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BackgroundDuring the current Coronavirus Disease 2019 (COVID-19) pandemic, diabetic patients face disproportionately more. Anti-inflammatory effects of hypoglycemic agents have been reported, and their beneficial or harmful effects in patients with diabetes and COVID-19 remain controversial. PurposeThis study was performed to clarify this association. Data SourcesRelevant literature was searched on China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, Chinese periodical service platform VIP Database, Sinomed (China Biology Medicine, CBM), MedRxiv, PubMed, ScienceDirect, Web of Science, Ovid Databases (LWW), Springer Link, Wiley Online Library, Oxford Academic, Nature Press Group, Cochrane Library and BMJ Evidence-Based Medicine up to November 14, 2020. Study SelectionOnly observational studies of hypoglycemic agents vs. drugs or therapy without hypoglycemic agents in adult diabetic patients with COVID-19 were included. Data ExtractionData of death and poor composite outcomes were extracted. Data SynthesisThe pooled effects were calculated using the fixed-effects or random-effects models based on heterogeneity assessment. LimitationMost studies were retrospective cohort studies with relative weak capability to verify causality. ConclusionHome use of metformin might be beneficial in decreasing mortality in diabetic patients infected with SARS-CoV-2. There is insufficient evidence to conclude that metformin and other hypoglycemic agents are associated with poor composite outcomes. More prospective studies, especially RCTs are needed. Registration-PROSPEROCRD42020221951.
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Objective:To explore the association between left-behind status, screen time (ST) and behavior of autism in rural preschool children.Methods:Cross section study was used in this study.A sample of 3 636 rural preschool children aged from 3 to 6 years old in 26 kindergartens were selected from four counties in Anhui province of China.The contents of the questionnaire include: basic information questionnaire, self-made left behind status questionnaire, self-made screen time questionnaire, Clancy autism behavior scale.EpiData 3.2 and SPSS 23.0 software were used for data entry and statistical analysis.Chi-square test was used to analyze the difference of positive rate of autism behavior.Logistic regression analysis was used to further explore the relationship between left-behind status, screen time and autism behavior of rural preschool children.Results:Compared with non-left-behind children (NLBC), the risk of autism behavior for left-behind children (LBC) increased 36%.The risk of autism behavior increased by 40% for 1 h/d <ST≤ 2 h/d and 85% for ST>2 h/d when compared with ST ≤ 1 h/d.While comparing to NLBC with ST ≤ 1 h/d, the risk of autism behavior increased by 97% in LBC with 1 h/d <ST ≤2 h/d and 159% in LBC with ST>2 h/d.Conclusions:There is an additive effect on the risk of autism behavior when left-behind experience and excessive ST combined together.The daily ST should be strictly controlled within 2 h/d for NLBC, and within 1 h/d for LBC in order to reduce the risk of autism behavior in preschool children of rural areas.
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BackgroundThe effect of using Angiotensin-converting enzyme inhibitors (ACEIs) and Angiotensin-receptor blockers (ARBs) on the risk of coronavirus disease 2019 (COVID-19) is a topic of recent debate. Although studies have examined the potential association between them, the results remain controversial. This study aims to determine the true effect of ACEI/ARBs use on the risk of infection and clinical outcome of COVID-19. MethodsFive electronic databases (PubMed, Web of science, Cochrane library, China National Knowledge Infrastructure database, medRxiv preprint server) were retrieved to find eligible studies. Meta-analysis was performed to examine the association between ACEI/ARBs use and the risk of infection and clinical outcome of COVID-19. Results22 articles containing 157,328 patients were included. Use of ACEI/ARBs was not associated with increased risk of infection (Adjusted OR: 0.96, 95% CI: 0.91-1.01, I2=5.8%) or increased severity (Adjusted OR: 0.90, 95% CI: 0.77-1.05, I2=27.6%) of COVID-19. The use of ACEI/ARBs was associated with lower risk of death from COVID-19 (Adjusted OR: 0.66, 95% CI: 0.44-0.99, I2=57.9%). Similar results of reduced risk of death were also found for ACEI/ARB use in COVID-19 patients with hypertension (Adjusted OR: 0.36, 95% CI: 0.17-0.77, I2=0). ConclusionThis study provides evidence that ACEI/ARBs use for COVID-19 patients does not lead to harmful outcomes and may even provide a beneficial role and decrease mortality from COVID-19. Clinicians should not discontinue ACEI/ARBs for patients diagnosed with COVID-19 if they are already on these agents.
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Objective@#To explore the association between resilience and cognitive impairment in the elderly.@*Methods@#A face-to-face questionnaire survey was conducted among 6 524 elderly people aged 60 and over in Anhui Province by cluster sampling. The survey included general demographic characteristics, resilience and cognitive function. Statistical methods such as t-test, chi-square test, binary Logistic regression were used for data analysis.@*Results@#The incidence of cognitive impairment in the elderly was 13.6%(886/6 524). The score of resilience in the elderly with normal cognitive function was (64.89±11.96), while it was (56.10±11.12) in the elderly with impaired cognitive function and the difference was statistically significant (t=20.511, P<0.001). Logistic regression analysis showed that there was a statistical correlation between resilience and cognitive impairment in the elderly (OR=0.936, 95%CI: 0.930~0.943). After adjusting for depression, gender, age and other related factors, there was still a statistical correlation between resilience and cognitive impairment in the elderly (OR=0.963, 95%CI: 0.955~0.971).@*Conclusions@#Resilience is related to cognitive impairment in the elderly, and higher resilience is the protective factor for cognitive impairment.
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Objective To explore the association between resilience and cognitive impairment in the elderly. Methods A face-to-face questionnaire survey was conducted among 6 524 elderly people aged 60 and over in Anhui Province by cluster sampling. The survey included general demographic characteristics, resilience and cognitive function. Statistical methods such as t-test,chi-square test,binary Logistic regression were used for data analysis. Results The incidence of cognitive impairment in the elderly was 13. 6% (886/6 524). The score of resilience in the elderly with normal cognitive function was (64. 89±11. 96), while it was (56. 10±11. 12) in the elderly with impaired cognitive function and the difference was statisti-cally significant (t=20. 511,P<0. 001). Logistic regression analysis showed that there was a statistical cor-relation between resilience and cognitive impairment in the elderly ( OR=0. 936,95%CI:0. 930~0. 943). After adjusting for depression,gender,age and other related factors,there was still a statistical correlation be-tween resilience and cognitive impairment in the elderly (OR=0. 963,95%CI:0. 955~0. 971). Conclusions Resilience is related to cognitive impairment in the elderly,and higher resilience is the protective factor for cognitive impairment.
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Objective To know the anxiety status of preschool children in rural areas and to explore its influential factors. Methods Subjects of 1363 rural preschool children aged 3-6 years were selected from Anhui Province( Changfeng and Feixi county of Hefei city; Qianshan county of Anqing city; Funan county of Fuyang city) . The primary caregivers of preschool children were investigated by Chinese version of Spence Preschool Anxiety Scale (SPAS),Devereux Early Childhood Assessment for Preschoolers (DECA-P2) ,Neglect Norms for Children Aged 3 to 6 Years in Rural Areas of China,Adaptation Partnership Growth Affection Resolve (APGAR),Self-rating anxiety scale (SAS) and Self-rating depression (SDS). Result-s Among the 1363 preschool children,the positive rate of anxiety was 14. 7％. Physical injury fears score was highest (1. 24±0. 84),followed by social phobia anxiety (0. 86±0. 75) and separation anxiety (0. 85± 0. 74) . Except for obsessive compulsive disorder,the other four types of anxiety and total anxiety scores were negatively correlated with the total protective factors of mental resilience (r=-0. 054- -0. 070,P<0. 05). Besides,all anxiety scores were positively correlated with behavioral problems(r=0. 121-0. 237,P<0. 05)and neglect degree (r=0. 157-0. 269,P<0. 05). The results of multiple linear regression analysis of different anxiety types showed that gender,family type,family income status,parental rearing pattern was consistent or inconsistent,children' s neglect degree,behavior problem and anxiety/depression status of primary caregivers were the main factors affecting the anxiety level of preschool children in rural areas. Conclusions In order to reduce or avoid anxiety of preschool children,it is necessary to establish a good family environment,im-prove parents' upbringing level,and take effective education intervention.
