1.Introduction The coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has swept the globe as a pandemic[1].As of 1 April 2021,there were about 129.5 million confir...1.Introduction The coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has swept the globe as a pandemic[1].As of 1 April 2021,there were about 129.5 million confirmed cases of COVID-19,and 2.8 million deaths attributable to COVID-19[2].While some countries have suppressed COVID-19,most governments worldwide are still mobilizing available resources to contain the spread of SARS-CoV-2 in communities,facilitate COVID-19 treatments in hospitals,expand COVID-19 vaccination,and accelerate drug and vaccine development[3].展开更多
BACKGROUND:We aimed to examine prospective associations between diff erent intensities and diff erent types of physical activity(PA)in early pregnancy and hypertensive disorders of pregnancy(HDP)among Chinese women.ME...BACKGROUND:We aimed to examine prospective associations between diff erent intensities and diff erent types of physical activity(PA)in early pregnancy and hypertensive disorders of pregnancy(HDP)among Chinese women.METHODS:A total of 6,820 pregnant women from the Tongji-Shuangliu Birth Cohort were included in this study.The pregnancy physical activity questionnaire(PPAQ)was used to assess PA,including household/caregiving,occupational,sports/exercise,and transportation activities in the first trimester of pregnancy.The diagnosis of HDP was collected,including gestational hypertension(GH)and preeclampsia(PE).Data were analyzed by unconditional multivariate logistic regression,and the odds ratio(OR)and 95%confi dence interval(CI)were calculated.RESULTS:A total of 178(2.6%)of the 6,820 women were diagnosed with HDP,of which 126(1.8%)were GH and 52(0.8%)were PE.Overall,we found no association between PA in early pregnancy and PE.A trend toward lower risk was found only among women with GH and among those with higher levels of moderate-to-vigorous intensity physical activity(MVPA)(adjusted OR 0.54,95%CI 0.31–0.96).No association was observed between PA and HDP in early pregnancy,regardless of diff erent intensities or types of PA.CONCLUSION:MVPA in the first trimester is an influencing factor of HDP.Encouraging pregnant women to engage in MVPA in the fi rst trimester may help to prevent GH.展开更多
With improved overall survival of cervical cancer patients, the importance of the quality of life (QOL) is increasingly recognized. This study was conducted to compare the QOL of women with different stage cervical ca...With improved overall survival of cervical cancer patients, the importance of the quality of life (QOL) is increasingly recognized. This study was conducted to compare the QOL of women with different stage cervical cancer before and after treatment to facilitate improved cervical cancer prevention and treatment. We used the generic Medical Outcomes Study Short Form-36 (MOS SF-36) to collect QOL information. Based on SF-36, we interviewed cervical cancer patients at West China Second Affiliated Hospital and Sichuan Cancer Hospital between May 2010 and January 2011. A total of 92 patients with precancerous lesions, 93 with early cancer, and 35 with advanced cancer responded to our survey. Average physical component summary (PCS) scores were significantly different between the three groups at every time point (P < 0.05). Average mental component summary (MCS) scores were significantly different between the three groups after treatment (P < 0.05). Average PCS and MCS scores increased gradually from the pretreatment to posttreatment period for patients with precancerous lesions. However, they reached the lowest at 1 month after treatment for patients with early and advanced cancers and rebounded between 1 and 6 months after treatment. Our results indicate that patients with precancerous lesions and early cervical cancer show better overall QOL than do those with advanced cervical cancer. Additionally, patients with early cancer recover more quickly than do those with advanced cancer in terms of both physical and mental functions. Thus, early detection and treatment initiatives may improve the QOL for patients with precancerous lesions and cervical cancer.展开更多
The overall survival of patients with cervical cancer has improved due to detection at an early stage and availability of comprehensive treatments in China. As patients' lives prolonged, it is important to underst...The overall survival of patients with cervical cancer has improved due to detection at an early stage and availability of comprehensive treatments in China. As patients' lives prolonged, it is important to understand their health-related quality of life(QoL) during and after treatment. We used the EQ-5D questionnaire to assess QoL of 194 patients with cervical lesions at Sichuan University West China Second Hospital between May 2010 and January 2011. Patients were surveyed before primary treatment and at 1, 3, and 6 months after primary treatment. Results showed a consistent decline in EQ-5D scores in the spectrum of cervical lesions at each time point after treatment(all P < 0.05). For patients with precursor lesions, there was an increasing trend along the timeline of treatment(P < 0.01). For patients with early-stage cervical cancer, EQ-5D scores declined in the first month(P = 0.01) and gradually increased to higher levels at 6 months post-treatment than those before treatment(P < 0.01). EQ-5D scores followed a similar trend in patients with advanced cervical cancer(P = 0.04), though they did not statistically rebound after 6 months(0.84 ± 0.19 vs. 0.86 ± 0.11, P = 0.62). Regarding advanced cervical cancer, EQ-5D scores for women above 40 years of age appeared to recover more rapidly and reached higher levels than those for women below 40 years(P = 0.03). Caution and extra care are recommended in the early period of cervical cancer treatment given the slight deterioration in the QoL, and in particular, for younger cervical cancer patients. Our study implies that health care providers may need to improve the health-related QoL of cervical cancer patients.展开更多
Cardiovascular disease(CVD)and depression and anxiety contribute substantially to the current disease burden worldwide as well as in China.Both depression and anxiety are highly prevalent among patients with CVD.We sy...Cardiovascular disease(CVD)and depression and anxiety contribute substantially to the current disease burden worldwide as well as in China.Both depression and anxiety are highly prevalent among patients with CVD.We systematically reviewed the literature to disentangle the role of depression and anxiety disorders in the onset and prognosis of CVD with an emphasis on cohort studies conducted in the Chinese population.Despite the lack of large-scale prospective studies in China,the available evidence implies that both depression and anxiety are closely associated with the onset and prognosis of CVD,including ischemic heart disease and stroke,in Chinese adults.Putative behavioral and biological mechanisms are implicated in the link between depression/anxiety and CVD.Timely screening and diagnosis followed by proper treatment should be implemented for depression and anxiety in both the general population and patients with CVD.Current standard treatments such as selective serotonin reuptake inhibitors and psychotherapies are recommended for CVD patients with depression,although their efficacy for reducing CVD morbidity and mortality remains uncertain.In conclusion,prospective studies on the link between depression/anxiety and the onset and prognosis of CVD are urgently needed in the Chinese population,and more efforts are warranted to examine the efficacy of depression and anxiety treatments for CVD patients,particularly the integrated care model of including psychiatrists in a multidisciplinary clinical group.展开更多
China faces a substantial burdensome pandemic of obesity.Recent data from the Chinese Centre for Disease Control and Prevention suggested that over an estimated 8.1%of Chinese adults(85 million Chinese adults)had obes...China faces a substantial burdensome pandemic of obesity.Recent data from the Chinese Centre for Disease Control and Prevention suggested that over an estimated 8.1%of Chinese adults(85 million Chinese adults)had obesity in 2018,which was three times the level in 2004.[1]To understand the trends of overweight and obesity in China,we accessed the country/territory-level year-specific data of age-standardized summary exposure value(SEV,standing for the pooled proportion among the population),deaths,and disability-adjusted life of years(DALYs)for high body mass index(BMI,high BMI was defined as the BMI level higher than theoretical minimum risk exposure level[25 kg/m2])and its associated diseases for 204 countries/territories between 1990 and 2019 using data from the Global Burden of Disease Collaborative Network.[2]Previous literature described detailed methods for the data synthesis.[3,4]Using the country/territory-level data by year,we calculated the estimated annual percentage changes(EAPCs)with 95%uncertainty intervals(UI)to estimate the annual changing patterns of age-standardized SEV,death,and DALY rates among 204 countries/territories.To compare statistics from China and other regions,we calculated the corresponding estimates from regions including global,North Africa and Middle East,Sub-Saharan Africa,Western Pacific Region,European Union,Latin America and Caribbean,and South Asia.展开更多
Background Fetal macrosomia,defined as birth weight equal or over 4000 g,is a major concern for both neonatal and maternal health.A rapid increasing trend in fetal macrosomia is observed in different regions of China....Background Fetal macrosomia,defined as birth weight equal or over 4000 g,is a major concern for both neonatal and maternal health.A rapid increasing trend in fetal macrosomia is observed in different regions of China.We aimed to examine the association between fetal macrosomia and risk of childhood obesity in Western China.Methods All macrosomic live singletons (≥ 4000 g),and a random sample of singletons with normal birth weight (2500-3999 g) born in four districts of Chengdu,Western China,in 2011 were included in the cohort study.Maternal demographics,obstetric factors,labor and delivery summary at baseline were extracted from the Chengdu Maternal and Child Health Management System.Anthropometric measurements before 3 years and infant feeding information at around 6 months were also collected.Childhood obesity under 3 years was primarily defined as a weight-for-length/height z score ≥ 1.645 using the WHO growth reference.Secondary definitions were based on weight-for-age and body mass index (BMI)-for-age over the same cut-offs.Results A total of 1767 infants were included in the analyses,of whom 714 were macrosomic.After controlling for maternal age,parity,gestational age and anemia at the first antenatal visit,pre-pregnancy BMI,gestational weight gain,gestational age at birth,baby age and sex,and breastfeeding practices at 6 months,the risk of childhood obesity defined according to weight-for-length/height among macrosomic babies was 1.90 (95% confidence interval 1.04-3.49) times that of babies with normal birth weight.The risk of childhood obesity for macrosomic babies was 3.74 (1.96-7.14) and 1.64 (0.89-3.00) times higher based on weight-for-age and BMI-for-age,respectively.Conclusion Fetal macrosomia is associated with increased risk of obesity in children under 3 years in Western China.展开更多
基金supported by the National Nature Science Foundation of China(81930124)for An Panthe International Postdoctoral Exchange Fellowship Program of the China Postdoctoral Council(20180062)for Xiong-Fei Pan.
文摘1.Introduction The coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has swept the globe as a pandemic[1].As of 1 April 2021,there were about 129.5 million confirmed cases of COVID-19,and 2.8 million deaths attributable to COVID-19[2].While some countries have suppressed COVID-19,most governments worldwide are still mobilizing available resources to contain the spread of SARS-CoV-2 in communities,facilitate COVID-19 treatments in hospitals,expand COVID-19 vaccination,and accelerate drug and vaccine development[3].
基金supported by Hainan Provincial Natural Science Foundation of China(821QN414,822RC845,821RC557)the Central Guidance on Local Science and Technology Development Fund of Hainan Province(ZY2021HN19)Hainan Clinical Medical Research Center Project(LCYX202205).
文摘BACKGROUND:We aimed to examine prospective associations between diff erent intensities and diff erent types of physical activity(PA)in early pregnancy and hypertensive disorders of pregnancy(HDP)among Chinese women.METHODS:A total of 6,820 pregnant women from the Tongji-Shuangliu Birth Cohort were included in this study.The pregnancy physical activity questionnaire(PPAQ)was used to assess PA,including household/caregiving,occupational,sports/exercise,and transportation activities in the first trimester of pregnancy.The diagnosis of HDP was collected,including gestational hypertension(GH)and preeclampsia(PE).Data were analyzed by unconditional multivariate logistic regression,and the odds ratio(OR)and 95%confi dence interval(CI)were calculated.RESULTS:A total of 178(2.6%)of the 6,820 women were diagnosed with HDP,of which 126(1.8%)were GH and 52(0.8%)were PE.Overall,we found no association between PA in early pregnancy and PE.A trend toward lower risk was found only among women with GH and among those with higher levels of moderate-to-vigorous intensity physical activity(MVPA)(adjusted OR 0.54,95%CI 0.31–0.96).No association was observed between PA and HDP in early pregnancy,regardless of diff erent intensities or types of PA.CONCLUSION:MVPA in the first trimester is an influencing factor of HDP.Encouraging pregnant women to engage in MVPA in the fi rst trimester may help to prevent GH.
文摘With improved overall survival of cervical cancer patients, the importance of the quality of life (QOL) is increasingly recognized. This study was conducted to compare the QOL of women with different stage cervical cancer before and after treatment to facilitate improved cervical cancer prevention and treatment. We used the generic Medical Outcomes Study Short Form-36 (MOS SF-36) to collect QOL information. Based on SF-36, we interviewed cervical cancer patients at West China Second Affiliated Hospital and Sichuan Cancer Hospital between May 2010 and January 2011. A total of 92 patients with precancerous lesions, 93 with early cancer, and 35 with advanced cancer responded to our survey. Average physical component summary (PCS) scores were significantly different between the three groups at every time point (P < 0.05). Average mental component summary (MCS) scores were significantly different between the three groups after treatment (P < 0.05). Average PCS and MCS scores increased gradually from the pretreatment to posttreatment period for patients with precancerous lesions. However, they reached the lowest at 1 month after treatment for patients with early and advanced cancers and rebounded between 1 and 6 months after treatment. Our results indicate that patients with precancerous lesions and early cervical cancer show better overall QOL than do those with advanced cervical cancer. Additionally, patients with early cancer recover more quickly than do those with advanced cancer in terms of both physical and mental functions. Thus, early detection and treatment initiatives may improve the QOL for patients with precancerous lesions and cervical cancer.
基金sponsored by a grant from the China Ministry of Health Special Funds for Public Sector Research (No. 2009020027)
文摘The overall survival of patients with cervical cancer has improved due to detection at an early stage and availability of comprehensive treatments in China. As patients' lives prolonged, it is important to understand their health-related quality of life(QoL) during and after treatment. We used the EQ-5D questionnaire to assess QoL of 194 patients with cervical lesions at Sichuan University West China Second Hospital between May 2010 and January 2011. Patients were surveyed before primary treatment and at 1, 3, and 6 months after primary treatment. Results showed a consistent decline in EQ-5D scores in the spectrum of cervical lesions at each time point after treatment(all P < 0.05). For patients with precursor lesions, there was an increasing trend along the timeline of treatment(P < 0.01). For patients with early-stage cervical cancer, EQ-5D scores declined in the first month(P = 0.01) and gradually increased to higher levels at 6 months post-treatment than those before treatment(P < 0.01). EQ-5D scores followed a similar trend in patients with advanced cervical cancer(P = 0.04), though they did not statistically rebound after 6 months(0.84 ± 0.19 vs. 0.86 ± 0.11, P = 0.62). Regarding advanced cervical cancer, EQ-5D scores for women above 40 years of age appeared to recover more rapidly and reached higher levels than those for women below 40 years(P = 0.03). Caution and extra care are recommended in the early period of cervical cancer treatment given the slight deterioration in the QoL, and in particular, for younger cervical cancer patients. Our study implies that health care providers may need to improve the health-related QoL of cervical cancer patients.
文摘Cardiovascular disease(CVD)and depression and anxiety contribute substantially to the current disease burden worldwide as well as in China.Both depression and anxiety are highly prevalent among patients with CVD.We systematically reviewed the literature to disentangle the role of depression and anxiety disorders in the onset and prognosis of CVD with an emphasis on cohort studies conducted in the Chinese population.Despite the lack of large-scale prospective studies in China,the available evidence implies that both depression and anxiety are closely associated with the onset and prognosis of CVD,including ischemic heart disease and stroke,in Chinese adults.Putative behavioral and biological mechanisms are implicated in the link between depression/anxiety and CVD.Timely screening and diagnosis followed by proper treatment should be implemented for depression and anxiety in both the general population and patients with CVD.Current standard treatments such as selective serotonin reuptake inhibitors and psychotherapies are recommended for CVD patients with depression,although their efficacy for reducing CVD morbidity and mortality remains uncertain.In conclusion,prospective studies on the link between depression/anxiety and the onset and prognosis of CVD are urgently needed in the Chinese population,and more efforts are warranted to examine the efficacy of depression and anxiety treatments for CVD patients,particularly the integrated care model of including psychiatrists in a multidisciplinary clinical group.
基金West China Hospital of Sichuan University(1.3.5 Project for Disciplines of Excellence,Nos.ZYGD18022 and 2020HXF011).
文摘China faces a substantial burdensome pandemic of obesity.Recent data from the Chinese Centre for Disease Control and Prevention suggested that over an estimated 8.1%of Chinese adults(85 million Chinese adults)had obesity in 2018,which was three times the level in 2004.[1]To understand the trends of overweight and obesity in China,we accessed the country/territory-level year-specific data of age-standardized summary exposure value(SEV,standing for the pooled proportion among the population),deaths,and disability-adjusted life of years(DALYs)for high body mass index(BMI,high BMI was defined as the BMI level higher than theoretical minimum risk exposure level[25 kg/m2])and its associated diseases for 204 countries/territories between 1990 and 2019 using data from the Global Burden of Disease Collaborative Network.[2]Previous literature described detailed methods for the data synthesis.[3,4]Using the country/territory-level data by year,we calculated the estimated annual percentage changes(EAPCs)with 95%uncertainty intervals(UI)to estimate the annual changing patterns of age-standardized SEV,death,and DALY rates among 204 countries/territories.To compare statistics from China and other regions,we calculated the corresponding estimates from regions including global,North Africa and Middle East,Sub-Saharan Africa,Western Pacific Region,European Union,Latin America and Caribbean,and South Asia.
文摘Background Fetal macrosomia,defined as birth weight equal or over 4000 g,is a major concern for both neonatal and maternal health.A rapid increasing trend in fetal macrosomia is observed in different regions of China.We aimed to examine the association between fetal macrosomia and risk of childhood obesity in Western China.Methods All macrosomic live singletons (≥ 4000 g),and a random sample of singletons with normal birth weight (2500-3999 g) born in four districts of Chengdu,Western China,in 2011 were included in the cohort study.Maternal demographics,obstetric factors,labor and delivery summary at baseline were extracted from the Chengdu Maternal and Child Health Management System.Anthropometric measurements before 3 years and infant feeding information at around 6 months were also collected.Childhood obesity under 3 years was primarily defined as a weight-for-length/height z score ≥ 1.645 using the WHO growth reference.Secondary definitions were based on weight-for-age and body mass index (BMI)-for-age over the same cut-offs.Results A total of 1767 infants were included in the analyses,of whom 714 were macrosomic.After controlling for maternal age,parity,gestational age and anemia at the first antenatal visit,pre-pregnancy BMI,gestational weight gain,gestational age at birth,baby age and sex,and breastfeeding practices at 6 months,the risk of childhood obesity defined according to weight-for-length/height among macrosomic babies was 1.90 (95% confidence interval 1.04-3.49) times that of babies with normal birth weight.The risk of childhood obesity for macrosomic babies was 3.74 (1.96-7.14) and 1.64 (0.89-3.00) times higher based on weight-for-age and BMI-for-age,respectively.Conclusion Fetal macrosomia is associated with increased risk of obesity in children under 3 years in Western China.
