2019年重庆市30岁及以上人群归因于被动吸烟的肺癌疾病负担研究

目的 分析重庆市肺癌发病死亡和疾病负担归因于被动吸烟的情况,为开展肺癌防治提供建议。 方法 肺癌死亡个案数据来源于2019年重庆市肿瘤登记报告系统,被动吸烟率来自2013年重庆市慢性病及危险因素监测。计算人群归因危险度百分比(population attributable risk percent, PAR%)、被动吸烟导致的肺癌发病、死亡和疾病负担。采用Excel 2010与SPSS 25.0进行统计分析,率的比较采用χ²检验。 结果 2013年30岁及以上成年人被动吸烟率为52.37%。2019年重庆市30岁及以上人群肺癌发病率与标化发病率分别为118.44/10万与80.83/10万,死亡率与标化死亡率分别为96.51/10万、63.58/10万。肺癌发病率和死亡率归因于被动吸烟的PAR%分别为19.76和19.04,归因发病率与归因标化发病率分别为23.41/10万和16.34/10万,归因死亡率与归因标化死亡率分别为18.38/10万和12.40/10万。2019年重庆市30岁及以上肺癌早死所致寿命损失年率(years of life lost,YLL)、残疾所致寿命损失年率(years lived with disability,YLD)、调整伤残寿命损失年率(disability adjusted life year,DALY)分别为21.16‰、0.31‰、21.47‰,YLL率、YLD率、DALY率归因于被动吸烟的PAR%分别为21.16、19.76和20.49,归因YLL率为4.34‰,归因YLD率为0.06‰,归因DALY率为4.40‰。 结论 2019年重庆市30岁及以上人群肺癌发病率、死亡率、YLL率、DALY率高,被动吸烟率高,肺癌归因于被动吸烟的疾病负担重,应加强落实控烟工作。     

Family Caregivers' Subjective Caregiving Burden,Quality of Life,and Depressive Symptoms Are Associated With Terminally Ill Cancer Patients' Distinct Patterns of Conjoint Symptom Distress and Functional Impairment in Their Last Six Months of Life

Context

Family caregivers constitute a critical component of the end-of-life care system with considerable cost to themselves. However, the joint association of terminally ill cancer patients' symptom distress and functional impairment with caregivers' subjective caregiving burden, quality of life (QOL), and depressive symptoms remains unknown.

Time to REST: epidemiology and burden

Restless legs syndrome (RLS) is a neurological disorder characterized by a compelling urge to move, accompanied by disturbing sensations within the legs. It is now recognized that RLS is a common condition that has a substantial impact on sleep, daily activities and quality of life. Recent data from the REST (RLS Epidemiology, Symptoms, and Treatment) general population study show that symptoms of RLS are present in approximately 7% of the general population, and that 2–3% experience moderate or severe symptoms at least twice a week. Amongst this RLS cohort, approximately 88% reported sensory disturbances and 76% reported sleep-related symptoms. These symptoms had a marked effect on everyday life, with up to 50% of the RLS cohort reporting disruption of everyday activities or personal relationships. Sleep disturbances in turn lead to impaired daytime functioning. RLS is associated with a significant impairment of quality of life, comparable with that seen in chronic medical conditions such as diabetes or depression. Given the significant burden of morbidity associated with RLS, there is a strong case for treatment in patients with troublesome symptoms.     

中国急性心肌梗塞的疾病经济负担

主要通过对急性心肌梗塞疾病经济负担的研究，总体描述进行二线预防的重要性。资料主要来源于中文文献检索、政府统计报表。主要利用直接医疗费用来计算疾病经济负担，而未考虑直接非医疗费用和间接费用。中日急性心肌梗塞的发病率约为45／10万。55／10万。城市高于农村，男性高于女性。在2000年，急性心肌梗塞的死亡率在城市为32．39／10万，农村为17．99／10万，其死亡率随年龄增长而相应增长。与发病率一样，城市高于农村，男性高于女性。25岁以上人群因急性心肌梗塞而损失的DALY在2000年为3．57DALYs／千人口。怎性心肌梗塞的直接医疗费用在国家卫生部部属医院为28257元／例，省级医院为8663元／例，县级医院为5447无／例。测算2000年急性心肌梗塞的疾病经济负担为13亿元。19亿元。但由于只有10．6％的急性心肌梗塞病人得到临床床治疗，因此，本测算结果可能低估了在中国实际发生的疾病经济负担。     

从医务人员的证据意识谈举证责任倒置

文章从剖宫产术后伴发腰腿痛病例分析入手，认为举证责任倒置就在我们诊疗工作中，就在我们协调医患关系的过程中。因此需要在临床实践中去感悟举证责任置的深刻含义，从而树立证据意识，做好证据的收集与保存工作，一旦发生诉讼有证为据，并由此提出了“医学证据学”的构想，而医学证据的特点有待进一步深入研究。     

Burden of injuries and diseases in Yunnan Tin Miners

The burden of injuries is underestimated to an even greater extent in developing countries than in industrialized countries. The objective of this paper is to analyze injuries and diseases in the monitored work place of the world's largest tin mining operation in Yunnan, South China.     

Asbestos fiber type in malignant Mesothelioma: An analytical scanning electron microscopic study of 94 cases

Although the association between asbestos exposure and malignant mesothelioma is indisputable, controversy continues regarding the relative contribution of the various types of asbestos fibers to the development of mesothelioma. We examined the types of asbestos fibers recovered from lung parenchyma in more than 90 cases of malignant mesothelioma from the United States, using an analytical scanning electron microscope. Almost half of the patients were former asbestos insulators or shipyard workers. The fibers were recovered from lung tissues obtained at autopsy or surgical resection by means of a sodium hypochlorite digestion procedure. Amosite absestos was identified in 81% of the cases and accounted for 58% of all fibers 5 μm or greater in length. Tremolite/actinolite/anthophyllite were identified in 55% of the cases and accounted for 10% of all fiber types. Chrysotile was identified in 21% of the cases and accounted for 3% of fibers exceeding 5 μm in length. Crocidolite was found in 16% of the cases and accounted for 3% of fibers exceeding 5 μm in length. Nonasbestos mineral fibers (commonly found in the lungs of the general population) were observed in 71% of the cases and accounted for 25% of all fibers 5 μm or greater in length. The findings in this study are at odds with the assertion that crocidolite asbestos is responsible for most mesotheliomas in the United States. © 1993 Wiley-Liss, Inc.     

PLPP2: Potential therapeutic target of breast cancer in PLPP family

PLPPs (Phospholipid phosphatases) are widely expressed in different human tissues, regulate cell signal transduction, and are overexpressed in cancers such as gliomas, pancreatic adenocarcinoma, lung adenocarcinoma, and so on. As a member of the PLPP family, PLPP2 (phospholipid phosphatase 2) plays a vital role in the occurrence and development of breast cancer, but its mechanism is still unclear. Our research found that PLPP2 was overexpressed in breast cancer, and the higher expression level of PLPP2 showed a worse prognosis for breast cancer patients. Further analysis showed that overexpression of PLPP2 affected the expression of CDC34 (cell-division cycle 34), LSM7 (Like-Smith 7), and SGTA (small glutamine-rich tetratricopeptide repeat-containing protein alpha) through EMT (epigenetic-mesenchymal transition) related pathways to promote the occurrence and development of breast cancer. In vitro, silencing PLPP2 significantly reduced the proliferation, invasion, and migration abilities of human breast cancer cells MDA-MB-231. ER+ is a common subtype of breast cancer. Furthermore, we found that the overexpression of PLPP2 was significantly related to the poor prognosis of ER+ breast cancer. These results indicate that PLPP2 has value as a potential therapeutic target for breast cancer, especially for ER+ breast cancer.     

2014—2019年江西省伤害死亡情况及疾病负担分析

目的 了解江西省居民伤害死亡流行情况及其疾病负担,为科学制定本省伤害防制策略和措施提供依据。方法 利用中国死因登记报告信息系统2014—2019年江西死因监测数据,应用Excel 2007和SPSS 17.0软件进行数据整理和分析。采用死亡数、粗死亡率、标化死亡率、构成比、潜在减寿年数（PYLL）、减寿率（PYLLR）和平均潜在减寿年数(AYLL)等指标进行统计学描述,趋势变化采用年度变化百分比（APC）进行分析。结果 2014—2019年江西报告伤害死亡25 638人,年均粗死亡率为 50.81/10万,年均标化死亡率为 49.55/10万。男性死亡率高于女性、城市死亡率高于农村。伤害死亡前5位死因分别为道路交通事故、跌落、溺水、自杀和中毒。溺水、交通事故、跌落分别是0～14岁、15～44和45～64岁、≥65岁的首位伤害死因。2014—2019年江西省前5位伤害死因中,跌落粗死亡率呈上升趋势（APC = 8.22%）,中毒粗死亡率均呈下降趋势。2014—2019年伤害PYLL为692 196.73人年,PYLLR为14.24‰,AYLL 为 33.77年。PYLL及PYLLR 交通事故最高,AYLL最高的为溺水。15～44岁年龄组PYLL最高。结论 江西省伤害死亡负担较重,应根据不同人群的伤害死亡特征制定相应的防控策略和措施。