Objective To assess the prevalence of the metabolic syndrome (MS) in Shanghai adults according to the criteria of the US National Cholesterol Education Programme Adult Treatment PanelⅢ ( NCEP ATP Ⅲ) definition. Methods Randomly selected adults were studied by means of stratified sampling. A cross-sectional study was conducted in Shanghai with a representative sample of 7 414 Chinese adults aged 35-74 years.Results Defined by the ATPⅢ criterion, the preliminary prevalence of MS was 19.81%. The prevalence of MS was 16.21% (95%CI 15.37%-17.05% ) after age was adjusted. The prevalence of MS was higher in female than in male (22.59% vs 16.64% ,P<0.01 ), and higher in urban than rural residents( 17.43% vs 17.16% ,P<0.01 ). The prevalence of MS increased with age in both male and female, especially in females aged above 55 years. There were 19.81% subjects with over 3 risk factors. The most common combination of four components in MS were central obesity, high triglyceridemia, low high-density lipoprotein-cholesterol and hypertension. Conclusions There is a high prevalence of MS in Shanghai adults. MS is increasingly becoming a noteworthy health problem. Early-diagnosis and integrated-methods of prevention and treatment of MS are mandatory.

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.

Objective To estimate the prevalence of chronic kidney disease and to identify influencing factors among patients enrolled in diabetes management by the community health centers in Shanghai. Methods A questionnaire survey and physical examination were conducted in patients with type 2 diabetes through a random sampling method. Eligible date of 1 618 subjects were enrolled in the study. Estimated glomerular filtration rate was calculated according to equation of the Modification of Diet in Renal Disease Study for serum creatinine. Logistic regression was performed to examine the association between risk factors and chronic kidney disease. Results The prevalence of chronic kidney disease was 43.4%, of which 16.1%were in Stage 1, 14.8%in Stage 2, 11.6%in Stage 3, and 1.0%in Stage 4/5 in the total of 1 618 patients, but only 3.6% of the patients as defined in this study were aware of their condition. A higher prevalence of chronic kidney disease in females than that in males ( 47. 3% vs 37.8%). The prevalence of chronic kidney disease increased with age (χ2tend＝38.663,P<0.01). Female gender, older age, lower education, lower monthly income per capital, long duration of diabetes, uncontrolled glycosylated hemoglobin, uncontrolled systolic blood pressure, and uncontrolled triglycerides, were influencing factors of chronic kidney disease. Conclusion The patients under diabetes management in community health centers had higher prevalence of chronic kidney disease with lower awareness. Patients with type 2 diabetes should be encouraged to control blood glucose, blood pressure and blood lipids, to reduce the risk for chronic kidney disease. 而下降,2、3期均随年龄增大而升高(2 期 χ2趋势＝34.626,3 期,均 P<0.01) .城乡患病率总体上无差别,仅见3期患病率市区高于郊区(14.4%对9.2%, χ2＝10.465,P<0.01).按糖尿病病程长短进行分层发现,总的患病率随病程延长而升高 ,2、3期也呈现同样趋势( 2 期,3 期,均 P<0.05,图1) .

ObjectiveTo investigate the status, characteristics of population distribution and trends of chronic obstructive pulmonary disease (COPD) deaths among the registered residents in Chongming District, Shanghai from 2002 to 2022, and to provide a scientific basis for precise prevention and control of COPD. MethodsCOPD death data were obtained from the Shanghai Chongming District Death Surveillance System, and indicators such as crude mortality rate, standardized mortality rate, mortality rate by age group, and probability of premature death were calculated for the registered residents with COPD. Joinpoint 5.0.2 software was adopted to analyze the annual percent change (APC) and average annual percent change (AAPC), followed by an analysis of trend changes. ResultsFrom 2002 to 2022, the average annual crude mortality rate and average annual standardized mortality rate of COPD among the residents of Chongming District were 73.49/100 000 and 34.00/100 000, respectively, and both were higher in males than those in females. The crude mortality rate of COPD among the residents aged ≤69 years in Chongming District was 6.78/100 000, followed by 218.28/100 000 in the age group of ≥70 years and 1 042.77/100 000 in the age group of ≥80 years, respectively. The standardized mortality rates for the whole population (AAPC=-9.75%), males (AAPC=-9.06%) , and females (AAPC=-12.25%) all showed a downward trend (all P<0.001). In addition, there was a decreasing trend in the crude mortality rates for the residents aged ≤69 years (AAPC=-7.51%), aged ≥70 years (AAPC=-9.89%), and aged ≥80 years (AAPC=-8.85%) (all P<0.001). Furthermore, the probability of premature death of COPD decreased from 1.45% in 2002 to 0.08% in 2022. ConclusionThe mortality rate and probability of early premature death of COPD among the registered residents in Chongming District, Shanghai from 2002 to 2022 show a downward trend, and the mortality rate of declining in males is slower than that in females. The elderly with advanced age account for the highest number of deaths. Therefore, targeted intervention measures should be taken for key groups to reduce the mortality rate of COPD.

ObjectiveTo evaluate the validity of four screening questionnaires on chronic obstructive pulmonary disease (COPD) among community residents in Shanghai, and to provide a scientific basis for selecting suitable screening questionnaires and plans for the community use. MethodsA multi-stage random sampling method was used to select community residents aged ≥40 for COPD questionnaire screening and spirometry. The screening questionnaires included the COPD Population Screener Questionnaire (COPD-PS), the COPD Screening Questionnaire (COPD-SQ), the COPD Diagnosis Questionnaire (CDQ), and the Lung Function Questionnaire (LFQ). The diagnostic gold standard for COPD was defined as a ratio of post-bronchodilator forced expiratory volume in one second to forced vital capacity (FEV1/FVC) less than 0.7. The receiver operating characteristic (ROC) curve was used to assess the validity of each questionnaire, and DeLong’s test was used to compare the area under the curve (AUC) of different questionnaires. ResultsAmong the 1 122 residents screened, 99 (8.8%) were diagnosed with COPD based on the gold standard criteria. The AUC values for the four questionnaires ranged from 0.643 to 0.682, with no statistically significant differences in screening accuracy among them (P>0.05). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each questionnaire at recommended cut-off points were as follows: COPD-PS (sensitivity: 33.3%, specificity: 84.9%, PPV: 17.6%, NPV: 92.9%), COPD-SQ (34.3%, 85.8%, 19.0%, 93.1%), CDQ (73.7%, 42.4%, 11.0%, 94.4%), and LFQ (48.5%, 74.8%, 15.7%, 93.8%). Optimal cut-off values for this population differed from the recommended values. When selecting the optimal cut-off value, the sensitivity of COPD-PS (58.6%), COPD-SQ (55.6%), and LFQ (64.7%) increased, while the specificity of CDQ (75.9%) increased. The AUC of sequential lung function testing for all four screening questionnaires increased to 0.7 or above. The optimal cut-off values for the four questionnaires in this population differed from the recommended values. When applying the optimal cut-off values, the sensitivity of three questionnaires increased: COPD-PS (58.6%), COPD-SQ (55.6%), and LFQ (64.7%), while the specificity of CDQ rose to 75.9%. The AUC of each questionnaire increased to above 0.7 when followed by sequential lung function testing. ConclusionThe COPD-PS, COPD-SQ, CDQ, and LFQ have limited value for COPD screening among Shanghai community residents, indicating that further refinement of these tools is needed.