Background: Gallbladder and biliary tract cancer (GBTC) has greatly damaged the health of patients and is accompanied by a dismal prognosis. The worldwide distribution of GBTC shows extensive variance and the updated data in China is lacking. This study was to determine the current status, trends, and predictions in the burden of GBTC over the past 30 years in China. Methods: This was a descriptive, epidemiological, secondary analysis of the Global Burden of Disease, Injuries, and Risk Factor Study 2019 data. Data including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of GBTC in China by year, age, and sex were assessed. Joinpoint regression analysis was conducted to evaluate trends of disease burden due to GBTC from 1990 to 2019. Nordpred age-period-cohort analysis was applied for the projection of mortality and incidence due to GBTC from 2019 to 2044. Results: Nationally, there were 38,634 (95% uncertainty interval [UI]: 27,350–46,512) new cases and 47,278 (95% UI: 32,889–57,229) patients due to GBTC, causing 34,462 (95% UI: 25,220–41,231) deaths, and 763,584 (95% UI: 566,755–920,493) DALYs in 2019. Both cases and rates of burden owing to GBTC were heavier among males and at old age. From 1990 to 2019, the age-standardized rates of incidence, prevalence, mortality, and DALYs of GBTC generally increased from 1990 to 2019, with average annual percentage change at 0.8% (95% confidential interval [CI]: 0.6–1.0%), 1.3% (95% CI: 1.1–1.5%), 0.4% (95% CI: 0.2–0.6%), and 0.2% (95% CI: 0.1–0.4%), respectively. Even though the age-standardized incidence rate and age-standardized mortality rate in both sexes were predicted to decline gradually from 2019 to 2044, the number of new cases and deaths were expected to grow steadily. Conclusions: GBTC is becoming a major health burden in China, particularly among males and older individuals. Given the aging population and increasing burden, effective strategies and measurements are urged to prevent or reduce the number of new cases and deaths of GBTC.

Background: Pancreatitis is a common disease of the digestive system. Acute pancreatitis is one of the most common reasons for gastrointestinal hospital admission, and chronic pancreatitis significantly reduces quality of life. However, national epidemiological data on pancreatitis in China are lacking. This study aimed to quantify the disease burden of pancreatitis in China from 1990 to 2019. Methods: This study was based on the Global Burden of Disease Study 2019 dataset. Age-standardized rates of incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) were used to describe the disease burden of pancreatitis, and estimated annual percentage change (EAPC) was used to indicate the average change in age-standardized rates. We also described the trend of pancreatitis-related mortality and DALYs, which are attributable to alcohol use by age and sex. Results: From 1990 to 2019, the ASIR, ASPR, ASMR, and age-standardized DALYs of pancreatitis in China decreased by 10.90, 1.50, 0.49, and 15.54 per 100,000, respectively, with EAPCs of À1.35 (95% uncertainty interval [UI]: À1.67, À1.02) and À0.37 (95% UI: À0.43, À0.31), À2.01 (95% UI: À2.07, À1.94) and À2.32 (95% UI: À2.37, À2.28), respectively. Recently, the numbers of incident and prevalent cases have risen, with estimates of 380,018 (95% UI: 308,669-462,767) and 493,765 (95% UI: 416,705-578,675), respectively, in 2019. Among men, the disease burden of pancreatitis was more severe than among women, and with variances in the distribution among different age groups. Age-standardized DALYs caused by alcohol-related pancreatitis have gradually worsened in the past decade, accounting for 34.09% of the total in 2019. Conclusions: The disease burden of pancreatitis in China has declined in the past 30 years, but the exacerbation of population aging poses a challenge to prevention and control of pancreatitis. Alcohol use has gradually become an important factor in the disease burden of pancreatitis in recent years.

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Background: To explore the association and understand gender disparities between nutritional status and quality of life among centenarians.Methods: It was a full-sample survey of centenarians conducted in Hainan that included a total of 1,002 eligible centenarians whose age had been verified. The Mini Nutritional Assessment – Short Form (MNA-SF) questionnaire and the EuroQol five dimensions visual analog scale (EQ-5D-VAS) were used to measure participants’ nutritional status and quality of life, respectively. Findings: In the 1002 centenarians (822 women and 180 men), 797 (79·5%) reported multimorbidity. The adjusted standardized β estimate for the association between the MNA-SF and EQ-5D scores was 0·508 in the complete sample. With reference to the normal nutrition group, the standardized β estimate of the association between EQ-5D score and nutritional status were −0·179 and −0·583 for the at risk of malnutrition and malnutrition groups, respectively (both P <0·001). Nutritional status significantly affected the five dimensions of quality of life, particularly mobility and self-care. Compared with the normal nutrition group, the malnutrition group had greater odds of low mobility (Odds ratio (OR)=23·15; 95% CI: 9·81–54·64) and low self-care (OR=24·58; 95% CI: 12·62–47·89). Among males, nutritional status was significantly associated with the usual activities and anxiety/depression dimensions after adjustment. Female participants had results similar to the general population. Interpretation: Malnutrition and being at risk of malnutrition is prevalent among centenarians. Maintaining normal nutritional status is an important protective factor and should receive more attention to improve centenarians’ quality of life.

Abstract Background Objective deterioration in activities of daily living (ADLs) exists among older people, and particularly worsens with age. Considering the criterion standard of positive aging and longevity, little information focusing on centenarians is available. The present study aimed to examine the relationship between serum albumin and ADLs among centenarians in long-lived areas. Methods This population-based cross-sectional study investigated a complete sample of Chinese persons aged ≥100 years in Hainan, the longest-lived area of China (n=1002). We assessed serum albumin levels and basic and instrumental activities of daily living (BADLs and IADLs). Results Of 1002 participants included in the analysis, 287 (28.64%) had BADL disabilities and 648 (64.67%) had IADL disabilities. The median serum albumin level was 38.5 g/L (interquartile range, 36.2–41.3). The multivariable analyses controlling for socio-demographic characteristics, lifestyle, morbidities, and other influential factors showed that albumin level was associated with the total score of BADL ( standard β=0.335, P<0.001) and IADL ( standard β=0.206, P<0.001). With the increasing of albumin level, the risk of ADLs disability decreased (BADL: odds ratios [OR] = 0.835, 95% Confidence interval [CI]: 0.797-0.876; IADL: OR=0.863, 95%CI: 0.824-0.905). In the stratified analyses, similar results were found in both sex, but were more prominent in women. Conclusions Higher levels of serum albumin was a protective factor for the decline of ADLs in centenarians. This association can be observed in both genders and is more pronounced in women.

Background To explore the causes of endoscopic misdiagnosis of gastrointestinal cyst as solid lesion and the diagnostic value and limitations of EUS, guide clinicians to develop appropriate treatment strategies and improve the ability to identify SMT. Methods We enrolled patients diagnosed with gastrointestinal SMT between January 2001 and December 2021 who underwent endoscopic resection with postoperative pathological diagnosis of cyst. Age, sex, maximum lesion diameter, judge the texture of lesion, origin and echo are potential factors affecting the diagnostic accuracy of cysts. Results The diagnostic accuracy of EUS assessment 39.3% higher than that without EUS assessment (6.7%). The error rate was 60.7%, lower than that without EUS assessment (93.3%), suggesting that preoperative EUS assessment improved the diagnostic accuracy of gastrointestinal cyst (Fisher's accurate test, P = 0.033). The diagnostic accuracy of “judge the texture of lesion” was higher than that of no touch (P = 0.031). When the lesion size increased by 1 cm, the diagnostic accuracy decreased by about 21%. Hypoechoic lesions were less likely to be diagnosed correctly than anechoic lesions (P = 0.003). Conclusions The main cause of misdiagnosing gastrointestinal cyst as solid lesion is that no EUS assessment was performed before endoscopic resection or anechoic lesion was judged as hypoechoic lesion by preoperative EUS assessment.

Abstract Background Objective deterioration in activities of daily living (ADL) exists in older people, particularly grows with age. While as the criterion standard of positive aging and longevity, little information that focuses on centenarians is available. The objective of this study is to examine the relationship between serum albumin and activities of daily living among centenarians in long-lived areas.Methods design—population-based cross-sectional study; setting—a complete sample study in Hainan, the longest-lived areas of China; subjects—Chinese older adults aged 100 and above (N=1002); measurements—serum albumin, basic and instrumental activities of daily living (BADL and IADL).Results Of 1002 participants included in the analysis 287(28.64%) were BADL disability, and 648(64.67%) were IADL disability. The median serum albumin level was 38.5 g/L (interquartile range, 36.2-41.3). In multivariable analyses controlling for socio-demographic characteristics, lifestyle characteristics and other influential factors, low albumin in the bottom quartile were associated with BADL disability (OR=5.994;95% CI: 3.542-10.143) and IADL disability (OR=4.398; 95% CI, 2.661-7.269). Serum albumin concentration showed a significant inverse linear relationship with ADL disability (P for trend <0.001). In sex-stratified analyses, the association was more pronounced in women. And we found a nonlinear relationship between serum albumin and IADL disability in female centenarians (P=0.025) from restricted cubic splines.Conclusions Low levels of albumin were associated with the decline in ADL function in centenarians, and this association was gender-specific and more prominent in the female.

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