Objective To investigate the effect of Hydroxychloroquine plus Leflunomide on the lipid profile and disease activity index in patients with rheumatoid arthritis (RA).Methods A total of 140 elderly patients with RA who met the American College of Rheumatology (ACR) criteria were treated with Hydroxychloroquine (Group A,n =70) or leflunomide combined with hydroxychloroquine (Group B,n=70),and 100 healthy volunteers were selected as controls.The lipid profile was compared between the patient groups and control group.Lipid levels,Disease Activity Score 28 (DAS28),erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured before treatment and 6 months after treatment between Group A and Group B.Results Compared with the control group,RA patients exhibited higher levels of total cholesterol (TC,P＜0.05),low-density lipoprotein cholesterol (LDL-C,P＜0.05) and triglycerides (TG,P＜0.01),and lower levels of high-density lipoprotein cholesterol (HDL-C,P＜0.05).After 6 months of treatment,the disease activity index (DAS28,P＜0.01),the duration of morning stiffness (P＜0.01),ESR,CRP,swollen joint count (SJC) and tender joint count (TJC) decreased in RA patients,compared with controls (P＜0.01 or 0.05).HDL-C levels increased and LDL-C levels decreased in Groups A and B after treatment,compared with pretreatment (P＜0.05 for all).After treatment,TC levels decreased in Group B,compared with Group A (P＜ 0.05),while TG levels had no significant difference between the two groups (P＞0.05).TC and LDL-C levels,ESR,CRP,DAS28,SJC and TJC were lower in Group B than in Group A (all P＜0.05).Conclusions Hydroxychloroquine in combination with Leflunomide therapy can not only control inflammation but also improve the lipid profile,and is more effective than single-drug therapy.The combination may reduce the risk of atherosclerosis and cardiovascular events in patients with RA.

Objective To evaluate the values of bilateral inferior petrosal sinus sampling ( BIPSS),high dosage dexamethasone suppression test (HDDST) and pituitary image in the differential diagnosis of ACTH-dependent Cushing's syndrome. Methods Totally 87 patients with confirmed pathological diagnosis were recruited in the study.All received the procedure of BLPSS,HDDST,and pituitary MRI with dynamic enhancement.The diagnostic performances of three differential diagnosis methods in ACTH-dependent Cushing's syndrome were evaluated.Results Seventy-eight patients were diagnosed as cases of pituitary ACTH adenoma,and the remaining 9 were confirmed cases of ectopic ACTH syndrome due to the thymic carcinoid.The sensitivity and specificity of HDDST,pituitary MRI,and BIPSS for the diagnosis of ACTH-dependent Cushing's syndrome were 82.1％ and 100％,79.5％ and 44.4％,92.3％ and 100％,respectively.In Cushing's disease,the diagnostic accuracy was 83.9％ with HDDST,77.0％with pituitary MRI,and93.1％ with BIPSS.In those patients with Cushing's disease,the coincidence of lateralization was 83.9％ with BIPSS and 64.5％ with MRII.Conclusion BIPSS was better than the other two methods in differential diagnosis of ACTH-dependent Cushing's syndrome.Compared with the pituitary MRI,the concordant rate of BIPSS in lateralization of the tumor is higher,and it is more reliable.

Objective To evaluate the utility of waist-to-height ratio ( WHtR ) in predicting metabolic syndrome ( MS) among non-overweight Chinese adults, and to investigate the difference by age and sex. Methods Based on a population-based cross-sectional survey on MS in Zhejiang province in 2010, data of 10 792 non-overweight (body mass index<24. 0 kg/m2 ) adults aged 18 years and older were analyzed by using the receiver operating characteristic(ROC)curve analysis and multiple logistic regression. Results The area under ROC curve (AUC) values of WHtR in MS prediction were 0. 765(95%CI 0. 740-0. 789) and 0. 786(95%CI 0. 765-0. 807), and odds ratios(OR) of WHtR for MS were 1. 23(95%CI 1. 20-1. 27) and 1. 22(95%CI 1. 20-1. 26) in non-overweight men and women, respectively. These two values were with significant difference among non-overweight adults with different agedandsexes(P<0.01). No-overweightmenhadsmallerAUCandORamong18-34agegroupwhilelargerAUCand OR among 35-49, 50-64, and 65-plus age groups than women. The AUC and OR showed slight difference among age groups in non-overweight men, while these two values decreased with age in non-overweight women. The optimal cutoff value was higher in non-overweight women (0. 509 vs 0. 498) than that in men. Non-overweight men aged 50-64 years old had higher cutoff value than those aged 18-34, 35-49, and 65-plus years, while among non-overweight women the cutoff values increased with age. Conclusion WHtR had preferable discriminatory power and association with MS among non-overweight Chinese adults. Further studies should be conducted to explore the difference by age and sex.

Objective To analyze and discuss the current research status,hotspots,frontiers,and progress in work practice of family pharmacists both in domestic and abroad by Citespace.Methods The database of Web of Science Core Collection and CNKI were selected for data extraction.They searched for literature from the database from establishment to April 1,2023 using the topic words"family pharmacist"and"home pharmaceutical care"both in Chinese and English.The network diagrams of essential nodes such as authors,countries,institutions,and key words were analyzed and drawn Results A total of 439 Chinese and 572 English literatures were included in the study.Scholars such as Mei Shen,Shihui Bao,Zhongzhuang Wang,Hughes Carmel M,Jamieson Hamish A,and Chen Timothy F have significantly contributed.The UK and the United States were leading countries in family pharmacists.Most of China's top ten research institutions were from Shanghai,Beijing.The top five Chinese literature keywords were pharmaceutical care,community,pharmacist,rational drug use,family pharmacist.The top five English literature keywords were pharmaceutical care,care,management,older people,and impact.Conclusions According to keyword clustering and burst analysis,research hotspots in foreign countries mainly focus on pharmaceutical services,adverse drug reactions,adherence,etc.,which is consistent with the development direction of pharmaceutical services in China.However,domestic pharmacy's development and literature publication are slightly behind those of foreign countries,and there is still some development space for pharmaceutical services in China.

ObjectiveTo study the epidemiological characteristics of diabetes mellitus and awareness rate in Zhejiang adults.MethodA total of 17 437 adults from 15 counties were randomly selected with stratified multi-stage cluster sampling method from July to November,2010.Each participant was required to complete a set of standardized questionnaire,physical examination,and blood specimen collection.ResultsThe overall standardized rate of diabetes mellitus was 5.94％ ( crude prevalence 8.80％ ).It was increased by 96.67％ during past 8 years,as compared with the prevalence 3.02％ in 2002.The standardized rate of diabetes mellitus of the urban and rural area were 7.52％ and 5.19％ ( crude prevalence 11.33％ and 7.09％ ),respectively.The standardized rate of diabetes mellitus in the urban was higher than rural ( u =6.58,P＜0.05 ).The standardized rate of diabetes mellitus of the male and the female were 5.74％ and 6.15％ ( crude prevalence 8.36％ and 9.13％ ),respectively,without significant difference ( u =1.39,P＞0.05 ).The awareness rate of diabetes mellitus was 59.19％ ( 56.66％ in male and 61.23 ％ in female,x2 =3.26,P＞0.05 ).The awareness rate of the urban was higher than the rural (63.47％ vs 54.69％,x2=12.20,P＜0.01 ).ConclusionThe prevalence of diabetes mellitus showed a rapidly rising trend in Zhejiang province.The effective intervention should be taken at its early stage.

Objective To access the prevalence of type 2 diabetes mellitus ( T2DM) and its associated risk factors among adults with obesity in Zhejiang province. Methods The enrolled subjects were selected among local residents aged≥18 years with body mass index≥28 kg/m2 from 15 counties by multi stage stratified cluster random sampling from July to November, 2010. Each participant was required to attend complete questionnaire, physical examination, and testing overnight fasting blood specimen. Results A total of 1 351 residents were enrolled, including 613 males and 738 females. The prevalence of T2DM in adult population with obesity was 15. 03%, being 14. 03% in male, and 15. 85% in female;and that in urban area was 16. 64%, and in rural area was 13. 93%. Data from multivariable logistic regression showed that factors such as ageing (OR=1. 473, 95% CI 1. 243-1. 747), a family history of T2DM(OR=8. 945, 95% CI 5. 481-14. 598), staple food intake (OR=1. 185, 95% CI 1. 017-1. 380), triglyceride(≥1. 7 mmol/L, OR=1. 542, 95%CI 1. 066-2. 232) were risk factors of T2DM;while annual income(OR=0. 695, 95%CI 0. 544-0. 888), and milk intake(OR=0. 750, 95%CI 0. 567-0. 993) were shown as protective factors. Conclusion The prevalence of T2DM in adults with obesity was raised, ageing, a family history of T2DM, staple food intake, and dyslipidemia appeared to be major risk factors for T2DM.

Objective To study the influence of diet and behavior related factors on the peripheral blood triglyceride levels in adults,through a cross-sectional survey.Methods The current study included 13 434 subjects without histories of major chronic diseases from a population-based cross-sectional survey:the 2010 Metabolic Syndrome Survey in Zhejiang Province.A generalized linear model was used to investigate the influence of diet/behavior-related factors on the peripheral blood triglyceride levels.Results Mean TG of the sample population appeared as (1.36± 1.18) mmol/L.The proportions of elevated TG and marginally elevated TG were 10.3％ and 11.0％ respectively,with statistically significant difference seen between males and females (x2=44.135,P＜0.001).In this sampled population,the daily intake of cooking oil was exceeding the recommendation levels by over 50％ while the intake of fruit,milk,nuts and physical exercise were much below the recommendation.There were statistically significant differences between smoking,alcohol-intake,meat,fruit and water intake in male population from this study.However,in females,the intake of aquatic product and physical exercise showed statistically significant differences.After controlling for other variables,factors as age,drinking,staple food and aquatic products showed positive influence on TG,while milk presented negative influence on TG.Through interaction analysis,fruit and meat intake in males and staple food in females showed positive influence on TG,when compared to the reference group.Conclusion Hyperglyceridemia appeared as one of the major metabolic abnormities in Zhejiang province.Programs on monitoring the alcohol,staple food and meat intake should be priority on intervention,in the communities.

Objective To explore the association between socioeconomic status (SES) and blood pressure control in diagnosed hypertension patients. Methods The database of Zhejiang provincial survey on metabolic syndrome which implemented in 2010 in which prior hypoertensive patients were brought into this sutdy. Descriptive statistics were applied to test the distributive differences of relevant factors(age, sex, marital status, hypertension duration, BMI, education level, per capita household yearly income,smoking, alcohol drinking, fruit and vegetable intake) between patients with optimally-controlled blood pressure and those without. The SES of diagnosed hypertension patients was measured separately by two common indicators:education level and the per capita household yearly income. Univariate and multivariate logistic regression models were used to differentiate the association between those two SES indicators and blood pressure control, and the trend of the association was also tested. Results Totally, 2 394 hypertension patients were diagnosed and identified. Of the patients analysed, the overall mean was (61.53±10.64) years, and 55.7%(1 334 cases) had ≤5 years' disease duration. 1 090 achieved optimal blood pressure control, which accounted for a proportion of 45.5%. 1 676 had elementary school education and below, accounting for 70.1%. The patients with per capita household yearly income of<5 000 Yuan and 5 000-14 999 Yuan groups were 401(29.4%) and 690(50.5%) respectively. 416(17.4%) were smokers and 541(22.6%) were alcohol drinkers. Based on the statistical tests, we found that the distributions of age, marital status, hypertension duration, body mass index, smoking and alcohol drinking were different between two groups(t or χ2 values were 4.57,5.44,6.40,6.21,5.99,3.98,respectively,all P values were<0.05). Optical blood pressure control in higer education level group was significantly better than that of in lower education level (χ2=12.65,P<0.001), and there was no statistical significance association between per capita household yearly income and optimal blood pressure control(χ2=2.78,P=0.249). Multivariate logistic regression models revealed that, of those two SES indicators, a positive association was shown between education level and optimal blood pressure control: compared with patients in the category of‘elementary school and below, those of‘junior high school and above observed an OR of 1.40 (95%CI:1.09-1.81). And in further trendχ2 test, we identified a trend of such association(χ2trend=12.74,P=0.002).However, no significant association has been recognized between per capita household yearly income and optimal blood pressure control:compared with patients in the category of<5 000 Yuan group, those of 5 000-14 999 Yuan and≥15 000 Yuan groups had OR of 0.93(95%CI:0.72-1.20)and 1.04(95%CI:0.83-1.31)respectively. Conclusion Among all diagnosed hypertension patients, those with lower education level have poorer blood pressure control and should be labelled as the key population for intense health education and standardized management to improve their blood pressure control status.

Objective To explore the association between socioeconomic status (SES) and blood pressure control in diagnosed hypertension patients. Methods The database of Zhejiang provincial survey on metabolic syndrome which implemented in 2010 in which prior hypoertensive patients were brought into this sutdy. Descriptive statistics were applied to test the distributive differences of relevant factors(age, sex, marital status, hypertension duration, BMI, education level, per capita household yearly income,smoking, alcohol drinking, fruit and vegetable intake) between patients with optimally-controlled blood pressure and those without. The SES of diagnosed hypertension patients was measured separately by two common indicators:education level and the per capita household yearly income. Univariate and multivariate logistic regression models were used to differentiate the association between those two SES indicators and blood pressure control, and the trend of the association was also tested. Results Totally, 2 394 hypertension patients were diagnosed and identified. Of the patients analysed, the overall mean was (61.53±10.64) years, and 55.7%(1 334 cases) had ≤5 years' disease duration. 1 090 achieved optimal blood pressure control, which accounted for a proportion of 45.5%. 1 676 had elementary school education and below, accounting for 70.1%. The patients with per capita household yearly income of<5 000 Yuan and 5 000-14 999 Yuan groups were 401(29.4%) and 690(50.5%) respectively. 416(17.4%) were smokers and 541(22.6%) were alcohol drinkers. Based on the statistical tests, we found that the distributions of age, marital status, hypertension duration, body mass index, smoking and alcohol drinking were different between two groups(t or χ2 values were 4.57,5.44,6.40,6.21,5.99,3.98,respectively,all P values were<0.05). Optical blood pressure control in higer education level group was significantly better than that of in lower education level (χ2=12.65,P<0.001), and there was no statistical significance association between per capita household yearly income and optimal blood pressure control(χ2=2.78,P=0.249). Multivariate logistic regression models revealed that, of those two SES indicators, a positive association was shown between education level and optimal blood pressure control: compared with patients in the category of‘elementary school and below, those of‘junior high school and above observed an OR of 1.40 (95%CI:1.09-1.81). And in further trendχ2 test, we identified a trend of such association(χ2trend=12.74,P=0.002).However, no significant association has been recognized between per capita household yearly income and optimal blood pressure control:compared with patients in the category of<5 000 Yuan group, those of 5 000-14 999 Yuan and≥15 000 Yuan groups had OR of 0.93(95%CI:0.72-1.20)and 1.04(95%CI:0.83-1.31)respectively. Conclusion Among all diagnosed hypertension patients, those with lower education level have poorer blood pressure control and should be labelled as the key population for intense health education and standardized management to improve their blood pressure control status.

OBJECTIVETo explore the association between socioeconomic status (SES) and blood pressure control in diagnosed hypertension patients.

METHODSThe database of Zhejiang provincial survey on metabolic syndrome which implemented in 2010 in which prior hypoertensive patients were brought into this sutdy. Descriptive statistics were applied to test the distributive differences of relevant factors (age, sex, marital status, hypertension duration, BMI, education level, per capita household yearly income, smoking, alcohol drinking, fruit and vegetable intake) between patients with optimally-controlled blood pressure and those without. The SES of diagnosed hypertension patients was measured separately by two common indicators: education level and the per capita household yearly income. Univariate and multivariate logistic regression models were used to differentiate the association between those two SES indicators and blood pressure control, and the trend of the association was also tested.

RESULTSTotally, 2 394 hypertension patients were diagnosed and identified. Of the patients analysed, the overall mean was (61.53 ± 10.64) years, and 55.7% (1 334 cases) had ≤ 5 years' disease duration. 1 090 achieved optimal blood pressure control, which accounted for a proportion of 45.5%. 1 676 had elementary school education and below, accounting for 70.1%. The patients with per capita household yearly income of < 5 000 Yuan and 5 000-14 999 Yuan groups were 401 (29.4%) and 690 (50.5%) respectively. 416 (17.4%) were smokers and 541 (22.6%) were alcohol drinkers. Based on the statistical tests, we found that the distributions of age, marital status, hypertension duration, body mass index, smoking and alcohol drinking were different between two groups (t or χ² values were 4.57, 5.44, 6.40, 6.21, 5.99, 3.98, respectively, all P values were < 0.05). Optical blood pressure control in higer education level group was significantly better than that of in lower education level (χ² = 12.65, P < 0.001), and there was no statistical significance association between per capita household yearly income and optimal blood pressure control (χ² = 2.78, P = 0.249). Multivariate logistic regression models revealed that, of those two SES indicators, a positive association was shown between education level and optimal blood pressure control: compared with patients in the category of 'elementary school and below, those of 'junior high school and above observed an OR of 1.40 (95% CI: 1.09-1.81). And in further trend χ² test, we identified a trend of such association (χ² trend = 12.74, P = 0.002). However, no significant association has been recognized between per capita household yearly income and optimal blood pressure control: compared with patients in the category of < 5 000 Yuan group, those of 5 000-14 999 Yuan and ≥ 15 000 Yuan groups had OR of 0.93 (95% CI: 0.72-1.20) and 1.04 (95% CI: 0.83-1.31) respectively.

CONCLUSIONAmong all diagnosed hypertension patients, those with lower education level have poorer blood pressure control and should be labelled as the key population for intense health education and standardized management to improve their blood pressure control status.

Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Demography ; Education ; Feeding Behavior ; Fruit ; Humans ; Hypertension ; Income ; Logistic Models ; Metabolic Syndrome ; Smoking ; Social Class ; Treatment Outcome ; Vegetables