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Objective:To identify the risk factors of heart failure in elderly patients with hip fracture by Meta-analysis.Methods:The clinical studies on perioperative heart failure in elderly patients with hip fracture were searched by computer in Pubmed, EMbase, Cochrane Library, Medline, Web of Science, CNKI, CBM, Wanfang and VIP database. The retrieval period was from the establishment of the databases to October 2021. The literature screening, data extraction and quality evaluation were completed by two researchers, and the selected literature were statistically analyzed by RevMan5.3 software.Results:A total of 17 articles were included in this study, involving 1 76 611 patients and 24 related risk factors. Cardiac history ( OR= 4.47, 95% CI 3.56-5.62), positive balance of perioperative inflow and outflow ( OR=5.99, 95% CI 3.30-10.87), anemia ( OR= 3.78, 95% CI 2.50-5.69), and the number of complications >4 ( OR=6.21, 95% CI 3.71-10.38), electrolyte disorder ( OR=7.40, 95% CI 3.77-14.54), preoperative cognitive impairment ( OR=3.60, 95% CI 1.39-9.31) and American Society of Anesthesiologists (ASA) grade ≥ 3 ( OR= 4.73, 95% CI 2.73-8.12) were statistically significant risk factors ( P<0.05). Conclusions:Cardiac history, positive balance of perioperative inflow and outflow, anemia, number of complications >4, electrolyte disorder, preoperative cognitive impairment and ASA grade ≥3 were the risk factors of perioperative heart failure in elderly patients with hip fracture.
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The formation of most proteins consists of two steps: the synthesis of precursor proteins and the synthesis of functional proteins. In these processes, propeptides play important roles in assisting protein folding or inhibiting its activity. As an important polypeptide chain coded by a gene sequence in lipase gene, propeptide usually functions as an intramolecular chaperone, assisting enzyme molecule folding. Meanwhile, some specific sites on propeptide such as glycosylated sites, have important effect on the activity, stability in extreme environment, methanol resistance and the substrate specificity of the lipase. Studying the mechanism of propeptide-mediated protein folding, as well as the influence of propeptide on lipases, will allow to regulate lipase by alternating the propeptide folding behavior and in turn pave new ways for protein engineering research.
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Lipase/metabolism , Molecular Chaperones/metabolism , Protein Folding , Protein Precursors , Substrate SpecificityABSTRACT
@#The diagnosis and management of congenital heart disease (CHD), the most common inborn defect, has been a tremendous success of modern medicine. With the development of diagnostic techniques, surgical procedures and interventional techniques, more than 90% of CHD children can survive to adulthood. Consequently, the prevalence of patients with CHD has shifted away from infancy and childhood towards adulthood. Adult CHD cardiology is now encompassing not only young or middle-aged adults but also patients aged above 60 years. Standardized guidelines can provide good theoretical support for the comprehensive management of adult CHD. Ten years after the European Society of Cardiology guidelines for the management of grown-up CHD released in 2010, the new version was officially released in August 2020. The new version of guidelines updated the classification and stratification of diseases, comprehensive intervention methods and intervention timing, and put forward some new concepts, new intervention standards and methods. For adult CHD that has not been repaired or needs to be repaired again, the indication and mode of surgical intervention and perioperative management have a great impact on the prognosis. The new version of the guidelines provides a detailed description of the surgical and intervention indications and methods for different diseases, and clarifies the management methods for high-risk groups. This article attempts to interpret this newly updated guideline from the perspective of a surgeon, sort out several key diseases introduced by the guideline, and strives to provide a concise and actionable guideline for domestic counterparts.
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Objective: To investigate the effects of lycopene on glycolipid metabolism and pancreatic tissue inflammation in obese mice and its underlying mechanism. Methods: The obese mouse model was induced by a high-fat diet (HFD). The effects of lycopene on body weight, blood glucose, blood lipid and body fat were observed after 8 weeks of administration. Pathological changes of pancreas were observed by HE staining. Protein expressions involved in TLR4/MyD88/NF-κB signaling pathway were detected by Western blotting, and the degree of macrophage infiltration in the pancreatic tissues of obese mice were detected by IHC. Results: Lycopene significantly inhibited body weight gain and reduced fasting blood glucose, as well as improved glucose tolerance and blood lipid level in obese mice. In addition, lycopene also reduced vacuolization, edema degeneration, islet hypertrophy and other inflammatory lesions in pancreatic tissues. Moreover, the protein expression levels of TLR4, MyD88 and NF-κB in pancreatic tissue were decreased and the inflammatory infiltration was reduced. Conclusion: Lycopene can improve blood glucose, lipid metabolism and pancreatic inflammation in obese mice, and its mechanism may be related to the regulation of TLR4/MyD88/NF-κB signaling pathway.
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Objective Analyze the correlation of depression between the childhood abuse behavior and adulthood cyberbullying behavior, so as to discuss and provide evidences for preventing the cyberbullying behavior of college students. Methods A total of 4 040 college students were surveyed after multistage stratified cluster random sampling from 6 universities in Shanxi Province of China by using childhood trauma questionnaire, self-rating depression scale and cyberbullying scale. Results In the three dimensions of cyberbullying, cyber-verbal bullying behavior, identity concealing behavior and cyber-forgery fraud behavior, male students and only child students scored higher than that of female students and non-only child students (all P<0.001). There was a positive correlation between childhood abuse, adult depression and cyberbullying (all P<0.001). The mediation effect results showed that depression symptoms of college students were mediating between childhood abuse experience and cyberbullying behavior (the mediation effect result was 0.090, P<0.001), the mediation effect contributed 12.16% to the total effect, the mediation model fitting index were 2/df=39.96，RMSEA=0.101，CFI=0.948，TLI=0.924，SRMR=0.043. Conclusions Childhood abuse experience and adulthood depression are closely related to the implementation of cyberbullying behavior in college, and depression plays part of mediating role in predicting the implementation of cyberbullying behavior in college students who has childhood abuse experience.
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ObjectiveTo investigate the clinical features of patients with Caroli disease. MethodsThe clinical data were collected from 41 patients who were diagnosed with Caroli disease in The Fifth Medical Center of Chinese PLA General Hospital from April 2015 to January 2020, and the patients were divided into type I group with 16 patients and type Ⅱ group with 25 patients. A retrospective analysis was performed for general information, laboratory markers, and clinical features. The independent samples t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data; a Spearman correlation analysis was also performed. ResultsThe type Ⅰ group had a significantly higher level of albumin (Alb) than the type Ⅱ group (t=0.976, P=0.048), and the type Ⅱ group had a significantly higher prothrombin time (PT) than the type I group (Z=3.115, P=0.001). Compared with the type I group, the type Ⅱ group had significantly higher incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (χ2=6.077, 5.468, and 2.403, P=0.002, 0.019, and 0.028). In the patients with type Ⅱ Caroli disease, the level of cholinesterase was negatively correlated with the incidence rates of esophageal and gastric varices and portal hypertension (r=-0.468 and -0.436, P=0.018 and 0.029); Alb level was negatively correlated with the incidence rate of esophageal and gastric varices (r=-0.561, P=0.004); red blood cell count was negatively correlated with the incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (r=-0.662, -0.566, and -0.436, P＜0.001, P=0.003, and P=0.029); hemoglobin count was negatively correlated with the incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (r=-0.605, -0.590, and -0.510, P=0.001, 0.002, and 0.009); PT was positively correlated with the incidence rates of esophageal varices and portal hypertension (r=0.488 and 0.520, P=0.013 and 0.008). ConclusionCompared with the patients with type I Caroli disease, the patients with type Ⅱ Caroli disease have a higher incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension, with the changes in clinical indicators such as the decrease of Alb level and the increase of PT level, and they tend to have poor prognosis.
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ObjectiveTo investigate the features and changing trend of drug-induced liver injury (DILI) in the elderly from 2009 to 2019, and to provide a reference for clinical prevention and treatment of DILI in the elderly. MethodsA retrospective analysis was performed for the clinical data of 2107 elderly patients, aged ≥60 years, who were diagnosed with DILI in The Fifth Medical Center of Chinese PLA General Hospital from January 2009 to December 2019, and they were divided into groups according to age. Related clinical data were analyzed, including age, sex, clinical features, prognosis, and regional distribution. The Chi-square test was used for comparison of categorical data between groups. ResultsAmong the 2107 patients with DILI, there were 802 male patients and 1305 female patients, with a male/female ratio of 1∶1.63. Cholestasis type was the most common clinical type and was observed in 1439 patients (68.3%). There was the highest number of patients in the 60-64 years group (942 patients, 44.7%), among whom 618(65.6%) were female, 589(62.5%) had cholestasis type, 471(50.0%) had chronic DILI, 421(44.7%) had drug-induced liver cirrhosis, and 25(2.7%) had drug-induced liver failure. There were 187 patients in the 75-79 years group, among whom 110 (58.8%) patients were male, 137(73.3%) had cholestasis type, 114(60.9%) had liver cirrhosis, 4(2.1%) had drug-induced liver failure. The results showed that chronic DILI was more common in the 60-64 years group, and liver cirrhosis was more common in the 75-79 years group. As for prognosis, in the 60-64 years group, 27 patients (2.9%) were cured, 885 (93.9%) were improved, 30(32%) had no response or died; in the 65-69 years group, 16 (2.8%) were cured, 528 (92.0%) were improved, and 30(5.2%) had no response or died; in the 70-74 years group, 9(2.8%) were cured, 305(94.1%) were improved, and 10 (3.6%) had no response or died. The results showed that there was no significant difference in mortality rate between the different age groups (P＞0.05). The proportion of elderly DILI patients among hospitalized DILI patients increased from 15.90% in 2009 to 22.05% in 2013 and 27.51% in 2019, with a 1.73-fold increase in 11 years. As for regional distribution, the patients in North China accounted for the highest proportion of 47.08% (the patients from Hebei, Shanxi, and Inner Mongolia accounted for 24.92%, 10.96%, and 10.25%, respectively), followed by those in Northeast China who accounted for 17.85%. The patients in Beijing accounted for 11.53%. ConclusionThe proportion of elderly DILI patients among hospitalized DILI patients tends to increase in these years. Cholestasis type is the most common clinical type, and most of the patients with this clinical type progress to chronic DILI and drug-induced liver cirrhosis. Early diagnosis, early intervention, and standardized treatment of elderly DILI should be taken seriously.
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Icariin (ICA) is one of the main active ingredient,isolated from Herba epimedii of Chinese medicine plant.It is generally used to treat osteoporosis,kidney dificiency and others.In this paper,the pharmacological effects of Icariin were summarized in the fields of anti-osteoporosis,antitumor,immunomodulation,improving reproduction,lowering blood sugar and protecting nervous system in the literatures.This paper provides a basic understanding of icariin for future studies.
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Objective To validate the analysis capability of RapidHITTM 200 system for four kinds of routine forensic samples and the recyclable capability of template, template DNA and PCR products in the process of twice duplicate detection. Methods The buccal swabs underwent the test twice by RapidHITTM 200 system, and the template DNA and PCR products that arose in the system were also tested for two times. After four kinds of routine forensic samples were detected by RapidHITTM 200 system, the follow-up tests of the template, template DNA and PCR products that arose in the system were performed. Re-sults The STR loci could be detected in the buccal swabs by the system for the first time. However, part of the STR loci lost during the second test. And the peak value obtained in the second test was significantly reduced than the one in the first time. The average STR loci detection rates of the template DNA and PCR products were both less than 50％ in the second test, which were significantly reduced than that in the first test. In addition, the analysis capability of the system for the tissues and buccal swabs was better than that for the blood and cigarette butts. Compared with the first test, the STR loci detection rate of the tested items, template DNA and PCR products decreased with the numbers of tests. Conclusion RapidHITTM 200 system is more effective in retesting buccal swabs than other samples, whereas the items, DNA template, PCR products obtained in the first and second time cannot be directly used for the further application and study of forensic medicine.
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In2O3nanoparticles-modified multiwalled carbon nanotubes (In2O3-MWCNTs) were successfully prepared as solid phase extraciton (SPE) adsorbent for the determination of three food preservatives(benzoic acid,sorbic acid,and methylparaben) in beverage samples coupled with high performance liquid chromatography (HPLC).Because of the large surface area and amount of hydroxyl groups on the surface of In2O3nanoparticles,In2O3nanoparticles could interact with specific functional groups.In2O3-MWCNTs adsorbent was prepared based on the large surface area of In2O3and superior thermal and chemical stability of MWCNTs.The obtained adsorbent was characterized via transmission electron microscope (TEM),thermogravimetric analysis (TGA),and Fourier transform-infrared (FT-IR) spectroscopy.Several experimental parameters affecting the extraction efficiency were investigated by single-factor experiments,such as adsorbents amount,sample volume,eluent volume,sample pH,and eluent type.The first four factors were then further evaluated by means of a Taguchi's L16(44) orthogonal array experimental design.According to the results of orthogonal array experiment,the optimal conditions were chosen as follows: 0.15 g of adsorbent amount,5.0 mL of sample volume,0.6 mL of ACN-H2O (60:40,0.1% formic acid,V/V) as eluent,and sample pH 4.0.Under the optimum conditions,the LODs (S/N=3) and LOQs (S/N=10) for three preservatives were in the range of 0.004-0.012 μg/mL and 0.012-0.038 μg/mL,respectively.The recoveries ranged from 70.2% to 109.4%.The method is rapid,sensitive,and suitable for the determination of preservatives in food samples.
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Objectives: To analyze the relationship between lung ultrasound B line and NT-proBNP, E/e' in order to explore the accuracy of B lines for diagnosing pulmonary edema in patients with acute heart failure (AHF). Methods: A total of 124 AHF patients admitted in out hospital from 2016-02 to 2017-02 were enrolled. According to the number of B line, patients were divided into 3 groups: Mild pulmonary edema group, patients with B line<15, Moderate pulmonary edema group, 15≤B line<30 and Severe pulmonary edema group, B line≥30. Basic clinical condition and echocardiography parameters were compared among 3 groups; relationships between B line and NT-proBNP, E/e', EF, pulmonary artery pressure were analyzed respectively; the sensitivity and specificity for B-line diagnosing NT-proBNP≥5000 pg/ml and E/e'≥14 were evaluated by ROC curve analysis. Results: Compared with Mild and Moderate pulmonary edema groups, Severe pulmonary edema group had the severer NYHA grade, more wet rale, higher NT-proBNP level and more chest X-ray of pulmonary congestion, P<0.05. Compared with Mild pulmonary edema group, Moderate and Severe pulmonary edema groups had decreased LVEF, P<0.05; Severe pulmonary edema group showed increased diastolic function such as elevated E/A, pulmonary artery pressure and E/e',P<0.05.B line was positively related to NT-proBNP,E/e'and pulmonary artery pressure,negatively related to EF.B line had the best correlation to NT-proBNP (r=0.803, P<0.001), the next was E/e'(r=0.794, P<0.001) and the worst was pulmonary artery pressure (r=0.330, P<0.001). The cutoff values of B line for diagnosing NT-proBNP≥5000pg/ml and E/e'≥14 were both 30, the AUC of ROC=0.823 and 0.768 respectively. Conclusions: Lung ultrasound B line had good correlation to NT-proBNP and E/e', which could accurately assess the pulmonary edema in AHF patients.
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Objective:This study is conducted to analyze the impact of county medical alliance on patient flows under the NRCMS in Dingyuan county of Anhui province. Methods: data on patient-flow were collected through the NRCMS information platform and related policy documents for 2015-2016, and interviews were conducted to study the main reform practices in the county medical alliance. Results: The patient flow under the NRCMS varied in the way of 1) the total number of inpatients seeking treatment outside of the county decreased by 3.31%;2) the treat-ment volume of county-level hospitals and township health centers were increasing,and the latter one is growing faster than the former,meanwhile,the treatment volume of the village clinics declined,and 3) the hospitalization expenses per inpatient for patients who seek treatment outside the county are much higher than the expenses incurred within the county. Conclusions:the development of county-level medical alliance has influence on patients with common disea-ses who used to seek treatment by helping to reduce the number of inpatients outside the county and reduce the pres-sure of the new rural cooperative fund. However, significant problems still exist such as shortage of talented practi-tioners,and lagging development of information technology system.
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Objective: To compare the clinical features between very late stent thrombosis (VLST) and very late in-stent restenosis, to discuss the potential risk factors for VLST occurrence. Methods: Our research included in 2 groups: VLST group, 21 ACS patients with coronary angiography (CAG) confirmed VLST admitted in our hospital and Control group, 38 ACS patients with CAG confirmed very late in-stent restenosis at same period of time. Basic clinical data, laboratory tests and relevant examinations were compared between 2 groups; potential risk factors for VLST occurrence were studied by Logistic regression analysis. Results: ① There were 8 (38.1%) patients discontinued anti-platelet therapy in a month by themselves in VLST group and 5 (13.2%) in Control group, P=0.03. ② 13 (61.9%) patients presented as ST-segment elevation myocardial infarction (STEMI) in VLST group, while all (100%) patients presented as Non-ST-segment elevation ACS (NST-ACS) in Control group, P<0.001. ③ The age, gender, previous histories of hypertension, diabetes, MI, smoking and interventional therapy were similar between 2 groups, P>0.05. ④ Compared with Control group, VLST group had decreased LVEF, P=0.001, increased peak values of TnI and NT-pro BNP, elevated WBC and hs-CRP, all P<0.001. ⑤ The index of echocardiography, blood lipid profiles, glucose and creatinine were similar between 2 groups, P>0.05. ⑥ Logistic regression analysis showed that discontinued anti-platelet therapy, elevated NT-pro BNP and hs-CRP were the independent risk factors for VLST occurrence, P<0.05. Conclusion: VLST may have life-threatening clinical features, insisted anti-platelet therapy and improved cardiac function could reduce VLST occurrence.
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Objective To investigate the effect of oxcarbazepine(OXC) and sodium valproate(VPA) on electroencephalogram(EEG) and peripheral blood levels of homocysteine(Hcy) and asymmetric dimethylarginine(ADMA) in adult patients with partial epilepsy.Methods From May.2014 to May.2015,a total of 100 patients with partial epilepsy were enrolled and randomly divided into treatment group(treated with OXC) and control group(treated with VPA),with 50 cases in each group.After treatment,changes of EEG indices,Hcy,ADMA,cognitive function and adverse reaction were analyzed.Results Before treatment,there was no significant difference of EEG indices between the two groups(P>0.05).After treatment,the incidence rates of α wave decreasing more than 0.5 Hz,increasing of θ wave and increasing of δ wave were significantly different(P0.05).After treatment,serum Hcy and ADMA levels were both significantly increased(P0.05).After treatment,MMSE score of treatment group was higher than that of control group(P<0.05).In treatment group,there were 1 case of skin rash and 2 cases of gastrointestinal discomfort,which were self-improved.In control group,there were 3 cases of dizziness,5 cases of skin rash and 1 case of gastrointestinal discomfort,which were self-improved.Conclusion The effects of OXC and VAP on peripheral blood levels of Hcy and ADMA could be similar,and compared with VAP,OXC could significantly improve cognitive function in patients with epilepsy.
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Objective To optimize the ethanol extraction technology ofLichong ShengsuiDecoction.Methods An L9(34) orthogonal test was used in the study. The extraction rates of calycosin glycoside, icariin, baohuosideⅠ, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, astragaloside, and ginsenoside Rd were set as indexes. The influence of ethanol concentration, extraction time, extraction temperature, and amount of ethanol on the yield of Lichong ShengsuiDecoction were detected by comprehensive scoring method.Results The optimal ethanol extraction technology forLichong ShengsuiDecoction was soaking for 2 h with ten times of 60% ethanol and then reflux extracting for two times; extraction time was 1.5 h each time at 80℃.ConclusionThe optimal extraction technology is efficient, stable and feasible, which can provides data for the further study ofLichong ShengsuiDecoction.
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Objective To investigate and compare the clinical efficacies of acupuncture at myofascial trigger points and extracorporeal shock wave and their effects on the quality of life in patients with myofascial pain syndrome. Method Seventy-eight patients with myofascial pain syndrome were allocated, using a random number table, to acupuncture and shock wave groups, 39 cases each. The two groups received acupuncture at myofascial trigger points and extracorporeal shock wave, respectively. The clinical therapeutic effects were compared between the two groups of patients after 20 consecutive days of treatment. The quality of life score was recorded in the two groups of patients before and after one month of treatment. Result The VAS score (1.57±0.83), the PRI score (1.87±1.06) and the PPI score (0.94±0.72) in the acupuncture group were lower than the VAS score (2.16±0.95),the PRI score (2.68±1.14) and the PPI score (1.53±0.81) in the shock wave group. All had a statistically significant difference (P<0.05). The VAS score, the PRI score and the PPI score decreased significantly in the two groups of patients after treatment compared with before. Eight scaled scores: physical functioning, physical role functioning, bodily pain, social role functioning, vitality, general health perceptions, emotional role functioning and mental health increased significantly in the two groups of patients after treatment compared with before (P<0.05) and increased more in the acupuncture group (P<0.05). The marked efficacy rate was 84.6% in the acupuncture group, which was significantly higher than 61.5% in the shock wave group (P<0.05). Conclusion Both acupuncture and extracorporeal shock wave therapy have a marked clinical effect on myofascial pain syndrome. It can further improve the quality of life in the patients.
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Objective To explore the effect of enriched environmental stimulation on mouse brain cognitive reserve to enhance the sensitivity of brain age gap estimation (BrainAGE).Methods Twenty-one healthy adult C57BL / 6J male mice,15 months old,were divided into a group with a standard environment and two groups with enriched environments.All the groups underwent magnetic resonance microcopy.Scaled subprofile model was used to analyze the features reflecting the changes of brain cognitive reserve.Results There were significant differences between the mean BrainAGE of the two groups with enriched environments and that of the remained standard environment group,then it's proved that some assumption might be reasonable that brain cognitive reserve could be estimated based on BrainAGE.Optim ized BrainAGE model made explanations for 58.9％ differences during stimulus phase in enriched environment.Conclusion Improved BrainAGE model gains high sensitivity when used to measure the redundancy of brain cognitive reserve.
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Objective To explore the effect of enriched environmental stimulation on mouse brain cognitive reserve to enhance the sensitivity of brain age gap estimation (BrainAGE).Methods Twenty-one healthy adult C57BL / 6J male mice,15 months old,were divided into a group with a standard environment and two groups with enriched environments.All the groups underwent magnetic resonance microcopy.Scaled subprofile model was used to analyze the features reflecting the changes of brain cognitive reserve.Results There were significant differences between the mean BrainAGE of the two groups with enriched environments and that of the remained standard environment group,then it's proved that some assumption might be reasonable that brain cognitive reserve could be estimated based on BrainAGE.Optim ized BrainAGE model made explanations for 58.9％ differences during stimulus phase in enriched environment.Conclusion Improved BrainAGE model gains high sensitivity when used to measure the redundancy of brain cognitive reserve.
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<p><b>BACKGROUND</b>The prevalence of developmental dysplasia of the hip (DDH) is unknown in China. We aimed to determine the prevalence of DDH in Chinese adults.</p><p><b>METHODS</b>In this study, we performed a cross-sectional survey of a nationally representative sample of Chinese adults. All participants underwent questionnaire investigation, physical examination, and X-ray examination. Factors associated with DDH were analyzed with logistic regression.</p><p><b>RESULTS</b>We invited 29,180 individuals aged 18 years and over to participate, randomly selected from 18 primary sampling units (street districts in urban areas and townships in rural areas). The survey and examination were completed in 25,767 people (10,296 men and 15,471 women). DDH was diagnosed in 391 people, yielding an overall DDH prevalence of 1.52%. Based on this information, we estimate the number of individuals with DDH in China to be approximately 16.05 million. DDH prevalence increased with age (odds ratio = 1.53 [1.03-2.27], P = 0.036), was significantly higher among women than men (2.07% vs. 0.75%, P< 0.001), and was higher among rural residents than urban residents (1.75% vs. 1.29%, P< 0.001). Economic development was independently associated with the presence of DDH. There was no evidence of an association between body mass index alone, education, or current smoking or drinking and risk of DDH (P > 0.05).</p><p><b>CONCLUSIONS</b>DDH has become an important public health problem. Special attention should be paid to residents with DDH. Screening for DDH should be performed in China.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Age Distribution , Body Mass Index , China , Epidemiology , Cross-Sectional Studies , Hip Dislocation, Congenital , Epidemiology , Logistic Models , Multivariate Analysis , Prevalence , Risk Factors , Sex DistributionABSTRACT
<p><b>BACKGROUND</b>Nontraumatic osteonecrosis of the femoral head (NONFH) is a debilitating disease that represents a significant financial burden for both individuals and healthcare systems. Despite its significance, however, its prevalence in the Chinese general population remains unknown. This study aimed to investigate the prevalence of NONFH and its associated risk factors in the Chinese population.</p><p><b>METHODS</b>A nationally representative survey of 30,030 respondents was undertaken from June 2012 to August 2013. All participants underwent a questionnaire investigation, physical examination of hip, and bilateral hip joint X-ray and/or magnetic resonance imaging examination. Blood samples were taken after overnight fasting to test serum total cholesterol, triglyceride, and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels. We then used multivariate logistic regression analysis to investigate the associations between various metabolic, demographic, and lifestyle-related variables and NONFH.</p><p><b>RESULTS</b>NONFH was diagnosed in 218 subjects (0.725%) and the estimated NONFH cases were 8.12 million among Chinese people aged 15 years and over. The prevalence of NONFH was significantly higher in males than in females (1.02% vs. 0.51%, χ2 = 24.997, P < 0.001). Among NONFH patients, North residents were subjected to higher prevalence of NONFH than that of South residents (0.85% vs. 0.61%, χ 2 = 5.847, P = 0.016). Our multivariate regression analysis showed that high blood levels of triglycerides, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol, male, urban residence, family history of osteonecrosis of the femoral head, heavy smoking, alcohol abuse and glucocorticoid intake, overweight, and obesity were all significantly associated with an increased risk of NONFH.</p><p><b>CONCLUSIONS</b>Our findings highlight that NONFH is a significant public health challenge in China and underscore the need for policy measures on the national level. Furthermore, NONFH shares a number of risk factors with atherosclerosis.</p>