To surrey the body mass index (BMI) and depression symptom among the middle-aged and elderly population in Pudong New Area of Shanghai, China, and to explore their association, so as to provide suggestions for the mental health promotion in communities.
We utilized the data of the "Shanghai Pudong New Area Healthy City Evaluation Project" in 2019, which adopted a quota sampling method to survey a total of 6 000 Pudong New Area permanent residents.A total of 2 823 cases of middle-aged and elderly people over 40 years old were included in this study.The survey included the subject's basic information, lifestyle, subjective well-being and depression symptom, etc.The Personal Well-being Index (PWI) Scale was used to evaluate subjective well-being, and PHQ-9 was used to evaluate depression symptom.The subjects were divided into normal, overweight and obese groups according to their BMI.A One-Way χ2 test was used to compare the difference in the prevalence of depression symptom between different characteristic groups; Logistic regression was used to analyze the association between BMI and depression symptom.
In all the 2 823 subjects, there were 38.5% of overweight and 6.7% of obese.The prevalence of depression symptom in middle-aged and elderly people was 46.5%.The prevalence of depression symptom was 44.7% in normal BMI group, 47.4% in overweight group, and 56.1% in obese group.After controlling for sociodemographic factors, self-rated economic status, self-rated health status, subjective well-being and lifestyle, it was found that in the male population, compared with normal group, overweight group (OR=1.342, 95%CI: 1.053-1.710) and obese group (OR=1.960, 95%CI: 1.208-3.179) had a higher risk of depression symptom (P < 0.05);while the association between overweight, obese and depression symptom was not statistically significant (all P>0.05) in the female population.
BMI is associated with depression symptom among middle-aged and elderly residents.Overweight and obese may be a risk factor for middle-aged and elderly men (over 40 years old) in Pudong New Area, but this association does not exist in middle-aged and elderly women.We need pay more attention to the male who were overweight or obese in intervention of depression symptom.
To investigate the puberty development, iodine nutrition and thyroid function, and to explore their association among school-aged girls in Minhang District, Shanghai.
From Jan to Mar 2019, a cluster sampling method was used to select 6 junior high schools in the east, south, north, and middle areas in Minhang District, Shanghai.A total of 532 girls of Grade 6 in selected schools were included in the study.Physical examination was conducted, and their urine and blood samples were collected to determine urinary iodine concentration (UIC) and thyroid functions.Pubertal Development Scale (PDS) was used to define the pubertal stage.Multiple linear regression models and Logistic regression models were conducted to analyze the associations between puberty stage and thyroid functions.
A total of 513 participants met the criteria and had complete data.Most of the participants were in pubertal stage 4, accounting for 47.17% (242/513), The urinary iodine on Thursday (median: 172 μg/L) was significantly higher than that on Monday (median: 134 μg/L)(P < 0.01), and the weighed urinary iodine excretion was significantly different in girls with different pubertal stage (P=0.025).After adjusting for the iodine nutrition status, for each one point increase in PDS score, triiodothyronine (TT3), tetraiodothyronine (TT4) and free triiodothyronine (FT3) decreased by 0.47, 0.01 and 0.10 nmol/L, respectively.For each one level increase in puberty stage, TT3, TT4 and FT3 decreased by 0.26, 0.01 and 0.09 nmol/L, respectively.Girls in post-puberty had the lower levels of TT3 (OR=0.57, 95%CI: 0.34-0.95), TT4 (OR=0.54, 95%CI: 0.32-0.92) and FT3 (OR=0.53, 95%CI: 0.31-0.90) as compared with girls in pre-puberty. The levels of TT3 (OR=0.52, 95%CI: 0.35-0.77) and FT3 (OR=0.55, 95%CI: 0.37-0.81) were significantly lower in girls after menarche than those without menarche.
There is anassociation between pubertal stage and thyroid functions in school-aged girls during puberty in Minhang District, Shanghai.TT3, TT4, and FT3 levels decline with the process of puberty.
To investigate and analyze the epidemiological characteristics of a cluster of coronavirus disease 2019 (COVID-19) spread by a super spreader in Taizhou, Zhejiang Province, and provide reference for prevention and control of COVID-19.
The field epidemiological investigation was conducted to investigate the confirmed cases and close contacts; the data were analyzed with descriptive method. Chi-squared test was used to compare the differences of attack rates among close contacts.
A total of 23 epidemiological related cases were identified, including 20 confirmed cases and 3 asymptomatic infection cases. Thirteen (56.52%) were males, ten (43.48%) were females, and the median age was 51 years old with the range of 30 to 70 years old.The second generation case firstly developed symptoms on Jan 19th and was confirmed on Jan 30th, 2020.The first generation cases were from Wuhan and the last case was confirmed on Feb 3rd, 2020.The epidemic spread to the fifth generation with a total attack rate of 6.07% (21/346), among which the third generation case was a super spreader who directly transmitted to 12 subsequent cases with a significantly higher attack rate than other cases (27.27% vs. 2.98%, χ2=39.754, P < 0.001).
The expansion of the epidemic can be attributed to the lack of timely control of imported personnel from high risk regions, the lacking awareness of novel infectious diseases at the early stage of the epidemic and the appearance of the super spreader.To form a normalized prevention mechanism, it is necessary to improve the alertness of novel infectious diseases among medical staffs and the masses, implement prevention and control strategies in time.
To compare the efficacy and safety of pegylated liposomal doxorubicin (PLD) and epirubicin in adjuvant chemotherapy for HER-2 negative breast cancer after surgery.
The clinical data of 368 patients with HER-2 negative breast cancer who underwent breast cancer surgery and adjuvant chemotherapy in Huashan Hospital, Fudan University from May 2015 to Feb 2020 were retrospectively collected.Among them 175 patients receiving PLD chemotherapy were included in the experimental group, and 193 patients receiving epirubicin chemotherapy were included in the control group.The incidences of adverse reactions during chemotherapy between the two groups were compared.In addition, a total of 101 patients were followed up for 3 years to observe the long-term efficacy, including 45 cases in PLD group and 56 cases in epirubicin group.The disease-free survival, recurrence and metastasis were compared between the two groups.
PLD group was superior to epirubicin group in the adverse reactions of hair loss, nausea and vomiting, and myocardial damage (P < 0.05), but the incidence of hand-foot syndrome in PLD group was higher than that in epirubicin group (P < 0.05).None of the patients died in the two groups.Six of the 45 patients (13.3%) in PLD group and 10 of 56 patients (17.8%) in epirubicin group had relapsed and metastasized.The 3-year disease-free survival (DFS) in PLD group was comparable to epirubicin group without significant difference (P=0.09).
The efficacy of doxorubicin liposomes in adjuvant chemotherapy after HER-2 negative breast cancer surgery is comparable to that of traditional epirubicin.Its adverse effects of hair loss, nausea and vomiting and cardiotoxicity are better than epirubicin.
To explore the clinical characteristics of multidisciplinary team (MDT) mode and the effect on the outcomes of pernicious placenta previa.
In this retrospective study, data were analyzed for 76 singleton patients who had pernicious placenta previa and underwent elective cesarean delivery in Obstetrics & Gynecology Hospital of Fudan University between Jan 1, 2013 and Dec 31, 2018.According to the time of application of MDT, patients were divided into control group and observation group. Control group was treated with obstetrical diagnosis and treatment, while observation group was treated with MDT mode.The operation time, intraoperative blood loss, the incidence of massive hemorrhage, hysterectomy, total blood loss volume and postpartum hemorrhage rate, clinical use of blood, puerperal infection rate, and neonatal outcomes were compared between the two groups.
There were 23 cases in control group and 53 cases in observation group.Compared with control group, the operation time, intraoperative blood loss, the incidence of massive hemorrhage, hysterectomy rate, the postpartum hemorrhage rate as well as the allogeneic transfusion rate and allogeneic transfusion volume in observation group were all significantly reduced (P=0.01, P=0.002, P=0.0002, P=0.001, P=0.007, P=0.001, P=0.006, respectively), while there was no significant difference between total blood loss volume and the puerperal infection rate in the two groups.Moreover, there was no significant difference in neonatal asphyxia rate and birth weight between the two groups.No neonatal death occurred since the MDT mode was introduced.
The application of MDT mode can optimize the perioperative management process of the pernicious placenta previa, reduce the intraoperative hemorrhage and massive hemorrhage, decrease the risk of hysterectomy, and improve maternal and neonatal outcomes.
To evaluate the effect of health intervention on psychological anxiety anddepression of mild to moderate chronic obstructive pulmonary disease (COPD) patients in community.
Ten communities in Pudong New Area, Shanghai were randomly selected as the research sites, and all patients with mild to moderate COPD were included as the research objects. All the subjects in 4 communities were selected by cluster sampling from the ten communities for 6 months of intensive health education. The other 6 communities were taken as the control group, and all the subjects were given a routine health education.The Hospital Anxiety and Depression Scale (HADS) questionnaire was used to evaluate the anxiety and depression of patients at baseline and after the intervention.
A total of 464 COPD patients were enrolled (242 in intervention and 222 in control), among which 282(60.8%) successfully finished the follow-up, including 155 cases in the intervention group and 127 cases in the control group.It was showed that the the intervention improved the proportion of patients with regular medication (P=0.036, OR=2.24, 95%CI: 1.06-4.74) and their understanding of lung function (P=0.019, OR=2.66, 95%CI: 1.18-6.03).The difference-in-difference model showed that the influence of intervention on male depression scales was statistically significant (P=0.006, didt=-1.75).There was no statistically significant effect of intervention on male anxiety scales and female anxiety and depression scales.
The intervention alleviated the depression of male patients with mild to moderate COPD in Pudong New Area, Shanghai, but had little effect on the anxiety of male patients and the anxiety and depression of female patients. Community COPD interventions need to be further improved in the future, especially for female patients.
To explore the difference of intestinal microbial gas production and the proportion of various gas components in preterm infants within 4 weeks after birth.
A total of 19 preterm infants admitted to Shanghai Children's Hospital, Shanghai Jiao Tong University from May 1, 2020 to Jun 1, 2020 were enrolled in this study.All preterm infants met the inclusion criteria that the gestational age ≥ 28 weeks and < 37 weeks, and had no deformity or metabolic diseases. Written consent was obtained from all the parents of preterm infants before inclusion.The feces were collected within 3 days, 1 week, 2 weeks, 3 weeks and 4 weeks after birth and sent to the laboratory for treatment within 12 hours.The collected feces were inoculated into the medium with lactose (LAT), fructo-oligosaccharides (FOS), 2'-Fucosyllactose (FL-2) and galacto-oligosaccharides (GOS) as the main carbon sources for in vitro fermentation. The gas production of intestinal flora, various gas components (carbon dioxide, hydrogen, methane, hydrogen sulfide) and other metabolic indicators were detected.
In the four culture media, the gas production of intestinal flora in preterm infants increased gradually.Since birth till 4 weeks after birth, methane was detected in the gas produced by intestinal microorganisms in vitro, while carbon dioxide, hydrogen and hydrogen sulfide were commonly produced in the second week after birth, and their descending proportion order was carbon dioxide, hydrogen, methane and hydrogen sulfide.In addition, the intestinal gas produced in medium with FL-2 was the least, in medium with LAT was the most.
The intestinal gas produced by intestinal flora in preterm infants increased with age during the first 4 weeks of life.The feces of preterm infants within 4 weeks after birth may contain methanogens.
To compare the effects of propofol and desflurane anesthesia on patients' responses to the tracheal tube with target-controlled infusion of remifentanil during recovery from general anesthesia after vestibular schwannoma resection.
Sixty patients undergoing vestibular schwannoma resection from Oct 2019 to May 2020 with general anesthesia were randomly assigned to propofol (group P, n=30) or desflurane anesthesia (group D, n=30).At the end of surgery, propofol or desflurane was discontinued, and the remifentanil infusion was maintained at an effect-site concentration of 2.0 ng/mL until extubation.The incidence and severity of coughing, hemodynamic parameters and recovery profiles were evaluated.
The incidence of coughing during the emergence was significantly higher in group D than that in group P (70.00% vs. 19.2%, P < 0.000 1), and so was the grade of coughing (P=0.000 4).The mean arterial pressure and heart rate were higher in group D than that in group P at extubation (P < 0.05), but group P showed shorter recovery proflles (P < 0.05).
In patients with target-controlled infusion of remifentanil after vestibular schwannoma resection, desflurane anesthesia causes higher incidence, more severity of coughing and longer recovery profile than propofol anesthesia at extubation.
To compare the clinical application, complications and unplanned port removal of total lyimplanted central venous-access port devices (TIVAP) with three different approaches (subclavian vein via subclavian, subclavian vein via supraclavicular, and internal jugular vein).
Clinic data of 556 cases implanted central venous access port devices in the Department of Interventional Radiology and Oncology, Yixing People's Hospital between Dec.2013 and Oct.2019 were analyzed retrospectively.The patients were divided into three groups according to the different catheter implantation sites, subclavian vein via subclavian approach (group A), subclavian vein via supraclavicular approach(group B) and internal jugular vein approach(group C)and to compare the complications and unplanned port removal.
We didn't find any correlations between age, gender, infusion port location, tumor type, purpose of port, regular maintenance and complications.In group A, complications occurred in 23 of 169 patients (13.61%), including 5 cases of pneumothorax, 2 cases of pocket hematoma, 6 cases of pinch-off syndrome, 3 cases of catheter migration, 3 cases of TIVAP related infection, 2 cases of port exposure, 1 case of catheter thrombosis or occlusion and 1 case of fibrin sheath, and 11 cases were unplanned removed (6.51%).In group B, complications occurred in 11 of 174 patients (6.32%), including 1 cases of pocket hematoma, 2 cases of catheter migration, 2 cases of TIVAP related infection, 1 case of catheter fracture, 3 cases of port exposure, 1 case of catheter thrombosis or occlusion, 1 case of fibrin sheath, and 8 cases were unplanned removed (4.60%).In group C, complications occurred in 16 of the 213 patients (the rate was 7.51%), including 1 case of pocket hematoma, 1 case of mediastinal hematoma, 3 cases of catheter migration, 3 cases of TIVAP related infection, 1 case of wound dehiscence, 3 cases of port exposure, 2 cases of catheter thrombosis or occlusion, 2 cases of fibrin sheath, and 10 cases were unplanned removed (4.69%).There were no significant differences about unplanned port removal rate among the 3 groups.Pairwise comparison indicated that group A had higher complication tendency (P=0.024, P=0.051).
The three different operation approaches of TIVAP are safe and effective for long term intermittent venous access.The complication rates were higher tendency in subclavian vein via subclavian approach than other two approaches, especially happening in pneumothorax and pinch-off syndrome.If you wantto aviod these two types of complications, the other two approaches could be chosen priority.
Along with the coming of aged society, the prevalence of aortic valvular disease is significantly increasing.Nowadays, transcatheter aortic valve replacement (TAVR) has been established as the optimal treatment of aortic stenosis in the population with intermediate and high surgical risk.Moreover, TAVR has also been performed for pure aortic valve regurgitation.Whereas, ineffectiveness of the first valve still might occur confronted with individualized anatomical structure, hemodynamical characteristics and different valve types.Intraprocedural valve-in-valve deployment is increasingly applied in these patients undergoing TAVR with an unsatisfied first valve.The immediate and mid-term clinical and hemodynamic results have demonstrated its safety and feasibility.Here, we briefly review the risk factors in need for a second valve following TAVR, the prognosis and challenges in the valve-in-valve technique.
Hippo pathway is highly evolutionarily conserved and is associated with the development and advances of various human diseases.In recent years, studies have shed light on the significant role of Hippo pathway in kidney injury and repair.Some data point out the Hippo pathway loss promotes proliferation and regeneration of tubular epithelial cells after acute kidney injury (AKI).However, other evidence shows that the persistent inactivation of Hippo pathway in the post-acute phase of AKI may induce the transition of AKI to chronic kidney disease (CKD).Therefore, a comprehensive understanding of the functional contribution of Hippo pathway in the repair of AKI and the development of CKD will help to discover new therapeutic targets and strategies for AKI.In this review, we summarize how Hippo pathway regulates adaptive repair after AKI and discuss how sustained inactivation of Hippo pathway triggers maladaptive responses and causes CKD progression.
Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain or discomfort, stool irregularities and bloating.Over the years, IBS has been described from a strict illness of the gastrointestinal tract (biomedical model) to a more complex multi-symptomatic disorder of the brain-gut axis (biopsychosocial model).Here, we briefly review the progress in application of biopsychosocial medical model in the diagnosis and treatment of irritable bowel syndrome.
The incidence and mortality of colorectal cancer (CRC) in China have maintained an upward trend, and most patients were at an advanced stage when it was discovered.Research progress have been made on the pathogenesis and molecular pathways of CRC, while long non-coding RNAs (LncRNAs) are involved in the occurrence of CRC.Tumor suppressor gene LncRNA-p21, oncogenes LncRNA colorectal neoplasia differentially expressed (LncRNA-CRNDE), LncRNA taurine up-regulating gene 1 (LncRNA-TUG1), gastric adenocarcinoma related LncRNA (LncRNA-GAPLIC) and other LncRNAs are abnormally expressed in CRC, and regulate the occurrence and development of CRC through a variety of ways.The regulation of cell proliferation, migration, invasion and apoptosis is of great significance to the early screening, treatment and prognosis of CRC.This article reviews the research progress on the above 4 kinds of LncRNAs in the development of CRC.
Cervical cancer is one of the malignant tumors that seriously threaten women's health.It is established that infection of human papilloma virus (HPV) is the main cause of cervical cancer, while the exact mechanism remains unclear.The human apolipoprotein B mRNA editing enzyme catalyzed polypeptide (APOBEC) family is a group of cytidine deaminases that can edit DNA or RNA sequences.Recent studies have found that APOBEC3s are important members of the innate immune system, which play an important role in the defense process of anti-viral infection and are also closely related to the occurrence and development of a variety of tumors.APOBEC3B may be especially closely associated with HPV infection and cervical cancer.This paper reviews the relationships of APOBEC3 with HPV clearance, mutation, and occurrence of cervical cancer.
