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Objective@#To investigate the intake of liquid dairy products and identify its influencing factors among the fourth grade students in Nanjing City. @*Methods@#The fourth grade students were selected as the study subjects in Nanjing City using a multi-stage random cluster sampling method in September 2020. Their general information, frequency of liquid dairy product intake one week prior to survey and mean intake amount per time were collected. According to the 2016 Dietary Guidelines for Chinese Residents, weekly intake of liquid dairy products of 2 100 g and greater was defined eligible. Factors affecting the frequency and amount of liquid dairy product intake were identified using multivariable logistic regression analysis.@*Results@#A total of 2 268 questionnaires were allocated and 2 216 valid questionnaires were recovered, with an effective recovery rate of 97.71%. The respondents included 1 199 boys ( 54.11% ) and 1 017 girls ( 45.89% ). The frequency of liquid dairy product intake was (6.41±4.86) times per week, and the median intake amount was 1 250.00 g per week (interquartile range, 1 750.00 g per week). There were 607 students ( 27.39% ) consuming liquid dairy products of 2 100 g and greater a week, and 1 016 students ( 45.85% ) consumed liquid dairy products for 7 times and more a week. Multivariable logistic regression analysis showed that living in urban areas ( OR=1.204, 95%CI: 1.005-1.443 ), knowing nutrition labels ( OR=1.221, 95%CI: 1.021-1.460 ), periodical measurement of body weight (OR=1.486, 95%CI: 1.098-2.011) and restricted intake of sugar-containing drinks ( OR=1.264, 95%CI: 1.005-1.590 ) facilitated the intake of liquid dairy products for 7 times and more a week, and students with periodical measurement of body weight were more likely to consume liquid dairy products for 2 100 g and greater a week ( OR=1.821, 95%CI: 1.240-2.676 ).@*Conclusions@#Inadequate intake of liquid dairy products is found among the fourth grade students in Nanjing City. Residence, awareness of nutrition labels, periodical measurement of body weight, and parental restriction of sugar-containing drink intake affect the intake of liquid dairy products.
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Objective:To explore the association between different paths of diabetic progression and dyslipidemia in a Nanjing adult population.Methods:From January 2017 to June 2018, 61, 098 local residents aged ≥18 years were selected from the Chronic Disease and Risk Factor Surveillance database in Nanjing using a five-stage stratified cluster random sampling method. Data were collected through interview surveys, physical measurements, and laboratory examinations. The relationship between different rates of diabetic progression and dyslipidemia was analyzed using complex weighting and multilevel models.Results:In all, 60, 283 participants were finally enrolled in the study. The weighted proportions of normal glucose regulation, pre-diabetes, and diabetes were 71.2%, 17.9%, and 10.9%, respectively. The overall weighted prevalence, awareness, treatment, and control of dyslipidemia were 29.8%, 41.6%, 28.9%, and 22.9%, respectively. The weighted proportion of patients with dyslipidemia combined with diabetes was 52.9%. The weighted prevalence of dyslipidemia in adults with normal glucose regulation, pre-diabetes, and diabetes was 24.0%, 38.8%, and 52.9%, respectively (all P<0.001). Compared to the normal glucose regulation group, subjects with pre-diabetes ( OR = 2.04, 95% CI: 1.95-2.13) or diabetes ( OR= 3.87, 95% CI: 3.66-4.10) had possibly gradually increased risks of dyslipidemia (all P<0.001). In addition, there was an increasing trend toward awareness, treatment, and control of dyslipidemia with increasing levels of glucose (all P<0.001). The weighted awareness of dyslipidemia in adults with normal glucose regulation, pre-diabetes, and diabetes was 36.3%, 42.8%, and 56.2%, respectively; the corresponding rates of treatment and control were 23.7%, 29.2%, and 43.7%, and 20.4%, 22.6%, and 30.1%, respectively. Conclusion:Diabetes and dyslipidemia have become the main chronic diseases in the Nanjing population.
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Objective:To investigate the joint associations of smoking and insufficient physical activity with hypertension, diabetes and dyslipidemia in male adults.Methods:Based on the data from the 2017 Nanjing Chronic Diseases Risk Factors Surveillance Program, 61 098 Nanjing residents aged 18 and older was randomly recruited from 12 districts, using the multi-stage stratified cluster sampling method. Information about smoking behaviors, physical activity and chronic disease-related indicators within the first 12 months before the survey was obtained through questionnaires.Results:Among the 29 848 valid male samples, the proportions of non-smokers, current smokers and ex-smokers were 59.6%, 37.2% and 3.2%, and the proportions of those who had physically active<600 MET-min/w (insufficient physically active) and ≥600 MET-min/w (adequate physically active) were 18.8% and 82.2%, respectively. In non-smokers, current smokers and ex-smokers, the prevalence of hypertension was 24.7%, 34.0% and 43.8%, and the prevalence of diabetes was 8.8%, 12.3% and 16.5%, and the prevalence of dyslipidemia was 26.8%, 36.1% and 41.9%, respectively. Multivariate logistic regression analysis showed that current smokers had a higher risk of hypertension ( OR=1.164, 95% CI: 1.086-1.248), diabetes ( OR=1.324, 95% CI: 1.207-1.452), and dyslipidemia ( OR=1.291, 95% CI: 1.216-1.371) than non-smokers in male adults. Compared with people who had adequate physical activity, someone with insufficient physical activity had higher hypertension ( OR=1.452, 95% CI: 1.331-1.583), diabetes ( OR=1.170, 95% CI: 1.041-1.315) and dyslipidemia ( OR=1.245, 95% CI: 1.158-1.338). And current smokers with insufficient physical activity had the highest risk of hypertension ( OR=1.749, 95% CI: 1.550-1.974), diabetes ( OR=1.363, 95% CI: 1.165-1.595), and dyslipidemia ( OR=1.614, 95% CI: 1.461-1.782) in male adults. Conclusions:Smoking and insufficient physical activity are risk factors for hypertension, diabetes, and dyslipidemia. People who is characterized by smoking together with insufficient physical activity presents with increased risk on developing hypertension, diabetes, and dyslipidemia.
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Objective:To analysis and compare the burden of ischemic heart disease (IHD) attributable to metabolic risks in population aged 25 years and older in 2011 and 2017 in Nanjing.Methods:The data were extracted from the Nanjing Chronic Disease and Risk Factor Surveillance (2011 and 2017), the Nanjing Mortality Surveillance (2011 and 2017) and the 2016 Global Burden of Disease Study (GBD). Using GBD′s Comparative Risk Assessment Theory, the attribution burden was estimated by comparing the observed health outcomes with the health outcomes that may be observed when exposed to counterfactual levels. Based on population attributable fractions, the deaths and life expectancy losses of ischemic heart disease due to high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high total cholesterol (TC), high body mass index (BMI) and combination of four risks were estimated in 2011 and 2017. The average population structure of the world′s population from 2000 to 2025 wasusedas the standard population for standardization.Results:The number of IHD deaths attributable to four metabolic risks combination was 3 204, andwhich resulted in a loss of life expectancy of 0.90 years in 2017. High SBP appeared as the major cause of IHD deaths and Years of Life Lost (YLL). In 2017, the world standardized mortality rate (25.60×10 －5, 19.94×10 －5 and 6.83×10 －5) and the standardized YLL rate (389.31×10 －5, 335.16×10 －5, 134.60×10 －5) of the population due to high systolic blood pressure, high total cholesterol and high body mass index were significantly lower than those in 2011 (31.75×10 －5, 26.74×10 －5, 7.45×10 －5 and 469.07×10 －5, 463.70×10 －5, 142.66×10 －5); the world standardized rate and the standardized YLL rate due to high blood sugar (11.90×10 －5 and 174.61×10 －5) were significantly higher than those in 2011 (9.67×10 －5 and 150.61×10 －5) (all P<0.05). Males appeared to have higher standardized rate of YLL of IHD deaths than females, due to having metabolism risks( P<0.05). Conclusion:Metabolic exposures especially high SBP are the important risk factors whichleadto IHD deaths in Nanjing.
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Objective:To explore the blood glucose control status, influencing factors, and self-management level of patients before participating in diabetes self-management groups in the Nanjing community, and to provide baseline data and the scientific basis for the community to promote self-management activities for diabetic patients.Methods:From April to June 2017, patients in diabetes self-management groups were recruited through the use of multi-stage cluster random sampling. Prior to the self-management group activities, patients were surveyed for general conditions, physical examinations and blood glucose and blood lipid tests were conducted, and the Chronic Disease Self-Management Research Measurement Form was used to investigate the patient's self-management level face to face.Results:A total of 345 diabetic patients were included, and 342 effective scales were returned with an effective rate of 99.1%. The age of the 342 patients with diabetes was (63.8±8.7) years, 129 (37.7%) were male and 213 (62.3%) were female. The average levels of FPG and HbA1c were (7.61±2.23) mmol / L and (7.15±1.57) %, respectively. The FPG and HbA1c control compliance rates were 44.7% (153 cases) and 52.3% (179 cases), respectively. The level of FPG [(7.85±2.32) mmol/L compared with (7.29±2.07) mmol/L] and HbA1c[(7.31±1.78) mmol/L compared with (6.93±1.23) mmol/L] was higher in patients with a diabetes course ≥5 years than that of patients with diabetes course <5 years, and the level of HbA1c [(7.30±1.64) mmol/L compared with (6.92±1.44) mmol/L] was higher in patients with primary school education and below than that in junior high school and above. Compared with the non-control group, the proportion of married patients (42.9%, 132 cases) in the FPG control group was lower, with lower levels of BMI [(23.38±3.27) kg/m 2vs. (26.27±3.40) kg/m 2], waist circumference [(84.47±10.97) cm vs. (88.74±10.48) cm], and hip circumference [(94.46±8.68) cm vs. (97.40±9.92) cm]. In the HbA1c control group, the proportion of males (44.2%, 57 cases), those with primary school education or below (47.3%, 97 cases), and those with a diabetes course ≥5 years (44.1%, 86 cases) were lower. BMI [(25.52±3.50) kg/m 2vs. (26.26±3.19) kg/m 2], waist circumference [(85.34±11.63) cm vs. (88.47±9.80) cm], systolic blood pressure [(132.65±14.73) mmHg vs. (136.15±15.14) mmHg], total cholesterol [(4.41±1.08) mmol/L vs. (4.76±1.11) mmol/L], and triacylglycerol [(1.67±0.72) mmol/L vs. (1.92±1.12) mmol/L] were all lower, and the levels of HDL [(2.73±0.97) mmol/L was higher than that of (2.48±1.02) mmol/L], with statistically significant differences (all P <0.05). In terms of the level of self-management, compared with the non-control group, the weekly stretching and/or strength training time of the FPG control group was (26.27±41.27) min higher than (17.06±33.46) min, and the difference was statistically significant ( P<0.05); HbA1c control group weekly stretch and/or strength exercise time (7.32±20.82) min vs. (16.47±14.33) min, weekly endurance exercise time (105.67±50.75) min vs. (91.66±51.07) min, symptom management self-efficacy (6.87±1.62) points (6.36±1.93) points were higher, fatigue (2.52±2.23) points(3.07±2.54) points, dyspnea (0.27±0.82) points (0.67±1.46) points, social. Both the activity and/or role restriction scores (0.58±0.64) and (0.74±0.79) scores were lower, and the differences were statistically significant (all P<0.05). Conclusions:Patients with diabetes in communities in Nanjing have better blood glucose control and higher levels of self-management. Patients with good control of BMI, blood pressure and blood lipids have higher blood glucose compliance rates. Communities with conditions can gradually promote self-management group activities to further control patients' blood glucose levels and reduce the incidence of complications.
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This study analyzed the distribution of high-risk population, the compliance and detected lesions of colorectal cancer screening from the Cancer Screening Program in urban areas of Kunming,Yunnan Province from 2014 to 2017. A total of 127 960 residents were included,of which 14 791 (11.70%) cases were diagnosed with high risk of colorectal cancer by the National Cancer Center High Risk Population Assessment System. A total of 3 484 cases completed colonoscopy clinical screening and the rate of participation was 23.55%. The screening results showed that 592 positive cases were detected, and the positive rate was 17.17%. The detection rates of polyps,adenomas,advanced adenomas,precancerous lesions and colorectal cancer were 16.27%,13.12%,7.18%,7.63% and 0.26%, with 567, 457, 250, 266 and 9 cases, respectively.
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Objective To analyze changes in quality of life(QOL)of diabetic patients before and after self-management group activities and potential factors influencing the changes.Methods From April to June 2014, volunteer patients with medical records confirming diagnosis of diabetes were recruited through telephone notification,poster announcements,and letter invitation.At baseline and six months later, interviews were conducted to analyze changes in QOL.A total of 633 participants were recruited who agreed to enter aself-management group. Paired t-tests were used to compare QOL before and after the self-management group activities, andbinary logistic regression analysis was used to analyze the potential influencing factors. Results Six hundred and three participants completed the 6-session activities with a response rate of 95.2%. Compared to baseline, the QOL scores in eight domains were all higher after six months.Single factor analysis showed that QOL of those with high income(χ2=6.72,P=0.035),the fruit and vegetable intake improvement group (χ2=5.11, P=0.024), the moderate-intensity physical activity improvement group (χ2=16.29, P=0.000), the eating habits improvement group (χ2=7.34, P=0.007), the self-confidence to manage diabetes improvement group(χ2=20.48,P=0.000),the glycemic control group(χ2=5.10,P=0.024),and the body-mass index improvement group(χ2=4.80,P=0.028)were higher than for other groups. Multi-factor analysis results showed that moderate physical activity improvement (OR=1.711, P=0.020) and self-confidence to manage diabetes improvement (OR=2.935, P=0.000) were factors related to improvement of QOL.Conclusion Self-management group activities were important ways to improve QOL.
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Objective To evaluate the effect of a community-based self-management model and the quality of life in patients with hypertension in Nanjing.Methods From April to June 2014,multistage stratified random sampling was used to randomly select patients with hypertension from the standardized management of basic public health services among 11 districts in Nanjing.A baseline survey and a follow-up after 3 months were conducted by well-trained investigators through face-to-face interviews to estimate the effect of self-management on quality of life. Results There were 586 patients investigated in the baseline survey.Among them,575 patients finished group activities six times;the follow-up rate was 98.1%.After a self-management group intervention, the awareness of hypertension-related knowledge and six aspects of self-management behaviors were measured; the scores of all dimensions improved significantly, and SF-36 increased to 32.03 ± 17.33. Multi-factor analysis results showed that those who were single and had complications felt improvement in their blood pressure control, experienced improvement in their stress conditions,and their quality of life improved.The OR(95% CI)values were 1.93(1.06-3.52),1.96(1.21-3.19), 1.79 (1.11-2.89), and 2.51 (1.59-3.97). Conclusion Carrying out self-management group work with community patients with hypertension that is focused on prevention and control of physical, psychological, and social aspects of life can improve their quality of life.
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Objective To evaluate the effectiveness of a chronic disease self-management program (CDSMP) in the Nanjing community. Methods From April to June 2016, the volunteer patients with chronic diseases from National Basic Public Health Services Plan were recruited and agreed to enter the CDSMP. A total of 42 self-management groups were established. The Nanjing CDSMP was based on the model of the Shanghai CDSMP developed by Stanford University. Questionnaire surveys, anthropometric measurements, and laboratory examinations were collected at 3 measurement moments (baseline, after 6 months, and after 12 months). Qualitative data were obtained from 1-2 participants in each self-management group. Paired t-tests, paired Chi-square tests, generalized estimating equation, and content analysis were used to evaluate the effectiveness of the CDSMP. Results Among 562 eligible patients, 548 completed 3 questionnaire surveys, physical measurements, and laboratory examinations. Sixty-six interviewees completed qualitative evaluations. Compared with baseline, the time of stretching or strengthening exercise and aerobic exercise; the scores on communication with the medical doctor; self-efficacy to manage symptoms and manage disease in general; quality of life in physical component summary and mental component summary; and rate of glucose control were all higher after 6 months and after 12 months interventions, whereas the score of fatigue; pain, health distress; social/role activities limitation; and the value of body weight, systolic blood pressure, and triglyceride were all decreased (all P values<0.01). The satisfaction rate of CDSMP in general, and content were 87.9%, 90.9%, and 83.3%, respectively. Conclusion Overall, the Nanjing CDSMP was successful in improving knowledge and self-management skills, increasing self-management behaviors, self-efficacy, health status, and quality of life, and decreasing body weight, blood pressures, and lipids. It is suggested that CDSMP may be widely used in Nanjing communities.
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Objective To evaluate the diabetes self-management program based on Chinese local patients in Nanjing community. Methods From April 2014 to June 2014, diabetes patients were recruited through health records system screening in the community health service centers, letter invitation, poster announcements at communities, and telephone notification. A total of 53 self-management groups were established. Nanjing diabetes self-management program included six 1-1.5 hours sessions scheduled on consecutive weeks, based on the blueprint of Shanghai Chronic Disease Self-Management Program (CDSMP) developed at Stanford University. Baseline and three-month later interviews were conducted respectively. Results A total of 636 patients were recruited and agreed to enter CDSMP; 603 completed the 6-session activities, with the response rate being 94.8%. Compared to baseline, nine of the patients' the awareness rate of diabetes-related knowledge, six of self-management behaviors, the scores of quality of life in physical component summary [(47.51 ± 9.47) vs. (49.10 ± 8.27) points, t=6.170, P=0.000] and mental component summary [(47.09±11.95) vs. (49.13±10.74) points, t=5.157, P=0.000] were all higher after three months (all P values<0.05). Three months after implementation, the level of systolic blood pressure, diastolic blood pressure, fasting plasma glucose and total cholesterol decreased respectively by (1.42±0.52) mmHg (1 mmHg=0.133 kPa), (0.98 ± 0.34) mmHg, (0.66 ± 0.16) mmol/L, (0.15 ± 0.56) mmol/L,the differences were statistically significant (tpaired values were 3.935, 2.030, 4.889, 4.899, all P values<0.05). Conclusion The diabetes self-management program based on Chinese local patients for Nanjing may improve patients' awareness rate of diabetes-related knowledge, self-management behavior, the quality of life, and health status. CDSMP could be applied effectively in Nanjing.
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Objective:To explore the methods and condition in which calcium ionorphore(CI) induces the CML cells to differentiate into dendritic cells(DCs).Methods:Mononuclear cells were separated from peripheral blood or bone marrow of CML patients whose WBC counts were more than 30?30~9 L~ -1 when samples were collected,then lymphocytes and monocytes were discarded by pouring out supernatant twice at different culture time point. Slightly adherent cells were cultured in RPMI1640 containing 10%FCS(Fetal calf serum),with or without CI(375 ng/ml) and GM-CSF(200 ng/ml) at 37℃,5%CO_2 humidified atmosphere for 96 h. To evaluate the effect of CI on inducing CML cells to differentiate into DCs,the phenotype of these cells were analyzed by flow cytometry and the morphology change was observed under inverted microscope and electron microscope. Better condition was also explored for DCs differentiation from CML cells under the effect of CI.Results:After 96 h of culture with CI and GM-CSF,the CML cells acquired morphology of mature DCs and significantly up-regulation of CD80,CD86,CD40,CD86 and HLA-DR.Conclusion:CML cells might acquire typical morphology and immunological phenotype of mature DCs when being cultured with CI and GM-CSF.