Objective To investigate the prevalence of anxiety and depression in elderly patients with metabolic syndrome (MS) and its related factors.Methods A total of 672 subjects aged 60 or over undergoing health check-up in two Nanjing community health service centers from November 2015 to October 2016 were enrolled in the study.The basic information and the history of hyperlipidemia,hypertension and diabetes were collected by questionnaire survey;the results of physical examination and biochemical testing were documented.The prevalence of anxiety and depression were investigated by the Hospital Anxiety and Depression Scale (HADS).According to MS diagnostic criteria,the subjects were divided into MS group (n=181) and non-MS group (n=491).The HADS scores of two groups were compared and the influencing factors related to anxiety and depression were analyzed.Results The levels of systolic blood pressure (SBP),diastolic blood pressure (DBP),body mass index(BMI),levels of fasting blood glucose (FBG),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) were higher and high density lipoprotein cholesterol (HDL-C) was lower in MS group than those in non-MS group (all P<0.05).The prevalence rates of anxiety and depression in MS group (30.9% and 34.8%) were significantly higher than those in non-MS group (20.2% vs.25.1%,χ2=8.655,6.288,P=0.003,0.012).Multivariate logistic regression analysis showed that obesity (BMI≥28 kg/m2),high FBG (≥7.0 mmol/L),hypertension [blood Pressure≥140/90 mmHg (1 mmHg=0.133 kPa)] were the independent risk factors for anxiety in MS patients (OR=3.987,2.827,2.375,respectively,all P<0.05);obesity (BMI≥28 kg/m2),high FBG(≥7.0 mmol/L),smoke,high TC (≥5.2 mmol/L),hypertension (≥140/90 mmHg) were the independent risk factors for depression in MS patients (OR=7.718,3.233,2.071,1.932,1.910,respectively,all P<0.05).Conclusion Elderly patients with metabolic syndrome are prone to anxiety and depression,and obesity,high FBG,hypertension and other factors are the risk factors for anxiety and depression.

Objective To evaluate the association between vitamin D (VD) and vascular endothelial injury in hypertensive patients.Methods Ninety nine patients with hypertension and 126 healthy subjects (control group) from the same community in Nanjing were recruited in the study.The serum levels of fasting blood glucose (GLU),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were measured.Serum 25-hydroxy vitamin D (25-OH-D) and nitric oxide (NO) levels were determined by enzyme-linked immunosorbent assay.The level of plasma endothelial microparticles was measured by flow cytometry.The data were statistically analyzed with SPSS version 19.O.Results The serum 25-(OH)-D [(55.22 ± 11.92) nmol/L vs.(64.17 ± 21.52) nmol/L,t =-3.71],vitamin D binding protein (VDBP) [(257.32 ±141.31) ng/mlvs.(314.21±124.13) ng/ml,t=-3.21],NO levels [(39.35±13.33)μmol/L vs.(43.42 ± 11.83) μmol/L,t =-2.42] in hypertension group were significantly lower than those in control group.And the circulating endothelial cell particles (4.95 ± 1.78 vs.2.84 ± 2.07,t =8.05) in hypertension group was significantly higher than that in control group.In hypertensive patients,the circulating endothelial cell particles in VD deficiency group was significantly higher than that in low VD group and normal VD group [(6.42 ± 1.25)％ vs.(4.6 ± 1.68)％,(3.15 ±0.90)％,F =15.08].And the serum NO level in VD deficiency group was significantly lower than that in other two groups [(36.57 ± 10.52) μmol/L vs.(39.77 ± 13.01) μmol/L,(46.26 ± 25.90) mol/L,F =1.20].Multiple linear regression analysis showed that low serum 25 (OH) D(B =-0.189,SE =0.033,β =0.509,t =-5.72) and gender (B =-0.682,SE =0.351,β =-0.182,t =-2.054) were the risk factors of vascular endothelial injury.Conclusion The serum vitamin D levels in hypertensive patients is decreased,and vitamin D deficiency may be a risk factor for endothelial injury in hypertension.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.