A cohort study on the influence of the chronic diseases on falls among middle-aged and older Chinese / 中华流行病学杂志

Objective: To analyze the influence of chronic diseases on falls among middle-aged and older Chinese. Methods: Baseline data of 13 670 middle-aged and older adults recruited from China Health and Retirement Longitudinal Study (CHARLS) in 2011 were used and followed up to 2018, among those were 7 443 (54.45%) middle-aged people aged 45-59 and 6 227 (45.55%) older adults aged 60 and above. The Cox proportional hazards model was used to analyze the effects of different types, the number of chronic diseases and the interaction between chronic illness and other factors on the fall risk of middle-aged and older people. Results: After adjusting for confounding factors, respiratory diseases increased the risk of falls by 21% (HR=1.21, 95%CI:1.02-1.45), and arthritis increased the risk of falls by 27% (HR=1.27,95%CI: 1.12-1.43) in the group aged 45-59, kidney disease increased the risk of falls by 26% (HR=1.26, 95%CI: 1.03-1.53) in the group aged 60 and above. A linear dose-response relationship between the number of chronic diseases and fall risk (χ2=133.61, P<0.001) was found in all the age groups. The interaction between having chronic diseases and the factors of females (HR=1.64, 95%CI: 1.43-1.89), impaired activities of daily living (ADL) (HR=1.66, 95%CI: 1.39-1.99), and having a fall history (HR=2.58, 95%CI: 2.24-2.97) increased the risk of falls. Conclusions: There is a positive linear relationship between the number of chronic diseases and the fall risk among Chinese aged 45 and above. The female middle-aged and elderly patients with chronic diseases and the middle-aged and elderly patients with impaired ADL or a history of falls are the high-risk groups for falls that need to be focused on intervention. The window of fall injury prevention should be moved forward to the middle-aged stage in time.

Doppler grading for decompression bubbles / 中国职业医学

Ultrasonic bubble detection has been widely used in predicting the risk of decompression sickness and evaluating the efficiency and safety of decompression procedures. Currently, the widely used SPENCER scale is conducted by using Doppler ultrasound to monitor the bubble signal in the precordial region of subjects. KM grading system is a computerized system based on Doppler ultrasound. The grading score can be converted into SPENCER bubble grading scale score and the bubble grading is precise and suitable for the motion status. On the basis of the above two methods, the KISMAN integrated severity score, extended SPENCER bubble grading and simplified Doppler bubble grading system were established. They not only coordinated analysis of Doppler ultrasound bubble detection results with other risk factors of decompression disease, but also convenient to use computer for processing detection results. With the in-depth application of Fourier technique and empirical mode decomposition in Doppler audio bubble signal detection, methods such as three-parameter fuzzy analysis and energy operator method are playing an important role in automatic bubble analysis. Optimization of detection technology and improvement of sensitivity and accuracy of automatic analysis are important development directions in the field of decompression bubble Doppler grating technology.

Risk factors of high birth weight in rural areas of Shanxi Province / 中华疾病控制杂志

@# Objective To estimate the association between the risk of high birth weight(HBW) and maternal environmental and behavioral factors exposure during pregnancy in rural areas. Methods Data were collected from the surveillance system of birth population and adverse pregnancy outcome in Pingding County, Shanxi Province during 2007 and 2012, where we followed up 204 controls with normal birth weight, 125 cases with HBW≥4 200 g and 171 cases with HBW 4 000-4 200 g. Case control study was performed to explore the potential risk factors of HBW. Results The total number of births was 18 749, including 1 177 cases of high birth weight, with an incidence rate of 6.28% between 2007 and 2012. Concerning the case control study on HBW<4 200 g, after adjusting parental reproductive age and parity, the risk of HBW was 3.10(95% CI：1.67-5.76)times higher among women with gestational weeks ≥42 than that of women with gestational weeks < 42. The risk of HBW in boys was 2.30(95% CI：1.46-3.63)times higher than that in girls. No significant association was observed between maternal BMI before pregnancy and the risk of HBW；Regarding the case control study on HBW≥4200 g, after adjusting maternal reproductive age and parity, the risk of HBW was 3.01(95% CI:1.49-6.08) times higher among women with gestational weeks≥42 than that of those with gestational weeks <42. The risk of HBW was 1.91(95% CI:1.15-3.16)times higher among women with pre-pregnancy BMI≥24 than that of those with pre-pregnancy BMI< 24. The risk of HBW was 2.59(95% CI:1.06-6.32)times higher in women who ate soybean products ≥4 times a week than that of those who ate soybean products less than once a week. Conclusion It would be of public health significance to reduce the risk of high birth weight, which can be reduced by managing pre-pregnancy BMI, diet during pregnancy and controlling gestational week.