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Objective: To compare the differences in clinical symptoms and the time required for diagnosis of benign paroxysmal positional vertigo (BPPV) between older patients and young and middle-aged patients in the structured inquiry of dizziness history. Methods: The medical records of 6 807 patients diagnosed with BPPV from the Vertigo Database of Vertigo Clinical Diagnosis, Treatment, and Research Center of Beijing Tiantan Hospital, Capital Medical University, between January 2019 and October 2021 were retrospectively analyzed. The data included basic demographic information, clinical symptoms in a structured medical history questionnaire, and the time interval from the appearance of BPPV symptoms to diagnosis consultation. The patients were divided into the young and middle-aged group (<65 years old) and the older group (≥65 years old). The differences in clinical symptoms and consultation time were compared between these two groups. Categorical variables were represented by numbers (%), and compared using Chi-squared tests or Fisher's exact probability test for analysis; whereas, continuous variables conforming to normal distribution were represented by mean±standard deviation. Both data groups were compared and analyzed by Student's t-test. Results: The mean age of the older group was 65-92 (71±5) years, while the mean age of the middle-aged group was 18-64 (49±12) years. The incidence of vertigo (42.5% vs. 49.1%, χ2=23.69, P<0.001); vertigo triggered by changes in position of the head or body (52.4% vs. 58.7%, χ2=22.31, P<0.001); and autonomic symptoms (10.1% vs. 12.4%, χ2=7.09, P=0.008) were lower, but hearing loss (11.8% vs. 7.8%, χ2=27.36, P<0.001) and sleep disorders (18.5% vs. 15.2%, χ2=11.13, P=0.001) were higher in the older group than in the young and middle-aged group. The time from the appearance of dizziness to diagnosis was commonly longer in the older patient group than the other group (55.0% vs. 38.5%, χ2=55.95, P<0.001). Conclusions: Older patients with BPPV have more atypical symptoms and complex concomitant symptoms than young and middle-aged patients. For older patients with dizziness, positional testing is needed to confirm the possibility of BPPV even if the clinical symptoms are atypical.
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Middle Aged , Humans , Aged , Aged, 80 and over , Adolescent , Young Adult , Adult , Benign Paroxysmal Positional Vertigo/therapy , Dizziness/diagnosis , Retrospective Studies , Patients , Surveys and QuestionnairesABSTRACT
In order to improve the laboratory identification ability of Lodderomyces elongisporus, we analyzed the main biological characteristics of Lodderomyces elongisporus isolated from peripheral venous blood and catheter blood of a brain stem infarction patient with a body temperature of 38.4 ℃, observed the colony color of the strain on CHROMagar Candida medium and the ascospores on Mcclary agar, identified the isolates with Vitek 2 compact, MALDI-TOF MS and sequence analysis, and tested the MICs with borth microdilution. The MICs of antifungal agents against Lodderomyces elongisporus are well below the normal values of these drugs. The central venous catheter was removed and antifungal drugs were used until two weeks after the last positive blood culture. During the medication perios, the blood culture was repeatedly negative, the patient had no fever and the infection index decreased to normal, which can be used for clinical reference.
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Objective@#To examine the correlation between frailty and lifestyle factors among middle-aged and elderly populations, so as to provide insights into the management of frailty among middle-aged and elderly populations.@*Methods @#Middle-aged and elderly residents at ages of 45 ot 69 years were recruited using the convenient sampling method from seven townships in Changxing County of Zhejiang Province from 2019 to 2020. The demographic characteristics and lifestyle factors were collected using questionnaires, and the frailty was measured using the Chinese version of Tilburg Frailty Indicator ( TFI ). Factors affecting frailty were identified among middle-aged and elderly populations using the multivariable logistic regression model.@*Results@#A total of 7 170 residents were surveyed, including 2 780 males ( 38.77% ) and 4 390 females ( 61.23% ), which had a median age of 56 (interquartile range, 10) years. The median frailty score was 2 (interquartile range, 3 ) among the study subjects, and the median frailty score was 2 ( interquartile range, 2 ) among residents at ages of 45 to 59 years, and 2 (interquartile range, 3) among residents at ages of 60 to 69 years. The overall detection of frailty was 16.07%, and the detection of frailty was 13.52% among subjects at ages of 45 to 59 years and 21.01% among subjects at ages of 60 to 69 years. Multivariable logistic regression analysis identified physical activity ( OR=0.826, 95%CI: 0.719-0.949 ) and sleep quality ( OR: 3.376-11.493, 95%CI: 2.907-15.808 ) as factors affecting frailty among middle-aged and elderly residents. Following age stratification, physical activity ( OR=0.817, 95%CI: 0.681-0.981 ) and sleep quality ( OR: 3.076-11.566, 95%CI: 2.518-18.216 ) as factors affecting frailty among subjects at ages of 45 to 59 years, while sleep quality ( OR: 3.777-11.827, 95%CI: 3.002-18.547 ) significantly correlated with frailty among residents at ages of 60 to 69 years.@*Conclusion@#Physical activity and sleep quality are associated with the risk of frailty among middle-aged and elderly populations.
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Objective@#To understand prevalence, control of hypertension and intake of sodium and potassium among residents aged 50-69 years old in Zhejiang Province.@*Methods@#A multi-stage random cluster sampling method was used to select 3 032 residents aged 50-69 years old in Zhejiang Province. The demographic characteristics, prevalence and control of hypertension were collected through a questionnaire survey, and physical measurement was also performed. The stratified random sampling method was used to detect the level of sodium and potassium in the 24 h urine of 676 subjects. The total amount of 24 h urinary sodium ≥102.55 mmol and the ratio of 24 h urinary sodium and potassium content ≥2 were defined as excessive.@*Results@#The prevalence of hypertension (95%CI) was 56.89% (54.39%-59.40%), and the awareness, treatment and control rate of hypertension were 58.25% (55.01%-61.49%), 45.37% (42.10%-48.65%) and 19.75% (17.01%-22.50%), respectively. 78.99% (n=534) of residents had excessive 24 h urinary sodium, and 95.41% (n=360) of residents had excessive ratio of 24 h urinary sodium and potassium.@*Conclusion@#The prevalence of hypertension in residents aged 50-69 years old in Zhejiang Province was at a high level, and the control of hypertension was not satisfactory in 2017. Most of residents have excessive level of sodium intake and the level of sodium and potassium intake was not balanced.
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Objective @#To evaluate the risk of cardiovascular disease in hypertensive patients managed by communities in Tongxiang in the next 10 years,and to provide evidence for the development of cardiovascular disease prevention strategies. @*Methods@#The information about hypertensive patients managed by communities was collected from Tongxiang resident health records management system. The risk of ischemic cardiovascular disease（ICVD）in the next 10 years was assessed by the Assessment Scale of 10-Year ICVD Risk in Chinese.@*Results@# A total of 27 173 hypertensive patients managed by communities with complete data were recruited,including 11 868 males,accounting for 43.68%,and 15 305 females,accounting for 56.32%. The median（inter-quartile range）of the total scores of 10-year ICVD risk in hypertensive patients was 8.00（3.00）,with 9.00（2.00）in males and 8.00（2.00）in females. The total scores of 10-year ICVD risk in males was significantly higher than those in females（P<0.05）. A total of 8 764 patients had high 10-year ICVD risk,accounting for 32.25%. The proportion of high10-year ICVD risk in females with hypertension was higher than that in males（P<0.05）. The weights of ICVD risk factors in males were 54.58% in age,17.42% in systolic blood pressure,14.27% in smoking,7.77% in body mass index,4.51% in total cholesterol and 1.45% in diabetes;the ones in females were 63.57% in age,14.63% in systolic blood pressure,9.81% in body mass index,6.00% in total cholesterol,5.88% in diabetes and 0.11% in smoking.@*Conclusion @#The ICVD risk of hypertensive patients managed by communities in Tongxiang is higher in the next 10 years. Male patients should focus on the control of blood pressure and smoking,while female patients should focus on the control of blood pressure and body weight.
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Objective @#To explore the positive rates and influencing factors of depression and anxiety among managed diabetic patients in community and to provide evidence for the future mental health intervention.@*Methods@#Random sampling method was used to select the diabetic patients from the local health information platform in Ningbo. The anxiety and depression symptoms of the diabetic patients were evaluated by 9-Item Patient Health Questionnaire（PHQ-9）and 7-Item Generalized Anxiety Disorder Scale（GAD-7）. Logistic regression model was applied to analyzing the influencing factors for anxiety and depression in diabetic patients.@*Results@#A total of 1 032 diabetic patients were enrolled,with a response rate of 91.98%. The positive rate of depression was 9.01% and the positive rate of anxiety was 3.78%. The results of multivariate logistic regression analysis showed that divorced/widowed（OR=3.046,95%CI：1.522-6.100）,having two comorbidities or more（OR=6.723,95%CI：2.495-18.120）and suffering diabetes for more than ten years（OR=2.668,95%CI：1.406-5.062）were the risk factors for depression in diabetic patients,while having a college education or above（OR=0.288,95%CI：0.093-0.893）was the protective factor for depression in diabetic patients;unmarried（OR=13.244,95%CI：1.268-138.377）,having two comorbidities or more（OR=6.979,95%CI：2.164-22.503） and suffering diabetes for more than ten years（OR=3.109,95%CI：1.241-7.787）were the risk factors for anxiety in diabetic patients.@*Conclusion@#Marital status,the number of comorbidity,course of diabetes and education level could affect the occurrence of depression in diabetic patients;marital status,the number of comorbidity and course of diabetes could affect the occurrence of anxiety in diabetic patients.
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Objective@#To learn the current status of injury among community residents in Zhejiang Province,and to provide reference for injury prevention strategy.@*Methods@#A total of 38 005 residents were recuited from 11 counties or districts in Zhejiang Province by multi-stage cluster random sampling. A retrospective questionnaire survey was conducted to collect their injury occurrence from June 1st of 2017 to May 31st of 2018,then analyzed the incidence,mortality and types of injury.@*Results@#Among 38 005 respondents,2 186 injuries occurred,the incidence rate of injury was 5.75%. The incidence rate of injury in males and females were 5.67% and 5.84%,respectively. The incidence rate of injury in rural respondents（6.97%）was higher than that（4.79%）in urban respondents（P<0.05）. Seven respondents died of injury and the mortality rate was 18.42/100 000. The top five types of injury were falls（2.27%）,traffic accidents（1.53%）,animal bites（0.69%）,sharp articles（0.50%）and blunt articles（0.41%）. The lowest incidence rate of injury lay in 15 to 24 years old,and the highest lay in 65 to 74 years old. The incidence rate of injury increased with age（P<0.05）. The first type of injury in respondents aged 15 to 44 years old was traffic accidents,while others was falls.@*Conclusion@#The incidence of injury is higher in rural residents than in urban residents in Zhejiang Province,which increase with age. Falls and traffic accidents are the main threats to residents in Zhejiang Province.
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Objective To investigate the prevalence characteristics for high risk adults of type 2 diabetes in Zhejiang. Methods From June to October in 2010, 19113 local residents aged≥18 years old were selected among 7571 families from fifteen counties in Zhejiang by a four stage stratified-random sampling method. A self-designed questionnaire was completed to collect information on demographic characteristics, risk factors, and physical activity. At the same time, physical examinations including measurements of height, weight, blood pressure, and blood lipid levels were carried out. The high-risk population was determined according to the 2017 edition of China′s Guidelines for the Prevention and Treatment of Type 2 Diabetes. Results Finally, 17437 people completed all the investigation projects. Among them, 14455 people were at high risk of type 2 diabetes [aged (49.3+15.1) years, 6902 men (47.75％) and 7553 women (52.25％)]. The crude prevalence rate of high risk type 2 diabetes was 82.90％(standardized rate:79.26％). A significantly higher prevalence rate of high risk type 2 diabetes was associated with the age group of 45 to 60 years (83.47％), men (84.49％), class 1 rural area (84.59％), primary school education level (87.04％), marital status (84.40％), and average annual family income less than 10000 yuan (all P<0.05). Among the eight high risk factors, the detection rate of ≥40 years old was the highest (78.12％) and the detection rate of history of cardiovascular disease was the lowest (1.54％). The detection rates of overweight/obesity/central obesity, dyslipidemia, hypertension, sedentary lifestyle, pre-diabetes, and family history of type 2 diabetes were 42.86％, 31.28％, 29.98％, 29.18％, 7.28％, and 3.81％, respectively. High risk of type 2 diabetes was dominated by 1 high-risk factor (31.75％) or 2 high-risk factors (31.39％) or 3 high-risk factors (22.13％). The adults with 4 high-risk factors (11.01％) and 5 or more high-risk factors (3.71％) were less in number. The detection rates of all the risk factors and aggregation distribution of various risk factors were significantly different between different genders, age groups, regions and educational levels, marital status, and family per capita annual income. Conclusion The epidemic level of high-risk type 2 diabetes in Zhejiang province is relatively high, and health management of high risk of type 2 diabetes in community should be actively taken as early as possible according to the population distribution characteristics.
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Objective To explore the influencing factors related to thyroid carcinoma.Methods Matched by sex,age and original residential areas,659 pairs of cases and controls were recruited and studied.Methods including both single factor analysis and multivariate conditional logistic regression analysis were carried out to identify the influencing factors.Results Multivariate conditional logistic regression analysis showed that higher education,being diabetic,alcohol intake,tea drinking,occupational physical activity and the frequency of eating fishes/eggs etc.,were potentially protective to thyroid carcinoma.Depression,personal history of CT examination and less salt intake seemed to be risk factors on thyroid carcinoma.For males,factors as alcohol intake,tea drinking,occupational physical activity and frequent egg-eating appeared protective.For females,higher education,diabetes,tea drinking,occupational physical activity,frequent consumption of fishes/eggs,short duration of menstruation appeared as possibly protective.Conclusion Higher education,diabetes,alcohol intake,tea drinking,occupational physical activity,frequent consumption of fishes/eggs,depression,personal history of CT examination and less salt intake served as potential influencing factors to thyroid carcinoma.
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Objective To explore the influencing factors related to thyroid carcinoma.Methods Matched by sex,age and original residential areas,659 pairs of cases and controls were recruited and studied.Methods including both single factor analysis and multivariate conditional logistic regression analysis were carried out to identify the influencing factors.Results Multivariate conditional logistic regression analysis showed that higher education,being diabetic,alcohol intake,tea drinking,occupational physical activity and the frequency of eating fishes/eggs etc.,were potentially protective to thyroid carcinoma.Depression,personal history of CT examination and less salt intake seemed to be risk factors on thyroid carcinoma.For males,factors as alcohol intake,tea drinking,occupational physical activity and frequent egg-eating appeared protective.For females,higher education,diabetes,tea drinking,occupational physical activity,frequent consumption of fishes/eggs,short duration of menstruation appeared as possibly protective.Conclusion Higher education,diabetes,alcohol intake,tea drinking,occupational physical activity,frequent consumption of fishes/eggs,depression,personal history of CT examination and less salt intake served as potential influencing factors to thyroid carcinoma.
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Objective To learn the salt intake level of residents with hypertension in rural community and the influencing factors of salt restriction behavior. Methods We used random cluster sampling method to extract two rural communities. A total of 200 residents with hypertension or high - risk of hypertension were selected as the subjects. We conducted general information questionnaire,hypertension knowledge,attitudes and behavior questionnaire,3 - day salt intake survey and urine sodium detection to evaluate the level of sodium intake. We used multivariate logistic regression equation modeling to predict influencing factors of salt restriction behavior. Results After the completion of the investigation,M (QR )for daily sodium intake of 173 cases in the intervention group was 6. 72(5. 18)g,and the main route were through the salt,monosodium glutamate ,soy sauce,pickles. Daily 24 hours urinary sodium excretion amount was 90. 10(62. 28) mmol / 24 h and 152 cases(87. 86% )of respondents had salt - restriction - spoon,and 108 cases(71. 05% )use the salt- restriction - spoon,but only 53 cases(49. 07% )used the spoon correctly. The frequency of spoon for salt restriction and sodium intake was negatively correlated(P ﹤ 0. 05),whether spoon for salt restriction was used correctly and 24 - hour urinary sodium excretion was negatively correlated( P ﹤ 0 . 0 5 ). By multivariate logistic regression analysis ,those people who had high level of the average annual household income(OR = 2. 75,95% CI:1. 16 - 6. 53),identified 6 g of salt a day(OR = 5. 43,95% CI:1. 22 - 24. 07),regular consumption of vegetables(OR = 9. 35,95% CI:1. 16 - 75. 01) and initiative to take measures to control salt( OR = 5. 05,95% CI:1. 19 - 21. 45)were more likely to use salt -restricted spoons. Residents of drinking(OR = 0. 13,95% CI:0. 02 - 0. 84)did not tend to use salt - restricted spoons. Conclusion For people with high NaCl intake and no restriction behavior,the level of health knowledge,especially the knowledge of sodium salt,should be improved and the good dietary habits including salt - limited support tools and correct methods should be promoted .
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Objective To study the influence of diet and behavior related factors on the peripheral blood triglyceride levels in adults,through a cross-sectional survey.Methods The current study included 13 434 subjects without histories of major chronic diseases from a population-based cross-sectional survey:the 2010 Metabolic Syndrome Survey in Zhejiang Province.A generalized linear model was used to investigate the influence of diet/behavior-related factors on the peripheral blood triglyceride levels.Results Mean TG of the sample population appeared as (1.36± 1.18) mmol/L.The proportions of elevated TG and marginally elevated TG were 10.3％ and 11.0％ respectively,with statistically significant difference seen between males and females (x2=44.135,P＜0.001).In this sampled population,the daily intake of cooking oil was exceeding the recommendation levels by over 50％ while the intake of fruit,milk,nuts and physical exercise were much below the recommendation.There were statistically significant differences between smoking,alcohol-intake,meat,fruit and water intake in male population from this study.However,in females,the intake of aquatic product and physical exercise showed statistically significant differences.After controlling for other variables,factors as age,drinking,staple food and aquatic products showed positive influence on TG,while milk presented negative influence on TG.Through interaction analysis,fruit and meat intake in males and staple food in females showed positive influence on TG,when compared to the reference group.Conclusion Hyperglyceridemia appeared as one of the major metabolic abnormities in Zhejiang province.Programs on monitoring the alcohol,staple food and meat intake should be priority on intervention,in the communities.
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Objective To study the influence of diet and behavior related factors on the peripheral blood triglyceride levels in adults,through a cross-sectional survey.Methods The current study included 13 434 subjects without histories of major chronic diseases from a population-based cross-sectional survey:the 2010 Metabolic Syndrome Survey in Zhejiang Province.A generalized linear model was used to investigate the influence of diet/behavior-related factors on the peripheral blood triglyceride levels.Results Mean TG of the sample population appeared as (1.36± 1.18) mmol/L.The proportions of elevated TG and marginally elevated TG were 10.3％ and 11.0％ respectively,with statistically significant difference seen between males and females (x2=44.135,P＜0.001).In this sampled population,the daily intake of cooking oil was exceeding the recommendation levels by over 50％ while the intake of fruit,milk,nuts and physical exercise were much below the recommendation.There were statistically significant differences between smoking,alcohol-intake,meat,fruit and water intake in male population from this study.However,in females,the intake of aquatic product and physical exercise showed statistically significant differences.After controlling for other variables,factors as age,drinking,staple food and aquatic products showed positive influence on TG,while milk presented negative influence on TG.Through interaction analysis,fruit and meat intake in males and staple food in females showed positive influence on TG,when compared to the reference group.Conclusion Hyperglyceridemia appeared as one of the major metabolic abnormities in Zhejiang province.Programs on monitoring the alcohol,staple food and meat intake should be priority on intervention,in the communities.
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The microRNA-21 (miR-21) is known to play a major role in cancer progression; however, its function in the cardiovascular system appears to be even more complex and conflicting. To characterize miR-21 expression in the plasma of individuals with or without metabolic syndrome (MetS), 58 MetS cases and 96 non-MetS controls were investigated. Expression levels of miR-21 were significantly decreased in the circulation of MetS subjects (OR=0.52, 95% CI: 0.29-0.92) compared with that of non-MetS subjects. Body mass index (BMI) and the number of MetS components had a negative correlation with the level of miR-21, whereas age was inversely related to the level of miR-21. No significant difference was detected in miR-21 levels between the sexes (P=0.056). MiR-21 might be a negative regulating factor in MetS.
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Adult , Aged , Female , Humans , Male , Middle Aged , Down-Regulation , Metabolic Syndrome , Blood , Genetics , MicroRNAs , Blood , Genetics , Metabolism , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain Reaction , Risk FactorsABSTRACT
Objective:The study is to compare the prevalence and related factors of suicidal ideation in ado-lescents between China and Philippine.Methods:Our research data was downloaded from the website of world health organization (WHO).It was the data of China and Philippine from the Global school-based student health survey(GSHS)which was launched by the WHO,and 9173 students in China and 7338 students in Philippine aged 11 -16 years were involved.The situations of being serious injury,being bullied,sense of loneliness,insomnia, sense of hopelessness,friends,smoking,alcohol consumption,drug abuse and exercise were assessed by the ques-tionnaire.The definition of suicidal ideation was that ever thinking of suicide seriously in the last 12 months.Results:The rate of having suicidal ideation in China and Philippine were 17.4% (1544 /8881 )and 19.3% (1371 /7089),respectively.Multivariate analysis showed that female (OR =1.45),grade two and three of middle school (OR =1.29,1.43),being serious injury (OR =1.35),being bullied (OR =1.87),sense of loneliness (OR =1.47),insomnia (OR =1.55),sense of hopelessness (OR =3.36),alcohol consumption (OR =1.45)and drug abuse (OR =1.55)were the risk factors to suicidal ideation in China adolescents,and having good friends (OR=0.66)and exercise regularly (OR =0.78)were the protective factors.However,the female,grade,sense of lone-liness,insomnia and drug abuse were not the risk factors to suicidal ideation in Philippine adolescents,and other fac-tors were similar to China sample.Conclusion:There may be differences in the prevalence rate of suicidal ideation between adolescents in China and Philippine,with lower rate in China.Meanwhile,there are similarities in the relat-ed factors on the adolescent suicidal ideation of the two countries,with more risk factors in China sample.Therefore,the individualized targeted measures should be taken to prevent suicide in China and Philippine respectively.
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Promoted vigorously by state and government , it is a strategic emphasis of a new round of medical reform that public hospitals combine with social capital .In order to expect more attention to the hot issue from wheth-er theoretical or practical views , this article draws lessons from the experiences that foreign hospitals have managed to combine with social capital , to analyze the necessity of the new medical mode under the background of the medical re -form policies implementation and the enlarged health industry flourishing development , and meanwhile to discuss the value of the new medical mode for the present medical situation .
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<p><b>OBJECTIVE</b>To investigate the epidemiologic characteristics and factors associated with the avoidance of activity, that induced by fear of falling in the community-dwelling elderly so as to provide evidence for preventing elderly from falling and to increase the quality of life.</p><p><b>METHODS</b>A cross-sectional study was conducted in 1 972 elderly in Zhejiang. Data were collected through face-to-face interview. Both Univariate and multivariate logistic regression models were used to explore the related factors on the avoidance of activity induced by fear of falling.</p><p><b>RESULTS</b>Of the 1 972 elderly, 43.15% (95% CI: 40.97%-45.34%) appeared avoidance of activity induced by fear of falling. There were no significant difference between males (41.79%, 95% CI: 38.61%-44.98%) and females (44.36%, 95% CI: 41.34%-47.38%), with χ² = 1.32, P > 0.05. The corresponding figures of the 60-69 years group, 70-79 years group and the ≥ 80 years group were 37.07%, 44.87% and 59.04%, respectively (Trend χ² = 48.93, P < 0.01). Of those elderly who ever fell in the past 12 months, 51.94% (95% CI: 46.34%-57.53%) of them were afraid of falling which would lead to avoid of engaging in physical activities. Of the elderly who had no histories of falling in the past 12 months, 41.52% (95% CI: 39.14%-43.89%) feared of falling and avoided engaging in related activities (χ² = 11.56, P < 0.01). Results from the Multivariate logistic regression analysis showed that the related factors would include general/poor perceived health status (OR = 1.53-1.69), impaired vision (OR = 1.95-2.98), impaired hearing (OR = 1.77), use of assistive devices (OR = 2.71), osteoporosis (OR = 3.35), dizziness (OR = 3.05), age ≥ 80 years old (OR = 1.56) and the level of received education.</p><p><b>CONCLUSION</b>Avoidance of physical activity induced by fear of falling among community-dwelling elderly was commonly seen. Health education and intervention measures should be strengthened to the elderly, so as to encourage them to engaging in physical activities and to improve their quality of life.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Accidental Falls , Cross-Sectional Studies , Fear , Logistic Models , Motor Activity , Quality of LifeABSTRACT
<p><b>OBJECTIVE</b>To explore the association between socioeconomic status (SES) and blood pressure control in diagnosed hypertension patients.</p><p><b>METHODS</b>The database of Zhejiang provincial survey on metabolic syndrome which implemented in 2010 in which prior hypoertensive patients were brought into this sutdy. Descriptive statistics were applied to test the distributive differences of relevant factors (age, sex, marital status, hypertension duration, BMI, education level, per capita household yearly income, smoking, alcohol drinking, fruit and vegetable intake) between patients with optimally-controlled blood pressure and those without. The SES of diagnosed hypertension patients was measured separately by two common indicators: education level and the per capita household yearly income. Univariate and multivariate logistic regression models were used to differentiate the association between those two SES indicators and blood pressure control, and the trend of the association was also tested.</p><p><b>RESULTS</b>Totally, 2 394 hypertension patients were diagnosed and identified. Of the patients analysed, the overall mean was (61.53 ± 10.64) years, and 55.7% (1 334 cases) had ≤ 5 years' disease duration. 1 090 achieved optimal blood pressure control, which accounted for a proportion of 45.5%. 1 676 had elementary school education and below, accounting for 70.1%. The patients with per capita household yearly income of < 5 000 Yuan and 5 000-14 999 Yuan groups were 401 (29.4%) and 690 (50.5%) respectively. 416 (17.4%) were smokers and 541 (22.6%) were alcohol drinkers. Based on the statistical tests, we found that the distributions of age, marital status, hypertension duration, body mass index, smoking and alcohol drinking were different between two groups (t or χ² values were 4.57, 5.44, 6.40, 6.21, 5.99, 3.98, respectively, all P values were < 0.05). Optical blood pressure control in higer education level group was significantly better than that of in lower education level (χ² = 12.65, P < 0.001), and there was no statistical significance association between per capita household yearly income and optimal blood pressure control (χ² = 2.78, P = 0.249). Multivariate logistic regression models revealed that, of those two SES indicators, a positive association was shown between education level and optimal blood pressure control: compared with patients in the category of 'elementary school and below, those of 'junior high school and above observed an OR of 1.40 (95% CI: 1.09-1.81). And in further trend χ² test, we identified a trend of such association (χ² trend = 12.74, P = 0.002). However, no significant association has been recognized between per capita household yearly income and optimal blood pressure control: compared with patients in the category of < 5 000 Yuan group, those of 5 000-14 999 Yuan and ≥ 15 000 Yuan groups had OR of 0.93 (95% CI: 0.72-1.20) and 1.04 (95% CI: 0.83-1.31) respectively.</p><p><b>CONCLUSION</b>Among all diagnosed hypertension patients, those with lower education level have poorer blood pressure control and should be labelled as the key population for intense health education and standardized management to improve their blood pressure control status.</p>
Subject(s)
Humans , Alcohol Drinking , Blood Pressure , Body Mass Index , Demography , Education , Feeding Behavior , Fruit , Hypertension , Income , Logistic Models , Metabolic Syndrome , Smoking , Social Class , Treatment Outcome , VegetablesABSTRACT
<p><b>OBJECTIVE</b>To evaluate the cognition and emotional response of the public in Zhejiang province during the epidemic of human H7N9 avian influenza and provide scientific support for group psychological intervention under public health emergency.</p><p><b>METHODS</b>57 communities in 19 counties from Hangzhou, Jiaxing and Lishui district of Zhejiang province were selected as survey sites using stratified clustered sampling method from March, 2013 to April, 2014. 2 319 ordinary civilians were chosen using convenience sampling method and 390 individuals who had close contact history with H7N9 avian influenza patients, 109 family members of patients and 281 medical workers, were selected using census method. The inclusion criteria for subjects were: subjects aged over 10 years; could complete the questionnaire independently or with the help of the investigators. A total of 2 709 subjects were surveyed by avian influenza risk perception and response questionnaire, negative emotion questionnaire was also used to see their cognition and negative emotion related to the disease. Spearman correlation analysis was used to analyze the interrelationship between public risk perception, response and negative emotions.</p><p><b>RESULTS</b>95.10% (2 576)of the subjects have sensed the risk of epidemic and 91.00% (2 465) of the subjects have taken preventive measures in 2 709 subjects. The positive rate for depression, neurasthenia, fear, anxiety and hypochondriasis were 36.40% (986) , 37.21% (1 008) , 79.70% (2 159) , 33.41% (905) , 27.69% (750) respectively (χ(2)=1 935.89, P<0.001) ;the P(50)(P(25)-P(75)) of the depression scores of patients' family members, medical workers and the general public were 0.50 (0.00-0.83), 0.17 (0.00-0.67), 0.17 (0.00-0.50) (H= 7.27, P=0.03) ; the neurasthenia scores were 0.20 (0.00-0.60), 0.2 (0.00-0.40), 0.00 (0.00-0.20) (H= 64.74, P<0.001) ; fear scores were 0.83 (0.33-1.17), 0.33 (0.17-0.67), 0.33 (0.17-0.83) (H=30.03, P< 0.001) ; anxiety scores were 0.17(0.00-0.50), 0.00(0.00-0.33), 0.00(0.00-0.17) (H=51.82, P<0.001). The neurasthenia, fear, anxiety scores (P(50)(P(25)-P(75))) for females among the public were 0.00(0.00-0.20), 0.50(0.17-0.83), 0.00(0.00-0.17), which were higher than those of male's (0.00(0.00-0.20), 0.33(0.00-0.67), 0.00(0.00-0.17)) (χ(2) values were 5.26, 27.52, 8.29, P<0.05); Among medical staff, the depression, neurasthenia, fear, anxiety and hypochondriasis scores for females were 0.33(0.00-0.67), 0.20(0.00-0.40), 0.50(0.17-0.83), 0.00(0.00-0.33), 0.00(0.00-0.50) respectively, which were higher than those of males'(0.00(0.00-0.50), 0.00(0.00-0.40), 0.33(0.17-0.50), 0.00(0.00-0.17), 0.00(0.00-0.00))(χ(2) values were 7.22, 7.97, 14.46, 4.93, 5.22, P<0.05); for the family members of the patients who were in poor mental conditions when doing self-assessment, their depression and neurasthenia scores were 0.50(0.08-0.96), 0.30(0.00-0.55), which were higher than those of people in good mental conditions (0.17(0.00-0.83), 0.20(0.00-0.60)) (χ(2) values were 12.95, 11.20, P<0.05). Spearman correlation analysis showed that the subjects' risk perception level was positively correlated with depression, neurasthenia, fear, and hypochondriasis, with the correlation coefficients 0.07, 0.07, 0.08, 0.04, respectively (P<0.05) ; the subjects' risk response level was also positively related with depression, neurasthenia, fear, anxiety and hypochondriasis, and the correlation coefficients were 0.09, 0.09, 0.12, 0.05, 0.04, respectively (P<0.05).</p><p><b>CONCLUSION</b>The general public was highly concerned about the epidemic of H7N9 avian influenza and developed certain levels of negative emotions. The female, equal or over 60 years old, those with poor educational level, agricultural related occupation and poor physical and psychology health were risk factors of disease related negative emotions. The subject's risk perception and response level was positively related with depression, neurasthenia, fear and hypochondriasis.</p>
Subject(s)
Female , Humans , Male , Anxiety , China , Depression , Epidemics , Family , Fear , Hypochondriasis , Influenza A Virus, H7N9 Subtype , Influenza, Human , Psychology , Neurasthenia , Occupations , Risk Factors , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To understand the prevalence of dyslipidemia among non-overweight adults and related factors in Zhejiang province.</p><p><b>METHODS</b>A total of 10 868 non-overweight adults (aged ≥18 years and BMI<24.0 kg/m²) included in a population-based cross-sectional survey on metabolic syndrome in Zhejiang province in 2010 were selected to conduct questionnaire survey, health examination and blood fat detection.</p><p><b>RESULTS</b>The overall prevalence of dyslipidemia in this population was 41.38%. The prevalence was significantly higher in males (43.19%) than in females (39.84%) (χ² = 12.53, P < 0.001). The prevalence of dyslipidemia significantly decreased in males (trend χ² = 47.61, P < 0.001) but increased in females (trend χ² = 3.88, P < 0.05) with age. There was no significant difference in the prevalence between urban area (41.21%) and rural area (41.49%) (χ² = 0.08, P = 0.774). Multiple logistic regression analysis showed that sex, family history of chronic diseases, smoking, alcohol use, high meat and egg diet, cooking with animal oil, physical activity, central obesity and BMI were factors related to prevalence of dyslipidemia.</p><p><b>CONCLUSION</b>The prevalence of dyslipidemia was high among the non-overweight adults in Zhejiang, and family history, smoking, high-fat diet, physical inactivity, central obesity seemed to be the major risk factors.</p>