Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-02-19 Cooperative journals: 《中国全科医学》
Abstract： Background As China's Traditional medicine is included in the ICD-11 code，the rational allocation of basic TCM medical resources is the guarantee to promote the integration of traditional Chinese medicine and western medicine and the universal coverage of high-quality medical resources. The uneven layout and service capabilities of grassroots medical institutions have led to a widespread imbalance in the supply and demand of medical resources in urban and rural areas. Objective Understand the development status of traditional Chinese medicine services in rural areas of China，scientifically evaluate the coverage and accessibility of grassroots traditional Chinese medicine diagnosis and treatment，provide new ideas for optimizing the spatial resource allocation of grassroots traditional Chinese medicine services，and propose optimization strategies accordingly.Methods Based on the seventh national population census data and path planning data，the concept of medical service radius is introduced to calculate the diagnosis and treatment scope of different levels of traditional Chinese medicine medical institutions under walking mode. Using methods such as spatial kernel density index and spatial standard deviation ellipse to reveal the spatial fairness of the supply and demand capacity of traditional Chinese medicine medical services. Based on the above results，propose types and measures for optimizing the layout of traditional Chinese medicine medical resources. Results As of 2022，there are a total of 699 medical institutions in Zengcheng District，including 18 traditional Chinese medicine medical institutions with beds. There are significant differences in the distribution of beds in traditional Chinese medicine medical institutions in different townships and streets. Meanwhile，the number of beds per thousand population in Zhongtan Town is 14.31，ranking first among all streets. The number of beds per thousand people in Yongning Street ranks last，with only 0.89 beds. Traditional Chinese medicine medical institutions in Zengcheng District have shown a clear dual center pattern，with weak accessibility to traditional Chinese medicine services for residents in the central part of Zhongxin Town，the northern part of Paitan Town，and the southwestern part of Shitan Town. The supply capacity of traditional Chinese medicine services varies greatly among different townships. There is still a certain degree of inconsistency between the spatial distribution of traditional Chinese medicine medical institutions and the overall spatial clustering of urban residents. There are differences in the radius of traditional Chinese medicine services between different townships. Conclusion Since the implementation of the development strategy of traditional Chinese medicine，China's Traditional medicine has been protected and developed. We should adopt a more scientific strategy to closely integrate traditional Chinese medicine services with the development of the city and the needs of residents. We should actively adopt a differentiated strategy of increasing facility points，combining resource transfer and sinking，and integrating traditional Chinese medicine information technology for diagnosis and treatment across regions，gradually achieving a true strategy of full coverage and equal emphasis on traditional Chinese and Western medicine.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-07-24 Cooperative journals: 《中国全科医学》
Abstract： Background The disease burden of esophageal cancer is high in China，more and more studies have shown that tobacco has a greater adverse effect on the development of esophageal cancer. Objective To understand trends inesophageal cancer deaths and burden of disease attributable to tobacco in China from 1990 to 2019，and provide data to inform the development of public health policies and interventions. Methods Global burden of disease 2019 （GBD 2019） data were used to extract the age-specific and sex-specific data on esophageal cancer deaths attributable to tobacco in China from 1990 to 2019. Mortality，disability adjusted life years（DALYs），years of life lost（YLLs），and disability adjusted life years （YLDs） were used to assess the disease burden of esophageal cancer attributable to tobacco in China. Joinpoint regression software and age#2;period-cohort modeling methods were applied to analyze the trends of disease burden and mortality with age，period and cohort. the Bayesian-period-cohort analysis （BAPC） was applied to predict the mortality rate of esophageal cancer attributable to tobacco in China from 2020 to 2030. Results From 1990 to 2019，the number of deaths caused by esophageal cancer attributable to tobacco among Chinese residents rose from 76，400 to 123，900，with an increase of 62.17%，and the standardized mortality rate declined from 9.30/100 000 to 6.20/100 000，with a decrease of 33.33%；the DALYs rose from 1，972，500 person-years to 2，822，600 person-years，with an increase of 43.10%，and the DALYs rate decreased from 220.50/100 000 to 134.47/100 000，with a decrease of 39.02%. In terms of gender，the disease burden of esophageal cancer attributable to tobacco was mainly caused by males，with 117，700 deaths and a standardized mortality rate of 12.82/100 000 in 2019 due to tobacco-attributable esophageal cancer in males，compared to 0.62 million deaths number and a standardized mortality rate of 0.63/100 000 in females. In 2019，the number of esophageal cancer deaths attributable to tobacco among Chinese residents peaked in the age group of >69-74 years，while DALYs peaked in the age group of >64-69 years，at 23，000 and 510，300 cases，respectively. The mortality rate continued to increase with age，especially after 50 years of age. The results of Joinpoint regression analysis showed that the AAPC value of esophageal cancer mortality attributable to tobacco was -1.4〔95%CI（-1.6，-1.2）〕 in China from 1990 to 2019，with -3.3〔95%CI（-3.6，-2.9）〕 for females，and -1.3〔95%CI（-1.4，-1.1）〕 for males；the AAPCfor DALYs rate was -1.7〔95%CI（-1.9，-1.5）〕，with -3.7〔95%CI（-4.0，-3.4）〕 for females and -1.5〔95%CI（-1.7，-1.3）〕 for males. Analysis of the age-period-cohort model of mortality from esophageal cancer attributable to tobacco showed a negative net offset of -1.690%〔95%CI（-2.024%，-1.354%）〕. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer among Chinese residents will be relatively stable with a small decrease from 2020 to 2030，with mortality rates declining from 12.64/100 000 in 2020 to 12.63/100 000 in 2030 for males，and from 0.6/100 000 in 2020 to 0.46/100 000 for females. Conclusion Mortality rates and DALYs due to tobacco-attributable esophageal cancer among Chinese residents increased and then declined from 1990 to 2019. The burden of disease due to tobacco-attributable esophageal cancer is mainly caused by males in term of gender，by middle-aged and elderly people by age，which should be given sufficient attention. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer will be stable and slightly decreasing from 2020 to 2030.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-03-28 Cooperative journals: 《中国全科医学》
Abstract： Background Diabetes is highly prevalent in China，the prevention and treatment of it and its related complications need a lot of medical resources. Local reports have revealed that although the mortality of diabetes is declining，the burden of diabetes is still increasing. Objective To understand the epidemiological characteristics and burden of diabetes in China from 1990—2019，forecast the incidence of diabetes in China from 2020 to 2030，to provide data for evaluating and formulating diabetes-related prevention and treatment policies and measures. Methods In August 2022，this study used data from the Global Burden of Disease Study 2019. Temporal trends of the incidence，mortality，disability-adjusted life years（DALY），years of life lost（YLL），and years lost due to a disability（YLD） of diabetes in China from 1990 to 2019 were described. The Bayesian-age-period-cohort analysis was used to predict the incidence of diabetes in China from 2020 to 2030. Results Compared with 1990，in 2019，the crude prevalence of diabetes increased to 265.45/100 000，with an increase of 63.12%，the standardized prevalence of diabetes increased to 204.31/100 000，with an increase of 15.93%，the crude mortality rate of diabetes increased to 12.16/100 000，with an increase of 105.41%，and the standardized mortality rate of diabetes increased to 9.44/100 000，with an increase of 2.61%. The YLL rate decreased from 204.71/100 000 in 1990 to 178.45/100 000 in 2019. The YLD rate increased from 260.74/100 000 in 1990 to 316.30/100 000 in 2019. The DALY rate increased from 465.46/100 000 in 1990 to 494.76/100 000 in 2019. Compared with 1990，the DALY rate of diabetes increased by 21.08% in males and decreased by 6.68% in females. The YLL rate，YLD rate and DALY rate increased with age in 2019. According to the prediction of the standardized incidence of diabetes in China from 2020 to 2030，the overall standardized incidence of diabetes would present a decreasing trend during the period，and the standardized incidence of diabetes in 2030 would decrease by 11.45% in men and 18.60% in women compared with 2020. Conclusion The burden of diabetes in China is still heavy，with a large number of illness cases and decreased cases，mainly manifested by a high burden caused by diabetes-related disability. Attention should be paid to early prevention of diabetes to reduce the occurrence of complications. The disease burden of males and middle-aged and elderly people is heavy，so sufficient attention should be paid to them. Although the predicted diabetes incidence will reduce between 2020 and 2030，the number of patients is still increasing，so the prevention and control of diabetes should not be slack.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-30 Cooperative journals: 《中国全科医学》
Abstract：
Background Diabetes is a chronic metabolic disease that has become one of the chronic diseases that threaten the health of our population. Objective To understand the epidemiological characteristics and disease burden of diabetes in China from 1990-2019, and to provide data for evaluating and formulating diabetes-related prevention and treatment policies and measures. Methods Using the results of the Global Burden of Disease Study 2019, we describe the changes and age distribution characteristics of incidence, mortality, disability adjusted life year (DALY), year of life lost (YLL), and year lived with disability (YLD) of diabetes in China from 1990 to 2019, and project the incidence of diabetes in China from 2020 to 2030 using Bayesian-period-cohort analysis (BAPC) method. Results In 2019, the crude prevalence of diabetes in China was 265.45/100,000 and the standardized prevalence was 204.31/100,000, an increase of 63.12% and 15.93%, respectively, relative to 1990; the crude mortality rate was 12.16/100,000 and the standardized mortality rate was 9.44/100,000, an increase of 105.41% and 2.61%, respectively. The YLL rate showed a decreasing trend, the YLD rate and DALY rate showed an increasing trend. The disease burden of diabetes in men is higher than that in women, and the growth rate is faster than that in women; the disease burden of diabetes increases with age; the incidence of diabetes in our population shows a decreasing trend during 2020-2030. Conclusion The disease burden of diabetes in China is still high, with a high number of morbidity and mortality. The disease burden is manifested by a high disease burden caused by disability, and attention should be paid to the early prevention of diabetes to reduce the occurrence of complications; the disease burden is higher in the male and middle-aged and elderly population, and sufficient attention should be paid to this population.
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