Mechanism of cytotoxic T lymphocyte－derived exosomes inhibiting hepatic stellate cell activation / 临床肝胆病杂志

ObjectiveTo investigate whether cytotoxic T lymphocyte （CTL）－derived exosomes can downregulate HBx expression and inhibit hepatic stellate cell （HSC） activation. MethodsThe supernatants of HepG2， HepGA14， and CTL cells were collected to extract exosomes， which were referred to as NC－exo， HBV－exo， and CTL－exo， respectively）. Transmission electron microscopy was used to observe their morphology， and Western Blot was used to measure the expression of the markers of exosomes CD63 and TSG101. NC－exo， HBV－exo， and CTL－exo labeled by BODIPY dye were mixed with HBV－exo at different ratios and were then co－cultured with HSC LX－2 （HSC－LX2）. A fluorescence microscope was used to observe whether exosomes could enter LX－2 cells， and an fluorescence microscope was used to observe cell morphological changes； quantitative real－time PCR （qPCR） was used to measure the expression of the activated biomarkers such as transforming growth factor－β1 （TGF－β1）， ɑ－smooth muscle actin （ɑ－SMA）， and collagen type I （Collagen I） in LX－2 cells. CTL－exo was added to the HepGA14 culture system； then qPCR was used to measure the mRNA expression level of HBV DNA， cccDNA， and HBx in exosomes in HepGA14 cells， and Western Blot was used to measure the protein expression level of HBx in exosomes. The t-test was used for comparison of normally distributed continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsThe exosomes were all microcysts with a double－layer membrane structure and were circular or elliptical in shape， with the expression of the signature proteins CD63 and TSG101， and the vesicles had a diameter of 50－100 nm. The fluorescence microscope showed that exosomes could enter LX－2 cells， and HSC were enlarged with extended cell processes. The results of qPCR showed that there were significant differences in the expression levels of TGF－β1， ɑ－SMA， and Collagen I genes between the NC－exo， HBV－exo， NC－exo+HBV－exo， and Con groups （F=444.678， 417.144， and 571.508， all P<0.05）. After the intervention of HepGA14 cells with CTL－exo， qPCR results showed that compared with the control group， there were significant reductions in the expression levels of HBV DNA and cccDNA in HepGA14 cells （all P<0.05）， the relative mRNA expression level of HBx in exosomes （P<0.05）， and the protein expression level of HBx （P<0.05）. CTL－exo and HBV－exo were mixed at different ratios （2∶1， 5∶1， 10∶1） and were then used for the intervention of LX－2 cells， and qPCR results showed that the expression levels of TGF－β1， ɑ－SMA， and Collagen I genes in LX－2 cells gradually decreased with the increase in the ratio of CTL－exo between groups （P<0.05）. ConclusionCTL－exo can downregulate the protein expression of HBx in HBV－exo to inhibit HSC activation， suggesting that CTL－exo has an anti－hepatitis B liver fibrosis effect.

Survey on health literacy and influencing factor of family caregivers of chronic disease patients in Beijing / 中华全科医师杂志

Objective:To survey the health literacy and related factors of family caregivers of patients with chronic diseases in Beijing.Methods:A survey was conducted from September to November 2018, among 1 350 family caregivers of patients with chronic diseases selected by stratified random sampling from 6 districts of Beijing. A self-filling questionnaire was used for the survey, which consisted of the basic information and health literacy of family caregivers. Health literacy included three parts: daily living habits, basic knowledge (knowledge of prevention and management of behavioral risk factors, knowledge related to chronic diseases and knowledge related to first aid) and chronic disease-related skills.Results:A total of 1 268 valid questionnaires were collected with a recovery rate of questionnaires was 93.9%. The median age of 1 268 family caregivers was 62 years (23-86) and 75.7% (960/1 268) were females. In terms of daily habits, smokers and drinkers accounted for 11.3% (143/1 268) and 21.5% (272/1 268) respectively; 82.7% (1 049/1 268) caregivers exercised regularly accounted, of whom 72.5% (761/1 049) exercised at least 4 times a week; 28.9% (366/1 268) caregivers had habit of light diet. In terms of basic knowledge of health literacy, 12.9% (163/1 268) of family caregivers mastered the basic knowledge (≥80% total score); family caregivers who were able to measure blood pressure, blood sugar, pulse, coping with hypoglycemia, cardiopulmonary resuscitation and dialing the emergency number correctly accounted for 27.4% (347/1 268), 18.1% (230/1 268), 15.1% (191/1 268), 15.7% (199/1 268), 6.0% (76/1 268) and 33.8% (429/1 268), respectively. For the six chronic disease-related skills, 23.7% (301/1 268) were able to call emergency number correctly and only 2.6% (33/1 268) were able to perform CPR. There were significant differences in the knowledge of behavioral risk factors ( χ 2=3.88, P=0.017), chronic disease related knowledge ( χ2=7.40, P=0.025), first-aid related knowledge ( χ2=12.04, P=0.002) and overall basic knowledge ( χ2=13.56, P=0.001) among family caregivers with different educational levels. There were significant differences in the knowledge of chronic diseases among family caregivers in different occupations ( χ2=8.78, P=0.012). Conclusion:The health literacy level of family caregivers of patients with chronic diseases in Beijing needs to be further improved, and there are differences in the health literacy of family caregivers with different educational qualifications and occupations.

Analysis on the knowledge, attitude and practice of ophthalmic nurses′ on prevention of post-operative intraocular infections in grade Ⅲ class A hospitals / 中国实用护理杂志

Objective:To investigate the knowledge, attitude and practice status of ophthalmic nurses on prevention and control of intraocular infection in grade Ⅲ class A hospitals.Methods:A self-made questionnaire was used to investigate the knowledge, attitude and practice of 236 nurses on prevention and control of intraocular infection in the ophthalmology department of 8 grade Ⅲ class A hospitals in Zhengzhou from January to June 2020. The correlation between the knowledge, attitude and practice were analyzed by Pearson correlation analysis and the influencing factors of each term were analyzed by multivariate Logistic regression.Results:The scores of knowledge, attitude, practice of all nurses were (26.08 ± 2.46), (67.45 ± 8.48), (50.31 ± 6.67) points, and the scoring rate were (87.0 ± 8.2)%, (84.3 ± 10.1)%, (83.9 ± 9.8)%, respectively. The scores of each dimension of knowledge, attitude and practice were significantly positively correlated ( r values were 0.26-0.42, all P<0.05), respectively. Multivariate Logistic regression analysis showed that education background, professional title and training experience of infection were the influencing factors of knowledge score ( P<0.05), education background, professional title, training experience of infection and demand were the influencing factors of attitude score ( P<0.05), and nursing age and work post were the influencing factors of practice score ( P<0.05). Conclusions:The level of knowledge, attitude and practice of ophthalmic nurses in grade Ⅲ class A hospitals on prevention and control of intraocular infection is overall good. Hospital management department still needs to make reasonable management countermeasures according to personnel characteristics to improve the knowledge, attitude and practice level of ophthalmic nurses and to reduce post-operative intraocular infection.

Cross-sectional analysis of gonadal hormone expression and relevant factors in female centenarians in Hainan, China / 中南大学学报(医学版)

OBJECTIVES@#Gonadal hormone is essential for the health of postmenopausal women, however, few studies have focused on the epidemiological distribution of gonadal hormones in postmenopausal women in very late postmenopausal women. This study aims to investigate and analyze the differences of serum gonadal hormone content and its influential factors among female centenarians in Hainan, China.@*METHODS@#The questionnaire and physical examination data of 741 female centenarians and 401 elderly females in Hainan Province were collected, and venous blood samples were taken to detect the indexes of lipid metabolism, bone metabolism, and gonadal hormone. The differences of gonadal hormones and relavant factors in female centenarians were analyzed and compared.@*RESULTS@#The serum levels of estradiol and progesterone of female centenarians were significantly higher than those of the elderly females (both P<0.001). The serum levels of estradiol and testosterone of ethnic minority centenarians were higher than those in Han nationality (P<0.001), and the serum estradiol and testosterone concentrations were relatively higher when the daily activities were more than 10 min (both P<0.05). Serum estradiol concentration was negatively correlated with apolipoprotein A-I, high density lipoprotein, triglyceride and bone formation markers such as calcium, inorganic phosphorus and vitamin D3, and was positively correlated with the special sequence of β-collagen (markers of bone resorption) (all P<0.01).@*CONCLUSIONS@#For the extremely late postmenopausal women (such as centenarians), there may be characteristic expressions of gonadal hormones, especially estradiol. There is an unprotective correlation of serum estradiol with lipid metabolism index and bone metabolism index in female centenarians, so it is necessary to evaluate the estrogen content and the use of estrogen therapy in postmenopausal women.

Survey on the training needs of chronic diseases among family health care workers in Beijing / 中华全科医师杂志

Objective:To survey the training needs for chronic diseases among family health care workers in Beijing.Methods:A questionnaire survey on training needs for chronic disease was conducted from September to November 2018 among 820 family health care workers from 15 community health service centers in Beijing selected by stratified random sampling. The questionnaire consisted of demographic information and training needs related to chronic diseases. The training needs included: the knowledge and skills related to chronic diseases: the types of chronic diseases expected to learn, the basic knowledge of chronic diseases (7 items), preventive health care knowledge (7 items), nursing and rehabilitation skills (9 items); the duration, frequency, method, time and location of training arrangement.Results:The survey showed that chronic disease that family health care workers most wanted to learn was hypertension (90.3%, 717/794); among the basic knowledge of chronic diseases, the highest need was disease risk factor (65.5%, 520/794); among the knowledge of preventive health care, the highest need was home safety protection (87.3%, 693/794); among nursing and rehabilitation skills, the highest need was blood glucose measurement (83.1%, 660/794). The female respondents had higher training need for basic knowledge of chronic diseases than males ( Z=2.51, P=0.012). There were significant differences in the needs for preventive health care knowledge among respondents of different gender ( Z=2.72, P=0.007), occupation ( H=15.02, P=0.001) and educational level ( H=12.01, P=0.002). Respondents with different age ( H=6.49, P=0.039), occupation ( H=52.93, P<0.001) and educational level ( H=9.56, P=0.008)) had different needs for nursing and rehabilitation skills. Among the respondents, 58.2% (462/794) indicated that duration of each course should be 30-59 min, 34.0% (270/794) wanted to participate in the training once a month, 53.1% (422/794) wanted to participate in the training in the form of large class, 39.2% (311/794) were willing to participate in the training on working days and 48.7% (387/794) wanted to be trained in community health service institutions. Conclusions:There are diverse training needs of family health care workers. Attention should be paid to the implementation of need-oriented training. It is crucial to promote the motivation of family health care workers to participate in the training, which can improve the training effect and facilitate their role in family health management.

Study on the characteristics of immunoglobulin and complement expression in centenarians in Hainan / 中华老年医学杂志

Objective:To investigate the characteristics of serum immunoglobulin and complement levels in centenarians in Hainan.Methods:Fasting venous blood samples from 969 centenarians in Hainan province were collected and from 364 seniors serving as the control group.Levels of serum immunoglobulin A, G, M and E, immunoglobulin light chain κ and λ, and complement C3 and C4 were measured.Serum immunoglobulin and complement levels were analyzed in subjects based on age, sex, ethnicity, diet and smoking.Results:Serum levels of immunoglobulin G and E, and immunoglobulin light chain κ were higher in the centenarian group than in the control group[15.9(13.8, 18.3)g/L vs.14.9(13.1, 16.9)g/L; 270.0(85.5, 851.0) vs.180.5 kU/L(58.0, 556.2)kU/L, 4.1(3.5, 4.9)g/L vs.4.0(3.1, 4.6)g/L, P<0.05]. Serum levels of immunoglobulin M, and complement C3 and C4 were lower in the centenarian group than in the control group[1.0(0.7, 1.4)g/L vs.1.1(0.8, 1.5)g/L, 1.0(0.9, 1.2) vs.1.1(1.0, 1.3), 0.2(0.2, 0.3) vs.0.3(0.2, 0.3), P<0.05]. Serum levels of immunoglobulin M and complement C3 were higher in female centenarians than in male centenarians[1.1(0.7, 1.4) vs.1.0(0.7, 1.3), 1.0(0.9, 1.1) vs.1.0(0.8, 1.1), P<0.05]. There were significant differences in immunoglobulin A, G and E, and immunoglobulin light chain κ and λ between centenarians of different ethnicities( P<0.01). Serum immunoglobulin M levels were higher in centenarians with a long history of milk-drinking than in those without the history[1.2(0.8, 1.5) vs.1.0(0.7, 1.4), P<0.01]. Conclusions:Serum levels of immunoglobulins and complements are different among centenarians of different ages, genders, ethnicities and diet habits.Factors such as advanced age, female gender, ethnic minority and milk drinking tend to promote the expression of immunoglobulins and complements.

Application of chromosomal microarray analysis in prenatal diagnosis of pregnant women with advanced age / 中华医学遗传学杂志

OBJECTIVE@#To assess the value of chromosomal microarray analysis (CMA) for the detection of fetal anomalies among pregnant women with advanced age.@*METHODS@#CMA results of 562 cases, in addition with the outcome of pregnancy and neonatal follow-up were reviewed.@*RESULTS@#Among the 562 amniotic fluid samples, 73 cases (12.99%) of fetal chromosomal abnormalities were detected, which included 21 cases (3.73%) of chromosomal aneuploidies and 52 cases (9.25%) of copy number variations (CNVs). The latters included 27 cases of pathological CNVs (4.80%), 4 cases of possible pathogenic CNVs (0.71%) and 42 cases of variants with unknown clinical significance (7.47%). Compared with those under 35, the detection rate of fetal chromosomal aneuploidies for women with advanced age was higher under the indications of voluntary test, abnormal ultrasonic structures, abnormal ultrasonic soft index and risks indicated by non-invasive prenatal testing (NIPT). No significant difference was found in the detection rate of CNVs between those ≥35 and 0.05). 552 cases (98.22%) of pregnant women have completed the followed up. Among 31 women with pathological and possible pathogenic fetal CNVs detected by CMA, 25 had terminated the pregnancy, 6 (19.35%) have delivered without obvious abnormality. 41 pregnant women with fetal CNVs of unknown clinical significance have completed the follow up, among whom 3 had terminated the pregnancy, 1 newborn was found with malformation after birth, which yielded an abnormal pregnancy rate of 9.76%. 480 pregnant women with negative CMA results have completed the follow up, among whom 5 (1.04%) had abnormal pregnancy or delivered a child with birth defect.@*CONCLUSION@#There is a certain difference between the outcome of pregnancy predicted by CMA testing and the actual outcome. The pregnancies with fetal CNVs with unknown clinical significance detected by CMA have a high adverse rate, which should attract clinical attention. CMA testing should be recommended for pregnant women with advanced age regardless of whether they have other symptoms. CMA combined with other detection methods is the trend for prenatal diagnosis.

Effectiveness of TBL+ CBD method applied in the course teaching of Introduction to General Practice / 中华医学教育探索杂志

Objective:To verify the application value of team-based learning (TBL) joint case-based discussion (CBD) method applied in the course teaching of Introduction to General Practice.Methods:Students from two clinical oriented classes in the same grade were divided into the experimental group ( n=35) and the control group ( n=35). The control group implemented the traditional teaching method, and the experimental group implemented the TBL joint CBD method. The teaching effect were compared between the two groups. SPSS 20.0 was used for frequency description and statistical test analysis. Non-normal distribution data were tested with Mann-Whitney U test. Results:After the teaching, the average rank of multiple-choice questions (35.28) and analytic questions (42.24) in the experimental group were significantly higher than those of the control group (32.68 and 25.52, respectively, P<0.05). Conclusion:The TBL joint CBD method applied in the course of general practice helps to improve students' test achievement, enhance their overall quality, and lay a foundation for training comprehensive competencies of general practitioners.

Prevalence of depression and its determinants among centenarians in Hainan / 中华老年医学杂志

Objective:To investigate the prevalence of depression and to analyze its determinants among centenarians in Hainan.Methods:A cross-sectional study on centenarians was conducted in Hainan from June 2014 to December 2016.A total of 910 centenarians, including 166 males and 744 females, were interviewed in their domiciles by trained investigators.A 15-item Geriatric Depression Scale(GDS-15)was used to assess depression for centenarians, and general sociodemographic details, sleep quality, cognitive function, activities of daily living, and lifestyles were recorded.Multivariate logistic regression analysis was used to determine major related factors for depression in centenarians.Results:Of the 910 centenarians, 292 were regarded as depressed and the prevalence was 32.1%.Univariate analysis showed that there were significant differences in gender, education, marital status, self-reported health, incontinence, dietary habits, sleep quality, activities of daily living, cognitive function, outdoor activities, watching TV, and social engagement between subjects with and without depression( P<0.05). Multivariate logistic regression analysis showed that living conditions, self-reported health, activities of daily living, and sleep quality were independent related factors for depression in centenarians( P<0.05). Among the above related factors, living with families( OR=0.50, P=0.026)and good sleep quality( OR=0.67, P=0.010)were protective factors for depression, whereas poor self-reported health( OR=3.34, P<0.001)and disability( OR=2.37, P=0.002)were risk factors for depression in centenarians. Conclusions:Living conditions, self-reported health, activities of daily living, and sleep quality were independently correlated with depression in Hainan centenarians.This study provides empirical evidence for depression interventions and mental health improvement in centenarians.

Analysis of clinical characteristics and related gene mutation characteristics in a case of maple syrup urine disease / 中华实用儿科临床杂志

The clinical characteristics and gene mutation characteristics of a child with typical maple syrup urine disease were analyzed retrospectively.The child is a boy, who showed unexplained milk refusal, poor reaction, foaming at the mouth, and encephalopathy symptoms 7 days after birth.The total leucine concentration was abnormally increased by blood tandem mass spectrometry, and the results of urine gas chromatography/mass spectrometry suggested that the concentrations of 2-hydroxy isovaleric acid, 2-keto isovaleric acid, 2-keto-3-methylpentanoic acid and 2-keto-isohexanoic acid were significantly increased.The gene detection results showed that c. 1028delC (p.S343Lfs*9) homozygous mutation was found in the BCKDHB gene.Understanding the clinical symptoms and gene mutation characteristics of this disease can help with the early detection and early diagnosis of this disease, so as to improve its prognosis to the greatest extent.

Clinical study of Changzhi-Xiaoyuan Decoction combined auxiliary nasal endoscopic surgery treating radioactive sinusitis / 国际中医中药杂志

Objective:To evaluate the clinical effect of Changzhi-Xiaoyuan Decoction auxiliary nasal endoscopic surgery for radioactive sinusitis. Methods:A total of 90 patients with radioactive sinusitis included inour hospital from May 2016 to June 2018 were divided into two group according to the random number table method, 45 in each group. The control group was treated with nasal endoscopic surgery, nasopharyngeal flushing after the surgery andoral clarithromycin. The observation group was treated with Changzhi-Xiaoyuan Decoction on the basis of the control group. Both groups were treated for 2 months, following up for 12 months. Before and after the treatment, for clinical symptom scores, using the modified Lund Mackay Postoperative Endoscopic Score (MLMES) respectively from bilateral maxillary sinus, Ethmoid sinus, frontalsinus, sphenoidsinus, olfactory cleft state of mucous membrane inflammation and mucus secretion and purulent secretion evaluation; tested the cilia transmission rateand clinical efficacy were evaluated. Results:The total effective rate of observation group was 91.1% (41/45), and the control group was 64.4% (29/45). There was statistically significant difference between two groups ( χ2=7.779, P=0.005). After the treatment, stuffy nose, turbinate swelling, nasal secretions, hyposmia, headaches scores of the observation group were significantly lower than those of the control group ( t value were 3.558, 5.582, 5.367, 7.442, 7.115, respectively, all Ps<0.01), the MLMES score was significantly lower than that of the control group ( t=4.762, P<0.01). After the treatment, cilia transmission rate (4.42 ± 0.51 mm/min vs. 3.87 ± 0.38 mm/min, t=5.801) of the observation group was significantly higher than that of the control group ( P<0.01). Conclusions:The Changzhi-Xiaoyuan Decoction combined with auxiliary nasal endoscopic surgery can reduce symptoms of radioactive sinusitis patients with sinus, restore the function of nasal mucosa, and enhance the clinical curative effect.

Roles of cerebral vascular dysfunction and microthrombosis in delayed cerebral ischemia after subarachnoid hemorrhage / 国际脑血管病杂志

Delayed cerebral ischemia (DCI) is common after subarachnoid hemorrhage (SAH), and often leads to cerebral infarction and poor neurological outcome. In the past, it was believed that DCI was mainly caused by cerebral vasospasm, but recent clinical trials have failed to confirm this hypothesis, and suggest that DCI has multiple pathophysiological mechanisms. This article reviews the roles of cerebral vascular dysregulation and microthrombosis in DCI after SAH.

Genetic analysis of a case of mosaic trisomy 21 associated with autism spectrum disorder / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a child with autism spectrum disorder (ASD) and congenital heart disease.@*METHODS@#G-banded chromosomal karyotyping was carried out for the patient and his parents. The child was also subjected to whole exome sequencing (WES) and low-coverage massively parallel copy number variation sequencing (CNV-seq). The result was validated by chromosomal microarray analysis (CMA).@*RESULTS@#The karyotype of the patient and his parents were normal. No significant genetic variation was found by WES. However, CNV-seq has discovered a 47, XY, +21 [10%]/46,XY [90%] mosaicism in the patient. The result was confirmed by CMA.@*CONCLUSION@#In addition to Down syndrome, low proportion mosaic trisomy 21 is also associated with ASD. WES and CNV-seq can enable accurate diagnosis for patient with unexplained ASD.

A study of health status in Hainan centenarians / 中华老年医学杂志

Objective To evaluate the health status of Hainan centenarians and compare the gender disparity,and to determine whether the‘ male-female health-survival paradox’is present among them.Methods A cross-sectional study was conducted on the health status and gender disparity of individuals aged 100 and over in Hainan province from June 2014 to December 2016.Data of sociodemographics,lifestyles as well as health-related parameters were collected.The multi dimensional health assessment of centenarians was conducted based on the recognition of standard on Chinese healthy elderly in 2013.Results A total of 940 centenarians(men 18.6％,women 81.4％)were included.The prevalences of hypertension,diabetes and dyslipidemia were 66.1％,9.8％,and 21.2％,respectively,while no significant gender difference was found.Male centenarians were more independent in activity of daily living than did female centenarians(41.1％ vs.25.9 ％,P ＜0.001).The prevalences of dementia(7.7％ vs.4.0％)and depression(33.6％ vs.18.9％)were more dominant in females than in males.Multivariate logistic regression showed that the proportions of functional disability,depression and sleep disorders were higher in female centenarians than in male centenarians (P＜0.05)after adjusting for general demographic characteristics,lifestyle and other health indicators.Conclusions Although the female proportion dominates the centenarian population,female general health states are worse than male centenarians.More attentions on physical and mental health should be paid to the female centenarians.

A study of health status in Hainan centenarians / 中华老年医学杂志

Objective@#To evaluate the health status of Hainan centenarians and compare the gender disparity, and to determine whether the'male-female health-survival paradox’is present among them.@*Methods@#A cross-sectional study was conducted on the health status and gender disparity of individuals aged 100 and over in Hainan province from June 2014 to December 2016.Data of sociodemographics, lifestyles as well as health-related parameters were collected.The multi-dimensional health assessment of centenarians was conducted based on the recognition of standard on Chinese healthy elderly in 2013.@*Results@#A total of 940 centenarians(men 18.6%, women 81.4%)were included.The prevalences of hypertension, diabetes and dyslipidemia were 66.1%, 9.8%, and 21.2%, respectively, while no significant gender difference was found.Male centenarians were more independent in activity of daily living than did female centenarians(41.1% vs.25.9%, P<0.001). The prevalences of dementia(7.7% vs.4.0%)and depression(33.6% vs.18.9%)were more dominant in females than in males.Multivariate logistic regression showed that the proportions of functional disability, depression and sleep disorders were higher in female centenarians than in male centenarians(P<0.05)after adjusting for general demographic characteristics, lifestyle and other health indicators.@*Conclusions@#Although the female proportion dominates the centenarian population, female general health states are worse than male centenarians.More attentions on physical and mental health should be paid to the female centenarians.

Survey on consultation length and waiting time of community general practice clinics / 中华全科医师杂志

Objective To survey the consultation length and waiting time of general practice clinics in community health service centers(CHSC).Methods Three CHSCs were selected from urban areas,urban-rural junction and rural areas Beijing Chaoyang District.The length of consultation,waiting time and the satisfaction of patients were surveyed by self-designed questionnaires among 373 patients visiting these three CHSCs between July to August 2018.Results In 364 patients who completed the questionnaire 69.0％(251/364) had a consultation length between 5 to 10 min,and the proportion of consultation length＜ 5 min was the highest (27.9％) in urban-rural junction.The waiting time was＜5 min in 43.7％ patients (159/364),only 9.3％ of patients waited for＞30 min.The proportion of patients with waiting＜5 min was the lowest (20.7％) in urban area.The distribution of consultion length was different among groups of the reason of consultion,frequently seen doctor and the familarity with the doctor(P＜0.05).Most patients were satisfied with the length of consultation (85.4％) and waiting time (74.5％).The satisfaction of patients in urban areas with the consultation length (75.2％) and waiting time (49.6％) was lower than that in urban-rural junction and rural areas.Conclusion The consultation length in general practice clinics of CHSC is relatively short,but patients are basically satisfied with the current status of consultation length and waiting time.However,consultation length and wating time should be regularly monitared,to promote the quality of care in general practice clinics.

Characteristics of serum lipid levels in 899 centenarians of Hainan / 中华老年医学杂志

Objective To investigate the characteristics of serum lipid levels in centenarians in Hainan province.Methods A total of 899 centenarians were enrolled.Fasting venous blood samples were collected,and serum levels of total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol (HDL-C),apolipoprotein A-1 (Apo A1),apolipoprotein B(Apo B) and lipoprotein (a) [Lp (a)] were determined.Characteristics of serum lipid levels in centenarians with different age and gender were analyzed.Results The ratio of male to female in this study was 1 ∶ 4,101 years of age comprised the largest proportion(20.4 ％,183 cases),and the highest age was 109 years old for men and 116 years old for women.People aged 102 years had the highest levels of TC,TG,LDL-C and Apo B,and also had the lowest levels of HDL-C and Apo A1.Serum levels of TC and LDL-C reached the peak at the age of 102 years and showed downward trends year by year.Serum levels of TC,TG,LDL-C,Apo A1 and Apo B were lower in males than in females(P＜0.01),and HDL-C had no significant difference between males and females(P ＞0.05).The detection rates for abnormal serum lipid levels were higher in females than in males(P＜0.01).Serum Lp(a) level was higher in females than in males.Conclusions Serum lipid levels show a peak expression at a certain age in centenarians of Hainan,and the types and ratio of abnormal blood lipids are higher in female centenarians than in male centenarians.

Relationship between thyroid nodules and lifestyle characteristics in Chinese centenarians / 中华超声影像学杂志

Objective@#To study the correlation of lifestyle characteristics with thyroid nodules in a population-based sample of centenarians in Hainan.@*Methods@#The study was based on China Hainan Centenarian Cohort Study (CHCCS) conducted in 18 cities and counties in Hainan province from 2014 to 2016. A group of multidisciplinary team interviewed and examined local centenarians with structured questionnaires and ultrasonography procedures. A total of 918 centenarians were analyzed after excluding those who refused ultrasonographic examinations or had relevant missing data. Thyroids of centenarians were examined by 3-year experienced sonographer, details on lifestyle characteristics and dietary habits were collected by standard procedure.@*Results@#Of the 918 centenarians, 683 (74.4%) had thyroid nodules under the ultrasonography procedures. The prevalence of thyroid nodules in different group of areca nut consumption varied significantly (P<0.05). In multivariate logistic regression model, the results showed female and areca nut intake were independently associated with thyroid nodules in centenarians (P<0.05).@*Conclusions@#The modifiable variables including areca nut intake as well as non-modifiable such as gender are independent determinants of thyroid nodules in centenarians. Further studies are warranted to explore and verify these associations in populations with different ranges of age.

Study on sleep quality and related determinants among centenarians in Hainan province / 中华流行病学杂志

Objective To investigate the sleep quality and related determinants among centenarians in Hainan.Methods A cross-sectional study of centenarians from 16 cities/counties was carried out in Hainan province between June 2014 and June 2016.Data related to demography,chronic diseases and lifestyles of the centenarians were collected.Pittsburg sleep quality index (PSQI) was used to assess the quality of sleep while multivariable logistic Regression model was used to determine the risk factors on the quality of sleep.Results Of the 730 centenarians in this study,225 suffered from sleep disorders (30.8％).The average score of PSQI was (6.44 ± 3.05),with the top three problems related to sleep as sleep inefficiency (48.5％),sleep latency (35.5％),and daytime dysfuntion (20.6％) among the centenarians.Results from the multivariate logistic analysis showed that incontinence,cardiovascular disease and chronic pain were risk factors,while habitual afternoon nap,and regular diet appeared as protective factors (P＜0.05),related to sleep disorder.Conclusions Quality of sleep had been a problem to the centenarians in Hainan.Intervention on risk factors of sleep disorder should be helpful on these centenarians.

Study on self-rated health and related factors in centenarians in Hainan province / 中华流行病学杂志

Objective To investigate the self-rated health and related factors in centenarians in Hainan province.Methods A cross-sectional study in centenarians from 18 cities and counties was carried out in Hainan between June 2014 and December 2016.They data about their demographics,chronic diseases,ability of daily life,mental health and sleep quality were collected in a household interview.Self-rated health status was classified into 5 degrees according to the subjective assessment by centenarians.Results Of 991 centenarians in this study,157 (15.8％) were in good self-rated health and 228 (23.0％) were in poor self-rated health.Multivariate logistic regression analysis showed that chronic pain,visual impairment,depression,limited ability of daily life and poor sleep quality were the factors associated with poor self-rated health in centenarians in Hainan (P＜0.05).Conclusion The proportion of centenarians in good self-rated health was low in Hainan,the influencing factors included chronic pain,visual impairment,depression,poor sleep quality and limited ability of daily life.It is necessary to conduct targeted intervention in centenarians in Hainan.