tbuckley/cabot-search huggingface dataset:
Clinicopathological characteristics and outcome of plasmablastic lymphoma patients: A single-center retrospective analysis.
Authors: Anna P Dabrowska-Iwanicka, Joanna Romejko-Jarosinska, Lukasz Targonski, Martyna Kotarska, Monika Swierkowska, Ewa Paszkiewicz-Kozik, Elzbieta Wojciechowska-Lampka, Wlodzimierz Osiadacz, Joanna Tajer, Marcin Szymanski, Lidia Poplawska, Beata Ostrowska, Katarzyna Domanska-Czyz, Anna Borawska, Robert Konecki, Agnieszka Druzd-Sitek, Jan Andrzej Walewski
Journal: Journal of Clinical Oncology (2020)

e20034 Background: Plasmablastic lymphoma (PBL) is a rare CD20-negative lymphoma with an aggressive clinical course and short median survival ranging from 9 to 32 months. It is often associated with HIV infection but it also affects immunocompetent patients. Due to the rare occurrence most data comes from small, retrospective series. Methods: This is a retrospective single-center analysis of PBL patients (pts) referred to MSCNRIO between 2003-2019. Diagnosis was established according to the WHO 2017 classification criteria. Kaplan–Meier method was used for calculating overall survival (OS) and progression-free-survival (PFS) and the log-rank test for comparisons. Univariate analysis of prognostic factors was carried out. Results: 24 pts with a diagnosis of PBL were included. The median age at diagnosis was 54 years (range 29-90). 15 pts (63%) were men. LDH was elevated in 10 pts (41%). Stage III or IV was reported in 21 (87.5%) pts, IPI score of 3-5 in 12 (50%) and ECOG performance status &gt; 1 in 7 pts (29%). 20 pts (83.3%) had extranodal involvement, including oropharynx (n = 12), gastrointestinal tract (n = 1), bone marrow (n = 7), skeletal bone (n = 9), central nervous system (n = 3), skin and subcutaneous tissue (n = 2). Only 3 pts (13%) were infected by HIV, 2 had history of immunosuppressive therapy. Pathologically, all cases were negative for CD20 and positive for CD38 or CD138 expression. Ki67 &gt; 90% was noted in 16 cases (66%). 11 pts received CHOP chemotherapy, 3 pts - thalidomide- and 4 pts - bortezomib-based regimens, 1 was treated with both agents. 4 pts received different protocols; 1 pt received no treatment. CR was observed in 8 pts (33%), PR in 6 (25%) and no response in 10 (42%). 2 pts received ASCT in the 1 st remission. 17 pts (71%) experienced relapsed/progressive disease. 16 pts died: 11 from disease progression, 2 from other neoplasm. With a median follow-up of 20 months (range 2-122) median OS was 21 months and 2-year OS rate was 46% (95%C.I 27%, 65%). 2-year PFS rate was 37% (95% C.I. 17%, 57%), with median PFS 12 months (range 0.7-105). On univariate analysis there was a trend for correlation of high IPI with PFS; (95%C.I 0.99-1.03, P= 0.08). Achieving CR significantly correlated with better OS (HR 5; 95% C.I. 1.41-17; P= 0.01)) and PFS (HR 5.1, 95%C.I. 1.4, 18; P= 0.004). Conclusions: Our results confirm other reported data on PBL. Patients in our cohort shared typical clinical features but majority of them were immunocompetent. PBL prognosis remains poor despite incorporating novel agents into treatment and requires new therapeutic approaches.
A cute cerebral infarction complicated with bilateral internal carotid artery thrombosis in a young adult
Authors: Lina Yue, Xiaoping Yang, Yulan Niu, Yulin Liu, Gang Chen, Manping Cheng, Rong Li, Juanqin Niu
Journal: BMJ (2018)

青年人患脑梗死病因复杂，主要有感染、外伤、自身免疫及家族遗传性等疾病，而在年轻人当中高同型半胱氨酸血症所引起急性脑梗死并动脉闭塞性疾病少见，现将1例高同型半胱氨酸血症并脑梗死报道如下，以提高对该病的认识。
Comparison of the cell-free DNA genomics in patients with metastatic breast cancer (MBC) who develop brain metastases versus those without brain metastases.
Authors: Neelima Vidula, Andrzej Niemierko, Katherine Hesler, Steven J. Isakoff, Dejan Juric, Laura Spring, Therese Marie Mulvey, Jerry Younger, Beverly Moy, Leif W. Ellisen, Aditya Bardia
Journal: Journal of Clinical Oncology (2020)

1094 Background: The genomics of patients with metastatic breast cancer (MBC) who develop brain metastases (BM) is not well understood given the difficulty in obtaining brain tumor for genotyping. We compared tumor genotyping results via cell-free DNA (cfDNA) collected at MBC diagnosis in patients who developed BM after MBC diagnosis with those who did not develop BM (non-BM). Methods: Patients at an academic institution who had cfDNA testing (Guardant 360/Next generation sequencing, 73 gene assay) at MBC diagnosis between 1/2016-12/2017, with ≥ 6 months of follow-up post testing, were identified. A chart review was done to identify tumor subtype, demographics, cfDNA results, and development of BM at or after MBC diagnosis. Pearson’s chi-squared and Wilcoxon rank sum tests were used to determine differences in clinical and cfDNA characteristics in BM vs. non-BM (p&lt;0.05 for statistical significance). Results: CfDNA results were available for 49 patients, of whom 13 (27%) developed BM (4 with BM at MBC diagnosis). The median time to BM development was 11 months. While patients with BM were younger at MBC diagnosis than non-BM (median age BM 53 vs. non-BM 61, p=0.05), they had similar subtype (BM vs. non-BM: HR+/HER2- 62% vs. 69%, HER2+ 8% vs. 14%, TNBC 23% vs. 17%, unknown 8% vs. 0%, p=0.3), de-novo vs. recurrent disease (BM vs. non-BM: de-novo 8% vs. 14%, recurrent 92% vs. 86%, p=0.6), and visceral disease (BM vs. non-BM: 77% vs. 56%, p=0.2) distributions. All patients with BM had ≥1 detectable cfDNA mutation vs. 88% of non-BM. While the median mutant allele frequency of the most common mutation was similar in BM vs. non-BM (2.4% vs. 3.7%, p=0.5), the mutation pattern varied. Patients with BM more often had mutations in BRCA1 (15% vs. 3%, p=0.1), APC (15% vs. 0%, p=0.02), and CDKN2A (15% vs. 0%, p=0.02), compared to non-BM. In 4 patients with BM at MBC diagnosis, mutations in APC (50%), CDKN2A (50%), and BRCA 1/2 (25%) were noted; 1 had coexisting APC and BRCA1/2 mutations and another had coexisting APC and CDKN2A mutations. Conclusions: Patients with MBC who develop BM may have different cfDNA genomics, particularly BRCA1, APC, and CDKN2A mutations. Further research is needed to determine the predictive value of cfDNA at MBC diagnosis in the identification of patients at higher risk of developing BM. [Table: see text]
Urinary tract infection in patients with kidney transplantation
Authors: Zheng-yu Huang, Min-ru Li, Liang-qing Hong, Ning Na, Pei-sheng Yang, Bin Liao, Xue-feng Hua
Journal: BMJ (2009)

To investigate the incidence, pathogen types and risk factors for urinary tract infection (UTI) in patients with kidney transplantation.Thirty-two out 176 patients (18.2%) had at least one UTI after transplantation.The most frequent pathogens isolated in urine culture were escherichia coli and enterococcus faecalis.With UTI and other 12 factors as independent variables, univariate and logistic recession analysis revealed that the risk factors for UTI after kidney transplantation were female gender (RR=0.216,95% CI 0.074-0.628 ,P<0.05) and diabetes mellitus history(RR=3.023,95% CI 0.998-9.157,P≤0.05).

Key words: 
Urinary tract infections;  Kidney transplantation
Testing for COVID-19
Authors: Talha Khan Burki
Journal: The Lancet Respiratory Medicine (2020)

On May 21, 2020, UK Health and Social Care Secretary, Matt Hancock, announced plans to roll out more than 10 million severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody tests. National Health Service (NHS) staff and patients, and workers and residents in care homes, will be the first groups to be offered the tests. Hancock also revealed that an antibody surveillance study led by the Office for National Statistics had found that around 17% of people in London and 5% of people elsewhere in the UK had tested positive for anti-SARS-CoV-2 antibodies.
Consensus on definition, diagnosis and medication therapy of insomnia: an explanation
Authors: 李舜伟
Journal: BMJ (2008)

失眠是临床上很常见的症状,各科医师均能遇到,但是在诊断和处理方面往往不够规范,所以,部分神经科和精神科专家经过反复讨论发表了一个共识,刊登在 2006年第39卷第2期上,希望各科医师共同执行.
Radiomic signatures to predict response to targeted therapy and immune checkpoint blockade in melanoma patients (pts) on neoadjuvant therapy.
Authors: Rivka R. Colen, Gabriel O. Ologun, Pascal Zinn, Murat AK, Reetakshi Arora, Elizabeth M. Burton, Isabella Claudia Glitza, Hussein Abdul-Hassan Tawbi, Sapna Pradyuman Patel, Adi Diab, Michael K. Wong, Jennifer Leigh McQuade, Merrick I. Ross, Sara Ahmed, Nabil Elshafeey, Jeffrey E. Gershenwald, Michael A. Davies, Michael T. Tetzlaff, Rodabe Navroze Amaria, Jennifer Ann Wargo
Journal: Journal of Clinical Oncology (2020)

10067 Background: Metastatic melanoma pt outcomes have been revolutionized by targeted therapy (TT) and immune checkpoint blockade (ICB), which are now being evaluated in the neoadjuvant (neoadj) setting. While tumor-based biomarkers may help predict response, predictors of response obtained by less invasive strategies could greatly benefit pt care and allow real-time treatment response monitoring. Radiomic signatures derived from computerized tomography (CT) images have recently been shown to predict response to ICB in stage IV pts. However, the association of radiomic features with pathological response following neoadj therapy has not been assessed. We sought to determine if radiomic assessment predicts pCR in pts receiving neoadj TT and ICB. Methods: We collected data for a cohort of melanoma pts with locoregional metastases who were treated with neoadj TT (n = 33) or ICB (n = 30). Pts received systemic therapy for 8-10 weeks prior to planned surgical resection. Responses were evaluated radiographically (RECIST 1.1) and via pathological assessment (evaluating for pathologic complete response; (pCR) versus &lt; pCR). Thirty two pts (19 ICB; 13 TT) were included in the radiomics analysis based on the availability of appropriate CT imaging. A total of 310 unique radiomic features (10 histogram-based and 300 second-order texture features) were calculated from each extracted volume of interest (VOI). Feature extraction was performed on baseline and initial on-treatment pre-operative CT scans. Features associated with pCR were assessed using a feature selection approach based on Least Absolute Shrinkage and Selection Operator (LASSO). Selected features were used to build a classification model for prediction of pCR to ICB or TT. Leave-One-Out Cross-Validation was performed to evaluate the robustness of the estimates. Results: Out of 310 radiomic features, three features measured at baseline were able to predict a pCR to neoadj ICB or TT with sensitivity, specificity and accuracy of 100%, though these signatures were non-overlapping. In the on-treatment pre-operative scans, 3 distinct features (also non-overlapping and distinct from the predictive pre-treatment signatures) also predicted pCR to ICB and TT with 100% sensitivity, specificity and accuracy. Conclusions: Radiomic signatures in baseline and on-treatment CT scans accurately predict pCR in melanoma pts with locoregional metastases treated with neoadj TT or ICB. These provocative findings warrant further investigation in larger, independent cohorts.
Case analysis and literature review of low-grade fibromyxoid sarcoma
Authors: Lei Wang, Ping Chen, Lei Shi, Hao Wang, Guang-yao Wang
Journal: BMJ (2013)

To explore the originating sites, clinical manifestations, imaging features, pathologic findings, treatments and prognosis of low-grade fibromyxoid sarcoma. Among 54 cases, 6 came from our hospital and the other 48 cases were reported in literatures from 1998 to 2012 in China Knowledge Resource Integrated Database (CNKI). Their data were reviewed for analysis. The usual presentation was a slowly growing, painless mass commonly located in extremities. The optimal treatment of extended resection could significantly reduce recurrence and improve survival. And a long-term follow-up was necessary.


Key words: 
Fibroma; Myxosarcoma; Literature review
Clinical efficacy of treating Denis type B thoracolumbar burst fracture with allogenic bone and calcium sulfate implanting in injured vertebra
Authors: Fei Yin, Zhenzhong Sun, Qudong Yin, Jun Liu, Yongjun Rui
Journal: BMJ (2014)

To compare the clinical efficacy of treating Denis type B thoracolumbar burst fracture with allogenic bone and calcium sulfate implanting in injured vertebra.A total of 46 patients were randomly assigned into 2 groups.Group A(n=22) received allogenic bone implanting in injured vertebra while group B(n=21) had calcium sulfate grafting in injured vertebra. Group A was better than group B in maintaining tanterior vertebral body height and lessening the degree of bone defect (P 0.05).


Key words: 
Spinal fractures; Bone transplantation; Calcium sulfate; Transplantation, homologous
Age-related clinicopathologic features and survival in papillary serous uterine cancer patients older and younger than 70: An exploratory analysis of a series of consecutive patients.
Authors: Jaren Lerner, Miguel Michel, Andrew Samir Iskandar, Jaspreet Kaur, Shahaf Tuler, Stephanie Farrell, Steven C. Plaxe, Constantin Dasanu
Journal: Journal of Clinical Oncology (2020)

e18104 Background: Papillary serous uterine cancer (PSUC) is a rare, clinically aggressive histotype accounting for 40% of uterine cancer deaths. Clinicopathologic characteristics and outcomes between older and younger PSUC patients may differ. Methods: With IRB approval, we conducted a retrospective analysis of 554 consecutive patients with uterine cancer treated at our institution from 2009-19. Consistent with findings from the SEER database, 28 patients (5%) had PSUC. Most PSUC patients were Caucasian; Latinas comprised 14.2%. Thirteen patients were seventy years of age or younger (≤70) and fifteen were older than seventy ( &gt; 70). Clinicopathologic features, therapy and survival were compared between two cohorts. Statistical analysis: Significance of associations was assessed with Fishers' exact test. Survival analysis was performed with Cox proportional model with censoring to calculate hazard ratios (HR). Results: The two cohorts were well-balanced for stage (TNM stages I+II vs. TNM stages III+IV). More than 90% of patients in each group had surgical excision/debulking, and nearly half of patients in each group received systemic chemotherapy. The most frequently used chemotherapy regimen was carboplatin-paclitaxel. Compared to patients ≤70, patients &gt; 70 were less likely to undergo postoperative radiation therapy (6% vs 61.5%; p = 0.001). Cancer-specific survival (CSS) was worse in patients &gt; 70 as opposed to patients ≤70 (21.8 vs. 27.4 months; HR 0.61, p = 0.03). Four PSUC patients &gt; 70 had a personal history of metachronous breast cancer; none ≤70 had a history of breast cancer. We identified five cases of breast cancer, two cases of colon cancer, and one case each of ovarian and uterine cancer in first-degree relatives of PSUC patients &gt; 70. Conclusions: Older PSUC patients displayed significantly shorter CSS than their younger counterparts. They were also less likely to receive radiation therapy. As personal and family history of older PCUS patients identified an excess of other cancers, comprehensive germline mutation testing may be warranted. Final statistical analysis, comparison to SEER data and significance will be presented.
乳果糖治疗小儿功能性便秘50例疗效观察
Authors: 高源
Journal: BMJ (2010)

小儿功能性便秘是儿科常见疾病,经常困扰家长和患儿,近年来发病率增加,占综合性儿科门诊总数的5%-10%,占小儿胃肠病门诊的25%,占小儿便秘的90%以上[1].目前,治疗该病尚无特效药物,相关报道也较少.本研究选取2008年5月至2009年6月武汉市儿童医院消化内科已经确诊为功能性便秘的患儿50例作为研究对象,观察北京韩美药品有限公司出品的乳果糖口服溶液对小儿功能性便秘的治疗效果。
口服去痛片引起大面积皮肤坏死一例
Authors: 党连强
Journal: BMJ (2005)

患者男,63岁,因会阴、阴囊皮肤溃烂4 d入院.患者入院前4 d因腹痛于3 d内连续自服去痛片(非那西汀、氨基比林、咖啡因、苯巴比妥合剂)20余片,第4天开始出现会阴及阴囊皮疹、肿胀,随即出现皮肤溃烂,到我院就诊.在皮肤科治疗2周后,出现阴茎皮肤坏死,遂转入我科.入科时体温38℃,心率84次/min,小腹中下部至双大腿上1/4处皮肤潮红,部分表皮坏死剥脱,有多个脓肿形成,阴囊、阴茎皮肤大部分坏死,黑色结痂,干燥、质硬,边缘液化。
N-terminal pro-brain natriuretic peptide levels after receipt of anthracycline for breast cancer.
Authors: Shruti R Patel, Joerg Herrmann, Robert A. Vierkant, Janet E. Olson, Fergus Couch, Antonious Ziad Hazim, Charles L. Loprinzi, Kathryn Jean Ruddy
Journal: Journal of Clinical Oncology (2020)

e24103 Background: Many of the 200,000 patients diagnosed with breast cancer (BC) annually in the United States receive anthracycline-based therapy, increasing their risk of future congestive heart failure. N-terminal brain natriuretic peptide (NT-proBNP) has been used as a biomarker of asymptomatic cardiac dysfunction in the general population and is of interest to identify patients who might benefit from echocardiography during survivorship. This study aimed to assess how age, baseline comorbidities, and time since BC diagnosis impact NT-proBNP levels after anthracycline-based chemotherapy. Methods: This retrospective study, using samples collected in our ongoing prospective Mayo Clinic Breast Disease Registry, included 20 survivors of non-metastatic BC patients per year for each of the first 5 years after anthracycline-based chemotherapy (n=100 total). NT-pro-BNP levels were assessed using a Roche immunoassay. Cardiac risk factors were obtained by chart review. Multivariable linear regression models assessed associations between NT-proBNP values and these independent variables: baseline cardiac risk factors (including hypertension, hyperlipidemia, obesity, diabetes mellitus, and smoking), tumor ER status (surrogate for possible endocrine therapy), time between diagnosis and serum collection, T and N status, use of trastuzumab, and age. Results: The mean age at the time of BC diagnosis was 52.2 (SD 9.8). 13% of tumors were human epidermal growth factor receptor (HER2)-positive and 71% were estrogen receptor (ER) positive. NT-proBNP was elevated in 34%. Mean NT-BNP level was higher (p=0.047) for those in years 4-5 (158 pg/mL) compared to those in years 1-3 (106 pg/mL) (See Table.) Models revealed years from diagnosis to serum draw (p=0.026), older age (p=0.006), more cardiac risk factors (p=0.064), and N2-3 (p=0.001) were associated with elevated NT-pro-BNP level. Use of trastuzumab, ER status, and tumor size were not associated with NT-proBNP. Conclusions: NT-proBNP is elevated in 1/3 of survivors who received anthracycline therapy for BC. As expected, cardiac risk factors and advancing age are associated with higher NT-proBNP. NT-proBNP values &gt;300 were only found in patients who were 4-5 years after diagnosis. Additional research will be needed to further define the diagnostic and prognostic merit of NT-proBNP in survivors after receipt of anthracycline therapy. [Table: see text]
Evaluation of an Electronic Health Record System With a Disease Management Program and Health Care Treatment Costs for Danish Patients With Type 2 Diabetes
Authors: Ryan Pulleyblank, Giovanni Mellace, Kim Rose Olsen
Journal: JAMA Network Open (2020)

Electronic health record (EHR) systems and disease management programs (DMP) are often promoted, but associated health care cost changes are not well understood.To evaluate the association between annual health care costs of patients with type 2 diabetes and the use of an electronic health record system with a disease management program (EHR/DMP) in general practice.This retrospective cohort study examined patients with type 2 diabetes in Denmark between January 1, 2008, and December 31, 2014, who attended practices that either used an EHR/DMP at a high level or never used the disease management system. An EHR/DMP system was rolled out across general practices in Denmark beginning in 2011 and was discontinued in 2014. Data were analyzed between March 2019 and March 2020.The main outcome was total health care costs, and the secondary outcomes were primary care, medication, nonhospital specialist, and hospital (total, outpatient, inpatient, and emergency) costs. Regression models were used to estimate EHR/DMP-associated percentage differences in patients' annual health care treatment costs across health care treatment categories. All models included general practice-level fixed effects and patient-level controls. Two-part models examined robustness of estimated associations for hospital cost categories.Of 33 970 patients included in the analysis, 15 953 (8016 [50.2%] male; mean [SD] age, 59.9 [13.3] years) attended 244 general practices that used the system at a high level, and 18 017 (9291 [51.6%] male; mean [SD] age, 60.0 [12.9] years) attended 344 general practices that had never used the system. Use of the EHR/DMP was associated with 3.2% higher (95% CI, 0.9%-5.6%) annual general practice treatment costs and with 6.4% lower (95% CI, -11.6% to -1.2%) annual hospital emergency visit costs. The associations between EHR/DMP use and annual total hospital (percentage difference, -0.8%; 95% CI, -7.5% to 5.7%) and total health care (percentage difference, -0.1%; 95% CI, -2.1% to 1.9%) cost changes were not statistically significant.Among patients with type 2 diabetes, attendance at general practices that used an EHR/DMP was associated with a moderate increase in primary care costs and a reduction in emergency hospital visit costs but no significant change in total health care costs. Large health care cost savings associated with improved use of EHR-based disease management systems should not be expected to be realized in the short term.
Phase I study of bintrafusp alfa, a bifunctional fusion protein targeting TGF-β and PD-L1, in patients with pretreated biliary tract cancer
Authors: Changhoon Yoo, Do-Youn Oh, Hye Jin Choi, Masatoshi Kudo, Makoto Ueno, Shunsuke Kondo, Li-Tzong Chen, Motonobu Osada, Christoph Helwig, Isabelle Dussault, Masafumi Ikeda
Journal: Journal for ImmunoTherapy of Cancer (2020)

Patients with biliary tract cancer (BTC) have poor prognosis with few treatment options. Bintrafusp alfa, a first-in-class bifunctional fusion protein composed of the extracellular domain of the transforming growth factor (TGF)-βRII receptor (a TGF-β 'trap') fused to a human IgG1 antibody blocking programmed death ligand 1 (PD-L1), has shown clinical efficacy in multiple solid tumors.In this phase I, open-label trial expansion cohort, Asian patients with BTC whose disease progressed after first-line chemotherapy received bintrafusp alfa 1200 mg every 2 weeks until disease progression, unacceptable toxicity, or withdrawal. The primary endpoint is safety/tolerability, while the secondary endpoints include best overall response per Response Evaluation Criteria in Solid Tumors version 1.1.As of August 24, 2018, 30 patients have received bintrafusp alfa for a median of 8.9 (IQR 5.7-32.1) weeks; 3 patients remained on treatment for >59.7 weeks. Nineteen (63%) patients experienced treatment-related adverse events (TRAEs), most commonly rash (17%), maculopapular rash and fever (13% each), and increased lipase (10%). Eleven (37%) patients had grade ≥3 TRAEs; three patients had grade 5 events (septic shock due to bacteremia, n=1; interstitial lung disease (reported term: interstitial pneumonitis), n=2). The objective response rate was 20% (95% CI 8 to 39) per independent review committee (IRC), with five of six responses ongoing (12.5+ to 14.5+ months) at data cut-off. Two additional patients with durable stable disease had a partial response per investigator. Median progression-free survival assessed by IRC and overall survival were 2.5 months (95% CI 1.3 to 5.6) and 12.7 months (95% CI 6.7 to 15.7), respectively. Clinical activity was observed irrespective of PD-L1 expression and microsatellite instability-high status.Bintrafusp alfa had clinical activity in Asian patients with pretreated BTC, with durable responses. Based on these results, bintrafusp alfa is under further investigation in patients with BTC (NCT03833661 and NCT04066491).NCT02699515.
Burden and trend analysis of injury mortality in China among children aged 0-14 years from 2004 to 2011
Authors: 殷召雪, 吴静, 罗杰斯, Pak Anita Wp, Choi Bernard Ck, 梁晓峰
Journal: BMJ (2015)

目标
研究中国从2004到2011年0～14岁儿童因伤害导致的死亡负担及其变化趋势。


设计
利用中国疾病监测系统和中国妇幼死亡监测系统2004至2011年的全国代表性数据，计算年龄别标化伤害死亡率及其95%可信区间、伤害死亡构成比。


地点
中国城市及农村。


研究对象
2004至2011年的0～14岁儿童。


结果
儿童因伤害所致死亡占全部死亡的比例从2004年的18.69% 增加到2011年的21.26%。0～14岁儿童年龄标化伤害死亡率呈v型变化：从2004到2007年，儿童年龄标化伤害死亡率由每10万人29.71减少到24.12，之后又增加到2011年的28.12。城乡变化趋势相似，但城市地区年龄标化伤害死亡率呈现稳定减少趋势。男生年龄标化死亡率高于女生，溺水、交通事故和跌落为儿童死亡的前三位原因。


结论
在中国，儿童伤害已经成为日益严重的公共卫生问题，儿童伤害死亡率升高主要由农村地区儿童死亡率升高所致。必须针对农村地区和重点人群采取更为有效的策略和措施，特别是加强对溺水、交通事故和跌落等伤害类型的防控。