ABSTRACT
Objective:To investigate the individual and combined effects of calf circumference and vitamin D levels on all-cause mortality risk in community-dwelling older adults based on the Chinese Longitudinal Healthy Longevity Survey.Methods:The calf circumference was measured in the baseline survey in 2012 and 2014.Low calf circumference was defined as <34 cm for men or 33 cm for women at screening.Vitamin D deficiency was defined as plasma 25-hydroxyvitamin D[25(OH)D]levels <50 nmol/L.All participants were followed up until 2018, when death outcomes and survival time were collected.Cox proportional hazard regression models were used to analyze the effects of calf circumference and 25(OH)D levels on the risk of all-cause mortality.Results:A total of 3 052 older adults were included in the analysis, of which 1 960(64.22%)had low calf circumference and 2 245(73.56%)had vitamin D deficiency.After 10 559.9 person-years of follow-up period, 1 312 death events were recorded.After adjusting for sociodemographic characteristics, physical activities, cognitive function, and multiple chronic diseases, calf circumference and 25(OH)D levels were negatively associated with the risk of all-cause mortality(both P<0.05). In the combined analysis, compared with the normal group, the risk of death was highest in the participants with both low calf circumference and vitamin D deficiency, which was higher than those with low calf circumference or vitamin D deficiency alone, with a hazard ratios( HR)(95% CI)of 2.51(1.81-3.45), 1.71(1.22-2.42)and 1.53(1.09-2.15), respectively.There was a significant additive interaction between low calf circumference and vitamin D deficiency on mortality(RERI>0). Conclusions:Low calf circumference and vitamin D deficiency are associated with higher mortality.Older adults with combined conditions had a even higher risk of death.Attention should be paid to joint screening and comprehensive intervention for older adults with both low calf circumference and vitamin D deficiency.
ABSTRACT
Objective:To investigate the level of intrinsic capacity in community-dwelling elderly people and the influencing factors, in order to provide supporting evidence for the improvement of intrinsic capacity, formulation of management strategies, and promotion of quality of life for the elderly.Methods:A cross-sectional survey was carried out from November 2020 to December 2020 with 236 community-dwelling elderly people in Beijing, who were recruited through a convenience sampling method.The investigation used questionnaires for general data and influencing factors for intrinsic capacity, and the World Health Organization intrinsic capacity questionnaire.Multivariate logistic regression was used to analyze the influencing factors for intrinsic capacity of the elderly.Results:Among 236 community-dwelling elderly people, 132(55.9%)had fair intrinsic capacity(≥4 points)and 104(44.1%)had poor intrinsic capacity(<4 points), with an average score of(3.39±0.95). Multiple Logistic regression analysis results showed that sex( OR=2.005, 95% CI: 1.093-3.676, P=0.025), age( OR=1.727, 95% CI: 1.043-2.860, P=0.034), social participation( OR=0.321, 95% CI: 0.170-0.604, P<0.001), entertainment( OR=2.073, 95% CI: 1.079-3.985, P=0.029), exercise( OR=2.975, 95% CI: 1.761-3.784, P=0.039), sleep( OR=0.508, 95% CI: 0.265-0.973, P=0.041), and emotions( OR=0.436, 95% CI: 0.196-0.970, P=0.042)were influencing factors for intrinsic capacity of community-dwelling elderly people. Conclusions:The intrinsic capacity of community-dwelling elderly people is in the middle range.Sex, age, social participation, entertainment, exercise, sleep, and emotions can affect intrinsic capacity.Therefore, intervention strategies based on influencing factors and improvement of lifestyles can help maintain good intrinsic capacity and reduce adverse effects of major health events.
ABSTRACT
Objective:To analyze the present situation of comprehensive geriatric assessment(CGA).Methods:By using the convenient sampling method, 191 departments across the country that applied to try out the Jing-Yi-Hui comprehensive geriatric assessment system developed by the Department of Geriatrics of Beijing Hospital from November 2020 to March 2021 were investigated.Through the self-designed questionnaire to investigate the basic situation of the department, the implementation of CGA and training needs.Results:CGA has been carried out in 104 departments(54.5%). There is no statistically significantly difference in the implementation rate of CGA among different levels of hospitals, different regions where hospitals are located and different cities where hospitals are located.Among the departments that have carried out CGA, 28 departments(26.9%)have carried out out-patient CGA, 57 departments(54.8%)have completed CGA by random staff of departments, 87 departments(83.7%)use paper questionnaires, and 51 departments(49.0%)had less than 10 cases per month for completing CGA.Among the 87 departments that did not carry out CGA, 68 departments(78.2%)were unable to charge fees, and 64 departments(73.6%)were short of professionals.More than 90% of the departments have CGA training needs.Conclusions:CGA in China is still in its infancy, and the development of CGA in geriatrics in various places is poor, and it is generally faced with the dilemma of being unable to charge fees and lack of standardization.
ABSTRACT
With the acceleration of aging process and the increase of average life in China, the number of disabled elderly in China is also growing rapidly, which undoubtedly brings a heavy care burden and pressure to families and society.Facing the great challenges brought by aging, the increasing evidences show that only by reducing the incidence of disease and disability from the source, improving the health level of the elderly, prolonging their healthy life and realizing healthy aging, we can fundamentally alleviate the great pressure brought by the aging society.The concept of motor function maintenance and health promotion of the elderly has become an important link and breakthrough to realize healthy aging and active health.Facing the requirements of active health medicine and the development trend of science and technology in the future, it is imperative to deeply study the motion characteristics and function maintenance of the elderly, and promote the development of sports medicine with innovative technologies such as internet, big data and artificial intelligence.In the future, we will continue to improve the assessment and maintenance system for motor function of the elderly, develop and optimize functional maintenance products that meet the exercise needs of the elderly, and actively build an elderly-friendly sports environment support system, thereby promoting the healthy China strategy and realize healthy aging to the greatest extent.
ABSTRACT
WHO proposed the concept of intrinsic capacity in the World Report on Aging and Health in 2015.As the basis of functional ability in the elderly, intrinsic capacity plays an important role in maintaining the quality of life and promoting healthy aging.However, research on intrinsic capacity is still in its infancy.This article reviews research progress on intrinsic capacity, including the concept, domains, screening methods and its impact on the health of the elderly, in order to provide a reference for further research on this subject.
ABSTRACT
With the acceleration of the aging process in China, the incidence rates of coronary heart disease and cerebral infarction have significantly increased.And iodine contrast agent is often used in imaging diagnosis and percutaneous intervention therapy.The contrast medium is filtered from the glomerulus in its original form and is not absorbed by renal tubules.However, the accumulation of iodine contrast medium in the kidney can lead to acute kidney injury.Kidney is one of the most important excretory and endocrine organs in human body.The prevention and treatment of contrast-induced nephropathy(CIN)have been widely concerned.The incidence rate of contrast-induced renal damage is higher and the prognosis is poorer in the elderly than in the non-elderly due to the decline of organ function in the elderly.At present, the mechanism of action for oxygen free radicals in CIN of the elderly is still unclear.This article reviews the researches on the role of oxygen free radical in CIN of the elderly studied by domestic and foreign scholars in recent years.
ABSTRACT
Objective:To investigate the relationship between sarcopenia and early renal dysfunction in elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 198 elderly patients with T2DM aged over 60 years undergoing treatment in the Geriatric Department of Beijing Hospital from July 2018 to July 2019 were enrolled in this retrospective case-control study.The estimated glomerular filtration rate(eGFR)is calculated according to the CKD-EPI Cr-Cys formula.Based on the eGFR, the patients were divided into normal renal function group(n=63, in CKD 1 stage)and mild renal dysfunction group(n=135, in CKD 2-3a stage). All subjects underwent physical examination, laboratory examination and dual energy X-ray bone density examination. Results:The age, weight, body mass index, abdominal circumference, serum creatinine, cystatin C, uric acid, diastolic pressure, the proportions of diabetes and hypertension were lower, and the high-density lipoprotein cholesterol, appendicular skeletal muscle mass(ASM)and skeletal muscle mass index(SMI)were higher, in the normal renal function group than in the mild renal dysfunction group( P<0.05 or 0.01). Spearman correlation analysis showed that eGFR was positively correlated with SMI( r=0.343, P<0.01). Logistic regression analysis showed that body weight( OR=1.318, 95% CI: 1.091-1.594), uric acid( OR=1.007, 95% CI: 1.001-1.012), diastolic blood pressure( OR=1.072, 95% CI: 1.033-1.112), years of diabetes( OR=1.075, 95% CI: 1.013-1.142)were risk factors, and the LSM( OR=0.136, 95% CI: 0.047-0.392)and SMI( OR=0.778, 95% CI: 0.703-0.860)were protective factors for the early renal dysfunction in elderly patients with T2DM. Conclusions:Elderly patients with T2DM are often co-existed with sarcopenia.Sarcopenia is associated with early renal dysfunction in elderly patients with T2DM.
ABSTRACT
Objective:To survey the attitudes and influencing factors towards advance -care planning(ACP)among elderly inpatients and their family members.Methods:A total of 197 elderly inpatients and 248 family members were enrolled by using a convenience sampling method, and they were investigated by a questionnaire.The differences in attitudes towards the nutrition support in the state of frailty and the advanced life support at the end of life between patients and their family members, and the influencing factors for making a living will were analyzed.Results:Compared with elderly inpatients, the proportions of their family members, who had heard of ACP/advance directives(ADs)(58.9% or 146/248 vs.41.6% or 82/197, χ2=13.070, P=0.000), who had discussed death(89.9% or 223/248 vs.55.3% or 109/197, χ2=69.334, P=0.000), who would make a living will(88.7% or 220/248 vs.46.7% or 92/197, χ2=92.461, P=0.000), who would know the true condition(97.2% or 241/248 vs.89.8% or 177/197, χ2=10.349, P=0.001), were significantly elevated.Towards the choice of tube feeding, percutaneous endoscopic gastrojejunostomy and deep-vein catheter insertion, family members had more positive attitudes than did patients themselves( χ2=42.996, 11.446 and 27.704, P=0.000, 0.003 and 0.000). Towards the life support during end-of-life including ventilator-assisted ventilation, electric defibrillation, extracorporeal cardiac compression and hemodialysis, there was no significant difference in attitudes between patients and family members( χ2=0.569, 1.866 and 4.337, P=0.752, 0.393 and 0.114), and the proportion of disapproval was higher in family members.The influencing factors for making a living will were the awareness of ACP/ADs( OR=0.187, 95% CI: 0.096-0.366, P=0.000)and having discussed death with family members( OR=0.450, 95% CI: 0.231-0.878, P=0.019). Conclusions:The proportion of elderly inpatients who are willing to make a living will is low in China, and its influencing factors are the awareness of ACP/ADs and having discussed death with family members.Thus, the promotion and education of ACP/ADs should be strengthened.
ABSTRACT
@#【Objective】To compare the imaging features and early diagnostic value of high frequency color Doppler ultrasonography and X- ray mammography in patients with breast carcinoma in situ. 【Methods】 The clinical data of 55 patients with breast carcinoma in situ confirmed by operation and pathology were collected and analyzed retrospectively ， including high frequency color Doppler ultrasonography and X-ray mammography.【Results】Among 55 cases，28 cases were diagnosed as breast carcinoma in situ by high frequency color Doppler ultrasonography ，with the diagnostic accuracy rate of 50.9%；39 cases were diagnosed as breast carcinoma in situ by X-ray mammography，with the diagnostic accuracy rate of 70.9% . Statistical results showed that the diagnostic accuracy of mammography for breast carcinoma in situ was significantly higher than that of high frequency color Doppler ultrasonography（P=0.049）. The diagnostic accuracy of X- ray mammography was 67.3% and that of high frequency color Doppler ultrasonography was 47.3%（P=0.034）. 43 cases of breast carcinoma in situ were diagnosed by color Doppler ultrasonography and X-ray mammography ，and the diagnostic accuracy was 78.2% ，which increased significantly. 【Conclusions】 X- ray mammography is superior to high- frequency color Doppler ultrasonography in the early diagnosis of breast carcinoma in situ. The combination of the two imaging methods can play a complementary role in improving the accuracy of diagnosis of breast carcinoma in situ and reducing the rate of missed diagnosis.
ABSTRACT
Objective To investigate the effect of antithrombotic strategies on cerebrovascular events in aged patients with nonvalvular artial fibrillation(nvAF).Methods The clinic data of 101 patients aged 80 years and over with nvAF admitted from January 2005 to June 2016 were retrospectively analyzed.The stroke and transient ischemic attack (TIA) occurred in 29 patients (28.7％,stroke/TIA group) and the remaining 72 patients were assigned in non-stroke/TIA group.The antithrombotic schemes and the antithrombotic drug-related bleeding were compared between two groups.Results Among 101 patients,there were 70 cases receiving antiplatelet therapy,19 cases receiving anticoagulation therapy and 12 cases receiving no antithrombotic therapy.The nvAF history was longer in the stroke/TIA group than that in non-stroke/TIA group [15.0(8.0,17.5) vs.6.0(3.0,12.8),Z=-3.645,P＜0.01];the proportion of anticoagulation therapy was higher in non-stroke/TIA group than that in stroke/TIA group (18/72 vs.1/29,x2=5.778,P＜0.01).The occurrence of medication-related bleeding was 15.6％(14/90) in patients with antiplatelet therapy and 12.0％(3/25) in patients with anticoagulation therapy (x2=0.196,P=0.658).There was no significant difference in the first time of stroke/TIA attack among patients with different antithrombotic schemes(x2=0.859,P=0.651).Conclusion The aged patients with nvAF are in a high risk of thromboembolism,but the proportion of using antithrombotic therapy is low.Anticoagulation therapy has a protective effect against the occurrence of stoke/TIA without increasing the risk of bleeding,which makes anticoagulation therapy advisable in the elderly patients.
ABSTRACT
Objective:To investigate the expression and clinical significance of B7-H3 and IL-21 in serum of patients with HBV-related primary liver cancer.Methods: Gathering 121 cases of HBV-related patients,50 cases of primary hepatic carcinoma of them were considered as hepatic carcinoma group,71 cases of benign group including 12 cases with acute hepatitis,21 cases of chronic moderate to severe hepatitis,20 cases of compensatory phase cirrhosis,18 cases of decompensated cirrhosis and 20 cases of healthy persons in the same period as normal control.The content of serum B7-H3 and IL-21 were detected by ELISA.HBV DNA quantitative results were analyzed by Quantitative Real-time PCR.Results: The levels of B7-H3 and IL-21 in patients with primary hepatic carcinoma were (207.60±57.16)ng/ml and(2 357.28±805.01)pg/ml,respectively,which were significantly higher than those of the normal control subjects(P<0.001).Comparison with the normal control subjects,the content of B7-H3 and IL-21 in serum of patients with different clinical types in the benign group increased significantly(P<0.001).B7-H3 and IL-21 were positively associated with each other in serum of patients with HBV-related primary liver cancer.The expression of sB7-H3 was not significantly correlated with the degree of HBV DNA replication.The expression of IL-21 was correlated with HBV DNA replication in patients with HBV associated hepatocellular carcinoma,but was not significantly correlated with the degree of HBV DNA replication.Conclusion: HBV-related primary hepatic carcinoma express sB7-H3 and IL-21 with high level.The continuous high expression of sB7-H3 and IL-21 in the body may be related to the development and prognosis of the patients.
ABSTRACT
Objective To explore the clinical value of real -time ultrasound elastography in the diagnosis of thyroid nodules , and to provide reference for the clinical diagnosis and treatment of patients with thyroid nodular lesions.Methods The clinical data of 62 patients with thyroid nodule occupying lesions were retrospectively analyzed.The results of real-time ultrasound elastography imaging and pathological diagnosis were compared ,and the accuracy ,sensitivity and specificity of real -time ultrasound elasticity imaging in the diagnosis of thyroid nodular lesions were analyzed.Results The patients with elastic grade 0,pathological examination showed follicular adenoma cystic degeneration;The patients with elastic gradeⅠ,pathological examination showed follicular hyperplastic nodules ;The patients with elastic grade Ⅱ,pathological examination showed follicular gland tumor;The patients with elastic grade Ⅲ,pathological examination showed papillary adenocarcinoma;The patients with elastic grade Ⅳ,pathological examination showed papillary adenocarcinoma .In patients with elastic grade 0,3 patients had proliferative nodules , and 5 cases were follicular adenomas .Among the patients with grade Ⅰ,5 cases were proliferative nodules ,8 cases were follicular adenoma ,1 case of papillary adenocarcinoma;of gradeⅡpatients,6 cases of proliferative nodules ,14 cases of follicular adenoma ,2 cases of papillary adenocarcinoma .Among the patients with grade Ⅲ,4 cases were follicular adenomas,and 6 cases were papillary adenocarcinomas .Among the patients with grade Ⅳ,3 cases were follicular adenomas,7 cases were papillary adenocarcinomas .The diagnostic accuracy of real -time ultrasound elastography was 93.5%,and the difference was not statistically significant (P>0.05).The sensitivity and specificity of real -time ultrasound elastography were 100.0% and 72.6%.Conclusion Real -time ultrasound elastography has high accuracy in the diagnosis of benign and malignant lesions of thyroid nodules ,it is worthy of being widely promoted .
ABSTRACT
Objective To evaluate the therapeutic effects of early intratympanic steroid of different concentrations and types combined with systemic steroid on severe idiopathic sudden sensorineurl hearing loss(ISSNHL).Methods We reviewed 95 patients with unilateral ISSNHL from January 2012 to June 2016 in the Department of Otolaryngology of the People's Hospital of Changshou and according to the steroid treatment methods,Patients were divided into systemic steroid therapy alone group(group A,30 cases),early intratympanic steroid of low concentration combined with systemic steroid group (group B,32 cases) and early intratympanic steroid of high concentration combined with systemic steroid group (group C,33 cases).Results Total effective rates of the group A,group B and group C were 46.67 ％,56.25 ％,78.79％.Group C was significantly higher than that of group A and group B(P＜0.05);the average pure tone threshold improvement was (46.67±9.32) in group C which was better than group A (20.53±8.83) and group B(25.19± 7.46),the differences were stastically significant (P＜0.01).Conclusion Severe ISSNHL should be treated by intratympanic steroid of high concentration combined with systemic steroid as early as possible in order to rescue the hearing,the efficacy of which is much better than other steroid treatments so far.
ABSTRACT
Objective To investigate proliferation and apoptosis of colonic epithelial cells from ulcerative colitis (UC)patients with active new-onset,remission and active recurrent stages,and to study the effects of 5-aminosalicylic acid (5-ASA)on proliferation and apoptosis of colonic epithelial cells during the treatment of inducing remission and maintanence remission. Methods From January 2002 to December 2012,twelve patients with mild-to-moderate UC who received treatment and long-term follow-up and achieved remission with 5-ASA and received long-term maintanence treatment with it were assigned to UC group.At the same period,10 healthy individuals with negative endoscopy results or solitary colonic polyp were assigned to control group.The biopsy tissues from colonoscopy for pathological examination of patients in UC group at new-onset active stage,remission stage and recurrence stage were obtained.Levels of proliferation marker Ki-67 and apoptosis of colonic epithelial cells were determined by immunohistochemistry and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL)assay,respectively.Data were expressed by median(lower quartile,upper quartile).Kruskal-Wallis test and Mann-Whitney test were performed to compare the differences between groups and Bonferroni method was used for correction.Results The median proliferation indexes (PI)of colonic epithelial cells of UC patients at new-onset active period,remission period and recurrent active period were 31 .65 % (19.14%,39.66%), 12.30% (11 .11 %,14.10%) and 44.15 % (33.65 %,52.45 %), respectively,which were all higher than those of control group (7.89% (6.54%,8.86%))there were statistically significant differentes among four groups (H =30.033,P <0.01 );those of new onset active period and recurrent active period were both higher than remission period,and the differences were statistically significant (all P <0.05/6).The median apoptosis indexes (AI)of colonic epithelial cells in UC patients at new-onset active period,remission period and recurrent active period were 24.18%(17.81 %,27.16%),44.19% (43.41 %,50.55 %),41 .24% (33.78%,46.24%),respectively,which were all higher than those of control group (2.65 %(2.48%,2.98%)),there were statistically significant differences among four groups (H =31 .563,P <0.01);and those of remission and recurrent active period were both higher than new-onset active period (all P <0.05/6).The median apoptosis/proliferation ratios of control group,new onset active period,remission period and recurrent active period were 0.320 0 (0.275 5 ,0.425 0),0.749 9 (0.634 9,1 .115 8 ),3.282 8 (3.133 1 ,4.406 8 )and 1 .008 2 (0.801 9, 1 .099 2),respectively,there were statically significant differences among four groups (H =29.441 ,P <0.01);those of new onset active period and recurrent active period were both lower than that of remission period and the differnces were statistically significant (both P <0.05/6 ).Conclusions Proliferation and apoptosis imbalance in colonic epithelial cells of UC patients is one of the important mechanisms for the pathgensis of UC.5-ASA does not promote the proliferation of epithelial cells during UC remission period.
ABSTRACT
Objective To study the role of CT in the evaluation after patellar dislocation triple surgeries.Methods Retrospectively analysed the CT measurements of 60 recurrent patellar dislocation patients (61 knees),who had undergone patellar dislocation triple surgeries,within one month before and after procedures.The measurements included patellar tilt angle,lateral patellar displacement,trochlear con-gruence angle,Tibial Tuberosity-Trochlear Groove distance,Insall-Salvati Ratio and Caton-Deschamps Index.Moreover,the troch-lear dysplasia classifications of all patients were evaluated.In addtion,an analysis has also been completed for 40 (41 knees)of 60 patients who had second postoperative CT examinations as follow-up assessment 3 to 6 months after surgeries.Results All one-month postoperative measurements decreased obviously with statistical significance(P <0.05 ).Furthermore,one case of subluxa-tion,1 1 cases of abnormal Tibial Tuberosity-Trochlear Groove distance,13 cases of abnormal Insall-Salvati Ratio and 14 cases of Ca-ton-Deschamps Index abnormities were also observed.Besides that,it was also found that all patients had trochlear dysplasia and 5 cases were diagnosed with patellar subluxation or dislocation at the second postoperative follow-up assessment.Conclusion The patients with redislocation or risks for patellar instability can be detectecd by CT which provides objective evidence for postoperative evaluation and further treatments.
ABSTRACT
Transforming growth factor-beta (TGF-beta) as a main switch has a crucial role in chronic rhinosinusitis (CRS) subtypes. The physiological functions of the secreted inactive TGF-beta are precisely regulated by suppressing factors, such as latency-associated peptide (LAP), latent TGF-beta-binding protein (LTBP) and fibrillin, as well as activating factors, such as integrins, proteases and thrombospondin-1. With progress in understanding the factors responsible for regulating TGF-beta functions, it has been revealed that the dysregulation of TGF-beta activation is closely associated with lung fibrosis and chronic obstructive pulmonary disease. Since the imbalance between TGF beta-regulating factors may be one of the main reasons for different phenotypes of CRS, we reviewed the advancement in the research of TGF-beta activation and its role in CRS pathogenesis, to provide insight into the CRS investigation in human.
Subject(s)
Humans , Chronic Disease , Latent TGF-beta Binding Proteins , Metabolism , Protein Binding , Rhinitis , Metabolism , Pathology , Sinusitis , Metabolism , Pathology , Transforming Growth Factor beta , MetabolismABSTRACT
Objective This study was to investigate the association between serum Bisphenol-A (BPA) and unexplained recurrent spontaneous abortion (RSA).Methods A hospitalbased 1 ∶ 2 matched case-control study was conducted.Sixty-two patients with unexplained recurrent abortion were included and matched with 2 normal controls by factors as age ( ± 2 years),living in the same district and the same gestational age.The levels of BPA in serum for 62 cases and 108 controls were detected under high performance liquid chromatography after fluorescent derivatization.Levels of serum BPA in each case was compared with that in control of age,BMI,education levels,occupation,exposure for passive smoking.Results The values of serum BPA in cases and controls were ( 0.009 ± 0.002 ) and (0.004 ± 0.012) μg/ml,respectively.The levels of serum BPA in cases was significantly higher than in controls (Z=3.506,P=0.0005).After adjusted by age,BMI,education levels,occupation,passive smoking history and other factors,when compared to BPA below 0.004 μg/ml.The adjusted ORs were 4.39 (1.15-16.71)for BPA levels between 0.004 μg/ml and 0.012 μg/ml,and 4.95 (1.77-13.82) for BPA over 0.012 μg/ml.The risk of unexplained recurrentspontaneous abortion increased progressively with the growth of serum BPA levels (x2 =9.179,trend test P=0.0024).There were significant differences on BPA among controls that with histories of two,three or more abortions (the levels were 0.004,0.008,0.018 μ g/ml,respectively,F=8.92,P=0.0002).Conclusion High BPA level might be associated with unexplained recurrent spontaneous abortion.
ABSTRACT
Allergic rhinitis (AR), with an increasing uptrend of the prevalence in many developed and developing countries, is a global health problem that affects people of all ages and ethnic groups. However, data on the prevalence of self-reported AR in western China are rare. This study investigated the epidemiological features of self-reported AR in western China. In the cross-sectional, population-based study, a validated questionnaire survey on self-reported AR was carried out in 4 major cities in western China by multistage, stratified and cluster sampling, from January to December 2008. The total prevalence rate was 34.3%, with 32.3% (Chongqing), 34.3% (Chengdu), 37.9% (Urumqi), 30.3% (Nanning), respectively. The prevalence presented to increase with age before 30 years old while decrease with age after 30 years old, and the highest prevalence was in 19-30 years group in Chongqing, Chengdu and Nanning which significantly showed "persistent and moderate-severe" type (P<0.0001); In Urumqi, there wasn't a significant increasing or decreasing trend of prevalence rate with age but with an "intermittent and mild"predominance (P<0.0001). There were no distinct sexual differences in prevalence rates in the 4 cities. The morbidity was positively related to monthly average temperature and sunshine (r=0.76645, P=0.0036; r=0.67303, P=0.0165), but negatively associated with relative humidity (r=-0.64391, P=0.0238) in Urumqi. Interestingly, the monthly morbidity was negatively associate with average temperature, sunshine and precipitation in Nanning (r=-0.81997, P=0.0011; r=-0.60787, P=0.0360; r=-0.59443, P=0.0415). Self-reported AR is becoming common in western China with a rapid development in recent years, affecting about three persons out of ten. The climatic factors may have an indirect impact on the prevalence rate through the effects on the local allergens.
ABSTRACT
<p><b>OBJECTIVE</b>This study was to investigate the association of Bisphenol A and unexplained recurrent spontaneous abortion.</p><p><b>METHODS</b>A hospital-based 1:1 matched case-control study was conducted. Sixty patients with unexplained recurrent abortion were included. Each case was matched with one normal control by age (± 2 years), living district and the same gestational age. The levels of Bisphenol A in urine for 60 cases and 60 controls were detected using high performance liquid chromatography after fluorescent derivatization. The levels of urinary Bisphenol A in case was compared with that in control in education levels, occupation, smoking history. Data was analyzed by means of Wilcoxon-test, Student-Newman-Keuls after rank transform, univariate and multivariate conditional Logistic regression analysis. The software used was SAS 9.1.3.</p><p><b>RESULTS</b>The values of urinary Bisphenol A in cases and controls were (0.10 ± 0.21) µg/ml, (0.03 ± 0.08) µg/ml, respectively. The level of urinary Bisphenol A in cases was significantly higher than that in controls (Z = 3.988, P < 0.0001). The urinary Bisphenol A levels in cases were significant higher than those in controls from senior middle school (the levels were 0.10, 0.06 µg/ml respectively, Z = 1.996, P = 0.0459), college (the levels were 0.14, 0.03 µg/ml respectively, Z = 2.586, P = 0.0097), workers or farmers (the levels were 0.08, 0.03 µg/ml respectively, Z = 2.265, P = 0.0235), businessmen (the levels were 0.10, 0.03 µg/ml respectively, Z = 2.544, P = 0.0109), and no passive smokers (the levels were 0.09, 0.03 µg/ml respectively, Z = 3.767, P = 0.0002). After adjustment by age, body mass index, marital status during pregnancy and other factors, compared to Bisphenol A below 0.06 µg/ml, the adjusted OR was 4.03 (1.67 - 9.74) for Bisphenol A levels between 0.06 µg/ml and 0.20 µg/ml, and was 5.46 (1.95 - 15.27) for Bisphenol A over 0.20 µg/ml. The risk of unexplained recurrent spontaneous abortion increased progressively with the growth of urinary Bisphenol A levels (χ(2) = 13.042, trend test P = 0.0003). There were significant differences on Bisphenol A among controls, two abortions, and three or more abortions (the levels were 0.03 µg/ml, 0.09 µg/ml, 0.21 µg/ml respectively, F = 9.04, P = 0.0002).</p><p><b>CONCLUSION</b>Exposure to Bisphenol A may be associated with unexplained recurrent spontaneous abortion.</p>
Subject(s)
Adult , Female , Humans , Pregnancy , Young Adult , Abortion, Habitual , Abortion, Spontaneous , Benzhydryl Compounds , Case-Control Studies , Causality , Maternal Exposure , Phenols , UrineABSTRACT
OBJECTIVE@#The serum levels of interleukin-4, interleukin-12 will be detected to elucidate and compare the involvement of Th1 and Th2 cells and the surface structures of nasal mucosa will also be observed in patients with allergic rhinitis (AR), chronic rhinosinusitis with nasal polyps (CRSwNP), chronic rhinosinusitis without nasal polyps (CRSsNP) and nasal septal deviation (NSD) to obtain the characteristics and regularity of pathological changes.@*METHOD@#The serum levels of interleukin-4, interleukin-12 were detected by enzyme linked immunosorbent assay method. Four pieces of nasal mucosa on lateral side of middle turbinate were sampled from four patients and observed by scanning electron microscope.@*RESULT@#The levels of interleukin-4 in AR and NSD groups were significantly higher than the healthy controls (P 0.05). There were two points of regularity with different degrees in our observations: (1) disoriented and absence of cilium; (2) the cellular separations at cell junctions were obvious, even with cells lost.@*CONCLUSION@#There was an immunologic deviation towards Th2 pattern in patients with NSD the same as AR. Both Th1 and Th2 with hyperactivity participated in chronic inflammatory process of CRSwNP and CRSsNP. The pathological changes of ciliated columnar epithelium in patients with the four types of rhinitis, suggest that a comprehensive treatment including antral irrigations, multiple antibiotics, topical steroid sprays, or antihistamines, as well as nasal surgery to correct nasal deformities should be adopted, which can effectively prevent the development and expanding of the nasal mucosa inflammation.