Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-01-24 Cooperative journals: 《中国全科医学》
Abstract： Background Gastroesophageal reflux disease（GERD）has a high incidence and a heavy disease burden in recent years，but there is a lack of data to understand the burden of GERD in China.This study describes and analyzes the disease burden of GERD in order to better understand the prevalence of GERD in China. Objective To analyze the disease burden and prevalence trend of GERD in China from 1990 to 2019，and to provide a reference for the prevention and treatment of GERD in China. Methods Crude and standardized incidence，prevalence，and DALY rates of GERD in China from 1990 to 2019 were obtained from the Global Burden of Disease Database 2019（GBD 2019）；the rate of change was calculated，and Joinpoint regression model was used to analyze the standardized incidence，prevalence，and DALY rates of GERD. Results In 2019，the crude and standardized rates of GERD incidence in China were 2 299.80 per 100 000 and 1 841.66 per 100 000，respectively. Compared with 1 761.59 per 100 000 and 1 849.31 per 100 000 in 1990，the crude rate increased by 30.55%，and the standardized rate decreased by 0.41%. In 2019，the crude rate and standardized rates of GERD prevalence in China were 5 739.55 per 100 000 and 4 509.32 per 100 000，respectively. Compared with 4 252.72 per 100 000 and 4 532.19 per 100 000 in 1990，the crude rate increased by 34.96%，and the standardized rate decreased by 0.51%. In 2019，the crude rate and standardized rates of GERD DALY rate in China were 44.37 per 100 000 and 34.94 per 100 000，respectively. Compared with 33.10 per 100 000 and 35.04 per 100 000 in 1990，the crude rate increased by 34.05%，and the standardized rate decreased by 0.29%. The age-standardized incidence，prevalence，and DALY rates were lower than crude rates after 1996. The standardized incidence，prevalence，and DALY rates of Chinese women were higher than those of men from 1990 to 2019. The results of Joinpoint regression analysis showed that the standardized incidence of GERD in China showed a downward trend from 1990 to 1994（APC=-1.0%），a downward trend from 2005 to 2010（APC=-1.4%），and an upward trend from 2014 to 2017（APC=3.2%）.The standardized prevalence of GERD in China showed a downward trend from 1990 to 1994（APC=-1.2%），a downward trend from 2005 to 2009（APC=-1.7%），and an upward trend from 2014 to 2017（APC=3.7%）. The standardized DALY rates of GERD in China showed a downward trend from 1990 to 1994（APC=-1.1%），a downward trend from 2005 to 2009（APC=-1.7%），and an upward trend from 2014 to 2017（APC=3.6%）. In 2019，the standardized incidence，prevalence，and DALY rates of GERD in China continued to increase with age，peaking at the age of 70 to 84 years. The number of new cases and cases of GERD in 2019 were respectively about 32.711 3 million and 81.636 5 million，and the populations were mainly concentrated in the age group of 45 to 59 years and 30 to 34 years. Conclusion From 1990 to 2019，the disease burden of GERD in China showed an upward trend in terms of crude rate and a slight decline in terms of standardized rate，indicating that aging had a great impact on the incidence，prevalence and DALY rate of GERD in China. In addition，it is important to pay attention to the middle-aged and young population，who account for a larger proportion of the population already suffering from GERD and may be closely related to overweight or obesity，alcohol consumption and dietary habits，etc.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-01-12 Cooperative journals: 《中国全科医学》
Abstract： Background Gallbladder cancer is featured by difficult early detection，poor treatment effectiveness and high mortality. An in-depth epidemiology research of gallbladder cancer can provide valuable data for the formulation of prevention and treatment strategies for gallbladder cancer. Objective To analyze the trend of disease burden of gallbladder cancer in China from 1990 to 2019，and to estimate its onset age，period，cohort effects and future trends. Methods Data of disease burden of gallbladder cancer，including the incidence，prevalence，mortality，disability adjusted life year（DALY）rate and corresponding standardized rates in China from 1990 to 2019 were extracted from the 2019 Global Burden of Disease Research （GBD 2019）database from March to June 2023. The annual percentage change（APC）and average annual percentage change （AAPC）were calculated using Joinpoint to analyze the trend of disease burden of gallbladder cancer in China from 1990 to 2019. A Bayesian age-period-cohort analysis（BAPC）model was created to predict the incidence of gallbladder cancer in China from 2020 to 2030. Results From 1990 to 2019，the standardized incidence rate of gallbladder cancer in China significantly rose from 1.58/100 000 in 1990 to 2.01/100 000 in 2019，with the AAPC of 0.82%（95%CI=0.65%-1.00%，P<0.001）. The standardized prevalence significantly rose from 1.64/100 000 in 1990 to 2.40/100 000 in 2019，with the AAPC of 1.34%（95%CI=1.14%- 1.54%，P<0.001）. The standardized mortality significantly rose from 1.61/100 000 in 1990 to 1.82/100 000 in 2019，with the AAPC of 0.40%（95%CI=0.24%-0.56%，P<0.001）. The standardized DALY rate significantly rose from 35.18/100 000 in 1990 to 37.71/100 000 in 2019，with the AAPC of 0.25%（95%CI=0.12%-0.38%，P<0.001）. The BAPC model revealed that the net drift values for the incidence and mortality of gallbladder cancer in China from 1990 to 2019 were 0.99（95%CI=0.81-1.18） and 0.42 （95%CI=0.21-0.63），respectively. The incidence and mortality of gallbladder cancer increased with age，and the incidence of gallbladder cancer achieved the peak in people aged 80 years and above. The risk of onset and death of gallbladder cancer showed a decreasing trend at first and then an increasing trend followed by a decreasing trend over time，both of which peaked from 2005 to 2009. In addition，the risk of onset and death of gallbladder cancer showed an increasing trend at first and then a decreasing trend over the time of birth cohort. The BAPC model predicted that the standardized incidence，morbidity，mortality and DALY rate of gallbladder cancer in China will show a slight upward trend from 2020 to 2030. Conclusion From 1990 to 2019，the standardized incidence，prevalence，mortality and DALY rate of gallbladder cancer in China showed an upward trend，and the disease burden was still serious. The prevention and treatment of gallbladder cancer among men and the elderly，and vigorous propaganda of medical knowledge about cancer prevention，biliary disease control and promotion of healthy lifestyles should be strengthen to reduce the disease burden of gallbladder cancer.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-07-21 Cooperative journals: 《中国全科医学》
Abstract： Background Inflammatory bowel disease（IBD） has become highly prevalent in recent years characterized by a prolonged disease course and high disease burden. However，there is a lack of data to understand the burden of IBD in China，which may hinder health care planning and resource allocation for the disease. Objective To investigate the burden of IBD and its variation tendency in China from 1990 to 2019，and analyze the influence of age，gender and period on IBD. Methods The incidence，mortality and disability adjusted life year（DALY） rate of IBD in China from 1990 to 2019 were collected using the Global Burden of Disease Database 2019. Joinpoint software was used to analyze the variation tendency and characteristics of standardized incidence，standardized mortality and standardized DALY rate of IBD，and Excel 2019software was used for data processing. Results From 1990 to 2019，the standardized incidence increased from 1.47 per 100 000 to 3.001 per 100 000 with AAPC of 2.50%〔95%CI（2.4，2.6）〕，the standardized mortality decreased from 0.86/100 000 to 0.35/100 000 with AAPC of -1.6%〔95%CI（-3.8，-3.4）〕，the standardized DALY rate decreased from 24.47/100 000 to 16.31/100 000，with AAPC of -2.20% （95%CI：-2.3，-2.0），the changes of trends were all statistically significant（P<0.05）. The standardized incidence and mortalityof of males were higher than females in each year，while the standardized DALY rate of females was higher than males before 1995，basically the same in males and females from 1995 to 2001，and higher in males than females after 2001. There was overall stable uptrend in the AAPC of the standardized incidence of IBD in all age groups by year（P<0.05） and overall downtrend in the AAPC of standardized mortality rate in all age groups，while the downtrend became slower with increasing age（P<0.05）. Conclusion From 1990 to 2019，the standardized mortality rate and DALY rate of IBD showed a downtrend，while the standardized incidence showed an uptrend. The standardized incidence and mortality of males were higher than females by year. The burden of IBD in elderly population deserves priority attention and will be a major public health challenge in China due to large population base and aging population.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-07-10 Cooperative journals: 《中国全科医学》
Abstract： Gastric cancer（GC）is one of the most heterogeneous and aggressive malignant tumors of the digestive system. Traditional chemotherapy drugs and epidermal growth factor receptor 2（HER2）targeted drugs such as Trastuzumab still have the disadvantages of high incidence of drug resistance，high toxic side effects and poor tolerance of patients. Therefore，it is imperative to develop more effective anti GC drugs. Novel targeted drugs against HER2 are currently available，but are ineffective or resistance in some cases，which is related to the low expression of HER2（HER2 IHC1+ or IHC2+/ISH-） in certain GC cells，accounting for about 40%-60% of all types. However，in clinical practice，these patients are still reported as HER2-negative GC. Therefore，accurate detection of HER2 expression is crucial to identify patients who may benefit from trastuzumab therapy. The emergence of antibody drug conjugates（ADC）provides a new therapeutic option for HER2-positive GC and it is expected to replace traditional GC chemotherapy in the future by its precise and efficient anti-tumor effect. Recent studies have found that ADC may have potential anti-tumor activity in HER2 low-expression GC，and related clinical studies are evaluating its effectiveness and safety in HER2 low-expression GC treatment. This article reviews the application and the latest research progress of ADC in HER2 low-expression GC patients in the era of targeted therapy and discusses the challenges faced in the application and development of HER2-targeted ADCs.
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