Background: Knee osteoarthritis (KOA) provides many challenges on the healthcare system. However, few studies have reported the epidemiology, particularly in a large population. Our study aimed to estimate the prevalence, incidence, trends, and patterns of diagnosed KOA in China. Methods: This was a longitudinal study. We used health insurance claims of 17.7 million adults from 2008–2017 to identify people with KOA. Trends in prevalence and incidence were analyzed using joinpoint regression. Results: We identified 2,447,990 people with KOA in Beijing, 60% of which were women. The 10-year average age-standardized prevalence and incidence of KOA was, respectively, 4.6% and 25.2 per 1000 person-years. Prevalence increased with age, surging after 55 years old. The average crude prevalence was 13.2% for people over 55 years old. The prevalence showed an increasing trend from 2008 to 2017, including a period of rapid rise from 2008 to 2011 (p < 0.05); the increase in prevalence was greatest in people under 35 years old (p < 0.05). Conclusion: Our analyses showed that the annual prevalence rate of KOA increased significantly from 2008 to 2017 in China. We need to increase our attention to women and the elderly over 55 years old, and also be alert to the younger trend of incidence of KOA.

Background: Hand-foot-and-mouth disease (HFMD) is considered to be self-limited, however, severe HFMD is a deadly threat for children worldwide, therefore, it is essential to define the clinical and epidemiologic characteristics of children with severe HFMD and identify the risk factors of death. Methods: Between 2013 and 2018, children who diagnosed with severe HFMD from Chongqing, China were enrolled in this population-based study. A total of 459 severe HFMD children cases were identified during the study period, including 415 survivors and 44 fatal cases. Demographic, geographical, epidemiological and clinical data of the cases were acquired and analyzed. Results: Risk factors of the death because of severe HFMD children included female, aged 1 ~ 3 years, enterovirus 71 infection, falling ill in winter, more than one children in home, being taken care of by grandparents, the caregivers’ education not more than 9 years, having fever more than 3 days, consciousness disorders, general weakness, vomiting, general weakness, abnormal pupillary light reflex, repeated cough, tachypnea, moist rales, white frothy sputum, pink frothy sputum, and cyanosis on lips or the whole body, tachycardia, arrhythmia, cold limbs, pale complexion, weakened pulse. (all p < 0.05). Spatial-temporal analysis detected high-value clusters, the most likely cluster located at rural countries in the northern parts of Chongqing, from January, 2015 to July, 2017. (p < 0.01). Besides, some urban districts were also found high incidence of severe HFMD cases according to the incidence maps. Conclusions: The detection of clinical risk factors and the temporal, spatial and socio-demographic distribution epidemiological characteristics of severe HFMD contribute to the timely diagnosis and intervention, the results of this study can be the reference of further clinical and public health practice.

BACKGROUND: Blood pressure (BP) time in target range (TTR) reflects the proportion of time that BP measurement is within a specified target range. We aim to summarize the evidence for relationships between TTR and adverse health outcomes. METHODS: Seven databases were searched. After quality assessment and data extraction, meta-analyses were performed to generate pooled estimates of the association (hazard ratios) between TTR and health outcomes. Primary outcomes were all-cause mortality and cardiovascular death. Secondary outcomes included major adverse cardiovascular events, myocardial infarction, stroke, heart failure, atrial fibrillation, and adverse kidney events. RESULTS: In all, 21 studies were included, mostly rated at low risk of bias. TTR was defined by systolic BP (SBP) in 15 studies and by both SBP and diastolic BP in 6 studies. Per SD increase of TTR was associated with significantly decreased risks of all-cause mortality (110–130 mm Hg SBP TTR: hazard ratios, 0.85 [95% CI, 0.82–0.89]; 120–140 mm Hg SBP TTR: 0.81 [95% CI, 0.70–0.94]; and 70–80 mm Hg diastolic BP TTR: 0.88 [95% CI, 0.83–0.93]), cardiovascular death (110–130 mm Hg SBP TTR: 0.83 [95% CI, 0.78–0.87]; 120–140 mm Hg SBP TTR: 0.76 [95% CI, 0.65–0.89]; and 70–80 mm Hg diastolic BP TTR: 0.85 [95% CI, 0.80–0.90]), major adverse cardiovascular events (120–140 mm Hg SBP TTR: 0.76 [95% CI, 0.70–0.83]), and heart failure (110–130 mm Hg SBP TTR: 0.84 [95% CI, 0.76–0.93] and 120–140 mm Hg SBP TTR: 0.78 [95% CI, 0.68–0.89]). However, there was not sufficient support for the association of TTR with myocardial infarction, stroke, atrial fibrillation, or adverse kidney events. CONCLUSIONS: Higher TTR was associated with reduced risks of all-cause mortality, cardiovascular death, major adverse cardiovascular events, and heart failure, highlighting the importance of sustained BP control in clinical practice. REGISTRATION: URL: https://www.crd.york.ac.uk/PROSPERO/ ; Unique identifier: CRD42023486437.

The impact of exposure to fine particulate matter (PM_2.5) on the incidence of knee osteoarthritis is unclear, especially in Beijing which is a highly polluted city. We conducted a time-series study to examine the correlation between PM_2.5 exposure and outpatient visits for knee osteoarthritis in Beijing. Changes (in percentage) in the number of outpatient visits corresponding to every 10-μg/m³ increase in the PM_2.5 concentration were determined using a generalized additive quasi-Poisson model. There were records of 9,797,446 outpatient visits for knee osteoarthritis in the study period from 1 January 2010 to 31 December 2017. The daily concentration of PM_2.5 was 86.8 (74.3) μg/m³ over this period. A 10-μg/m³ increase in PM_2.5 concentrations on lag days 0–3 was associated with a 1.41% (95% confidence interval: 1.40–1.41%) increase in outpatient visits for knee osteoarthritis. Females and patients aged above 65 years were more sensitive to the adverse effects of PM_2.5 exposure. The present findings demonstrate that short-term exposure to PM_2.5 resulted in an increase in the number of outpatient visits for knee osteoarthritis in Beijing. The findings shed light on the effects of air pollution on knee osteoarthritis and could guide risk-mitigating strategies in cities such as Beijing.

We aimed to provide reliable regression estimates of expenditures associated with various complications in type 2 diabetics in China. In total, 1,859,039 type 2 diabetes patients with complications were obtained from the Beijing Medical Claim Data for Employees database from 2008 to 2016. We estimated costs for complications using a generalized estimating equation model adjusted for age, sex, and the incidence of various complications. The average total cost for diabetic patients with complications was 17.12 thousand RMB. Prescribed drugs accounted for 63.4% of costs. We observed a significant increase in costs in the first year after the onset of complications. Compared with costs before the incidence of complications, the additional costs per person in the first year and >1 year after the event would be 10,631.16 RMB and 1150.71 RMB for cardiovascular disease, 1017.62 RMB and 653.82 RMB for cerebrovascular disease, and 301.14 RMB and 624.00 RMB for kidney disease, respectively. The estimated coefficients for outpatient visits were relatively lower than those of inpatient visits. Complications in diabetics exert a significant impact on total healthcare costs in the first year of their onset and in subsequent years. Our estimates may assist policymakers in quantifying the economic burden of diabetes complications.