-child policy took effect. In comparison, it increased by an average of 0.03% per month ( β3=0.07, P=0.001) after the implementation of the policy. After adjusting for the proportion of multiple births, the preterm birth rate significantly decreased before the policy took effect ( β1=－0.06, P=0.003), but increased by an average of 0.01% per month ( β3=0.07, P<0.001) after the policy took effect. There was no statistical significance in the transient impact of the policy on the preterm birth rate in this district ( β2=0.80, P=0.145). Conclusions:From 2013 to 2022, the preterm birth rates among women of advanced maternal age in Haidian District exhibit a "V"-shaped pattern with the implementation of the two-child policy as the turning point. It is necessary to continue strengthening maternal health care for women of advanced maternal age and ensure the targeted provision of related services to address the issue of increased preterm birth rates following the enforcement of the two-child policy.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

To analyze the characteristics of outpatient rare disease admissions at Xi′an Children′s Hospital based on the two batches of the China′s Rare Disease Catalogs.

Objective:To investigate, for multi-sensitized allergic rhinitis (AR) patients allergic to dust mites combined with other allergens (pollen, mold, animal dander, etc.), whether the single dust mite subcutaneous immunotherapy (SCIT) can improve the specific symptoms caused by other allergens in the patients, and to analyze the relationship between the effectiveness of symptom improvement in these patients and the type, quantity and severity of the allergens.Methods:A multicenter retrospective study was conducted to collect mul-sensitized AR patients from allergy or respiratory departments of 5 hospitals who received house dust mite allergen preparation SCIT for 12 to 36 months and met other inclusion and exclusion criteria from February to July 2024. General clinical data were collected and the perennial or seasonal symptoms before and after treatment were evaluated with visual analogue scale (VAS) to assess whether there was an perennial or allergen-specific symptom improvement (VAS score decrease ≥30%), by which the patients were divided into effective group and ineffective. R software was used to analyze the differences between groups by using Fisher′s exact test and Mann-Whitney U test. Results:A total of 62 patients were enrolled, and the treatment were effective in 39 of them, with an effective rate of 62.9%. For allergen-specific symptoms, the median age of the effective group was higher than that of the ineffective group (12 years old vs. 8 years old, P=0.039), and the effective rate in dust mite specific immunoglobin E (sIgE) grade ≤5 group was higher than that in sIgE grade >5 group (81.6% vs. 45.5%, P=0.008), and the effective rate of mold sIgE grade ≤2 group was higher than that of sIgE grade >2 group (83.3% vs. 28.6%, P=0.045), and there was no statistically significant correlation between the other allergen grades and the effective rate ( P>0.05). For perennial symptoms, the effective rate in the mold grade ≤2 group was higher than that in the sIgE grade >2 group (91.3% vs. 28.6%, P=0.010), and there was no statistically significant correlation between the other allergen grades and the effective rate ( P>0.05). There was no significant correlation between the treatment effectiveness of perennial or allergen-specific symptoms and the number of combined allergens, the grade of skin test, and the difference between the grade of combined allergens and that of dust mites ( P>0.05). Conclusion:Among the patients with multi-sensitized AR allergic to dust mites included in this study, single dust mite SCIT is effective in some of them, and for allergen-specific symptoms, the effective group was elder, and dust mite sIgE grade 6 and mold sIgE grade ≥2 was related to the low effective rate of SCIT. The present results are insufficient for selecting single or multiple AIT in any type of multi-sensitized patients.

Objective:To investigate, for multi-sensitized allergic rhinitis (AR) patients allergic to dust mites combined with other allergens (pollen, mold, animal dander, etc.), whether the single dust mite subcutaneous immunotherapy (SCIT) can improve the specific symptoms caused by other allergens in the patients, and to analyze the relationship between the effectiveness of symptom improvement in these patients and the type, quantity and severity of the allergens.Methods:A multicenter retrospective study was conducted to collect mul-sensitized AR patients from allergy or respiratory departments of 5 hospitals who received house dust mite allergen preparation SCIT for 12 to 36 months and met other inclusion and exclusion criteria from February to July 2024. General clinical data were collected and the perennial or seasonal symptoms before and after treatment were evaluated with visual analogue scale (VAS) to assess whether there was an perennial or allergen-specific symptom improvement (VAS score decrease ≥30%), by which the patients were divided into effective group and ineffective. R software was used to analyze the differences between groups by using Fisher′s exact test and Mann-Whitney U test. Results:A total of 62 patients were enrolled, and the treatment were effective in 39 of them, with an effective rate of 62.9%. For allergen-specific symptoms, the median age of the effective group was higher than that of the ineffective group (12 years old vs. 8 years old, P=0.039), and the effective rate in dust mite specific immunoglobin E (sIgE) grade ≤5 group was higher than that in sIgE grade >5 group (81.6% vs. 45.5%, P=0.008), and the effective rate of mold sIgE grade ≤2 group was higher than that of sIgE grade >2 group (83.3% vs. 28.6%, P=0.045), and there was no statistically significant correlation between the other allergen grades and the effective rate ( P>0.05). For perennial symptoms, the effective rate in the mold grade ≤2 group was higher than that in the sIgE grade >2 group (91.3% vs. 28.6%, P=0.010), and there was no statistically significant correlation between the other allergen grades and the effective rate ( P>0.05). There was no significant correlation between the treatment effectiveness of perennial or allergen-specific symptoms and the number of combined allergens, the grade of skin test, and the difference between the grade of combined allergens and that of dust mites ( P>0.05). Conclusion:Among the patients with multi-sensitized AR allergic to dust mites included in this study, single dust mite SCIT is effective in some of them, and for allergen-specific symptoms, the effective group was elder, and dust mite sIgE grade 6 and mold sIgE grade ≥2 was related to the low effective rate of SCIT. The present results are insufficient for selecting single or multiple AIT in any type of multi-sensitized patients.

Objective:To analyze the trends of preterm birth among women of advanced maternal age in Haidian District, Beijing from 2013 to 2022.Methods:A retrospective analysis was conducted on the birth registration data in Haidian District, Beijing, from January 2013 to December 2022, focusing on the records of women aged ≥35 who delivered between 22 and 44 weeks of gestation. The Joinpoint regression model was used to analyze the time trends of preterm birth rates among women of advanced maternal age in the Haidian District. Interrupted time series (ITS) analysis was applied to quantitatively evaluate the transient and long-term effects of China's universal two-child policy on the preterm birth rate among women of advanced maternal age.Results:(1) A total of 70 640 birth registration records from 68 587 women were finally included. The number of women giving birth peaked between 2016 and 2018 (8 158, 9 906, and 8 914 cases, respectively). The proportion of permanent residents in Beijing gradually decreased from 53.7% (2 175/4 049) in 2013 to 42.0% (4 160/9 906) in 2017 and then increased to over 98% between 2019 and 2022 [98.8% (7 828/7 925), 99.1% (6 283/6 340), 99.3% (5 970/6 014), and 99.5% (6 371/6 404), respectively]. (2) Among the 68 587 women, 57 339 (83.6%) were delivered at tertiary hospitals, and 35 496 (51.8%) were delivered by cesarean section. The proportion of multiple births increased slowly from 2.4% (236/9 906) in 2017 to 3.5% (225/6 404) in 2022. From 2013 to 2015, primiparous women accounted for the majority. Subsequently, the proportion of multiparous women increased annually, reaching 71.6% (6 385/8 914) in 2018 before gradually decreasing to 56.2% (3 600/6 404) in 2022. (3) A total of 70 640 live births were delivered. The highest number of deliveries was in 2017, with 10 139 cases. From 2013 to 2022, 36 995 male infants and 33 645 female infants were born, with preterm birth rates of 10.6% (3 914/36 995) and 9.4% (3 123/33 645), respectively. (4) Among the 70 640 infants, there were 124 extremely preterm infants (0.2%), 773 very preterm infants (1.1%), and 6 140 late preterm infants (8.7%), accounting for 1.8%, 11.0%, and 87.3% of all preterm infants (7 037 cases), respectively. (5) The optimal fitting results of Joinpoint regression indicated that the preterm birth rate showed a declining trend from 2013 to 2017 ( APC=－4.4%, 95% CI: -13.0% to -0.2%); with 2017 as the turning point, the preterm birth rate exhibited an upward trend from 2017 to 2022 ( APC=4.5%, 95% CI: 1.6% to 13.0%). (6) The results of ITS analysis revealed that the preterm birth rate instantly decreased by 0.79% ( β2=－0.79, P=0.026) in the month when the universal two-child policy took effect. In comparison, it increased by an average of 0.03% per month ( β3=0.07, P=0.001) after the implementation of the policy. After adjusting for the proportion of multiple births, the preterm birth rate significantly decreased before the policy took effect ( β1=－0.06, P=0.003), but increased by an average of 0.01% per month ( β3=0.07, P<0.001) after the policy took effect. There was no statistical significance in the transient impact of the policy on the preterm birth rate in this district ( β2=0.80, P=0.145). Conclusions:From 2013 to 2022, the preterm birth rates among women of advanced maternal age in Haidian District exhibit a "V"-shaped pattern with the implementation of the two-child policy as the turning point. It is necessary to continue strengthening maternal health care for women of advanced maternal age and ensure the targeted provision of related services to address the issue of increased preterm birth rates following the enforcement of the two-child policy.

Objective:To explore the structural equation model to explore the levels of work-related musculoskeletal disorders (WMSDs) and various risk factors in the feet and ankle of China's occupational population, providing scientific basis for for preventing WMSDs in feet and ankles.Methods:Data of 73497 national occupational epidemiological cases were selected from June 2018 to December 2023 used the Chinese version of the Electronic Questionnaire on Musculoskeletal Disorders. The adverse ergonomic factors and their source classification standard and confirmatory factor analysis were used to investigate foot and ankle WMSDs and their related risk factors (including individual factors, work organization, work posture, work type, fatigue, etc.) in key occupational groups in China, and structural equation model hypothesis, fitting, verification, and path and intermediary effect analysis were carried out. The model fit evaluation indexes included Chi-square specific degrees of freedom ( χ2/ df), gauge fit index (NFI), Tucker Lewis index (TLI), goodness of Fit index (GFI), adjusted Goodness of Fit index (AGFI) and approximate root mean square error (RMSEA) . Results:A total of 73497 occupational workers were surveyed, with local muscle fatigue and WMSDs incidence rates in the feet and ankles being 17.17% and 12.06%, respectively. The fitting index of the adjusted structural equation model basically meets the standard (GFI=1, AGFI=1, RMESA=0.042, NFI=0.716, TLI=0.663). The top three factors affecting feet and ankle WMSDs are feet and ankle muscle fatigue, work type, and work organization, with standardized path coefficients of 0.221, 0.105, and 0.095, respectively. The top two factors affecting feet and ankle muscle fatigue are work organization and work type, with standardized path coefficients of 0.548 and 0.383, respectively. Feet and ankle muscle fatigue, work type, work organization, and work posture have a direct effect on feet and ankle WMSDs, with effect values of 0.221, 0.105, 0.095, and 0.077, respectively. The organization and type of work can also have indirect effects through feet and ankle muscle fatigue, with effect values of 0.121 and 0.084, respectively.Conclusion:Feet and ankle muscle fatigue has a direct impact on WMSDs, and plays a mediating role between ankle and ankle WMSDs caused by work organization and work type. Feet and ankle muscle fatigue is an important pathway leading to feet and ankle WMSDs. It is recommended that employers and managers detect job fatigue early and take corresponding prevention and intervention measures, which can play a key role in preventing feet and ankle WMSDs.

Pyroptosis is a newly discovered programmed cell death in recent years.The researches show that pyroptosis plays an important role in many diseases.Leukemia is a malignant hematopoietic stem cell disease, which seriously threatens the health and life of children.Numerous studies have shown that pyroptosis is associated with the occurrence and development of leukemia, and elucidation the mechanism of pyroptosis in leukemia will provide a new method of clinical treatment.In this review, in order to enhance the understanding of the mechanism of pyroptosis and provide some ideas for the treatment of leukemia, the molecular mechanism of pyroptosis and its role in leukemia are reviewed.