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Background Changes in cognitive function exist before the onset of clinical Parkinson's disease. However, studies on association between cognitive function and prodromal Parkinson's disease (pPD) are limited. Objective To estimate probability of pPD and assess its association with global and domain cognitive function in Chinese elders. Methods Data were drawn from the Community-based Cohort Study on Nervous System Disease 2018 (baseline) and 2020 (follow-up). We selected 3911 residents aged 55 and above who participated the two waves, without Alzheimer's disease and Parkinson's disease, and with completed information on demographics, disease history, cognitive function test, and risk factors of Parkinson's disease. Cognitive function was assessed using the Chinese version of Montreal Cognitive Assessment Scale. Calculation of probability of pPD and assessment of possible (probability between 30% and <80%) or probable (probability ≥80%) pPD were performed according to the criteria published by the International Parkinson and Movement Disorder Society. Multiple linear regression model was employed to analyze the association between baseline cognitive function and follow-up probability of pPD. Results The medians of scores of baseline global cognitive function and cognitive domains in terms of memory, execution, visuospatial function, language, attention, and orientation were 23, 12, 9, 6, 5, 14, and 6, respectively. The median of follow-up probability of pPD was 0.87%, and the proportion of participants with possible or probable pPD was 0.4%. The differences in the distribution of follow-up probability of pPD were significant in groups by baseline global cognitive score quartiles (χ2=21.68, P<0.001). A higher baseline global cognitive score was considerably related to a lower follow-up probability of pPD, b(95%CI)=0.994(0.988~0.999), P=0.040. After adjusting for selected confounders, the results of multiple linear regression analyses showed that the probability of pPD in the highest quartile group was decreased by 10.7% (b=0.893, 95%CI: 0.794-0.992, P=0.034) relative to the lowest quartile group, and the trend was significant (trend P=0.031). Higher baseline index scores of execution, attention, and orientation were highly related to a lower follow-up probability of pPD (all P<0.05). Conclusion Declines in global cognitive function and cognitive domains of execution, attention, and orientation may associate with a higher probability of pPD in middle-aged and elderly population, which suggests the significance of cognitive intervention in early stage for pPD prevention.
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ABSTRACT OBJECTIVE：To study the association between CYP3A5，CYP3A4，ABCB1 and POR*28 genetic polymorphisms and drug dosage（D）and steady blood concentration/dosage（c0/D）of tacrolimus in lung transplant recipients after one year of tacrolimus administration. METHODS：By retrospective analysis，a total of 46 recipients who underwent lung transplantation in China-Japan Friendship Hospital during May 2017-May 2018 were selected. The c0 and D of tacrolimus were measured and collected after one year of tacrolimus administration，and c0/D was calculated. Recipients’genotypes of CYP3A5（rs776746）， CYP3A4（rs2242480，rs28371759），ABCB1（rs1045642，rs2032582，rs1128503）and POR*28（rs1057868）were collected. The relationship between genetic polymorphism and D，c0/D was analyzed statistically. RESULTS：The genotype frequency in this study were all in accordance with Hardy-Weinberg equilibrium （P＞0.05）. While maintaining tacrolimus c0 within therapeutic range， genetic polymorphism of CYP3A5（rs776746）and CYP3A4（rs2242480）influenced D and c0/D of tacrolimus significantly（P＜ 0.05）. There was no statistical significance in D or c0/D among different genotypes of other sites（P＞0.05）. There was statistical significance in D or c0/D among extensive metabolism type recipients with CYP3A5（rs776746）*1 and CYP3A4（rs2242480）*1G alleles，normal metabolism type recipients with only CYP3A5 （rs776746） *1 or CYP3A4 （rs2242480） *1G alleles and poor metabolism type recipients without CYP3A5（rs776746）*1 and CYP3A4（rs2242480）* 1G alleles（P＜0.05）. D of tacrolimus was the highest in extensive metabolism type recipient and the lowest in poor metabolism type recipient. CONCLUSIONS：The detection of genetic polymorphism of CYP3A5（rs776746）and CYP3A4（rs2242480）has guiding significance for individualized medication of tacrolimus after one year of tacrolimus administration.
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OBJECTIVE：To analyze the occurrence of acute kidney injury （AKI）after lung transplantation and its possible influential factors . METHODS ：Medical records of 64 patients who received lung transplantation in our hospital from April 2017 to June 2018 were included in this retrospective study. Patients were divided into AKI group （44 cases）and non-AKI group （20 cases），according to whether AKI occurred after operation. According to diagnostic criteria for lung transplantation in our hospital ， all patients were given Methylprednisolone sodium succinate for injection or Methylprednisolone sodium succinate for injection combined with Basiliximab for injection ，and triple immunosuppressive therapy of Tacrolimus capsules+Mycophenolate mofetil dispersible tablets or Mycophenolate mofetil capsules or Mycophenolate sodium enteric-coated tablets+Methylprednisolone tablets or Prednisone acetate tablets were given after operation. The occurrence of AKI in AKI group within a week after operation were recorded. Intraoperative influential factors （operation type ， operation duration ， ECMO support ， immune inhibitor use ， intraoperative blood loss ），postoperative influential factors [days of ICU ，mechanical ventilation and ECMO support ，median value of Scr within one week after operation ，median tacrolimus concentration and the use of potential nephrotoxic drugs （≥4 kinds）， hospitalization days] and survival rate one year after operation were observed in 2 groups. RESULTS ：Within one week after lung transplantation，44 patients（68.8％）had experienced at least one episode of AKI ，among which 19 cases（29.7％）were stage 1， 17 cases（26.5％）were stage 2 and 8 cases（12.5％）were stage 3. The incidence of AKI was the highest on post-operative day 4 （57.4％）. The incidence of AKI at stage 3 exhibited growth trend within the first week after operation ，and reached the highest on median post-operative day 5（8.7％）. Operation duration ，median value of Scr within one week after operation ，median tacrolimus concentration in non-AKI group were significantly shorter or lower than AKI group ；there was no significant difference in operation type， ECMO support ， use of immunosuppressive agents ， intraoperative blood loss ，ICU days ，mechanical ventilation days，ECMO support days ，the utilization rate of potential nephrotoxic drugs （ ≥4 kinds） and hospitalization days between 2 groups （P＞0.05）. There was no statistical significance in the survival rate at stage 1 and 2 one year after operation between AKI group and non-AKI group （P＞0.05）. One year after operation ，survival rate of AKI group at stage 3 was significantly lower than that of non-AKI group （P＜0.05）. CONCLUSIONS：The incidence of AKI is high after lung transplantation. Operation duration ，median value of Scr within one week after operation ，median tacrolimus concentration were possible factors for the occurrence of AKI after operation.
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OBJECTIVE： To study the correlation of tacrolimus concentrations among transplant patients’ whole blood， plasma and blood cells， analyze the effects of transplant types and ages on the their correlation， and to provide reference for rational drug use in clinic. METHODS： Totally 20 patients receiving tacrolimus anti-rejection therapy after transplantation and undergoing therapeutic drug monitoring （TDM） were randomly selected. According to the type of transplantation， they were divided into renal transplantation group and lung transplantation group （10 cases for each group）. According to age， they were divided into three groups： 20-40 years old group， 41-60 years old group and 61-80 years old group （4， 9， 7 cases for each group）. Their residual blood after TDM was collected. Chemiluminescence microparticle immuno assay （CMIA） was used to detect the concentration of tacrolimus in whole blood. UPLC-MS/MS was used to measure the concentrations of tacrolimus in plasma and blood cells. Pairs plots and Spearman rank correlation analysis were used to analyze the correlation of tacrolimus between whole blood and plasma， between whole blood and blood cells， between plasma and blood cells as well as the effects of transplant types and ages on tacrolimus concentrations among tansplant patient’s whole blood， plasma and blood cells. RESULTS： The correlation of tacrolimus concentrations in whole blood and plasma （r＝0.623，P＜0.01） was slightly stronger than that of whole blood and blood cells （r＝0.591， P＜0.01）； while the correlation of tacrolimus concentration in plasma and blood cells was relatively weak （r＝0.497，P＜0.05）. Transplant type and age had an effect on the correlation of tacrolimus concentrations among patients’ whole blood， plasma， blood cells. The correlation of tacrolimus concen- tration in whole blood， blood cells and plasma in renal transplantation group was also weak （all r＜0.5）， and was weaker than that in lung transplantation group. The correlation of tacrolimus concentration among whole blood， plasma and blood cells was weak in patients of aged 20-40 years old group （all r＜0.3）， and was weaker than that of patients of aged 41-60 years old group and 61-80 years old group. CONCLUSION： Post-transplantation patients’ tacrolimus concentrations in whole blood， plasma and blood cell have a weak correlation. Rejections and adverse effects should be monitored in these patients， especially those renal transplantation patients or those patients aged 20 to 40.
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Objective@#To analyze the status of dietary sodium intake of Chinese adult residents in fifteen provinces in 2015.@*Methods@#Data were collected from 2015 China Nutrition Transition Cohort Study. This cohort study used a three consecutive 24-h retrospective method to record food intake and weighing method to record household condiment consumption. In this study, 14 847 residents aged 18 years and over with complete data from 15 provinces in 2015 were selected for the comparison of dietary sodium intake (median) with different characteristics.@*Results@#Among the 14 847 residents, 47.1% were males, and the rural and northern residents accounted for 60.1% and 37.7%, respectively. Median sodium intake was 3 960.0 mg/d among residents in 2015. The sodium intake of males (4 272.1 mg/d) was higher than that of females (3 716.6 mg/d). Across age subgroups, sodium intake was highest among residents aged 45-59 years (4 257.0 mg/d; 18-44 years old, 3 867.1 mg/d; ≥60 years old, 3 799.0 mg/d). Sodium intake was higher in rural area (4 042.9 mg/d) than in urban area (3 866.8 mg/d), higher in north (4 229.2 mg/d) than in south (3 806.8 mg/d) (all P values <0.05). 11.8% of residents with dietary sodium intake were below 2 000 mg/d. The main sources of dietary sodium were condiments (79.4%), regular cooking foods (11.9%) and processed foods (8.7%). Among the condiments, the salt and soy sauce accounted for 63.6% and 10.4%, respectively.@*Conclusion@#In 2015, Chinese adult residents had higher dietary sodium intake with gender and regional differences. Condiments were the main source of dietary sodium.
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Objective To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China,to explore the influence of population economic factors on them.Methods A total of 3 367 farmers,including fishermen or hunters,aged ≥ 18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015.Basic information (age,gender),data on anthropometric (body height,weight and waist size),blood biochemical and socioeconomic (occupation,income,education level and living area) were included.According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005,five cardio-metabolic risk factors appeared as central obesity,increased triglycerides,decreased HDL-C,increased blood pressure and increased plasma glucose.Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.Results In 3 367 framers of 15 provinces (autonomous region and municipality),the prevalence rates of central obesity,increased blood pressure,increased plasma glucose,increased triglycerides and decreased HDL-C were 51.8％,59.0％,17.0％,25.5％ and 38.7％ respectively.Multivariate logistic regression analysis showed that the risks for central obesity (OR=3.69,95％CI:3.17-4.28) and decreased HDL-C (OR=3.28,95％CI:2.81-3.82) were higher in women than in men,and the risks for increased blood pressure (OR=0.73,95％ CI:0.63-0.84),increased blood glucose (OR=0.80,95％ CI:0.67-0.97) were lower in women than in men.Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend P＜0.05).Framers in western China had obviously lower risk for central obesity compared with farmers in central China.No significant correlation was found between farmers' income level,education level or the prevalence of metabolic risk factors.Conclusion In 15 provinces of China,the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5％ of the farmers,and the co-prevalence of cardio-metabolic risk factor was found in 60％ of farmers.The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender.It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.
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Objective To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China,to explore the influence of population economic factors on them.Methods A total of 3 367 farmers,including fishermen or hunters,aged ≥ 18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015.Basic information (age,gender),data on anthropometric (body height,weight and waist size),blood biochemical and socioeconomic (occupation,income,education level and living area) were included.According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005,five cardio-metabolic risk factors appeared as central obesity,increased triglycerides,decreased HDL-C,increased blood pressure and increased plasma glucose.Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.Results In 3 367 framers of 15 provinces (autonomous region and municipality),the prevalence rates of central obesity,increased blood pressure,increased plasma glucose,increased triglycerides and decreased HDL-C were 51.8％,59.0％,17.0％,25.5％ and 38.7％ respectively.Multivariate logistic regression analysis showed that the risks for central obesity (OR=3.69,95％CI:3.17-4.28) and decreased HDL-C (OR=3.28,95％CI:2.81-3.82) were higher in women than in men,and the risks for increased blood pressure (OR=0.73,95％ CI:0.63-0.84),increased blood glucose (OR=0.80,95％ CI:0.67-0.97) were lower in women than in men.Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend P＜0.05).Framers in western China had obviously lower risk for central obesity compared with farmers in central China.No significant correlation was found between farmers' income level,education level or the prevalence of metabolic risk factors.Conclusion In 15 provinces of China,the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5％ of the farmers,and the co-prevalence of cardio-metabolic risk factor was found in 60％ of farmers.The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender.It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.
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Objective: In order to evaluate the effect of catastrophic disease medical assistance policy in Qingdao and provide suggestions for Qingdao policy reform.Methods: This paper selects NSCLC and liver cancer as the typical deceases to analyze the effects of the policy on patients and medical insurance institutions and finally evaluate the effect of the policy.Results: results shows that after the implementation of special medicines and special medical equipment assistance, the rate of co-paying patients decreased 40.57%, and the pressure on medical insurance institutions' expenditure was significantly reduced;while after the implementation of large cost assistance, but rate of co-paying patients only decreased 7.13%, and the pressure on medical insurance institutions' expenditure was not effectively alleviated.Conclusions: Therefore, the policy not only protects patients with catastrophic disease by greatly reducing their medical burdens, but it also achieves the fine management of medical insurance fund and increases the efficiency of the fund.
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OBJECTIVE:To explore the necessity of developing therapeutic drug monitoring of vancomycin in our hospital and its existing problems,and provide a reasonable basis for the clinical rational use of vancomycin. METHODS:The cross-sectional survey was designed to collect the clinical data of 92 patients with therapeutic drug monitoring of vancomycin and statistically ana-lyze 192 cases of plasma concentration monitoring data. RESULTS:The average plasma trough concentration was (15.96 ± 8.06) mg/L;with the increase of age,the plasma trough concentration was increasing,there was no significant difference in the plasma trough concentration among different age groups (P=0.000);there were only 13 cases (6.77%) that obtained the plasma trough concentration within 30 min before the fourth dose;after using wancomycin,clearance rates of Cr and the endogenous creatinine were slightly higher than before,but there was no significant difference(P=0.722);36 cases(39.13%)showed vancomycin sus-ceptible gram positive cocci;after using wancomycin,the body temperature,white blood cell count and neutrophil percentage were lower than before,the differences were statistically significant (P=0.006,P=0.000,P=0.000);48 cases (52.17%) in treatment received initial loading dose,and only 15 cases (16.30%) did not use in combination with other anti infective drugs. CONCLU-SIONS:The results showed there are still a lot of problems in the treatment of vancomycin in our hospital,for example,the stan-dard rate of the plasma trough concentration is about 50%;most of the time of blood sampling is not reasonable;the detection rate of the pathogen is low;only about half of the cases are given the loading dose,etc. Therefore clinical pharmacists’intervention for blood sampling is an important part to promote rational drug therapy monitoring. Meanwhile,data interpretation of the monitoring results of serum drug concentration of vancomycin is a basic method for clinical pharmacists in clinical monitoring to correct the un-reasonable operations,and also the necessary measures for preventing the drug renal toxicity,it is a very important significance for the medication safety and effectiveness especially in severe infection patients,the elderly,the children and the people with renal function insufficiency.
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Objective To investigate trend of dietary nutrient intake among adult females in China. Methods The changes of dietary energy and major nutrient intake among females aged 25 to 55 years in 9 provinces were analyzed by using the data from Chinese Health and Nutrition Survey,2000-2011 (CHNS) and indicators of Chinese Dietary Reference Intakes (DRIs) 2013. Results During the past decade,the proportion of females with the intake of energy and protein meeting the requirement of recommendation decreased,while the proportion of females with low carbohydrate(<50%energy)and high fat(>30%energy)intakes increased. Meanwhile,the vitamin and mineral intakes among the females were also unsatisfactory,only small proportion of the females met the requirement for micronutrient intake,and this proportion continued to decline. In 2011,the proportion of the females who met the requirements for energy and protein intakes were 43.0% and 54.4%,respectively;the proportion of the females with low carbohydrate and high fat intakes were 40.2%and 63.8%,respectively;the proportion of females who met the requirements for vitamin A, thiamine,riboflavin,niacin,vitamin C and vitamin E intakes were 25.2%,10.7%,6.9%,54.9%,24.3%and 88.5% respectively and the proportion of females who met the requirements for calcium, magnesium,iron,zinc and selenium intakes were 3.3%,23.6%,50.9%,75.7%and 13.3%respectively. Conclusion Further nutritional education and intervention is needed to improve nutrition status among Chinese females.
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Objective To investigate trend of dietary nutrient intake among adult females in China. Methods The changes of dietary energy and major nutrient intake among females aged 25 to 55 years in 9 provinces were analyzed by using the data from Chinese Health and Nutrition Survey,2000-2011 (CHNS) and indicators of Chinese Dietary Reference Intakes (DRIs) 2013. Results During the past decade,the proportion of females with the intake of energy and protein meeting the requirement of recommendation decreased,while the proportion of females with low carbohydrate(<50%energy)and high fat(>30%energy)intakes increased. Meanwhile,the vitamin and mineral intakes among the females were also unsatisfactory,only small proportion of the females met the requirement for micronutrient intake,and this proportion continued to decline. In 2011,the proportion of the females who met the requirements for energy and protein intakes were 43.0% and 54.4%,respectively;the proportion of the females with low carbohydrate and high fat intakes were 40.2%and 63.8%,respectively;the proportion of females who met the requirements for vitamin A, thiamine,riboflavin,niacin,vitamin C and vitamin E intakes were 25.2%,10.7%,6.9%,54.9%,24.3%and 88.5% respectively and the proportion of females who met the requirements for calcium, magnesium,iron,zinc and selenium intakes were 3.3%,23.6%,50.9%,75.7%and 13.3%respectively. Conclusion Further nutritional education and intervention is needed to improve nutrition status among Chinese females.
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The receiver operating characteristic (ROC) curve analysis has been widely used in the evaluation of screening validity in Epidemiology and in determining the optimal operating point. At present, theories about ROC curves and computation methods have been established mainly based on cross-sectional data. It is important to understand the characteristics and the progress of ROC application in order to explore more researches on optimal cut-off value, which could also give suggestions on non-communicable diseases (NCD) prevention and control. This study reviewed the application of ROC curve analysis and softwares in NCD and pointed out the future work.
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Humans , Cross-Sectional Studies , Mass Screening , ROC Curve , SoftwareABSTRACT
<p><b>OBJECTIVE</b>To explore the association between dietary cholesterol intake and hypercholesterolemia among Chinese adults.</p><p><b>METHODS</b>In 2009, 4 244 adults aged 25-65 years old who participated in both 2004 and 2009 China Health and Nutrition Surveys, and with complete biochemical and dietary data were selected. Hypercholesterolemia were defined as with total cholesterol ≥ 6.22 mmol/L, according to 2007 Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Non-conditional logistic regression was used to investigate association between dietary cholesterol intake and hypercholesterolemia.</p><p><b>RESULTS</b>The average total cholesterol was 4.9 mmol/L, with prevalence of hypercholesterolemia as 9.6%, in 2009. During 2004 to 2009, dietary cholesterol showed a dramatical increase, with lower intake groups the most. Males who consumed middle or lower dietary cholesterol in 2004 and high intake in 2009 had significantly higher risk of having hypercholesterolemia. However, similar findings did not appear in females.</p><p><b>CONCLUSION</b>The associations between dietary cholesterol intake and hypercholesterolemia were different among Chinese males and females. Dramatic increase of dietary cholesterol intake was related to higher risk of hypercholesterolemia in males.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , China , Epidemiology , Cholesterol , Cholesterol, Dietary , Cohort Studies , Hypercholesterolemia , Epidemiology , Nutrition Surveys , Prevalence , Risk Factors , Sex DistributionABSTRACT
<p><b>OBJECTIVE</b>To investigate trend of dietary nutrient intake among adult females in China.</p><p><b>METHODS</b>The changes of dietary energy and major nutrient intake among females aged 25 to 55 years in 9 provinces were analyzed by using the data from Chinese Health and Nutrition Survey, 2000-2011 (CHNS) and indicators of Chinese Dietary Reference Intakes (DRIs) 2013.</p><p><b>RESULTS</b>During the past decade, the proportion of females with the intake of energy and protein meeting the requirement of recommendation decreased, while the proportion of females with low carbohydrate (< 50% energy) and high fat (> 30% energy) intakes increased. Meanwhile, the vitamin and mineral intakes among the females were also unsatisfactory, only small proportion of the females met the requirement for micronutrient intake, and this proportion continued to decline. In 2011, the proportion of the females who met the requirements for energy and protein intakes were 43.0% and 54.4%, respectively; the proportion of the females with low carbohydrate and high fat intakes were 40.2% and 63.8%, respectively; the proportion of females who met the requirements for vitamin A, thiamine, riboflavin, niacin, vitamin C and vitamin E intakes were 25.2%, 10.7%, 6.9%, 54.9%, 24.3% and 88.5% respectively and the proportion of females who met the requirements for calcium, magnesium, iron, zinc and selenium intakes were 3.3%, 23.6%, 50.9%, 75.7% and 13.3% respectively.</p><p><b>CONCLUSION</b>Further nutritional education and intervention is needed to improve nutrition status among Chinese females.</p>
Subject(s)
Adult , Female , Humans , Middle Aged , Ascorbic Acid , Calcium, Dietary , China , Diet , Energy Intake , Iron , Micronutrients , Nutrition Surveys , Nutritional Requirements , Nutritional Status , VitaminsABSTRACT
Objective To identify the use of body mass index (BMI) to predict the areas under curve (AUC) of hypertension,and to find the optimal cutoff of predicting the incidences of hypertension in Chinese adults. Method Using the data from Nationwide Nutrition and Health Survey to find the new cases of four-years hypertension,and to calculate the four-year cumulative incidence (CI) of hypertension,and operate the receiver operating characteristic (ROC),analyze the AUC and calculate the sensitivity and specificity of optimal cutoff. Results Four-year CI of hypertension were 17.2% (20.3% for men and 14.2% for women),the AUC were 0.62 and 0.61 for men and women,respectively. Conclusion The optimal cut off was applicable in monitoring the incidences of hypertension,and more verification should be carried out in the future when applying this cut off.