BackgroundMost of studies relating ambient cardiovascular hospital admissions exposure to hospital admissions for cardiovascular diseases (CVDs) were conducted among urban population. Whether and to what extent these results could be generalizable to rural population remains unknown. We addressed this question using data from the New Rural Cooperative Medical Scheme (NRCMS) in Fuyang, Anhui, China. MethodsDaily hospital admissions for total CVDs, ischaemic heart disease, heart failure, heart rhythm disturbances, ischaemic stroke, and hemorrhagic stroke in rural regions of Fuyang, China were extracted from NRCMS between January 2015 and June 2017. A two-stage time-series analysis method was used to assess the associations between NO 2 and CVD hospital admissions and the disease burden fractions attributable to NO 2 . ResultsIn our study period, the average number (standard deviation) of hospital admissions per day were 488.2 (117.1) for total CVDs, 179.8 (45.6) for ischaemic heart disease, 7.0 (3.3) for heart rhythm disturbances, 13.2 (7.2) for heart failure, 267.9 (67.7) for ischaemic stroke, and 20.2 (6.4) for hemorrhagic stroke. The 10 µg/m 3 increase of NO 2 was related to an elevated risk of 1.9% (RR: 1.019, 95% CI: 1.005 to 1.032) for hospital admissions of total CVDs at lag0-2 day, 2.1%(1.021, 1.006 to 1.036) for ischaemic heart disease, and 2.1% (1.021, 1.006 to 1.035) for ischaemic stroke, respectively. While no signi cant association was observed between NO 2 and hospital admissions for heart rhythm disturbances, heart failure, and hemorrhagic stroke. The attributable fractions of total CVDs, ischaemic heart disease, and ischaemic stroke to NO 2 were 6.52% (1.87-10.94%), 7.31% (2.19-12.17%) and 7.12% (2.14-11.85%), respectively. ConclusionsOur ndings suggest that CVD burdens in rural population are also partly attributed to short-term exposure to NO2. More studies across rural regions are required to replicate our ndings.

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Background Most of studies relating ambient cardiovascular hospital admissions exposure to hospital admissions for cardiovascular diseases (CVDs) were conducted among urban population. Whether and to what extent these results could be generalizable to rural population remains unknown. We addressed this question using data from the New Rural Cooperative Medical Scheme (NRCMS) in Fuyang, Anhui, China. Methods Daily hospital admissions for total CVDs, ischaemic heart disease, heart failure, heart rhythm disturbances, ischaemic stroke, and hemorrhagic stroke in rural regions of Fuyang, China were extracted from NRCMS between January 2015 and June 2017. A two-stage time-series analysis method was used to assess the associations between NO2 and CVD hospital admissions and the disease burden fractions attributable to NO2. Results In our study period, the average number (standard deviation) of hospital admissions per day were 488.2 (117.1) for total CVDs, 179.8 (45.6) for ischaemic heart disease, 7.0 (3.3) for heart rhythm disturbances, 13.2 (7.2) for heart failure, 267.9 (67.7) for ischaemic stroke, and 20.2 (6.4) for hemorrhagic stroke. The 10 µg/m3 increase of NO2 was related to an elevated risk of 1.9% (RR: 1.019, 95% CI: 1.005 to 1.032) for hospital admissions of total CVDs at lag0-2 day, 2.1% (1.021, 1.006 to 1.036) for ischaemic heart disease, and 2.1% (1.021, 1.006 to 1.035) for ischaemic stroke, respectively. While no significant association was observed between NO2 and hospital admissions for heart rhythm disturbances, heart failure, and hemorrhagic stroke. The attributable fractions of total CVDs, ischaemic heart disease, and ischaemic stroke to NO2 were 6.52% (1.87–10.94%), 7.31% (2.19–12.17%) and 7.12% (2.14–11.85%), respectively. Conclusions Our findings suggest that CVD burdens in rural population are also partly attributed to short-term exposure to NO2. More studies across rural regions are required to replicate our findings.

To the Editor: Liver cancer (LC) is one of the most commonly diagnosed cancers and the leading cause of cancer mortality in the world, with approximately 905,677 new cases and 830,180 deaths in 2020. [1] Clearly, the huge burden exerted by LC highlights the need to effectively decrease the incidence and mortality of LC.Unfortunately, survival rates of LC have been maintained at a low level to date. A recent meta-analysis showed that the age-standardized 5-year LC survival rate in China was 10.1% in 2003 to 2005 and 12.1% in 2012 to 2015. [2] The poor prognosis of LC may be partly attributed to the advanced stages once diagnosed for most patients, suggesting that early detection, early diagnosed, and early treatment of LC are warranted. [3] A population-based cancer screening program targeting LC in high-risk areas of rural China was initiated in 2007, in which combinations of B-scan ultrasound and serum alpha-fetoprotein (AFP) were recommended for screening high-risk populations. A study in Shanghai had revealed that this screening program was effective in reducing the mortality and burden of LC. [3] However, available evidence indicated that the compliance of LC screening programs in the Chinese population was unsatisfactory. Thus, it is necessary to explore associated factors for participation rates (PRs) in the population-based LC screening program. Some studies found that lower cancer prevention awareness was associated with lower PRs of cancer screening programs. [4][5][6] However, whether cancer prevention awareness could influence PRs of LC screening program remains unknown in China.