Abstract The aging process is increasingly accelerating in China, and the improvement of health literacy is a prerequisite to achieving health for all, and is an important strategy to promote healthy aging. Based on recent studies pertaining to health literacy among the elderly, this review, from the perspective of aging, summarizes the level and common influencing factors of health literacy among Chinese elderly populations, and discusses the health literacy promotion strategies among the elderly, so as to provide insights into improving the health literacy surveillance and promotion quality and health literacy levels among the elderly.

OBJECTIVETo evaluate incidence of postoperative delirium after hip surgery in elderly patients by meta-analysis.

METHODSFrom January 1, 2014 to December 31, 2013, clinical literatures about postoperative delirium after hip surgery in elderly patients,were searched from the Pubmed. Literature extract table were formed according to inclusion and exclusion criteria. Stata-12.0 was applied for Meta-analysis. P was used to test heterogeneity of study, random-effect model was performed when I2 > 50%. Subgroup analysis was used according to stage of age, assessment scale of delirium and statistical area of literature. Begg test was used to test publication bias.

RESULTSTwenty-one literatures were included. Incidence of postoperative delirium after hip surgery in elderly patients by weighted and combination was 17% [95% CI (16%, 18%)]. Incidence of postoperative delirium after optional hip surgery was decreased more than emergency operation in included 5 literatures [OR = 0.32, 95% CI (0.22, 0.45)]. Incidence of postoperative delirium in patients less than 80 years old was 21% [95% CI (19%, 23%)], while 21% [95% CI (19%, 24%)] in patients more than 80 years old. Incidence of postoperative delirium in CAM evaluation scale was 23% [95% CI (21%, 26%)], while 19% [95% CI (17%, 21%)] in other evaluation scales. Incidence of postoperative delirium in Asian area was 17% [95% CI (15%, 20%)], while 23% [95% CI (21%, 25%)] in European and American area. There was no publication bias tested by Begg test (P < 0.05).

CONCLUSIONIncidence of postoperative delirium after hip surgery in elderly patients increases higher, especially in emergency operation. A standardizing research method is benefit for evaluate incidence of postoperative delirium after hip surgery in elderly patients, decreasing heterogeneity and publication bias.

Aged ; Delirium ; epidemiology ; Hip Fractures ; surgery ; Humans ; Incidence ; Postoperative Complications ; epidemiology ; Publication Bias

Objective: To investigate the prevalence of cigarette and electronic cigarette ( e-cigarette ) use among adults in Zhejiang Province, so as to provide insights into tobacco control. Methods : Thirty study sites were randomly sampled from Zhejiang Province in 2020 using a multi-stage stratified random sampling method, and permanent residents at ages of 15 to 69 years were selected as study subjects. A questionnaire was designed based on the questionnaire for the China Adult Tobacco Survey to collect subjects' demographic characteristics, cigarette and e-cigarette use, smoking cessation and exposure to secondhand smoke ( SHS ). The weighted prevalence of smoking, current smoking, current e-cigarette smoking, smoking cessation and exposure to SHS was estimated based on the Seventh National Population Census in 2020. Results : A total of 19 200 questionnaires were recovered, and 19 180 were valid, with an effective recovery rate of 99.90%. The respondents had a mean age of ( 50.30±12.90 ) years, with a male to female ratio of 1∶1.06 and an urban/rural population ratio of 1∶1.31. Among all the respondents, there were 6 033 smokers ( 31.45% ), 4 163 current smokers ( 21.70% ), 201 current e-cigarette users ( 1.05% ), 146 cigarette and e-cigarette dual users ( 0.76% ), 1 870 respondents quitting smoking ( 31.00% of smokers ) and 7 189 respondents with exposure to SHS ( 47.87% of non-smokers ). The weighted prevalence of smoking, current e-cigarette use, cigarette and e-cigarette dual uses, smoking cessation and exposure to SHS was 20.49%, 1.34%, 0.94%, 29.56% and 49.53% in Zhejiang Province, respectively, and the prevalence of current smoking, current e-cigarette use, cigarette and e-cigarette dual uses and exposure to SHS was 40.39%, 2.39%, 1.86% and 55.31% among males and 0.35%, 0.28%, <0.01% and 46.02% among females, respectively. The highest prevalence of current smoking was seen among respondents at ages of 55 to 64 years ( 24.24% ), while the highest prevalence of current e-cigarette use and cigarette and e-cigarette dual uses was seen in adults at ages of 25 to 34 years ( 2.18% and 1.58% ). Conclusions The prevalence of current e-cigarette use was higher among adults in Zhejiang Province in 2020 than the nationwide level in China. The prevalence of cigarette use was lower among adults in Zhejiang Province in 2020 than the nationwide level in China; however, improving the management of tobacco control in public places and the capacity building of smoking cessation services is still required to reduce the use of cigarettes and e-cigarettes.

Objective: To investigate the changing trends in the prevalence of health literacy among rural residents in Zhejiang Province from 2016 to 2021, so as to provide the evidence for formulating the health promotion strategy in rural areas. Methods: Rural residents' health literacy surveillance data were retrieved in Zhejiang Province from 2016 to 2021. The prevalence of health literacy was evaluated among rural residents according to the criteria defined by Chinese Center for Health Education, and standardized by Zhejiang Provincial population data captured from the national population census in China. The 6-year cumulative increase from 2016 to 2021 was estimated to investigate the changing trends in the prevalence of health literacy. Results: Totally 55 568 rural residents were monitored in Zhejiang Province from 2016 to 2021, including 26 893 men (48.40%) and 28 675 women (51.60%) and 32 156 residents at ages of 45 to 65 years (57.87%). The prevalence of health literacy was 18.00%, 21.52%, 25.53%, 27.54%, 30.85%, and 34.32% among rural residents in Zhejiang Province from 2016 to 2021, appearing a tendency towards a rise (χ2trend=661.376, P<0.001), and a 16.32% 6-year cumulative increase was seen. The prevalence of basic knowledge and concept, healthy lifestyle and behaviors and basic skills all appeared a tendency towards a rise (P<0.05), with 6-year cumulative increase rates of 24.48%, 11.08% and 8.11%, respectively. Among six categories of health issues, the prevalence of chronic disease prevention, scientific health outlook and health information literacy showed a tendency towards a rise year by year (P<0.05), with 6-year cumulative increase rates of 29.73%, 21.07% and 15.98%, respectively, and the prevalence of basic medical care, safety and first aid, and infectious disease prevention literacy appeared a fluctuation (P<0.05), with 6-year cumulative increase rates of 12.85%, 6.36% and -0.47%, respectively. The prevalence of health literacy appeared an overall tendency towards a rise in rural residents with different genders, age groups, educational levels and occupations (P<0.05), with a minor 6-year cumulative increase in residents at ages of 55 years and older and farmers, while a tendency towards a decline was seen among illiterate rural residents, with a 6-year cumulative rise of -3.16%. Conclusions The prevalence of health literacy appeared a tendency towards a rise among rural residents in Zhejiang Province from 2016 to 2021; however, the rate of increase reduced year by year. Health education and promotion should be enhanced targeting the elderly, individuals with low educational levels and farmers.

Objective To evaluate the risk factors of breast cancer in Asian women and to provide evidences for establishing a risk assessment model. Methods Published studies concerning risk factors of breast cancer in Asian women were searched systemically and assessed by NOS (Newcastle-Ottawa Scale) items between 1995 and 2010. RevMan 4.2 software was used for data analysis and for calculating OR and its 95%CI on every risk factor. Results 27 studies including 403170 women were selected for Meta-analysis. According to NOS items, 20 studies were classified as A degree and 7 studies were evaluated as B degree. The risk factors of breast cancer and its pooled odds ratio values with statistical significance were as follows: 3.00 (95%CI: 1.68-5.36) when number of abortions≥3; 2.39 (95%CI: 1.78-3.21 ) when with family history of breast cancer; 1.54(95%CI: 1.30-1.82) when age at first live birth ≥30 (year); smoking was 1.50(95%CI: 1.03-2.20); 1.48(95%CI:1.20-1.83) with no live births; 1.29 (95%CI: 1.12-1.47) with no breast feeding; 1.26 (1.07-1.49)with age at menarche ≤12 (year) and 1.16(95%CI: 1.01-1.32) with alcohol drinking. Conclusion Number of abortions≥3, family history of breast cancer, age at first live birth ≥30 (year) ,smoking, no live births, no breast feeding, age at menarche ≤ 12 (year), and alcohol drinking were among the priorities in the establishment of breast cancer risk assessment model for Asian women.

Child ; Child, Preschool ; Female ; Follicle Stimulating Hormone ; blood ; Gonadotropins ; blood ; Humans ; Infant ; Infant, Newborn ; Male ; Sex Factors ; Time Factors

Objective:To investigate the current situation of insomnia in patients with acute coronary syndrome (ACS), and analyze the influencing factors of insomnia in the ACS patients, so as to provide information on the development of new strategies for the treatment of insomnia in ACS patients.Methods:This is a multicenter and prospective observational study. A total of 771 ACS patients who met the criteria were selected from March 2013 to June 2015. The baseline social demographic information, sleep quality questionnaire, general anxiety disorder scale-7(GAD-7),patient health questionnaire-9(PHQ-9), short-form 12 health survey questionnaire(SF-12), and enhancing recovery in coronary heart disease patients social inventory(ESSI) were completed within 7 days after admission. Logistic regression analyses were used to analyze the influencing factors of insomnia in ACS patients.Results:A total of 741 subjects with valid questionnaires were collected, including 510 males (68.8%) and 231 females (31.2%). Among them, 487 (65.7%) subjects had at least one insomnia symptom: 308 (41.6%) subjects had difficulty in falling asleep, 369 (49.8%) subjects were easy to wake at night, 116 (15.7%) subjects woke up earlier than they expected, 74 (10.0%) subjects experienced both woke up earlier and difficulty in falling asleep, and 53 (7.2%) subjects woke up earlier, woke up at night and had difficulty in falling asleep at the same time. Logistic regression analyses showed that before admission physical activity ( OR =0.636, 95% CI 0.411-0.984), depression ( OR=1.908, 95% CI 1.101-3.305) and low social support ( OR=0.278, 95% CI 1.198-3.301) were independent factors of insomnia in ACS patients. Conclusions:Nearly 2/3 ACS patients have symptoms of insomnia. Difficulty in falling asleep and easy to wake up at night are the most common manifestations. Physical activity, depression and social support independently are associated with insomnia.

Objective To explore the physical and mental health status on the ‘left behind ’ students in Anhui province and the related influential factors.Methods Stratified cluster sampling method was used to investigate the 682 out of 3421 students from 7 middle schools in both south and north Anhui province,using multidimensional sub-health questionnaire of adolescents (MSQA) and mental health test (MHT),for assessment of the general condition,physical and mental health status.Results 14.22％ of the ‘left behind’ students were in sub-health condition compared to 11.28％ among the normal students,and the mental sub-health status represented 13.64％ for the former and 10.84％ for the latter.In addition,the ‘left behind’ students appeared less content with their life than those of staying with their parents (P＜0.05).MHT scores in the subjects were positively correlated with the scores on MSQA and showed significant difference (P＜0.01).Results from the multiple linear regression analysis showed that the mental health condition among the left behind students was in linear regression relationship with the decreased physical activity (β =1.456,P=0.001 ),emotional problems (β =1.096,P=0.000 ) and problems of social adaptation (β=1.011,P=0.006).The status of physical sub-health in the Anhui province showed that there was no significant difference in each of the study group (P＞0.05).Conclusion Decreased physical activity and emotion aporia as well as difficult social adaptation were major factors leading to degenerated mental health levels in the‘left-behind’ adolescents.The findings suggested that the mental health status could be improved inthis population through better management on their body-health condition.

Objective To explore the risk factors and clinicopathologic characteristics of severe hand,foot and mouth disease (HFMD),and to provide a scientific basis for clinical interventions.Methods The clinical data of 2606 hospitalized children with HFMD in Ningbo No.2 Hospital were analyzed retrospectively from January 2010 to December 2012.Clinical characteristics were compared between two groups (regular case group and severe case group),and risk factors of severe HFMD were analyzed by Logistic regression test.The clinicopathologic features were analyzed from an autopsy case.Results Among total 2606 cases,619 cases were severe HFMD (23.7％).Logistic regression test showed that EV71 infection,poor spirit,blood glucose ＞ 9 mmol/L,high fever (temperature ≥ 39.1 ℃) lasted more than three days,younger than 3 years and abnormal neural reflex were the independent risk factors of HFMD seriousness.The results of the autopsy showed that the central nervous system,lung and intestinal were most severely.Conclusion Attention should be paid to observe the condition changes in HFMD patients with EV71 infection,younger than 3 years,nervous system symptoms,blood glucose ＞ 9 mmol/L and high fever.Targeted clinical intervention is particularly important for improving cure rate,and the protection of intestinal function can't be ignored.

OBJECTIVETo explore the relationship between quinone oxidoreductase1 (NQO1) gene nonsynonymous cSNP and the genetic susceptibility of esophageal cancer.

METHODSPolymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and Allele-Specific PCR (AS-PCR) were employed to assess the polymorphism of NQO1 genes both in 106 patients with esophageal cancer and control subjects matched by age, gender and origin.

RESULTSIt was shown that no C/C genotype was found at 406 of NQO1. The allelic frequency of NQO1 609T was significantly higher in patients with esophageal cancer than in the control subjects (P < 0.005) and the individuals with 609T allelic genotype of NQO1 gene were at greater risk to develop esophageal cancer (OR = 4.76, 95% CI = 1.064 - 3.397). But Individuals with mutant allele of NQO1 465 genotype did not show the rising risk of esophageal cancer.

CONCLUSIONSThe NQO1 C609T polymorphisms should likely be associated with the genetic susceptibility of esophageal cancer.

Alleles ; China ; Esophageal Neoplasms ; ethnology ; genetics ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; NAD(P)H Dehydrogenase (Quinone) ; genetics ; Polymorphism, Single Nucleotide