Objective To study the trend in the burden of colorectal cancer attributed to high body mass index (BMI) in China from 1990 to 2021, and to predict the mortality rate from 2022 to 2035. Methods Based on the 2021 Global Burden of Disease data, this paper analyzed the trends of colorectal cancer mortality and Disability-adjusted Life Years (DALY) rates and their standardized rates attributed to high BMI in China from 1990 to 2021, and calculated their average annual percent change (AAPC). Age-period-cohort (APC) models were applied to assess the age, period, and cohort effects on mortality, and the Bayesian age-period-cohort (BAPC) models were used to predict the mortality rate of colorectal cancer attributed to high BMI in China from 2022 to 2035. Results From 1990 to 2021, the standardized mortality rate (Age-standardized Mortality Rate, ASMR) and standardized DALY rate (Age-standardized Disability-adjusted Life Years Rate, ASDR) of colorectal cancer caused by high BMI in China increased significantly, and the ranking of risk factors rose from 9th to 5th and 4th respectively, with AAPC values of 2.43% (95%CI: 2.29-2.57) and 2.33% (95% CI: 2.21-2.46), which outpaced the global and each Socio-demographic Index (SDI) regions. The disease burden of male was significantly higher than that of female, and the net drifts in mortality rate of colorectal cancer associated with high BMI were 2.37 times higher than females. In addition, the mortality rate increased significantly with age, and showed a year-on-year increasing trend, and the cohort effect also showed a higher risk of death. It was predicted that the mortality rate of colorectal cancer attributed to high BMI in China will continue to rise in the future, increasing by 53.06% from 2022 to 2035. Conclusion In China, the disease burden of colorectal cancer attributed to high BMI continues to increase, especially in the male and elderly population. The colorectal burden associated with high BMI should be reduced by optimizing public health policies, including promoting healthy diet, enhancing weight management, promoting physical activity, and improving cancer screening strategies.

Objective To understand the trends of the mortality and DALY of ischemic heart disease (IHD) caused by high-salt diets，as well as their age-period-cohort effects among Chinese residents from 1990 to 2019. Methods Using the 2019 Global Burden of Disease Study (GBD 2019) data on IHD deaths and DALY attributed to high-salt diets among Chinese residents from 1990 to 2019, an age-period-cohort (APC) model was applied to explore the age-period-cohort effect. Results Among the 13 major risk factors for ischemic heart disease (IHD) in China in 1990 and 2019, age-standardized mortality and age-standardized DALY rates attributable to risk factors of high-salt diets led the way. Age-standardized mortality and age-standardized DALY rates were attributabled to high-salt diets showed a decreasing trend in both China and globally in 1990-2019, but were consistently higher in China than in the world. The results of the APC model show that from 1990 to 2019, the mortality rate and DALY rate of IHD attributed to a high-salt diet in China showed an increasing trend with age; over time, the risk of death and the risk of DALY for males showed a decreasing trend from 1990-1994 to 1995-1999, and an increasing trend from 1995-1999 to 2010-2014, and reached its peak in 2010-2014 (RR=1.17,95% CI: 1.12-1.21), followed by a decreasing trend. For males with a later birth cohort have a higher risk of death and DALY, while for females with a later birth cohort have a lower risk of death and DALY. Conclusion The burden of IHD disease attributed to a high-salt diet in China is still relatively heavy, and it is necessary to strengthen protection for high-risk populations such as young males and the elderly population to reduce the burden of IHD disease in China.

Objective To analyze the spatiotemporal characteristics of the clustered epidemics of common infectious diseases in primary and secondary schools and kindergartens in Hongshan District, Wuhan from 2015 to 2022, and to provide a basis for scientific development of control measures. Methods Descriptive epidemiological methods were used to describe events. Mean center method and standard ellipse method were used to reflect the overall distribution characteristics of the events, and hot spot analysis and nuclear density analysis were used to explore and analyze the spatiotemporal characteristics of clustered epidemics at annual and seasonal scales. Results From 2015 to 2022, a total of 1563 clustered outbreaks of infectious diseases were reported in primary and secondary schools and kindergartens in Hongshan District of Wuhan. The top three clustered epidemic diseases were hand-mouth-foot disease (HFMD)/herpangina, influenza like cases, and varicella, respectively. Primary schools were prone to influenza like cases (76.00%), kindergartens were prone to HFMD/herpangina (92.06%), and primary schools and middle schools were prone to varicella (69.70% and 21.21% respectively). As the years grew, the clustered epidemics showed a trend of spreading towards the northeast and southwest direction. Compared with other places, Luonan Street and Hongshan Street had a higher incidence density of clustered epidemic events (21.81% and 15.86% respectively), which requires special attention. The areas with the highest nuclear density value in each season were mainly concentrated in the middle of Hongshan District. There were two clusters of HFMD/herpangina concentrated in Luonan Street, Liyuan and Heping Street, which was different from other diseases. Conclusion When deploying medical resources and epidemic prevention and control work in schools within the jurisdiction, more emphasis should be placed on key streets and places to achieve the best cost-effectiveness.

Objective Based on the global burden of disease (GBD) study data, to analyze the current situation and changing trend of refractive disorders in China by comparing Japan, India, the United States, the United Kingdom and the world. Methods The prevalence, years lived with disability (YLD) rate of refractive disorders from 1990 to 2019 were obtained from the global health exchange (GHDx）database. The disease burden and change trend of refractive disorders were analyzed using Joinpoint and other software. Results In 2019, the number of refractive disorders in China exceeded 27 million, with the prevalence and YLD rate were 19.18‰ and 89.40/100,000 respectively. From 1990 to 2019, the prevalence and YLD rate of refractive disorders showed an increasing trend globally (except India), with the largest increase in China (up by 53.21% and 53.96% respectively). The age standardized YLD rates in China, Japan, the United States, and the United Kingdom were all lower than the global average level, but China's age standardized YLD rates were higher than the developed countries (Japan, the United States, and the United Kingdom). Conclusion From 1990 to 2019, there was a certain gap between China and developed countries in the control of refractive disorders. Therefore, it is necessary to understand the disease status from a global perspective in order to better prevent and control refractive disorders in the future.

Objective To analyze the data of prostate cancer in Wuhan from 2010 to 2019, understand the characteristics and trends of incidence, mortality, and YLL, and provide decision-making basis for Wuhan's cancer prevention and control strategies. Methods Data on deaths and incident cases of prostate cancer in Wuhan from 2010 to 2019 and from 2013 to 2017, respectively, were collected from the Wuhan Death Monitoring System. Indicators such as incidence rate, mortality rate, and years of life lost due to premature death (YLL) of prostate cancer in Wuhan were calculated using Excel 2016 and Python. The Bayesian Age-Period-Cohort Model (BAPC) was used to predict the mortality rate of prostate cancer in Wuhan from 2020 to 2024. The trend changes were described using the annual average percentage change (AAPC). Results From 2010 to 2019, the incidence, mortality, and YLL rates of prostate cancer in Wuhan showed an overall increasing trend (AAPC >0, P <0.05). The standardized mortality and incidence rates in the central urban area were significantly higher than those in the outer urban area, and the age group of 85 and above had the highest incidence and mortality rates. The age group of 0-54 had the largest increase in incidence and mortality rates. From 2020 to 2024, prostate cancer in Wuhan is expected to continue to increase slightly (an increase of 0.94%). Conclusion The incidence, mortality, and YLL rates of prostate cancer in Wuhan are showing an overall increasing trend, and this trend may continue. The characteristics are higher in the central urban area than in the outer urban area, and higher in the older age group than in the younger age group. Targeted measures need to be taken, and screening for high-risk populations should be strengthened.

Objective To analyze and compare the change of disease burden attributed to high temperature in the Chinese population in 2019 compared with 1990. Methods Based on the global burden of disease study data in 2019, the number of deaths, mortality, disability-adjusted life years (DALY) and DALY rate attributable to high temperature in Chinese population of different ages and genders in 1990 and 2019 were extracted to analyze the changing trend of disease burden attributable to high temperature exposure in Chinese population and its main causes. The Joinpoint regression model was used to analyze the trend of changes in standardized attributable DALY rates. Results Compared with 1990, the number of disease deaths attributable to high temperature in China in 2019 increased from 10 700 to 13 900, and the attributable DALY decreased from 532,200 to 276 100 person-years. The standardized mortality and DALY rates decreased by 35.25% and 65.20%, respectively. The burden attributable to high temperature was higher in males than in females, and the burden was relatively heavier in the population aged 70 and above. In 2019, chronic non-communicable diseases were the main cause of the attributable burden of high temperature exposure, and ischemic heart disease had the highest DALY burden, with an age-standardized DALY rate of 4.64/100 000. Conclusion The absolute death burden attributable to high temperature exposure in Chinese population is still increasing. It is necessary to pay more attention to high-risk groups such as men and the elderly, continue to strengthen environmental protection, and formulate relevant interventions in a targeted way to further reduce the disease burden caused by high temperature exposure.

Objective To assess the prevalence of female breast cancer in the city using data from the Wuhan Disease and Cause of Death Surveillance System for the past 10 years to provide a reference for breast cancer prevention and control. Methods The incidence case data from 2013 to 2017 and death case data from 2010 to 2019 in all districts of Wuhan city were collected. The incidence and mortality and their age-standardized rates were calculated. The joinpoint linear regression model was used to analyze the average annual percentage change (AAPC) , and the Bayesian age-period-cohort model (BAPC) was used to predict the mortality and age-standardized mortality of breast cancer among women in Wuhan from 2020 to 2024. Results The incidence and age-standardized incidence were 56.56/100 000 and 45.37/100 000 in 2013, and 67.46/100 000 and 52.01/100 000 in 2017, respectively. The changes showed an upward trend, but the difference was not statistically significant (P>0.05). The mortality and age-standardized mortality were 9.80/100 000 and 8.07/100 000 in 2010, and 10.47/100 000 and 7.13/100 000 in 2019, respectively. Although the rough mortality increased, the age-standardization mortality declined significantly (AAPC=2.13%, P<0.05). BAPC prediction results show that the standardized mortality rate of female breast cancer in Wuhan will drop to 6.33/100 000 in 2024. The peak age of incidence was in the age groups of 45-74 years and the peak age of mortality was in the age group of 85 years or older. In addition , the morbidity and mortality rates in the central urban area were higher than those in the distant urban area , and the difference decreased year by year. The BAPC predicted that the age-standardized mortality for breast cancer in women in Wuhan will decrease to 6.33 per 100 000 in 2024. Conclusion Breast cancer incidence and mortality rates in females in Wuhan show an increasing trend . However , the age-standardized mortality is on a significant downward trend due to the delay in the age of death. The elderly and those in central urban areas are the high-risk groups, so we should pay more attention to these groups , analyze the related risk factors , and take targeted prevention and control measures.

Objective To summary the hospitalization costs of lung cancer patients, and analyze the influence factors in these patients, and provide basis for controlling hospitalization costs of lung cancer patients. Methods The hospitalization costs data of hospitalized lung cancer cases in Wuhan from 2018 to 2020 were collected from medical records. Nonparametric test was used to analysis the data for single factor analysis. The patients were divided into two groups according on the upper quartile value of hospitalization cost, that is high-cost group (the cost ≥ the upper quartile value) and normal cost group (the cost “four major hospitals in Hubei^” respectively. The hospital type is an independent influencing factors, compared with specialized hospital, the OR is 4.726 for general hospital. The hospitalization days is the independent influencing factors, more hospitalization days has high cost. The treatment mode is the independent influencing factors, compared with non-operative treatment, the OR is 556.129, 18.156 and 5.212 for surgical model, radio therapy model and interventional model respectively. Conclusion The age, hospital level, hospital type, hospitalization days and treatment mode are the independent influencing factors of hospitalization costs. To reduce the hospitalization cost of lung cancer patients, we should standardize the diagnosis of lung cancer patients, and focus on standardizing the treatment mode, also considering other influencing factors, such as hospital level, hospital type.

Objective To evaluate the impact of particulate matter (PM) pollution on the hospitalization for respiratory diseases (RD), to estimate the avoidable economic loss by reducing the level of PM pollution, and to provide a basis for evaluating the cost-effectiveness of air pollution control. Methods The data of RD inpatients in two class-A tertiary hospitals in Wuhan from 2015 to 2019, PM concentration and meteorological data in Wuhan in the same period were collected. The generalized additive model (GAM) was used to estimate the impact of PM on the number of RD inpatients, and the cost of illness approach (COI) was used to estimate the avoidable economic loss caused by the reduction of PM concentration. Results PM pollution caused an increase in the number of RD inpatients. Each 10 g/m³ increase in PM_2.5 and PM₁₀ concentrations resulted in an increase of 1.71% and 0.71% in the number of RD inpatients, respectively. Among them, men and children aged 0-14 years were more affected. For every 10 g/m³ increase in PM_2.5 concentration, the number of hospitalized men and children aged 0-14 years increased by 1.97% and 2.65%, respectively. For every 10 g/m³ increase in PM₁₀ concentration, the number of hospitalized men and children aged 0-14 years increased by 0.87% and 0.88%, respectively. PM pollution caused 63 300 hospitalizations and 1.214 billion yuan of economic losses in 2015-2019,Wuhan. If the PM concentration is reduced to the recommended value of the World Health Organization in the same period, 194 million yuan of economic loss and 10100 hospitalizations could be avoided every year in Wuhan. Conclusion PM exposure can lead to heavy disease burden and economic loss. Taking effective measures to control PM concentration will bring great economic benefits.

Objective To analyze the epidemic trends and risk factors of cardiovascular disease (CVD) burden in China from 1990 to 2019, based on the Global Burden of Disease (GBD) study 2019, by comparing with the world, the USA, Japan and India. Methods Data were obtained from the Global Health Data Exchange (GHDx) database, and the prevalence, incidence, mortality, disability adjusted life years (DALY) rate and main risk factors of CVD in China in 2019 were analyzed by gender and age. Age-standardized rates were used to compare the trends of CVD burden in the world and other four countries. Results In 2019, the number of CVD patients, incidences and deaths in China was 120.33 million, 12.34 million, and 4.58 million, respectively. The prevalence, morbidity, mortality and DALY rate increased from 4 235.43/100 000, 447.81/100 000, 204.75/100 000 and 5 091.03/100 000 in 1990 to 8 460.08/100 000, 867.65/100 000, 322.30/100 000, and 6 463.47/100 000 in 2019, respectively, all of which were increasing with age. The burden of CVD in males was higher than that in females. After eliminating the influence of population aging, the age-standardized mortality rate of CVD in China decreased from 381.21/100 000 in 1990 to 276.93/100 000 in 2019, and the age-standardized DALY rate decreased from 7 412.81/100 000 to 4 938.38/100 000. However, they were still slightly higher than those in the world and significantly higher than those in the USA and Japan. In addition, the leading four risk factors of CVD in China in 2019 were hypertension, dietary risks, air pollution and tobacco. A higher burden of CVD caused by all these factors in China were above the global average level. Conclusion Due to hypertension, dietary factors, air pollution, tobacco and other reasons, coupled with the rapid aging of the population, the burden of CVD in China is still very serious, and relevant departments need to pay more attention to it.