Cosinor-rhythmometry for 24-h urinary sodium, potassium, creatinine excretion in the Chinese adult population / 中华医学杂志(英文版)

BACKGROUND@#The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels. The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion, possibly due to the circadian rhythm in urinary excretion. This study aimed to explore the circadian rhythm, characteristics, and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.@*METHODS@#Eighty-five participants (mean age 32.4 years) completed the 24-h urine collection by successively collecting each of the single-voided specimens within 24 h. The concentrations of the urinary sodium, potassium, and creatinine for each voided specimen were measured. Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium, potassium, and creatinine excretion. The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.@*RESULTS@#The metabolism of urinary sodium, potassium, and creatinine showed different patterns of circadian rhythm, although the urinary sodium excretion showed non-significant parameters in the cosinor model. A significant circadian rhythm of urinary creatinine excretion was observed, while the circadian rhythm of sodium was less significant than that of potassium. The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent, which had a nocturnal peak and fell to the lowest around noon to afternoon. In contrast, the peak of potassium was observed in the morning and dropped to the lowest point in the evening. The hourly urinary excretion followed a similar circadian rhythm.@*CONCLUSION@#It is necessary to consider the circadian rhythm of urinary sodium, potassium, and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.

Advance in Long-term Care Assessment Tools (review) / 中国康复理论与实践

In the developed countries, long-term care insurance system is adopted to deal with the problem of long-term care for the elderly. The developed countries use long-term care assessment tools to assess the objective needs of the elderly, and then adopt a hierarchical management system to achieve rational allocation of resources. The development of long-term care assessment tools in the developed countries is relatively mature. Long-term care assessment tools in the development countries not only assesse the activities of daily living of the elderly and cognitive ability, but also pay more attention to the assessment of medical care. Presently, China's mainland region is also doing long-term care insurance system pilot. The assessment tools of the pilot cities mainly assess activities of daily living, cognitive ability and social participation. As the first city to enter an aging population in China, Shanghai's assessment tool is more comprehensive, which not only includes activities of daily living, cognitive ability and social participation, but also includes medical care. In line with the national community-home care model, Shanghai has also increased home environmental assessment. Taiwan, combined with our cultural background on the basis of foreign assessment tools, pays more attention to the load of primary caregivers, so as to reduce the pressure of informal caregivers.