To understand the changing trends in the burden of chronic obstructive pulmonary disease (COPD) and the main risk factors for death in major countries participating in the Belt and Road Initiative (BRI) from 1990 to 2021, and to provide a reference for formulating COPD prevention and control strategies for these countries.

Data on age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized disability-adjusted life years (DALY) rate, and the attributable fraction of COPD death risk factors from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021 (GBD 2021) database for 13 major BRI participating countries: China, Egypt, Pakistan, Russia, the Philippines, Bangladesh, Myanmar, Thailand, Turkey, Iran, India, Indonesia, and Vietnam. Estimated annual percentage change (EAPC) was used to describe the trends in ASIR, ASMR, and age-standardized DALY rate in each country. Butterfly charts were used to compare the attributable fractions of COPD death risk factors by sex in 2021.

From 1990 to 2021, the ASIR of COPD generally showed an upward trend in Egypt, Turkey, Iran, Indonesia, and Vietnam, increasing from 129.68/100 000, 199.53/100 000, 114.36/100 000, 155.06/100 000, and 159.48/100 000 in 1990 to 177.45/100 000, 225.79/100 000, 152.05/100 000, 176.01/100 000, and 179.64/100 000 in 2021, respectively. The corresponding EAPCs (95%CI) were 0.92% (0.90–0.95), 0.38% (0.34–0.42), 0.96% (0.94–0.98), 0.36% (0.33–0.38), and 0.28% (0.24–0.33). The ASIR of COPD generally showed a downward trend in China, Pakistan, Russia, the Philippines, Bangladesh, Myanmar, Thailand, and India, decreasing from 271.22/100 000, 243.66/100 000, 162.10/100 000, 191.76/100 000, 260.88/100 000, 241.21/100 000, 164.34/100 000, and 275.49/100 000 in 1990 to 215.62/100 000, 231.91/100 000, 144.19/100 000, 165.78/100 000, 238.94/100 000, 234.81/100 000, 125.47/100 000, and 262.45/100 000 in 2021, respectively. The corresponding EAPCs (95%CI) were –0.84% (–0.88– –0.81), –0.18% (–0.22– –0.14), –0.53% (–0.59– –0.46), –0.14% (–0.16– –0.12), –0.29% (–0.35– –0.23), –0.91% (–0.94– –0.88), –0.67% (–0.74– –0.59), and –0.18% (–0.19– –0.17). From 1990 to 2021, the ASMR of COPD generally showed a downward trend in China, Egypt, Pakistan, Russia, the Philippines, Bangladesh, Myanmar, Thailand, Turkey, Iran, Indonesia, and Vietnam, decreasing from 231.78/100 000, 48.30/100 000, 83.97/100 000, 29.81/100 000, 46.58/100 000, 101.94/100 000, 135.53/100 000, 55.13/100 000, 57.54/100 000, 21.01/100 000, 53.00/100 000, and 54.29/100 000 in 1990 to 73.23/100 000, 25.87/100 000, 73.80/100 000, 13.04/100 000, 32.81/100 000, 59.65/100 000, 104.53/100 000, 19.80/100 000, 40.77/100 000, 17.44/100 000, 49.53/100 000, and 43.96/100 000 in 2021, respectively. The corresponding EAPCs (95%CI) were –4.25% (–4.48– –4.02), –0.32% (–0.44– –0.19), –0.66% (–0.92– –0.40), –3.23% (–3.60– –2.86), –1.11% (–1.22– –1.00), –1.97% (–2.33– –1.61), –4.05% (–4.36– –3.75), –0.92% (–1.01– –0.84), –0.72% (–1.11– –0.33), –2.12% (–2.32– –1.92), –0.19% (–0.31– –0.06), and –0.66% (–0.76– –0.55). From 1990 to 2021, the age-standardized DALY rate of COPD generally showed a downward trend in all 13 major BRI participating countries. Attributable death risk factor analysis for COPD deaths showed significant sex differences in the proportions of deaths attributed to ambient particulate matter pollution, household air pollution from solid fuels, and occupational risks, with males generally having higher proportions than females.

From 1990 to 2021, the burden of COPD generally showed a downward trend in the 13 major BRI participating countries, with significant differences among countries. The proportions of COPD deaths attributed to ambient particulate matter pollution, household air pollution from solid fuels, and occupational risks were higher in males than in females.

To evaluate the cost-effectiveness of different influenza vaccination rates among the elderly population aged 65 years and above in Qingdao city.

A Markov model was constructed to evaluate the cost-effectiveness of different influenza vaccination rates for influenza prevention. The per capita gross domestic product (GDP) of Qingdao city in 2021 was used as the willingness-to-pay threshold for one quality-adjusted life year (QALY). The target population was the elderly aged 65 years and above in Qingdao city. The model time horizon was one year. Three influenza vaccination rates were set at 20%, 40%, and 75%, respectively. Univariate and probabilistic sensitivity analyses were performed to assess the impact of different parameters on the results.

Compared with no influenza vaccination, a 20% vaccination rate could reduce the number of influenza infections by 11 942 cases, reduce the total cost by 847 831.97 CNY, and increase the total QALYs by 6 964.09; a 40% vaccination rate could reduce the number of influenza infections by 23 884 cases, reduce the total cost by 1 695 663.95 CNY, and increase the total QALYs by 13 928.19; and a 75% vaccination rate could reduce the number of influenza infections by 44 782 cases, reduce the total cost by 3 179 369.90 CNY, and increase the total QALYs by 26 115.36. Univariate sensitivity analysis showed that the top four parameters affecting the results were the influenza rate in the unvaccinated population, the influenza rate in the vaccinated population, the cost of inpatient treatment, and the cost of outpatient treatment, respectively. Probabilistic sensitivity analysis showed that all three vaccination rates had more than a 90% advantage compared with no vaccination.

Compared with no influenza vaccination, increasing the influenza vaccination rate among the elderly population aged 65 years and above in Qingdao city has a high cost-effectiveness advantage.

To establish and optimize a simple and efficient norovirus concentration and detection technique for seawater samples from shellfish farming areas to address global food safety hazards and meet the needs of precise infectious disease prevention and control.

Using murine norovirus as the experimental subject, a nano-alumina ceramic filter-based enrichment technique was combined with a novel azido bromide propidium (PMAxx) nucleic acid dye and real-time quantitative PCR (PMAxx-qPCR) to detect viable viruses. Viruses were first enriched using a filter membrane, initially concentrated with Tralk eluent, and then further concentrated using PEG precipitation. The detection efficacy of this method was evaluated and compared with traditional cell culture techniques.

With a 5 000-fold concentration, the recovery rate of this enrichment method reached 3.24%. Optimal detection of viable norovirus was achieved with a PMAxx dye concentration of 50 μmol, followed by 15 minutes of incubation in the dark, 10 minutes of light exposure, and then real-time quantitative PCR amplification.

The norovirus concentration and detection method established and optimized in this study significantly improved the recovery rate and detection accuracy of norovirus, which is of great significance for improving food safety testing and infectious disease prevention and control.

To analyze the trends in the burden of stroke and its risk factors among Chinese residents from 1990 to 2019, and to provide a scientific basis for formulating targeted stroke prevention and control strategies.

Data on the burden of stroke among Chinese residents in 1990, 2000, 2010, and 2019 were collected from the 2019 Global Burden of Disease Study (GBD 2019). Indicators such as disability-adjusted life years (DALYs), DALY rates, and population attributable fractions (PAFs) were used to analyze the trends in the burden of stroke and its risk factors among Chinese residents from 1990 to 2019.

In 2019, the DALY rates of stroke, ischemic stroke, and hemorrhagic stroke among Chinese residents increased with age, with the highest rates observed in the ≥70 age group (21 061.26/100 000, 11 858.11/100 000, and 8 505.17/100 000, respectively). The DALY rates of stroke, ischemic stroke, and hemorrhagic stroke were higher in men (3 739.30/100 000, 1 627.23/100 000, and 1 924.07/100 000, respectively) than in women (2 701.81/100 000, 1 376.19/100 000, and 1 184.82/100 000, respectively). From 1990 to 2019, the DALY rates of stroke and ischemic stroke increased (with average annual growth rates of 0.44% and 2.39%, respectively), while the DALY rate of hemorrhagic stroke decreased (with an average annual growth rate of –0.08%). In 2019, the top three risk factors for stroke in terms of DALYs, PAFs, and DALY rates were high systolic blood pressure (251763 million person-years, 54.80%, and 1 770.05/100 000, respectively), ambient air pollution (128473 million person-years, 27.95%, and 903.24/100 000, respectively), and smoking (10.099 3 million person-years, 21.96%, and 710.04/100 000, respectively). The top three risk factors for ischemic stroke were high systolic blood pressure (10.896 8 million person-years, 50.94%, and 766.11/100 000, respectively), ambient air pollution (5.737 8 million person-years, 26.81%, and 403.40/100 000, respectively), and high LDL cholesterol (4.427 7 million person-years, 20.69%, and 311.29/100 000, respectively). The top three risk factors for hemorrhagic stroke were high systolic blood pressure (12.919 0 million person-years, 58.18%, and 908.28/100 000, respectively), ambient air pollution (6.403 9 million person-years, 28.82%, and 450.23/100 000, respectively), and high-sodium diet (5.421 3 million person-years, 24.40%, and 381.15/100 000, respectively). From 1990 to 2019, the PAFs of eight risk factors for stroke increased and two decreased, six risk factors for ischemic stroke increased and four decreased, and eight risk factors for hemorrhagic stroke increased and two decreased. Among these, the PAF of ambient air pollution showed the largest increase (with average annual growth rates of 2.83%, 2.65%, and 2.90%, respectively), while the PAF of high-sodium diet showed the largest decrease (with average annual growth rates of –0.36%, –0.43%, and –0.16%, respectively).

The burden of stroke among Chinese residents remained high from 1990 to 2019, with an increasing trend in DALY rates. High systolic blood pressure remained the leading risk factor for stroke and its subtypes.

To understand the incidence trends of intestinal obstruction in Chinese residents from 1992 to 2021 and to provide a scientific basis for formulating precise prevention and control measures for intestinal obstruction.

Data on the number of cases, incidence rate, and age-standardized incidence rate (ASIR) of intestinal obstruction in Chinese residents from 1992 to 2021 were extracted from the Global Burden of Disease Study 2021 (GBD 2021) database. Descriptive analysis and Joinpoint regression models were used to evaluate the trends in the incidence of intestinal obstruction in Chinese residents and calculate the average annual percentage change (AAPC). The age-period-cohort (APC) model was used to assess the age, period, and cohort effects on the risk of intestinal obstruction in Chinese residents.

The incidence rates of intestinal obstruction in the total population, male residents, and female residents of China increased from 204.411/100 000, 227.272/100 000, and 179.973/100 000 in 1992 to 231.393/100 000, 259.508/100 000, and 201.923/100 000 in 2021, respectively. The ASIR decreased from 220.367/100 000, 247.453/100 000, and 192.676/100 000 in 1992 to 198.500/100 000, 226.548/100 000, and 170.553/100 000 in 2021, respectively. The AAPC values of ASIR were –0.355%, –0.302%, and –0.410% (all P<0.01), respectively. The APC model analysis showed that the age effect of the incidence of intestinal obstruction in the total population, male residents, and female residents of China showed an overall upward trend with increasing age. The age effect coefficients increased from 0.126, 0.103, and 0.183 for ages 0–4 years to 0.413, 0.725, and 0.453 for ages ≥95 years, respectively. The period effect of the incidence of intestinal obstruction in the total population, male residents, and female residents of China showed an overall downward trend over time. The period effect coefficients decreased from 1.000, 1.008, and 0.993 for the period 1992–1996 to 0.942, 0.958, and 0.920 for the period 2017–2021, respectively. The cohort effect of the incidence of intestinal obstruction in the total population, male residents, and female residents of China showed a trend of first increasing and then decreasing. The cohort effect coefficients for the total population increased from 0.591 for the 1897–1901 cohort to 1.079 for the 1942–1946 cohort and then decreased to 0.718 for the 2017–2021 cohort. The cohort effect coefficients for male residents increased from 0.640 for the 1897–1901 cohort to 1.076 for the 1947–1951 cohort and then decreased to 0.716 for the 2017–2021 cohort. The cohort effect coefficients for female residents increased from 0.638 for the 1897–1901 cohort to 1.142 for the 1927–1931 cohort and then decreased to 0.706 for the 2017–2021 cohort.

The ASIR of intestinal obstruction in Chinese residents showed an overall downward trend from 1992 to 2021, but it is still necessary to strengthen the prevention and control of intestinal obstruction in male and elderly populations.

To understand the trends in meningitis incidence and mortality among Chinese residents from 1990 to 2021, and to provide a reference for the development of relevant prevention and control policies and measures for meningitis in China.

Data on meningitis incidence and mortality among Chinese residents from 1990 to 2021 were collected from the Global Burden of Disease Study 2021 (GBD 2021) database. Descriptive analyses were conducted using indicators such as the number of cases, incidence rate, age-standardized incidence rate (ASIR), number of deaths, mortality rate, and age-standardized mortality rate (ASDR). Joinpoint regression models were used to analyze the trends in incidence and mortality rates of meningitis among Chinese residents and to calculate the average annual percentage change (AAPC). Age-period-cohort (APC) models were used to fit and estimate the age, period, and cohort effects on the risk of meningitis incidence and mortality among Chinese residents.

The incidence rate of meningitis among the total population, male residents, and female residents in China decreased from 28.34/100 000, 31.66/100 000, and 24.81/100 000 in 1990 to 4.82/100 000, 5.84/100 000, and 3.75/100 000 in 2021,respectively. The ASIR decreased from 30.83/100 000, 34.48/100 000, and 27.20/100 000 in 1990 to 5.79/100 000, 7.16/100 000, and 4.42/100 000 in 2021, respectively. The AAPC values for ASIR were –5.30%, –4.96%, and –5.71% (all P<0.001), respectively. The mortality rate of meningitis among the total population, male residents, and female residents in China decreased from 3.17/100 000, 3.60/100 000, and 2.71/100 000 in 1990 to 0.43/100 000, 0.50/100 000, and 0.36/100 000 in 2021, respectively. The ASDR decreased from 3.54/100 000, 4.02/100 000, and 3.06/100 000 in 1990 to 0.48/100 000, 0.58/100 000, and 0.38/100 000 in 2021, respectively. The AAPC values for ASDR were –6.31%, –6.11%, and –6.56% (all P<0.001), respectively. The APC model analysis showed that the age effects of both meningitis incidence and mortality initially decreased and then increased with age. The age effect coefficients for meningitis incidence among the total population, male residents, and female residents in China decreased from 1.945, 1.857, and 2.065 for ages 0–4 to –1.194, –1.112, and –1.381 for ages 45–49, and then increased to 1.874, 2.087, and 1.905 for ages 90–94, respectively. The age effect coefficients for meningitis mortality among the total population and male residents decreased from 2.425 and 2.386 for ages 0–4 to –1.279 and –1.381 for ages 25–29, and then increased to 2.116 and 2.371 for ages 90–94, respectively. The age effect coefficients for meningitis mortality among female residents decreased from 2.466 for ages 0–4 to –1.329 for ages 30–34, and then increased to 2.086 for ages 90–94. Both the period effects of meningitis incidence and mortality showed a decreasing trend. The period effect coefficients for meningitis incidence and mortality among the total population, male residents, and female residents in China decreased from 0.583 and 0.671, 0.555 and 0.652, and 0.612 and 0.686 for the period 1992–1996 to –0.362 and –0.368, –0.291 and –0.339, and –0.463 and –0.404 for the period 2017–2021, respectively. Both the cohort effects of meningitis incidence and mortality showed a fluctuating downward trend. The cohort effect coefficients for meningitis incidence and mortality among the total population, male residents, and female residents in China decreased from 0.094 and 0.150, 0.207 and 0.214, and –0.025 and 0.115 for the cohort 1902–1906 to –1.037 and –1.461, –1.097 and –1.537, and –1.002 and –1.401 for the cohort 2017–2021, respectively.

The incidence and mortality rates of meningitis among Chinese residents showed an overall downward trend from 1990 to 2021. However, it is still necessary to strengthen the prevention and control of meningitis among residents in younger and older age groups.

To understand the incidence trends of chronic obstructive pulmonary disease (COPD) among elderly adults in China and to provide a reference for optimizing COPD prevention and control strategies in China.

Data related to the incidence of COPD among Chinese residents aged ≥60 years from 1992 to 2021 were collected from the Global Burden of Disease Study 2021 (GBD 2021) database. Descriptive analyses were conducted using indicators such as the number of incident cases, incidence rate, and age-standardized incidence rate. Joinpoint regression models were used to analyze the trends in COPD incidence among elderly adults in China and to calculate the annual percentage change (APC) and average annual percentage change (AAPC). Age-period-cohort (APC) models were applied to fit and estimate the age, period, and cohort effects on the risk of COPD incidence among elderly adults in China.

The incidence rates of COPD among elderly adults in China overall, males, and females decreased from 1 374.91/1 000 001 359.40/100 000, and 1 389.29/100 000 in 1992 to 1 252.95/100 000, 1 207.43/100 000, and 1 179.24/100 000 in 2021, respectively. The age-standardized incidence rates decreased from 1 548.64/100 000, 1 590.77/100 000, and 1 515.03/100 000 in 1992 to 1 252.95/100 000, 1 331.37/100 000, and 1 190.16/100 000 in 2021, respectively. The AAPCs of the age-standardized incidence rates were –0.73%, –0.61%, and –0.83%, respectively (all P<0.05). The APC model analysis showed that the age effects on COPD incidence among elderly adults in China overall, males, and females all showed an increasing trend with age, with the age effect coefficients increasing from –0.817, –0.791, and –0.861 for ages 60-64 to 0.521, 0.611, and 0.504 for ages 90-94, respectively. The period effects on COPD incidence among elderly adults in China overall and females showed a trend of first decreasing and then increasing over time, with the period effect coefficients decreasing from 0.013 and 0.033 for the period 1992–1996 to –0.028 and –0.059 for the period 2007-2011, and then increasing to 0.013 and 0.024 for the period 2017–2021, respectively. The period effects on COPD incidence among elderly male adults showed an overall increasing trend over time, with the period effect coefficients increasing from –0.017 for the period 1992–1996 to 0.014 for the period 2017–2021. The birth cohort effects on COPD incidence among elderly adults in China overall, males, and females all showed a decreasing trend with birth year, decreasing from 0.255, 0.194, and 0.283 for the birth cohort 1902–1906 to –0.279, –0.307, and –0.258 for the birth cohort 1957–1961, respectively.

The age-standardized incidence rate of COPD among elderly adults in China showed an overall decreasing trend from 1992 to 2021, but the disease burden of COPD among males and elderly adults at advanced ages continues to increase.

To investigate the prevalence, awareness, and treatment rates of diabetic retinopathy (DR) among individuals aged 18–75 years with diabetes mellitus in Hubei province, and to provide scientific evidence for DR prevention and control.

In 2019, a multi-stage stratified cluster random sampling method was used to select 1 708 individuals aged 18–75 years with diabetes mellitus from four survey sites in Hubei province. Questionnaires, physical measurements, laboratory tests, and fundus examinations were conducted. The prevalence, awareness, and treatment rates of DR among individuals with diabetes with different characteristics were analyzed. Multivariable logistic regression analysis was used to analyze the influencing factors of DR.

After excluding individuals without fundus photographs or with unqualified photographs, a total of 1 489 participants were included in this study. The prevalence of DR was 12.6%, the awareness rate among individuals with DR was 13.3%, and the treatment rate was 18.5%. The awareness rate (χ²=4.207) and treatment rate (χ²=7.243) were significantly higher in urban residents than in rural residents (all P<0.05). With increasing education level, the awareness rate of DR showed a significant upward trend (χ²=3.045, P<0.05); the treatment rate of DR showed a marginally significant upward trend (χ²=2.616, P=0.053). With increasing annual household income, both the awareness rate (χ²=7.148) and treatment rate (χ²=3.228) of DR showed a significant upward trend. Individuals with diabetes who had urban employee medical insurance had higher DR awareness (χ²=11.503) and treatment rates (χ²=10.800) (all P<0.05). Multivariable logistic regression analysis showed that poor fasting blood glucose control (>7 mmol/L, Wald χ²=6.563), longer diabetes duration (≥5 years, Wald χ²=22.171), and having hypertension (Wald χ²=5.760) were associated with a higher risk of DR, while having urban employee medical insurance (Wald χ²=4.612) was associated with a lower risk of DR (all P<0.05).

The prevalence of DR among individuals aged 18–75 years with diabetes mellitus in Hubei province is not high, but the awareness and treatment rates are low. Prevention and control education and screening efforts should be strengthened for high-risk populations with DR, with a focus on improving the awareness and treatment rates of DR among individuals in rural areas, those with low education and income levels, and those with low medical insurance coverage.