Background:Irritable bowel syndrome(IBS)substantially affects quality of life and requires early prevention.This study aimed to elucidate the relationships between IBS and daily behaviors,including sedentary behavior(...Background:Irritable bowel syndrome(IBS)substantially affects quality of life and requires early prevention.This study aimed to elucidate the relationships between IBS and daily behaviors,including sedentary behavior(SB),physical activity(PA),and sleep.In particular,it seeks to identify healthy behaviors to reduce IBS risk,which previous studies have rarely addressed.Methods:Daily behaviors were retrieved from self-reported data of 362,193 eligible UK Biobank participants.Incident cases were determined by self-report or health care data according to RomeⅣcriteria.Results:A total of 345,388 participants were IBS-free at baseline,during a median follow-up of 8.45 years,19,885 incident IBS cases were recorded.When examined individually,SB and shorter(≤7 h/day)or longer(>7 h/day)sleep duration were each positively associated with increased IBS risk,and PA was associated with lower IBS risk.The isotemporal substitution model suggested that replacing SB with other activities could provide further protective effects against IBS risk.Among people sleeping≤7 h/day,replacing 1 h of SB with equivalent light PA,vigorous PA,or sleep was associated with 8.1%(95%confidence interval(95%CI):0.901-0.937),5.8%(95%CI:0.896-0.991),and 9.2%(95%CI:0.885-0.932)reduced IBS risk,respectively.For people sleeping>7 h/day,light and vigorous PA were associated with a 4.8%(95%CI:0.926-0.978)and a 12.0%(95%CI:0.815-0.949)lower IBS risk,respectively.These benefits were mostly independent of genetic risk for IBS.Conclusion:SB and unhealthy sleep duration are risk factors for IBS.A promising way to mitigate IBS risk for individuals sleeping≤7 h/day and for those sleeping>7 h/day appears to be by replacing SB with adequate sleep or vigorous PA,respectively,regardless of the genetic predisposition of IBS.展开更多
Objective Human adenovirus(HAdV)infection is common and can develop to serious conditions with high mortality,yet the mechanism of HAdV infection remains unclear.In the present study,the serum metabolite profiles of H...Objective Human adenovirus(HAdV)infection is common and can develop to serious conditions with high mortality,yet the mechanism of HAdV infection remains unclear.In the present study,the serum metabolite profiles of HAdV-7-infected patients with pneumonia or upper respiratory tract infection(URTI)were explored.Methods In total,35 patients were enrolled in the study following an outbreak of HAdV-7 in the army,of whom 14 had pneumonia and 21 had URTI.Blood samples were collected at the acute stage and at the recovery stage and were analyzed by untargeted metabolomics.Results Over 90% of the differential metabolites identified between the pneumonia patients and URTI patients were lipids and lipid-like molecules,including glycerophospholipids,fatty acyls,and sphingolipids.The metabolic pathways that were significantly enriched were primarily the lipid metabolism pathways,including sphingolipid metabolism,glycerophospholipid metabolism,and linoleic acid metabolism.The sphingolipid metabolism was identified as a significantly differential pathway between the pneumonia patients and URTI patients and between the acute and recovery stages for the pneumonia patients,but not between the acute and recovery stages for the URTI patients.Ceramide and lactosylceramide,involved in sphingolipid metabolism,were significantly higher in the pneumonia patients than in the URTI patients with good discrimination abilities[area under curve(AUC)0.742 and 0.716,respectively;combination AUC 0.801].Conclusion Our results suggested that HAdV modulated lipid metabolism for both the patients with URTI and pneumonia,especially the sphingolipid metabolism involving ceramide and lactosylceramide,which might thus be a potential intervention target in the treatment of HAdV infection.展开更多
Background The prospective association of dietary thiamine intake with the risk of cognitive decline among the general older adults remains uncertain.Aims To investigate the association between dietary thiamine intake...Background The prospective association of dietary thiamine intake with the risk of cognitive decline among the general older adults remains uncertain.Aims To investigate the association between dietary thiamine intake and cognitive decline in cognitively healthy,older Chinese individuals.Methods The study included a total of 3106 participants capable of completing repeated cognitive function tests.Dietary nutrient intake information was collected through 3-day dietary recalls and using a 3-day food-weighed method to assess cooking oil and condiment consumption.Cognitive decline was defined as the 5-year decline rate in global or composite cognitive scores based on a subset of items from the Telephone Interview for Cognitive Status-modified.Results The median follow-up duration was 5.9 years.There was a J-shaped relationship between dietary thiamine intake and the 5-year decline rate in global and composite cognitive scores,with an inflection point of 0.68 mg/day(95%confidence interval(Cl):0.56 to 0.80)and a minimal risk at 0.60-1.00 mg/day of dietary thiamine intake.Before the inflection point,thiamine intake was not significantly associated with cognitive decline.Beyond the inflection point,each unit increase in thiamine intake(mg/day)was associated with a significant decrease of 4.24(95%Cl:2.22 to 6.27)points in the global score and 0.49(95%Cl:0.23 to 0.76)standard units in the composite score within 5 years.A stronger positive association between thiamine intake and cognitive decline was observed in those with hypertension,obesity and those who were non-smokers(all p<0.05).Conclusions This study revealed a J-shaped association between dietary thiamine intake and cognitive decline in cognitively healthy,older Chinese individuals,with an inflection point at 0.68 mg/day and a minimal risk at 0.60-1.00 mg/day of dietary thiamine intake.展开更多
Background Depression,anxiety and schizophrenia among older persons have become global public health challenges.However,the burden of these disorders in ageing and aged countries has not been analysed.Aims To investig...Background Depression,anxiety and schizophrenia among older persons have become global public health challenges.However,the burden of these disorders in ageing and aged countries has not been analysed.Aims To investigate the burden of depression,anxiety and schizophrenia among older adults in ageing and aged countries.Methods Using data from the Global Burden of Disease Study 2019,we calculated the estimated annual percentage change(EAPC)in the age-standardised incidence rates(ASiR)and age-standardised disability-adjusted life years(DALYs)rates(ASDR)for depression,anxiety and schizophrenia of older people in ageing countries(China,India,Indonesia)and aged countries(Japan,Italy,Portugal)between 1990 and 2019.Trends in incidence and DALYs were analysed by gender and age.Results In 2019,the highest incidence of depression,anxiety and schizophrenia in the older population in aged countries was in Japan(927271.3(752552.3-1125796.5),51498.2(37625.7-70487.3)and 126.0(61.0-223.2),respectively),while the highest incidence in ageing countries was in China(5797556.9(4599403.4-7133006.5),330256.1(246448.9-445987.4)and 1067.7(556.2-1775.9),respectively).DALYs for these disorders were similar,with the highest in Japan and China.From 1990 to 2019,the ASIR for depressive disorders decreased in aged countries but increased in ageing countries;the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged countries.The ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and schizophrenia.The ASIR for depressive disorders was higher in older women,while the opposite was observed in anxiety disorders and schizophrenia.Notably,the conditions of burden of depressive disorders,anxiety disorders and schizophrenia in the 65-70-year-old age group were the most burdensome.Conclusions The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged countries.Raising awareness about formulating health policies for preventing and treating mental disorders in the older population is necessary to reduce the future burden posed by the ageing challenge.展开更多
Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate...Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate the efficacy and safety of ulinastatin in the treatment of septic shock patients.Methods:Three English databases(Embase,Medline,and Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure,Wanfang data,SinoMed,and VIP)were searched for published randomized controlled trials.Stata 16.0 software was used to conduct the meta-analysis.Results:A total of 48 articles were included(Chinese article 47,1 in English).The results show that the treatment of ulinastatin could reduce mortality(risk ratio=0.63,95%confidence interval(CI)(0.55,0.72)),multiple organ dysfunction syndrome(risk ratio=0.6,95%CI(0.53,0.68)),length of intensive care unit stay(mean difference(MD)=-3.92,95%CI(-4.65,-3.18)),length of hospital stay(MD=-4.39,95%CI(-6.63,-2.15))and decrease Acute Physiology and Chronic Health Evaluation II score(MD=-4.55,95%CI(-5.63,-3.47))and Sequential Organ Failure Assessment score(MD=-2.02,95%CI(-2.59,-1.44))with P<0.001.Moreover,it lowers TNF-α(standardized mean difference(SMD)=-1.78,95%CI(-2.24,-1.32)),Interleukin-6(SMD=-1.17,95%CI(-1.55,-0.8)),C reactive protein(SMD=-1.49,95%CI(-1.99,-0.99)),hypersensitive C-reactive protein(SMD=-1.9,95%CI(-2.87,-0.94))and procalcitonin(SMD=-0.89,95%CI(-1.12,-0.67))levels in the body.Conclusions:Available evidence shows that ulinastatin reduces case mortality rate,multiple organ dysfunction syndrome,length of intensive care unit stay,and length of hospital stay and decreases Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score.Moreover,it also lowers TNF-α,Interleukin-6,C reactive protein,hypersensitive C-reactive protein,and procalcitonin levels in the body.展开更多
Background:Current protein biomarkers are only moderately predictive at identifying individuals with mild traumatic brain injury or concussion.Therefore,more accurate diagnostic markers are needed for sport-related co...Background:Current protein biomarkers are only moderately predictive at identifying individuals with mild traumatic brain injury or concussion.Therefore,more accurate diagnostic markers are needed for sport-related concussion.Methods:This was a multicenter,prospective,case-control study of athletes who provided blood samples and were diagnosed with a concussion or were a matched non-concussed control within the National Collegiate Athletic Association-Department of Defense Concussion Assessment,Research,and Education Consortium conducted between 2015 and 2019.The blood was collected within 48 h of injury to identify protein abnormalities at the acute and subacute timepoints.Athletes with concussion were divided into 6 h post-injury(0-6 h post-injury)and after 6 h postinjury(7-48 h post-injury)groups.We applied a highly multiplexed proteomic technique that used a DNA aptamers assay to target 1305proteins in plasma samples from athletes with and without sport-related concussion.Results:A total of 140 athletes with concussion(79.3%males;aged 18.71±1.10 years,mean±SD)and 21 non-concussed athletes(76.2%males;19.14±1.10 years)were included in this study.We identified 338 plasma proteins that significantly differed in abundance(319 upregulated and 19 downregulated)in concussed athletes compared to non-concussed athletes.The top 20 most differentially abundant proteins discriminated concussed athletes from non-concussed athletes with an area under the curve(AUC)of 0.954(95%confidence interval:0.922-0.986).Specifically,after 6 h of injury,the individual AUC of plasma erythrocyte membrane protein band 4.1(EPB41)and alpha-synuclein(SNCA)were 0.956 and 0.875,respectively.The combination of EPB41 and SNCA provided the best AUC(1.000),which suggests this combination of candidate plasma biomarkers is the best for diagnosing concussion in athletes after 6 h of injury.Conclusion:Our data suggest that proteomic profiling may provide novel diagnostic protein markers and that a combination of EPB41 and SNCA is the most predictive biomarker of concussion after 6 h of injury.展开更多
Objective This study aimed to estimate spatiotemporal variations of global heat-related cardiovascular disease(CVD)burden from 1990 to 2019.Methods Data on the burden of heat-related CVD were derived from the Global B...Objective This study aimed to estimate spatiotemporal variations of global heat-related cardiovascular disease(CVD)burden from 1990 to 2019.Methods Data on the burden of heat-related CVD were derived from the Global Burden of Disease Study 2019.Deaths and disability-adjusted life years(DALYs)were used to quantify heat-induced CVD burden.We calculated the age-standardized mortality rate(ASMR)and DALY rate(ASDR)per 100,000population to compare this burden across regions.Generalized linear models were applied to evaluate estimated annual percentage changes(EAPC)for temporal trends from 1990 to 2019.The correlation between the socio-demographic index(SDI)and age-standardized rate was measured using the Spearman rank test.Results Heat-induced CVD caused approximately 90 thousand deaths worldwide in 2019.Global ASMR and ASDR of heat-related CVD in 2019 were 1.17[95%confidence interval(CI):0.13-1.98]and 25.59(95%CI:2.07-44.17)per 100,000 population,respectively.The burden was significantly increased in middle and low-SDI regions and slightly decreased in high-SDI regions from 1990 to 2019.ASMR showed an upward trend,with the most considerable increase in low-latitude countries.We observed a negative correlation between SDI and EAPC in ASMR(rs=-0.57,P<0.01)and ASDR(rs=-0.59,P<0.01)among204 countries.Conclusion Heat-attributable CVD burden substantially increased in most developing countries and tropical regions.展开更多
Owing to its heterogeneous and highly aggressive nature,hepatocellular carcinoma(HCC)has a high recurrence rate,which is a non-negligible problem despite the increasing number of available treatment options.Recent cli...Owing to its heterogeneous and highly aggressive nature,hepatocellular carcinoma(HCC)has a high recurrence rate,which is a non-negligible problem despite the increasing number of available treatment options.Recent clinical trials have attempted to reduce the recurrence and develop innovative treatment options for patients with recurrent HCC.In the event of liver remnant recurrence,the currently available treatment options include repeat hepatectomy,salvage liver transplantation,tumor ablation,transcatheter arterial chemoembolization,stereotactic body radiotherapy,systemic therapies,and combination therapy.In this review,we summarize the strategies to reduce the recurrence of high-risk tumors and aggressive therapies for recurrent HCC.Additionally,we discuss methods to prevent HCC recurrence and prognostic models constructed based on predictors of recurrence to develop an appropriate surveillance program.展开更多
AIM: To investigate hepatitis B virus(HBV) prevalence in the general population in China.METHODS: A total of 148931 individuals were investigated by multistage random sampling in Eastern China. Data were collected on ...AIM: To investigate hepatitis B virus(HBV) prevalence in the general population in China.METHODS: A total of 148931 individuals were investigated by multistage random sampling in Eastern China. Data were collected on demographics and hepatitis B vaccination history, and serum was tested for hepatitis B surface antigen(HBs Ag) by ELISA. RESULTS: A total of 11469 participants(7.70%, 95%CI: 7.57%-7.84%) were positive for HBs Ag. HBs Ag prevalence was 0.77% among children < 5 years old but increased progressively from adolescents(1.40%-2.55%) to adults(5.69%-11.22%). A decrease in HBs Ag prevalence was strongly associated with vaccination and familial history of HBV among both children and adult groups. Meanwhile, HBs Ag risk in adults was associated with invasive testing and sharing needles. The HBV immunization rate among participants aged < 20 years was 93.30%(95%CI: 93.01%-93.58%). Significant difference in HBs Ag prevalence appeared between vaccinated and unvaccinated participants(3.59% vs 10.22%). CONCLUSION: Although the national goal of HBs Ag prevalence < 1% among children < 5 years old has been reached, immunization programs should be maintained to prevent resurgence.展开更多
Objective This study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction(AMI)and stroke in Shenzhen.Methods Data on ischemic(n=72,945)and hemorrhagic(n=18,659)stroke and...Objective This study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction(AMI)and stroke in Shenzhen.Methods Data on ischemic(n=72,945)and hemorrhagic(n=18,659)stroke and AMI(n=17,431)incidence covering about 12 million people in Shenzhen from 2012 to 2016 were used.Immediate and gradual changes in incidence rates were analyzed using segmented Poisson regression.Results Following the smoke-free legislation,a 9%(95%CI:3%-15%)immediate reduction was observed in AMI incidence,especially in men(8%,95%CI:1%-14%)and in those aged 65 years and older(17%,95%CI:9%-25%).The gradual annual benefits were observed only in hemorrhagic and ischemic stroke incidence,with a 7%(95%CI:2%-11%)and 6%(95%CI:4%-8%)decrease per year,respectively.This health effect extended gradually to the 50-64 age group.In addition,neither the immediate nor gradual decrease in stroke and AMI incidence rates did not show statistical significance among the 35-49 age group(P>0.05).Conclusion Smoke-free legislation was enforced well in Shenzhen,which would generate good experiences for other cities to enact and enforce smoke-free laws.This study also provided more evidence of the health benefits of smoke-free laws on stroke and AMI.展开更多
BACKGROUND A limited number of studies have been conducted to test the magnitudes of the association between apparent treatment resistant hypertension(aTRH)and risk of cardiovascular disease(CVD).AIM To investigate th...BACKGROUND A limited number of studies have been conducted to test the magnitudes of the association between apparent treatment resistant hypertension(aTRH)and risk of cardiovascular disease(CVD).AIM To investigate the association between aTRH and risk of CVD and examine whether sex and age modify this association.METHODS We applied an observational analysis study design using data from the United States Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial(ALLHAT).ALLHAT recruited participants(n=25516)from 625 primary care settings throughout the United States,Canada,Puerto Rico,and United States Virgin Islands,aged 55 and older with hypertension and at least one additional risk factor for heart disease.aTRH was assessed from the year 2 visit.CVD event was defined as one of the following from the year 2 follow-up visit:Fatal or non-fatal myocardial infarction,coronary revascularization,angina,stroke,heart failure,or peripheral artery disease.Cox proportional hazards regression was used to examine the effect of aTRH on CVD risk.Potential modifications of sex and age on this association were examined on the multiplicative scale by interaction term and additive scale by joint effects and relative excess risk for interaction.RESULTS Of the total study participants(n=25516),5030 experienced a CVD event during a mean of 4.7 years follow-up.aTRH was associated with a 30%increase in risk of CVD compared to non-aTRH[hazards ratio(HR)=1.3,95%CI:1.19-1.42].Sex and age modified this relationship on both multiplicative and additive scales independently.Stratified by sex,aTRH was associated with a 64%increase in risk of CVD(HR=1.64,95%CI:1.43–1.88)in women,and a 13%increase in risk of CVD(HR=1.13,95%CI:1.01–1.27)in men.Stratified by age,aTRH had a stronger impact on the risk of CVD in participants aged<65(HR=1.53,95%CI:1.32–1.77)than it did in those aged≥65(HR=1.18,95%CI:1.05–1.32).Significant two-way interactions of sex and aTRH,and age and aTRH on risk of CVD were observed(P<0.05).The observed joint effect of aTRH and ages≥65 years(HR=1.85,95%CI:1.22–2.48)in males was less than what was expected for both additive and multiplicative models(HR=4.10,95%CI:3.63–4.57 and 4.88,95%CI:3.66–6.31),although three-way interaction of sex,age,and aTRH on the risk of CVD and coronary heart disease did not reach a statistical significance(P>0.05).CONCLUSION aTRH was significantly associated with an increased risk of CVD and this association was modified by both sex and age.Further studies are warranted to test these mechanisms.展开更多
Prolonged exposure to coal dust may lead to various lung diseases, especially coal workers’ pneumoconiosis(CWP)[1]. Developed countries such as the United States experienced a resurgence of pneumoconiosis in the earl...Prolonged exposure to coal dust may lead to various lung diseases, especially coal workers’ pneumoconiosis(CWP)[1]. Developed countries such as the United States experienced a resurgence of pneumoconiosis in the early 20t h century[2], and this phenomenon has become even more critical in developing countries[3]such as China and India.展开更多
Background Adverse childhood experiences(ACEs)and dementia are associated and comorbid with obesity.However,according to emerging research,the role of obesity in the association between ACEs and dementia seems controv...Background Adverse childhood experiences(ACEs)and dementia are associated and comorbid with obesity.However,according to emerging research,the role of obesity in the association between ACEs and dementia seems controversial.Aims This analysis aimed to explore the associations between ACEs and different dementia subtypes and the effect modification of long-term body mass index(BMI).Methods Data were obtained from the US Health and Retirement Study.Six ACEs were categorised as 0,1 and 2 or more.All-cause dementia,Alzheimer’s disease(AD)and other dementias were defined by self-reported or proxy-reported physician diagnosis.Cox proportional hazards regression was used to explore the associations of ACEs with new-onset all-cause dementia,AD and other dementias from 2010 to 2020.Effect modification of BMI in 2010 and BMI transition and trajectory(fitted by group-based trajectory modelling)from 2004 to 2010 were assessed.Results 15282 participants with a mean age of 67.0 years(58.0–75.0)were included in the 2010 data analysis.Significant interactions of ACEs with baseline BMI,BMI transition and BMI trajectory in their associations with new-onset all-cause dementia and AD were observed(all p<0.05).For instance,positive associations of two or more ACEs(vs none)with all-cause dementia and AD were found in those with a BMI trajectory of maintaining≥30 kg/m2(maintain obesity)rather than a decline to or maintaining<25 kg/m2(decline to or maintain normal weight),with hazard ratios(HRs)of 1.87(95%confidence interval(CI):1.45 to 2.42)and 1.85(95%CI:1.22 to 2.80),respectively.Conclusions ACEs were associated with dementia and AD in US adults with long-term abnormally elevated BMI but not with long-term normal or decreasing BMI.Integrated weight management throughout life could prevent dementia among those with childhood adversity.展开更多
Background Family environments can shape children’s personalities and social networks,rendering distinguishing adverse childhood experiences(ACEs)from family and society essential,but related evidence remains limited...Background Family environments can shape children’s personalities and social networks,rendering distinguishing adverse childhood experiences(ACEs)from family and society essential,but related evidence remains limited.Aims This cross-sectional study aimed to investigate the correlations between intrafamilial and social ACEs,their associations with depressive symptoms and cognitive impairment and the(education-moderated)mediating role of social ACEs.Methods Data for this cross-sectional study were from the China Health and Retirement Longitudinal Study.Nine intrafamilial(0,1,2,3,and 4 or more)and three social(0,1,and 2 or more)ACEs were identified.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale.Global cognition,including episodic memory and mental intactness,was calculated as z scores.Binary and ordered logistic regressions,generalised linear models with Gaussian family and identity link,and mediation analysis were used.Results 13435 participants aged 59.0(51.0–66.0)were included.Compared with participants with no intrafamilial ACEs,those with 1,2,3,and 4 or more intrafamilial ACEs tended to develop more social ACEs,with odds ratios(ORs)of 1.55(95%confidence interval(CI):1.36 to 1.76),2.36(95%CI:2.08 to 2.68),3.46(95%CI:3.02 to 3.96)and 6.10(95%CI:5.30 to 7.02),respectively.Both intrafamilial and social ACEs were associated with depressive symptoms(OR>3 for four or more intrafamilial ACEs and two or more social ACEs)and global cognition(β=−0.26 for four or more intrafamilial ACEs andβ=−0.29 for two or more social ACEs).Social ACEs mediated the associations of intrafamilial ACEs with depressive symptoms and global cognition by 12.3%and 13.1%,respectively.Furthermore,as education levels increased,the impact of intrafamilial ACEs on depressive symptoms was increasingly mediated through social ACEs,while the mediating role of social ACEs between intrafamilial ACEs and cognitive impairment gradually diminished.Conclusions Improving children’s social environments and elevating general education can prevent later-life depressive symptoms and cognitive impairment attributed to ACEs in China.展开更多
Objective To evaluate the association between serum uric acid(SUA)and kidney function decline.Methods Data was obtained from the China Health and Retirement Longitudinal Study on the Chinese middle-aged and older popu...Objective To evaluate the association between serum uric acid(SUA)and kidney function decline.Methods Data was obtained from the China Health and Retirement Longitudinal Study on the Chinese middle-aged and older population for analysis.The kidney function decline was defined as an annual estimated glomerular filtration rate(e GFR)decrease by>3 mL/min per 1.73 m^(2).Multivariable logistic regression was applied to determine the association between SUA and kidney function decline.The shape of the association was investigated by restricted cubic splines.Results A total of 7,346 participants were included,of which 1,004 individuals(13.67%)developed kidney function decline during the follow-up of 4 years.A significant dose-response relation was recorded between SUA and the kidney function decline(OR 1.14,95%CI 1.03-1.27),as the risk of kidney function decline increased by 14%per 1 mg/d L increase in SUA.In the subgroup analyses,such a relation was only recorded among women(OR 1.22,95%CI 1.03-1.45),those aged<60 years(OR 1.22,95%CI 1.05-1.42),and those without hypertension and without diabetes(OR 1.22,95%CI 1.06-1.41).Although the dose-response relation was not observed in men,the high level of SUA was related to kidney function decline(OR 1.83,95%CI 1.05-3.17).The restricted cubic spline analysis indicated that SUA>5 mg/dL was associated with a significantly higher risk of kidney function decline.Conclusion The SUA level was associated with kidney function decline.An elevation of SUA should therefore be addressed to prevent possible kidney impairment and dysfunction.展开更多
AIM:To determine the agreement of ocular biometric indices including axial length,keratometric readings,anterior chamber depth,and horizontal corneal diameter between the Pentacam AXL and IOL Master 500.METHODS:The st...AIM:To determine the agreement of ocular biometric indices including axial length,keratometric readings,anterior chamber depth,and horizontal corneal diameter between the Pentacam AXL and IOL Master 500.METHODS:The study was a large cross-sectional population-based study(Tehran Geriatric Eye Study)conducted from Jan 2019 to Jan 2020.A total of 160 clusters were randomly selected proportional to size(each cluster contained 20 individuals)from 22 strata of Tehran city.All people aged 60y and above were invited to participate in the study.For all participants,preliminary ocular examinations were performed including the measurement of uncorrected and best-corrected visual acuity,objective and subjective refraction,anterior and posterior segment examinations.All participants underwent an ocular biometry using the Pentacam AXL and IOL Master 500.RESULTS:The 95%limits of agreement(LoA)between the two devices were-0.13 to 0.19,-0.15 to 0.17,and-0.13 to 0.19 in normal,pseudophakic,and cataractous eyes,respectively.With increasing the axial length,the difference between the two devices significantly increased in all three groups of normal,pseudophakic,and cataractous eyes(P<0.001).The 95% LoAs between the two devices regarding the mean keratometry shows that the best LoAs were seen in cataractous(-0.33 to 0.81)and followed by normal eyes(-0.36 to 0.86)and the pseudophakic eyes(-0.48 to 0.90)had the widest LoA.The 95% LoAs for horizontal corneal diameter measurements were-0.08 to 0.86,-0.03 to 0.83,and-0.07 to 0.87 in normal,pseudophakic,and cataractous eyes,respectively.The 95% LoAs of anterior chamber depth measurements between the two devices was-0.39 to 0.19 and-0.37 to 0.13 in normal eyes and cataractous,respectively.CONCLUSION:The Pentacam AXL has excellent agreement with the gold standard,IOL Master 500 in measuring axial length.In eyes with cataracts,the difference between the two devices is more scattered.With the increasing of axial length,the difference between the two devices increased,which should be considered when using Pentacam AXL.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
Psychosis has increasingly become a social problem,emphasizing the need to understand the relationship between mental disorders and personality.This study aimed to investigate the relationship between mental disorders...Psychosis has increasingly become a social problem,emphasizing the need to understand the relationship between mental disorders and personality.This study aimed to investigate the relationship between mental disorders and personality among psychiatric outpatients based on real-world data.Symptom Checklist 90(SCL-90)and Eysenck Personality Questionnaire(EPQ)were used to evaluate the personality and psychopathological symptoms of patients(n=8409)in the Psychiatric Outpatient Department at Nanjing Drum Tower Hospital.t-test was used to compare scores between patients and national norms.Pearson’s correlation coefficient and path analysis were used to explore the relationship between mental health status and personality.The correlation coefficient between the neuroticism(N)score and each factor score of the SCL-90 test,as well as the correlation between psychoticism(P)and hostility and paranoia,exceeded 0.4.Path analysis revealed that the standardized path coefficients of N score and SCL-90 were all higher than 0.4.In addition,the standardized path coefficient of hostility and paranoia on P score were 0.313 and 0.280,respectively.Interpersonal sensitivity,depression and obsessive-compulsive symptoms were affected by extraversion(E)score,with standardized path coefficients of-0.149,-0.138,and-0.105,respectively.The path analysis also showed the direct and indirect effects of age,gender,education,and marital status on SCL-90.Patients characterized as melancholic had higher scores in all factors of SCL-90.In conclusion,mental health was related to personality traits of neuroticism,psychoticism and introversion.展开更多
Objective:The objective of the study is to describe the work-related quality of life(WRQOL)among nurses and explore its association with performance evaluation ratings.Methods:A cross-sectional design was utilized mea...Objective:The objective of the study is to describe the work-related quality of life(WRQOL)among nurses and explore its association with performance evaluation ratings.Methods:A cross-sectional design was utilized measuring the WRQOL scale and the previous performance appraisal rating.Multistage sampling approach was utilized with nurses stratified based on their position and then systematically random sampled based on their unit assignment.Results:One hundred and eighty-two nurses were included.About half reported a high quality of work life(101;55.5%).Low scores were noted on the subscale working conditions(100;54.9%),low to average responses for home-work interface(109;59.9%),control at work(100;54.9%),and stress at work(90;49.5%).A higher proportion of nurses reported positive responses toward the areas of general well-being(113;62.1%)and job-career satisfaction(112;61.5%),than in the other subscales.There were notable differences between WRQOL ratings:(1)Head nurses had the highest perceived quality of work life,followed by nurse supervisors and charge nurses(F=6.1,P<0.01)and(2)Nurses in the pay-patient services reported lower quality of working life,while those in office and outpatient services had more positive scores(F=4.6,P<0.01).Conclusion:Only more than half of the nurses reported a high quality of work life,some of its dimensions,particularly job and career satisfaction and working conditions,appeared to vary in the perceived degree across years in service,work hours,and position.The assessment of the quality of work life may serve as an important tool to address staff burnout,absenteeism and other issues that affect job performance among health-care professionals.展开更多
Summary:The corona virus disease 2019(COVID-19)is an emerging respiratory infectious disease caused by SARS-CoV-2,which first occurred in December 2019 in Wuhan,China.These days,in China,chest CT is used for diagnosis...Summary:The corona virus disease 2019(COVID-19)is an emerging respiratory infectious disease caused by SARS-CoV-2,which first occurred in December 2019 in Wuhan,China.These days,in China,chest CT is used for diagnosis of COVID-19,as an important complement to the reverse-transcription polymerase chain reaction(RT-PCR)test.Because of contacting with a large number of suspected or probable cases closely during chest CT examination,radiographers are easily infected with COVID-19.This article included the rearrangement of CT examination room in fever clinic,the rearrangement of human resources in radiology department,and the drafting of new operating procedures for radiologists who carry out CT examination on COVID-19 patients.This article also introduced the emergency management procedures of the department of radiology during the outbreak,and the experience of infection prevention for the staff of the department of radiology.展开更多
基金supported by grants from China CDC Key Laboratory of Environment and Population Health(2022-CKL-03)Peking University(BMU2021YJ044)supported by the General Program of National Natural Science Foundation of China(32170898)。
文摘Background:Irritable bowel syndrome(IBS)substantially affects quality of life and requires early prevention.This study aimed to elucidate the relationships between IBS and daily behaviors,including sedentary behavior(SB),physical activity(PA),and sleep.In particular,it seeks to identify healthy behaviors to reduce IBS risk,which previous studies have rarely addressed.Methods:Daily behaviors were retrieved from self-reported data of 362,193 eligible UK Biobank participants.Incident cases were determined by self-report or health care data according to RomeⅣcriteria.Results:A total of 345,388 participants were IBS-free at baseline,during a median follow-up of 8.45 years,19,885 incident IBS cases were recorded.When examined individually,SB and shorter(≤7 h/day)or longer(>7 h/day)sleep duration were each positively associated with increased IBS risk,and PA was associated with lower IBS risk.The isotemporal substitution model suggested that replacing SB with other activities could provide further protective effects against IBS risk.Among people sleeping≤7 h/day,replacing 1 h of SB with equivalent light PA,vigorous PA,or sleep was associated with 8.1%(95%confidence interval(95%CI):0.901-0.937),5.8%(95%CI:0.896-0.991),and 9.2%(95%CI:0.885-0.932)reduced IBS risk,respectively.For people sleeping>7 h/day,light and vigorous PA were associated with a 4.8%(95%CI:0.926-0.978)and a 12.0%(95%CI:0.815-0.949)lower IBS risk,respectively.These benefits were mostly independent of genetic risk for IBS.Conclusion:SB and unhealthy sleep duration are risk factors for IBS.A promising way to mitigate IBS risk for individuals sleeping≤7 h/day and for those sleeping>7 h/day appears to be by replacing SB with adequate sleep or vigorous PA,respectively,regardless of the genetic predisposition of IBS.
基金supported by the National Natural Science Foundation of China(No.82073617)Joint Research Fund for Beijing Natural Science Foundation and Haidian Original Innovation(No.L202007)+1 种基金Fundamental Research Funds for the Central Universities and Peking University Health Science Center(No.BMU2021YJ041)Peking University Medicine Fund of Fostering Young Scholars'Scientific&Technological Innovation(No.BMU2021PY005).
文摘Objective Human adenovirus(HAdV)infection is common and can develop to serious conditions with high mortality,yet the mechanism of HAdV infection remains unclear.In the present study,the serum metabolite profiles of HAdV-7-infected patients with pneumonia or upper respiratory tract infection(URTI)were explored.Methods In total,35 patients were enrolled in the study following an outbreak of HAdV-7 in the army,of whom 14 had pneumonia and 21 had URTI.Blood samples were collected at the acute stage and at the recovery stage and were analyzed by untargeted metabolomics.Results Over 90% of the differential metabolites identified between the pneumonia patients and URTI patients were lipids and lipid-like molecules,including glycerophospholipids,fatty acyls,and sphingolipids.The metabolic pathways that were significantly enriched were primarily the lipid metabolism pathways,including sphingolipid metabolism,glycerophospholipid metabolism,and linoleic acid metabolism.The sphingolipid metabolism was identified as a significantly differential pathway between the pneumonia patients and URTI patients and between the acute and recovery stages for the pneumonia patients,but not between the acute and recovery stages for the URTI patients.Ceramide and lactosylceramide,involved in sphingolipid metabolism,were significantly higher in the pneumonia patients than in the URTI patients with good discrimination abilities[area under curve(AUC)0.742 and 0.716,respectively;combination AUC 0.801].Conclusion Our results suggested that HAdV modulated lipid metabolism for both the patients with URTI and pneumonia,especially the sphingolipid metabolism involving ceramide and lactosylceramide,which might thus be a potential intervention target in the treatment of HAdV infection.
基金National Key Research and Development Program of China(2022YFC2009600,2022YFC2009605)National Natural Science Foundation of China(81973133)。
文摘Background The prospective association of dietary thiamine intake with the risk of cognitive decline among the general older adults remains uncertain.Aims To investigate the association between dietary thiamine intake and cognitive decline in cognitively healthy,older Chinese individuals.Methods The study included a total of 3106 participants capable of completing repeated cognitive function tests.Dietary nutrient intake information was collected through 3-day dietary recalls and using a 3-day food-weighed method to assess cooking oil and condiment consumption.Cognitive decline was defined as the 5-year decline rate in global or composite cognitive scores based on a subset of items from the Telephone Interview for Cognitive Status-modified.Results The median follow-up duration was 5.9 years.There was a J-shaped relationship between dietary thiamine intake and the 5-year decline rate in global and composite cognitive scores,with an inflection point of 0.68 mg/day(95%confidence interval(Cl):0.56 to 0.80)and a minimal risk at 0.60-1.00 mg/day of dietary thiamine intake.Before the inflection point,thiamine intake was not significantly associated with cognitive decline.Beyond the inflection point,each unit increase in thiamine intake(mg/day)was associated with a significant decrease of 4.24(95%Cl:2.22 to 6.27)points in the global score and 0.49(95%Cl:0.23 to 0.76)standard units in the composite score within 5 years.A stronger positive association between thiamine intake and cognitive decline was observed in those with hypertension,obesity and those who were non-smokers(all p<0.05).Conclusions This study revealed a J-shaped association between dietary thiamine intake and cognitive decline in cognitively healthy,older Chinese individuals,with an inflection point at 0.68 mg/day and a minimal risk at 0.60-1.00 mg/day of dietary thiamine intake.
基金Shanghai'Science and Technology Innovation Action Plan'medical innovation research(21Y11905600)Shanghai'Science and Technology Innovation Action Plan'Natural Science Foundation of Shanghai(21ZR1455100)+1 种基金the National Natural Science Foundation of China(81701344)the Shanghai Mental Health Center General Projects(2021-YJ-02).
文摘Background Depression,anxiety and schizophrenia among older persons have become global public health challenges.However,the burden of these disorders in ageing and aged countries has not been analysed.Aims To investigate the burden of depression,anxiety and schizophrenia among older adults in ageing and aged countries.Methods Using data from the Global Burden of Disease Study 2019,we calculated the estimated annual percentage change(EAPC)in the age-standardised incidence rates(ASiR)and age-standardised disability-adjusted life years(DALYs)rates(ASDR)for depression,anxiety and schizophrenia of older people in ageing countries(China,India,Indonesia)and aged countries(Japan,Italy,Portugal)between 1990 and 2019.Trends in incidence and DALYs were analysed by gender and age.Results In 2019,the highest incidence of depression,anxiety and schizophrenia in the older population in aged countries was in Japan(927271.3(752552.3-1125796.5),51498.2(37625.7-70487.3)and 126.0(61.0-223.2),respectively),while the highest incidence in ageing countries was in China(5797556.9(4599403.4-7133006.5),330256.1(246448.9-445987.4)and 1067.7(556.2-1775.9),respectively).DALYs for these disorders were similar,with the highest in Japan and China.From 1990 to 2019,the ASIR for depressive disorders decreased in aged countries but increased in ageing countries;the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged countries.The ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and schizophrenia.The ASIR for depressive disorders was higher in older women,while the opposite was observed in anxiety disorders and schizophrenia.Notably,the conditions of burden of depressive disorders,anxiety disorders and schizophrenia in the 65-70-year-old age group were the most burdensome.Conclusions The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged countries.Raising awareness about formulating health policies for preventing and treating mental disorders in the older population is necessary to reduce the future burden posed by the ageing challenge.
基金funded Secondary Classroom Project fund of Capital Medical University (Project Number:D2KT 2021092).
文摘Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate the efficacy and safety of ulinastatin in the treatment of septic shock patients.Methods:Three English databases(Embase,Medline,and Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure,Wanfang data,SinoMed,and VIP)were searched for published randomized controlled trials.Stata 16.0 software was used to conduct the meta-analysis.Results:A total of 48 articles were included(Chinese article 47,1 in English).The results show that the treatment of ulinastatin could reduce mortality(risk ratio=0.63,95%confidence interval(CI)(0.55,0.72)),multiple organ dysfunction syndrome(risk ratio=0.6,95%CI(0.53,0.68)),length of intensive care unit stay(mean difference(MD)=-3.92,95%CI(-4.65,-3.18)),length of hospital stay(MD=-4.39,95%CI(-6.63,-2.15))and decrease Acute Physiology and Chronic Health Evaluation II score(MD=-4.55,95%CI(-5.63,-3.47))and Sequential Organ Failure Assessment score(MD=-2.02,95%CI(-2.59,-1.44))with P<0.001.Moreover,it lowers TNF-α(standardized mean difference(SMD)=-1.78,95%CI(-2.24,-1.32)),Interleukin-6(SMD=-1.17,95%CI(-1.55,-0.8)),C reactive protein(SMD=-1.49,95%CI(-1.99,-0.99)),hypersensitive C-reactive protein(SMD=-1.9,95%CI(-2.87,-0.94))and procalcitonin(SMD=-0.89,95%CI(-1.12,-0.67))levels in the body.Conclusions:Available evidence shows that ulinastatin reduces case mortality rate,multiple organ dysfunction syndrome,length of intensive care unit stay,and length of hospital stay and decreases Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score.Moreover,it also lowers TNF-α,Interleukin-6,C reactive protein,hypersensitive C-reactive protein,and procalcitonin levels in the body.
基金supported by the Grand Alliance CARE Consortiumfunded in part by the National Collegiate Athletic Association(NCAA)+1 种基金the Department of Defense(DoD).supported by the Office of the Assistant Secretary of Defense for Health Affairs,through the Combat Casualty Care Research Program,endorsed by the Department of Defense,under Award No.W81XWH1420151。
文摘Background:Current protein biomarkers are only moderately predictive at identifying individuals with mild traumatic brain injury or concussion.Therefore,more accurate diagnostic markers are needed for sport-related concussion.Methods:This was a multicenter,prospective,case-control study of athletes who provided blood samples and were diagnosed with a concussion or were a matched non-concussed control within the National Collegiate Athletic Association-Department of Defense Concussion Assessment,Research,and Education Consortium conducted between 2015 and 2019.The blood was collected within 48 h of injury to identify protein abnormalities at the acute and subacute timepoints.Athletes with concussion were divided into 6 h post-injury(0-6 h post-injury)and after 6 h postinjury(7-48 h post-injury)groups.We applied a highly multiplexed proteomic technique that used a DNA aptamers assay to target 1305proteins in plasma samples from athletes with and without sport-related concussion.Results:A total of 140 athletes with concussion(79.3%males;aged 18.71±1.10 years,mean±SD)and 21 non-concussed athletes(76.2%males;19.14±1.10 years)were included in this study.We identified 338 plasma proteins that significantly differed in abundance(319 upregulated and 19 downregulated)in concussed athletes compared to non-concussed athletes.The top 20 most differentially abundant proteins discriminated concussed athletes from non-concussed athletes with an area under the curve(AUC)of 0.954(95%confidence interval:0.922-0.986).Specifically,after 6 h of injury,the individual AUC of plasma erythrocyte membrane protein band 4.1(EPB41)and alpha-synuclein(SNCA)were 0.956 and 0.875,respectively.The combination of EPB41 and SNCA provided the best AUC(1.000),which suggests this combination of candidate plasma biomarkers is the best for diagnosing concussion in athletes after 6 h of injury.Conclusion:Our data suggest that proteomic profiling may provide novel diagnostic protein markers and that a combination of EPB41 and SNCA is the most predictive biomarker of concussion after 6 h of injury.
基金supported by the Hubei Provincial Natural Science Foundation of China[Grant No.2021CFB032]Universities'Natural Science Researches in Jiangsu Province[Grant No.22KJD310005]the National Natural Science Foundation of China[Grant No.72204211]。
文摘Objective This study aimed to estimate spatiotemporal variations of global heat-related cardiovascular disease(CVD)burden from 1990 to 2019.Methods Data on the burden of heat-related CVD were derived from the Global Burden of Disease Study 2019.Deaths and disability-adjusted life years(DALYs)were used to quantify heat-induced CVD burden.We calculated the age-standardized mortality rate(ASMR)and DALY rate(ASDR)per 100,000population to compare this burden across regions.Generalized linear models were applied to evaluate estimated annual percentage changes(EAPC)for temporal trends from 1990 to 2019.The correlation between the socio-demographic index(SDI)and age-standardized rate was measured using the Spearman rank test.Results Heat-induced CVD caused approximately 90 thousand deaths worldwide in 2019.Global ASMR and ASDR of heat-related CVD in 2019 were 1.17[95%confidence interval(CI):0.13-1.98]and 25.59(95%CI:2.07-44.17)per 100,000 population,respectively.The burden was significantly increased in middle and low-SDI regions and slightly decreased in high-SDI regions from 1990 to 2019.ASMR showed an upward trend,with the most considerable increase in low-latitude countries.We observed a negative correlation between SDI and EAPC in ASMR(rs=-0.57,P<0.01)and ASDR(rs=-0.59,P<0.01)among204 countries.Conclusion Heat-attributable CVD burden substantially increased in most developing countries and tropical regions.
文摘Owing to its heterogeneous and highly aggressive nature,hepatocellular carcinoma(HCC)has a high recurrence rate,which is a non-negligible problem despite the increasing number of available treatment options.Recent clinical trials have attempted to reduce the recurrence and develop innovative treatment options for patients with recurrent HCC.In the event of liver remnant recurrence,the currently available treatment options include repeat hepatectomy,salvage liver transplantation,tumor ablation,transcatheter arterial chemoembolization,stereotactic body radiotherapy,systemic therapies,and combination therapy.In this review,we summarize the strategies to reduce the recurrence of high-risk tumors and aggressive therapies for recurrent HCC.Additionally,we discuss methods to prevent HCC recurrence and prognostic models constructed based on predictors of recurrence to develop an appropriate surveillance program.
基金Supported by National S and T Major Project Foundation of China,No.2011ZX10004-902Priority Academic Program Development of Jiangsu Higher Education Institutions,Jiangsu Province Health Development Project with Science and Education,No.ZX201109Research and Innovation Project for College Graduates of Jiangsu Province of China,No.KYZZ_0265
文摘AIM: To investigate hepatitis B virus(HBV) prevalence in the general population in China.METHODS: A total of 148931 individuals were investigated by multistage random sampling in Eastern China. Data were collected on demographics and hepatitis B vaccination history, and serum was tested for hepatitis B surface antigen(HBs Ag) by ELISA. RESULTS: A total of 11469 participants(7.70%, 95%CI: 7.57%-7.84%) were positive for HBs Ag. HBs Ag prevalence was 0.77% among children < 5 years old but increased progressively from adolescents(1.40%-2.55%) to adults(5.69%-11.22%). A decrease in HBs Ag prevalence was strongly associated with vaccination and familial history of HBV among both children and adult groups. Meanwhile, HBs Ag risk in adults was associated with invasive testing and sharing needles. The HBV immunization rate among participants aged < 20 years was 93.30%(95%CI: 93.01%-93.58%). Significant difference in HBs Ag prevalence appeared between vaccinated and unvaccinated participants(3.59% vs 10.22%). CONCLUSION: Although the national goal of HBs Ag prevalence < 1% among children < 5 years old has been reached, immunization programs should be maintained to prevent resurgence.
基金supported by the CAMS Innovation Fund for Medical Sciences[CIFMS2016-12M-3-001]the China Medical Board Strengthen Capacity of Study and Application on Burden of Disease in Health Care System of China-Establishment and Development of Chinese Burden of Disease Research and Dissemination Center[15-208]。
文摘Objective This study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction(AMI)and stroke in Shenzhen.Methods Data on ischemic(n=72,945)and hemorrhagic(n=18,659)stroke and AMI(n=17,431)incidence covering about 12 million people in Shenzhen from 2012 to 2016 were used.Immediate and gradual changes in incidence rates were analyzed using segmented Poisson regression.Results Following the smoke-free legislation,a 9%(95%CI:3%-15%)immediate reduction was observed in AMI incidence,especially in men(8%,95%CI:1%-14%)and in those aged 65 years and older(17%,95%CI:9%-25%).The gradual annual benefits were observed only in hemorrhagic and ischemic stroke incidence,with a 7%(95%CI:2%-11%)and 6%(95%CI:4%-8%)decrease per year,respectively.This health effect extended gradually to the 50-64 age group.In addition,neither the immediate nor gradual decrease in stroke and AMI incidence rates did not show statistical significance among the 35-49 age group(P>0.05).Conclusion Smoke-free legislation was enforced well in Shenzhen,which would generate good experiences for other cities to enact and enforce smoke-free laws.This study also provided more evidence of the health benefits of smoke-free laws on stroke and AMI.
文摘BACKGROUND A limited number of studies have been conducted to test the magnitudes of the association between apparent treatment resistant hypertension(aTRH)and risk of cardiovascular disease(CVD).AIM To investigate the association between aTRH and risk of CVD and examine whether sex and age modify this association.METHODS We applied an observational analysis study design using data from the United States Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial(ALLHAT).ALLHAT recruited participants(n=25516)from 625 primary care settings throughout the United States,Canada,Puerto Rico,and United States Virgin Islands,aged 55 and older with hypertension and at least one additional risk factor for heart disease.aTRH was assessed from the year 2 visit.CVD event was defined as one of the following from the year 2 follow-up visit:Fatal or non-fatal myocardial infarction,coronary revascularization,angina,stroke,heart failure,or peripheral artery disease.Cox proportional hazards regression was used to examine the effect of aTRH on CVD risk.Potential modifications of sex and age on this association were examined on the multiplicative scale by interaction term and additive scale by joint effects and relative excess risk for interaction.RESULTS Of the total study participants(n=25516),5030 experienced a CVD event during a mean of 4.7 years follow-up.aTRH was associated with a 30%increase in risk of CVD compared to non-aTRH[hazards ratio(HR)=1.3,95%CI:1.19-1.42].Sex and age modified this relationship on both multiplicative and additive scales independently.Stratified by sex,aTRH was associated with a 64%increase in risk of CVD(HR=1.64,95%CI:1.43–1.88)in women,and a 13%increase in risk of CVD(HR=1.13,95%CI:1.01–1.27)in men.Stratified by age,aTRH had a stronger impact on the risk of CVD in participants aged<65(HR=1.53,95%CI:1.32–1.77)than it did in those aged≥65(HR=1.18,95%CI:1.05–1.32).Significant two-way interactions of sex and aTRH,and age and aTRH on risk of CVD were observed(P<0.05).The observed joint effect of aTRH and ages≥65 years(HR=1.85,95%CI:1.22–2.48)in males was less than what was expected for both additive and multiplicative models(HR=4.10,95%CI:3.63–4.57 and 4.88,95%CI:3.66–6.31),although three-way interaction of sex,age,and aTRH on the risk of CVD and coronary heart disease did not reach a statistical significance(P>0.05).CONCLUSION aTRH was significantly associated with an increased risk of CVD and this association was modified by both sex and age.Further studies are warranted to test these mechanisms.
基金supported by the Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences(CIFM)[no. 2016-12M-3-001]the China Medical Board “Strengthen Capacity of Study and Application on Burden of Disease in Health Care System of China–Establishment and Development of Chinese Burden of Disease Research and Dissemination Center”[no. 15-208]。
文摘Prolonged exposure to coal dust may lead to various lung diseases, especially coal workers’ pneumoconiosis(CWP)[1]. Developed countries such as the United States experienced a resurgence of pneumoconiosis in the early 20t h century[2], and this phenomenon has become even more critical in developing countries[3]such as China and India.
基金This study is funded by the Major Program of the National Social Science Foundation of China(21ZDA107).
文摘Background Adverse childhood experiences(ACEs)and dementia are associated and comorbid with obesity.However,according to emerging research,the role of obesity in the association between ACEs and dementia seems controversial.Aims This analysis aimed to explore the associations between ACEs and different dementia subtypes and the effect modification of long-term body mass index(BMI).Methods Data were obtained from the US Health and Retirement Study.Six ACEs were categorised as 0,1 and 2 or more.All-cause dementia,Alzheimer’s disease(AD)and other dementias were defined by self-reported or proxy-reported physician diagnosis.Cox proportional hazards regression was used to explore the associations of ACEs with new-onset all-cause dementia,AD and other dementias from 2010 to 2020.Effect modification of BMI in 2010 and BMI transition and trajectory(fitted by group-based trajectory modelling)from 2004 to 2010 were assessed.Results 15282 participants with a mean age of 67.0 years(58.0–75.0)were included in the 2010 data analysis.Significant interactions of ACEs with baseline BMI,BMI transition and BMI trajectory in their associations with new-onset all-cause dementia and AD were observed(all p<0.05).For instance,positive associations of two or more ACEs(vs none)with all-cause dementia and AD were found in those with a BMI trajectory of maintaining≥30 kg/m2(maintain obesity)rather than a decline to or maintaining<25 kg/m2(decline to or maintain normal weight),with hazard ratios(HRs)of 1.87(95%confidence interval(CI):1.45 to 2.42)and 1.85(95%CI:1.22 to 2.80),respectively.Conclusions ACEs were associated with dementia and AD in US adults with long-term abnormally elevated BMI but not with long-term normal or decreasing BMI.Integrated weight management throughout life could prevent dementia among those with childhood adversity.
基金This study was funded by the Major Project of the National Social Science Fund of China(21ZDA107)the Fundamental Research Funds for the Central Universities(7101303357).
文摘Background Family environments can shape children’s personalities and social networks,rendering distinguishing adverse childhood experiences(ACEs)from family and society essential,but related evidence remains limited.Aims This cross-sectional study aimed to investigate the correlations between intrafamilial and social ACEs,their associations with depressive symptoms and cognitive impairment and the(education-moderated)mediating role of social ACEs.Methods Data for this cross-sectional study were from the China Health and Retirement Longitudinal Study.Nine intrafamilial(0,1,2,3,and 4 or more)and three social(0,1,and 2 or more)ACEs were identified.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale.Global cognition,including episodic memory and mental intactness,was calculated as z scores.Binary and ordered logistic regressions,generalised linear models with Gaussian family and identity link,and mediation analysis were used.Results 13435 participants aged 59.0(51.0–66.0)were included.Compared with participants with no intrafamilial ACEs,those with 1,2,3,and 4 or more intrafamilial ACEs tended to develop more social ACEs,with odds ratios(ORs)of 1.55(95%confidence interval(CI):1.36 to 1.76),2.36(95%CI:2.08 to 2.68),3.46(95%CI:3.02 to 3.96)and 6.10(95%CI:5.30 to 7.02),respectively.Both intrafamilial and social ACEs were associated with depressive symptoms(OR>3 for four or more intrafamilial ACEs and two or more social ACEs)and global cognition(β=−0.26 for four or more intrafamilial ACEs andβ=−0.29 for two or more social ACEs).Social ACEs mediated the associations of intrafamilial ACEs with depressive symptoms and global cognition by 12.3%and 13.1%,respectively.Furthermore,as education levels increased,the impact of intrafamilial ACEs on depressive symptoms was increasingly mediated through social ACEs,while the mediating role of social ACEs between intrafamilial ACEs and cognitive impairment gradually diminished.Conclusions Improving children’s social environments and elevating general education can prevent later-life depressive symptoms and cognitive impairment attributed to ACEs in China.
文摘Objective To evaluate the association between serum uric acid(SUA)and kidney function decline.Methods Data was obtained from the China Health and Retirement Longitudinal Study on the Chinese middle-aged and older population for analysis.The kidney function decline was defined as an annual estimated glomerular filtration rate(e GFR)decrease by>3 mL/min per 1.73 m^(2).Multivariable logistic regression was applied to determine the association between SUA and kidney function decline.The shape of the association was investigated by restricted cubic splines.Results A total of 7,346 participants were included,of which 1,004 individuals(13.67%)developed kidney function decline during the follow-up of 4 years.A significant dose-response relation was recorded between SUA and the kidney function decline(OR 1.14,95%CI 1.03-1.27),as the risk of kidney function decline increased by 14%per 1 mg/d L increase in SUA.In the subgroup analyses,such a relation was only recorded among women(OR 1.22,95%CI 1.03-1.45),those aged<60 years(OR 1.22,95%CI 1.05-1.42),and those without hypertension and without diabetes(OR 1.22,95%CI 1.06-1.41).Although the dose-response relation was not observed in men,the high level of SUA was related to kidney function decline(OR 1.83,95%CI 1.05-3.17).The restricted cubic spline analysis indicated that SUA>5 mg/dL was associated with a significantly higher risk of kidney function decline.Conclusion The SUA level was associated with kidney function decline.An elevation of SUA should therefore be addressed to prevent possible kidney impairment and dysfunction.
基金Supported by the Deputy of Research and Technology of Tehran University of Medical Sciences as a PhD Thesis.
文摘AIM:To determine the agreement of ocular biometric indices including axial length,keratometric readings,anterior chamber depth,and horizontal corneal diameter between the Pentacam AXL and IOL Master 500.METHODS:The study was a large cross-sectional population-based study(Tehran Geriatric Eye Study)conducted from Jan 2019 to Jan 2020.A total of 160 clusters were randomly selected proportional to size(each cluster contained 20 individuals)from 22 strata of Tehran city.All people aged 60y and above were invited to participate in the study.For all participants,preliminary ocular examinations were performed including the measurement of uncorrected and best-corrected visual acuity,objective and subjective refraction,anterior and posterior segment examinations.All participants underwent an ocular biometry using the Pentacam AXL and IOL Master 500.RESULTS:The 95%limits of agreement(LoA)between the two devices were-0.13 to 0.19,-0.15 to 0.17,and-0.13 to 0.19 in normal,pseudophakic,and cataractous eyes,respectively.With increasing the axial length,the difference between the two devices significantly increased in all three groups of normal,pseudophakic,and cataractous eyes(P<0.001).The 95% LoAs between the two devices regarding the mean keratometry shows that the best LoAs were seen in cataractous(-0.33 to 0.81)and followed by normal eyes(-0.36 to 0.86)and the pseudophakic eyes(-0.48 to 0.90)had the widest LoA.The 95% LoAs for horizontal corneal diameter measurements were-0.08 to 0.86,-0.03 to 0.83,and-0.07 to 0.87 in normal,pseudophakic,and cataractous eyes,respectively.The 95% LoAs of anterior chamber depth measurements between the two devices was-0.39 to 0.19 and-0.37 to 0.13 in normal eyes and cataractous,respectively.CONCLUSION:The Pentacam AXL has excellent agreement with the gold standard,IOL Master 500 in measuring axial length.In eyes with cataracts,the difference between the two devices is more scattered.With the increasing of axial length,the difference between the two devices increased,which should be considered when using Pentacam AXL.
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.
基金supported by a grant from the Health Commission of Nanjing(Grant Number:ZKX22019),China.
文摘Psychosis has increasingly become a social problem,emphasizing the need to understand the relationship between mental disorders and personality.This study aimed to investigate the relationship between mental disorders and personality among psychiatric outpatients based on real-world data.Symptom Checklist 90(SCL-90)and Eysenck Personality Questionnaire(EPQ)were used to evaluate the personality and psychopathological symptoms of patients(n=8409)in the Psychiatric Outpatient Department at Nanjing Drum Tower Hospital.t-test was used to compare scores between patients and national norms.Pearson’s correlation coefficient and path analysis were used to explore the relationship between mental health status and personality.The correlation coefficient between the neuroticism(N)score and each factor score of the SCL-90 test,as well as the correlation between psychoticism(P)and hostility and paranoia,exceeded 0.4.Path analysis revealed that the standardized path coefficients of N score and SCL-90 were all higher than 0.4.In addition,the standardized path coefficient of hostility and paranoia on P score were 0.313 and 0.280,respectively.Interpersonal sensitivity,depression and obsessive-compulsive symptoms were affected by extraversion(E)score,with standardized path coefficients of-0.149,-0.138,and-0.105,respectively.The path analysis also showed the direct and indirect effects of age,gender,education,and marital status on SCL-90.Patients characterized as melancholic had higher scores in all factors of SCL-90.In conclusion,mental health was related to personality traits of neuroticism,psychoticism and introversion.
文摘Objective:The objective of the study is to describe the work-related quality of life(WRQOL)among nurses and explore its association with performance evaluation ratings.Methods:A cross-sectional design was utilized measuring the WRQOL scale and the previous performance appraisal rating.Multistage sampling approach was utilized with nurses stratified based on their position and then systematically random sampled based on their unit assignment.Results:One hundred and eighty-two nurses were included.About half reported a high quality of work life(101;55.5%).Low scores were noted on the subscale working conditions(100;54.9%),low to average responses for home-work interface(109;59.9%),control at work(100;54.9%),and stress at work(90;49.5%).A higher proportion of nurses reported positive responses toward the areas of general well-being(113;62.1%)and job-career satisfaction(112;61.5%),than in the other subscales.There were notable differences between WRQOL ratings:(1)Head nurses had the highest perceived quality of work life,followed by nurse supervisors and charge nurses(F=6.1,P<0.01)and(2)Nurses in the pay-patient services reported lower quality of working life,while those in office and outpatient services had more positive scores(F=4.6,P<0.01).Conclusion:Only more than half of the nurses reported a high quality of work life,some of its dimensions,particularly job and career satisfaction and working conditions,appeared to vary in the perceived degree across years in service,work hours,and position.The assessment of the quality of work life may serve as an important tool to address staff burnout,absenteeism and other issues that affect job performance among health-care professionals.
文摘Summary:The corona virus disease 2019(COVID-19)is an emerging respiratory infectious disease caused by SARS-CoV-2,which first occurred in December 2019 in Wuhan,China.These days,in China,chest CT is used for diagnosis of COVID-19,as an important complement to the reverse-transcription polymerase chain reaction(RT-PCR)test.Because of contacting with a large number of suspected or probable cases closely during chest CT examination,radiographers are easily infected with COVID-19.This article included the rearrangement of CT examination room in fever clinic,the rearrangement of human resources in radiology department,and the drafting of new operating procedures for radiologists who carry out CT examination on COVID-19 patients.This article also introduced the emergency management procedures of the department of radiology during the outbreak,and the experience of infection prevention for the staff of the department of radiology.
