Objective To explore the influence of smoking on olfactory disorder in Parkinson's disease (PD). Methods According to smoking or not, 167 PD patients ( PD group) and 100 normal controls ( normal control group) were divided into smoking subgroups and non-smoking subgroups.The olfactory identification threshold was tested by T&T olfactory assessment.Results Compared with normal control group, the scores of MMSE and montreal cognitive assessment in PD group were significantly decreased ( all P<0.05 ) , age, smoking history, the rate of male had no statistical significance ( all P>0.05 ) .The olfactory identification threshold in PD group was significantly higher than normal control group (t=6.785, P=0.000).Compared with PD smoking subgroup, the olfactory identification threshold in non-smoking subgroup was significantly higher (t=-3.000, P=0.003).The olfactory identification threshold in normal control smoking subgroup was significantly lower (t=0.784, P=0.435). The olfactory identification threshold of PD smokers had no correlation with smoking pack-years or duration ( r=-0.104, P=0.441;r=-0.156, P=0.246) .Conclusion Smoking may protect olfactory disorder in PD patients, and it has no correlation with smoking pack-years or duration.

Objective: This study aims to analyze the effects of catastrophic disease insurance (CDI), especially to evaluate the influences of CDI on the discrepancy of benefits between the patients covered by the Employee's Medical Insurance (EMI) and the Resident's Medical Insurance (RMI).Methods: The data used in the study are collected from the health insurance database of Zhuhai City in the years of 2012 and 2014.A descriptive analysis is made to depict the general situation of CDI in the city, and a logistic regression model is used to analyze the factors that affect the probability to get the benefits of CDI.Moreover, a triple difference model is built up to probe into the CDI's effects on the discrepancy of reimbursement ratio between patients covered by EMI and RMI.Results: The benefits of CDI favor the patients with old age, high medical expenditures and chronic diseases.When other factors are controlled, patients covered by EMI have lower probability to get CDI benefits than those covered by RMI.Within the patients with high medical expenditures who have gotten the CDI benefits, those covered by EMI enjoy higher reimbursement ratio than those covered by RMI, but CDI decreases the discrepancy by 3.2%.Conclusions: Since the CDI gives more favor to the vulnerable population and narrows the gap of the benefits between EMI and RMI, the policy improves the equity of health security.

ObjectiveTo investigate the risk factors and morbidity of carotid atherosclerosis (CA) and unstable plague in patients with sleep apnea-related hypertension (SA-RH).MethodsA total of 603 SA-RH subjects screened by polysomnography according to apnea hypopnea index (AHI) were recruited and divided into 3 groups:mild (AHI 5-15 ),moderate (AHI 15-30) and severe (AHI ≥ 30) group,with hypertensive patients with AHI less than 5 served as control.CA was determined by doppler ultrasound as formation of plaque and/or intima-media thickness more than 0.9 mm.Unstable atheroma plaque (UAP) was defined as low echo plaque and/or admixing echo plaque.Results Gender,age,BMI and blood pressure were not matched among groups.The prevalence of CA increased in moderate and severe SA-RH than that in control ( P ＜ 0.01 ) with no significant difference for UAP among groups.Factor analysis was performed to extracted common factors that may influence CA and UAP,such as factor 1-6,represent obstructive sleep apnea (OSA),dyslipidemia (TC,LDL),BMI,blood pressure,age and duration of disease and dyslipidemia (TG,HDL) respectively.Logistic analysis show that OSA and dyslipidemia (TC,LDL) increased the risk of CA,with OR 1.36(95％ CI 1.15-1.59),1.31 (95％ CI 1.12-1.54)respectively,and dyslipidemia (TC,LDL) increased the risk of UAP,with OR 1.30 (95％ CI 1.06-1.58).ConclusionsIn SA-RH populations,higher prevalence of CA may be associated with severity of OSA independently,meanwhile the formation of UAP may be mainly associated with dyslipidemia.

Abstract: Objective To investigate the prevalence of dissociative tendency and its influencing factors among middle school students, so as to provide insights into prevention and early interventions of adolescent dissociative tendency. Methods: Students at ages of 13 to 18 years that studied in 9 high schools were sampled using a multistage, stratified, cluster sampling method from 3 counties (districts) of Hangzhou City from January, 2021 and March, 2022. Participants' demographics and social, school, family environment and psychological factors were collected using self-designed questionnaires and standardized scales. The dissociative tendency was initially screened using the Adolescent Dissociative Experience Scale (A-DES), and the diagnosed by three psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders (5th Edition). Factors affecting ADT were identified using a multivariable logistic regression model. Results: Totally 3 240 students were recruited, and 2 841 students were qualified, with a response rate of 87.69%. The respondents included 1 389 men (48.89%) and 1 452 women (51.11%), and had a mean age of (15.69±1.58) years. The prevalence of dissociative tendency was 24.04%, and the detection of dissociative tendency was higher among men than among women (29.23% vs. 19.08%; χ2=24.529, P<0.001). Multivariable logistic regression analysis identified negative teacher-student relationship (OR=1.055, 95%CI: 1.010-1.103), family emotional expressiveness (OR=0.872, 95%CI: 0.777-0.978), family conflict (OR=1.152, 95%CI: 1.045-1.271), family organization (OR=0.880, 95%CI: 0.780-0.992) and family cohesion (OR=0.871, 95%CI: 0.766-0.987) as factors affecting dissociative tendency among men, and somatization (OR=1.041, 95%CI: 1.002-1.082) and paranoid ideation (OR=1.094, 95%CI: 1.006-1.190) as factors affecting dissociative tendency among women. Conclusions The prevalence of dissociative tendency was 24.04% among middle school students. Negative teacher-student relationship, family emotional expressiveness, family conflict, family organization, and family cohesion may affect dissociative tendency among men, while somatization and paranoid ideation may affect dissociative tendency among women.

Objective To investigate the association between the obstructive sleep apnea-hypopnea syndrome(OSAHS) in hypertension and insulin.Methods A total of 521 patients were divided into 4 groups according to apnea-hypopnea index and OSAHS degrees.The control group ( group Ⅰ ),mild OSAHS group ( group Ⅱ ),moderate OSAHS group ( group Ⅲ ) and severe OSAHS group ( group Ⅳ ) had 89 patients,194 patients,118 patients and 120 patients respectively.Results The BMI[( 30.4 ± 3.8 )kg/m2],apnea-hypopnea index ( AHI,3.8 ± 0.1 ),Fasting insulin (FIns)[(3.08 ± 0.26 ) mU/L]and insulin resistance ( 2.43 ± 0.27 ) of patients in severe OSAHS group were significantly higher than that of in the control,mild OSAHS group and moderate OSAHS group ( P ＜ 0.01 ).The levels of saturation of minimum oxygen from skin of patients in severe OSAHS group was significantly lower ( MSpO2 ) than in that of the control,mild OSAHS group and moderate OSAHS group.Multiple linear regression analysis showed that fasting plasma insulin and insulin resistance was positive correlation with apnea-hypopnea index,while they also negatively associated with saturation of minimum oxygen.Conclusions FIns and insulin resistance strongly associate with AHI and levels of saturation of minimum oxygen from skin.Hypertensive patients with OSAHS have more chances to suffer with insulin resistance.

ObjectiveTo explore the determinants of average length of stay of three county hospitals and eleven countryside hospitals of Xinjiang province.MethodsRelative data of the county and the countryside hospitals from 2009 to 2010 were collected,and descriptive analysis and rank sum test were employed to explore the determinants of average length of stay.ResultsThe average length of stay of the county hospital was longer than the countryside hospital,the average length of stay had significant differences between the gender,age,and the disease classfication.ConclusionThe average length of stay of the county hospitals and countryside hospitals had difference significantly.

Objective To study the effect of small interfering ribonucleic acid (siRNA) silencing apoptosis signal-regulating kinase 1 (ASK1) on inflammatory response of lipopolysaccharide-induced alveolar epithelial A549 cells and its mechanism.Method Cell inflammation model of A549 cells was induced by lipopolysaccharide.The expression of ASK 1 in A549 cells was silenced by liposome transfection of siRNA.The mRNA and expression levels of ASK1,interleukin 6 (IL-6),interleukin 8 (IL-8) and tumor necrosis factor alpha (TNF-α) in A549 cells were detected by immunoblotting,real-time fluorescence quantitative polymerase chain reaction and enzyme-linked immunosorbent assay.Result The expression of IL-6,IL-8 and TNF-α in the experimental group was significantly higher than that in the control group (P＜0.001),which indicated that the inflammatory model of A549 cells was successfully constructed.The mRNA level and expression of ASK1 in the interference group was significantly lower than that in the negative control group and the blank control group (P＜0.01),indicating that silencing ASK1 was also successful.The expressions of IL-6,IL-8 and TNF-α in the interference group (0.37±0.04,0.32±0.04,0.48 ±0.13) were significantly lower than those in the negative control group (1.04±0.11,1.22±0.19,0.93±0.14) and the blank control group (1.01±0.14,1.01 ±0.23,1.02±0.25).The expression of IL-6,IL-8 and TNF-α protein in the interference group (pg/ml) (122.6± 11.0,537.2±42.4,159.2± 19.6) were also significantly lower than those in the negative control group (267.4±20.4,1 289.8±55.3,327.0±26.3) and blank control group (246.6±18.7,1 300.3±35.6,325.2± 18.3),with significant difference (P＜0.05).There was no significant difference in each value between negative control group and blank control group (P＞0.05).Conclusion Silencing ASK1 by siRNA can down-regulate the expression of IL-6,IL-8 and TNF-α in A549 cells,suggesting that ASK 1 may be involved in the regulation of lipopolysaccharide-induced inflammation in A549 cells.