Objective To investigate the associations of reproductive health indicators with lung function and chronic obstructive pulmonary disease(COPD)among women aged 40 years and above.Methods From Jul to Sep,2021,female subjects aged 40 years and above were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for COPD screening.A questionnaire was used to obtain information on demographic characteristics and reproductive health indicators.Linear regression was used to analyze the effects of reproductive health indicators on forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1).Logistic regression was also used to analyze the effects of reproductive health factors on FVC as a percentage of the predicted value(FVC%Pred)and FEV1%Pred as well as on COPD.Results A total of 1876 women aged 40 years and above were enrolled with mean age of(62.1±8.2)years old,among them,78.1%were menopausal,and 40.9%had been pregnant≥3 times.Multivariate analysis showed that FVC and FEV1 decreased in postmenopausal women,but menopause was not associated with a decrease in their percentage of predicted values.Pregnancies≥3 times was a risk factor for COPD(for 3 times,OR=4.92,95%CI:1.48-19.95,P<0.05;for≥4 times,OR=9.06,95%CI:2.32-41.57,P<0.01),while pregnancies of 2 times did not increase the risk of COPD.Conclusion In women aged 40 years and above,menopause is associated with poorer FVC and FEV1,and excessive pregnancy(≥3 times)is a risk factor for COPD.

Objective: To analyze the relationship between sedentary behavior and the force expiratory volume in 1 second (FEV₁) reduction in middle-aged and elderly people in communities. Methods: The participants aged ≥40 years were randomly selected from a natural population cohort in Songjiang District, Shanghai, for pulmonary function tests and survey by using international physical activity questionnaire, a generalized additive model was used to analyze the association between sedentary behavior and FEV₁ reduction in the study population and different sex-age subgroups. Results: A total of 3 121 study subjects aged ≥40 years were included. The prevalence of FEV₁ reduction was 14.8%, which was higher in men than in women. There were 24.8% participants were completely sedentary. The prevalence of FEV₁ reduction in women aged <60 years in complete sedentary group was 2.04 (95%CI: 1.11-3.72) times higher than that in non-complete sedentary group. In men aged <60 years, the prevalence of FEV₁ reduction increased with daily sedentary time (OR=1.16, 95%CI: 1.04-1.29), and the prevalence of FEV₁ reduction was also higher in those with sedentary time >5 hours/day than those with sedentary time ≤5 hours/day (OR=3.02, 95%CI: 1.28-7.16). The sensitivity analysis also found such associations. Conclusions: FEV₁ reduction rate in age group <60 years was associated with sedentary behavior. Complete sedentary behavior or absence of moderate to vigorous physical activity played important roles in FEV₁ reduction in women, while men were more likely to be affected by increased sedentary time, which had no association with physical activity. Reducing sedentary time to avoid complete sedentary behavior, along with increased physical activity, should be encouraged in middle-aged and elderly adults in communities to improve their pulmonary function.
Male ; Aged ; Middle Aged ; Humans ; Adult ; Female ; Infant ; Sedentary Behavior ; China/epidemiology* ; Exercise ; Surveys and Questionnaires ; Prevalence

Objective: To explore the combination of metabolism-related chronic diseases associated with the prevalence of non-alcoholic fatty liver disease (NAFLD) in community residents in Shanghai. Methods: The baseline data of Shanghai Suburban Adult Cohort and Biobank were used to understand the prevalence of five metabolism-related chronic diseases, including obesity, hypertension, hyperlipidemia, gout and diabetes, based on questionnaire survey, physical examination and blood biochemical detection. NAFLD was diagnosed by B-ultrasound detection and questionnaire. Multivariable logistic regression model was used to analyze the association of 31 metabolism-related chronic diseases combinations with the prevalence of NAFLD. Results: The median age (Q₁, Q₃) of 65 477 subjects was 60 (51, 66) years, and men accounted for 40.6%. The overall prevalence of NAFLD was 38.2%, and the prevalence of HAFLD in patients without any of the five metabolism-related chronic diseases was 12.0%. The chronic disease combination with the strongest association with NAFLD was obesity + hypertension + hyperlipidemia + gout + diabetes in the total population (OR=37.94, 95%CI: 31.02-46.41), in women (OR=36.99, 95%CI: 28.78-47.54) and in age group ≥60 years (OR=36.19, 95%CI: 28.25-46.36). The chronic disease combination with the strongest association with NAFLD was obesity + hyperlipidemia + gout + diabetes in men (OR=50.70, 95%CI: 24.62-104.40) and in age group <60 years (OR=49.58, 95%CI: 24.22-101.47). Conclusions: The prevalence of NAFLD in community residents in Shanghai was high. Attention needs to be paid to health of obese people and weight loss should be promoted for them. Community health education should be strengthened for patients complicated with gout, diabetes, hyperlipidemia and hypertension and it is necessary to correct abnormal serum uric acid, blood sugar, blood lipids and blood pressure in a timely manner to reduce the risk of NAFLD.

Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To determine the prevalence and risk factors of asthma among adults. Methods:A total of 37 670 adults aged 18 years and above was enrolled in Songjiang District， Shanghai using a multi-stage stratified sampling method between April 2016 and October 2017. Statistical analysis， such as t-test and Chi-square test， was performed to check the difference between the participants with asthma and non-asthma participants. Risk factors for asthma were examined by logistic regression analysis in all participants. Results:Overall， 36 698 subjects were enrolled in the study， in which 752 had asthma. The overall prevalence of asthma was determined to be 2.05%. The prevalence in females was 2.16%， and that in males was 1.88%， which didn’t achieve significance（P>0.05）. Compared to non-asthma participants， those with asthma were more likely to be older （［60.3±9.48］ years vs. ［56.29±11.31］ years）， widowed （6.91%>4.45%，P<0.05）， with educational level of primary school and below （58.64%>46.55%， P<0.01）， higher level of total cholesterol （TC） and low-density lipoprotein cholesterol （LDL-C） （P<0.05）， had more co-morbidities， such as hypertension （42.00%>15.00%，P<0.001）， chronic obstructive pulmonary disease （COPD） （6.25%>0.41%，P<0.001）， chronic bronchitis （51.33%>6.32%，P<0.001） and tuberculosis （2.66%>0.96%，P<0.05）， depression（2.13%>0.41%，P<0.05）， and Parkinson's disease （0.93%>0.39%，P<0.05）. Multivariable analysis showed that family history of asthma， history of hypertension， chronic bronchitis， COPD， depression and educational level of primary school and below were the risks factors associated with adult asthma （P<0.05）. Conclusion:Prevalence of adult asthma in Shanghai has increased in recent years. Targeted health education may be strengthened for improving adult awareness towards asthma and reducing the disease burden.

Objective: Most patients with asymptomatic colorectal diverticulosis are easily overlooked. However, some of diverticulosis become diverticulitis, bleeding and even perforation, which cause extensive harm to patients. The purpose of this study is to analyze the incidence, clinical features, diagnosis and treatment of colorectal diverticulosis in order to improve the clinical understanding of diverticulosis and its related complications. Methods: A descriptive cohort study was carried out. Clinical data of 554 patients with colorectal diverticulosis confirmed by CT, colonoscopy, digestive tract radiography or operation in Peking University First Hospital from January 2009 to June 2019 were retrospectively analyzed. Patients with malignant tumors, autoimmune diseases, long term use of immunosuppressive drugs, chronic liver diseases and renal diseases, and mental disorders were excluded. The analysis parameters included gender, onset age, clinical symptoms, location of diverticulitis, treatment and prognosis. According to the criteria established by the World Society of Emergency Surgery (WSES), acute diverticulitis was divided into 5 stages based on the extension of the infectious process. Stage 0 was simple diverticulitis and stage 1-4 was complicated diverticulitis. Results: Among the 554 patients with colorectal diverticulosis, 358 (64.6%) were males, the median onset age was 63 years; 191 patients (34.5%) had various digestive symptoms, of whom 113 (20.4%) had chronic constipation and abdominal distension, 78 (14.1%) had chronic diarrhea and abdominal pain; the other 363 patients had no obvious abdominal symptoms. Four hundred and six patients were found by colonoscopy and 465 patients were found by CT. Twenty-five patients were diagnosed by lower gastrointestinal tract radiography and 3 were confirmed during operation. There were 339 patients with multiple diverticula (61.2%) and 215 patients with single diverticulum (38.8%). 76.5% (424/554) of diverticula were located in colon, 37.0% (205/554) in ascending colon, 21.3% (118/554) in multiple sites, and 2.2% (12/554) in rectum. The median diameter of diverticulum was 7 mm, and 78 cases (14.1%) was ≥30 mm. Forty-nine patients (8.8%) developed acute diverticulitis, including 13 patients with simple diverticulitis and 36 patients with complicated diverticulitis. Among 36 patients with complicated diverticulitis, 29 (80.6%) were males, 27 (75.0%) had recurrent abdominal pain and fever before onset; diverticula of 25 cases were located in sigmoid colon; 11 cases in ascending colon. Nine cases developed sigmoid colon perforation and 8 cases developed vesicocolonic fistula, and these 17 patients underwent surgical treatment. The other 19 cases with complicated diverticulitis developed gastrointestinal bleeding, of whom 18 cases were male, 11 cases were located in ascending colon; 13 cases were healed after conservative treatment, 4 cases received endoscopic hemostatic intervention, and 2 cases underwent surgery. Conclusions: Colorectal diverticulosis is more common in male patients, and CT and colonoscopy are main diagnostic methods. The symptoms of complicated colonic diverticulitis are related to the location of diverticulum. In addition to symptomatic treatment, surgical procedures are the most important treatments.
Cohort Studies ; Colorectal Neoplasms ; Diverticulitis, Colonic ; Diverticulum ; Humans ; Male ; Middle Aged ; Retrospective Studies

Objective To explore the relationships between hyperuricemia (HUA)，serum uric acid (SUA) level and the chronic kidney disease (CKD) in adult residents of communities. Methods A cross-sectional study was conducted in Xinqiao town of Songjiang district, Shanghai and a total of 9 527 residents aged 20-75 years were selected by random cluster sampling. Logistic regression models were used to evaluate the association between SUA and CKD. Results Subjects were divided into five groups according to the gender-specific quintiles of SUA. The CKD prevalence in serum uric acid quintiles of male were 4.9%, 5.7%, 6.0%, 8.0% and 13.8% respectively，while of female were 12.8%, 12.7%, 11.9%, 13.3% and 18.2% respectively, increasing along with the increase of SUA among both sexes (all P<0.05). Compared to the serum uric acid first quintile, the multivariate-adjusted odds for CKD in male of the fourth and fifth quintiles were 2.12 (95% CI:1.32-3.39) and 3.84 (95% CI:2.45-6.02), and the multivariate-adjusted odds for CKD in female of the fifth quintile was 1.38 (95% CI:1.05-1.80). Hyperuricemia was defined by SUA>420 μmol/L(male) or >360 μmol/L(female). In the unadjusted model, HUA was significantly associated with CKD of all subjects (OR=2.03, 95% CI:1.69-2.44, P<0.001), and the association was still significant (OR=2.04, 95% CI:1.68-2.49, P<0.001) after adjustment for the potential confounders. The multivariate-adjusted odds of CKD associated with HUA was 2.89 (95% CI:2.12-3.94,) and 1.98 (95% CI:1.51-2.60) for male and female, respectively. Conclusion Hyperuricemia was independently associated with the increased prevalence of CKD among community-based population living in the Songjiang district, Shanghai.

Objective To investigate the prevalence and related factors of type 2 diabetes mellitus(T2DM) and its associated renal insufficiency in adult residents of a community in Shanghai. Methods A total of 9 257 residents aged 20-75 years old in a community of Shanghai were selected by random cluster sampling. All participants were interviewed to complete questionnaires, physical examination, examination of blood, urine and common biochemical indicators for T2DM, renal insufficiency and other related factors. Then the SPSS 19.0 software was used for analysis. Results Of the 9 257 respondents, eligible data of 8 207 subjects were enrolled in the study. The prevalence of T2DM was 12.7% (95% CI: 12.0%-13.4%), and the prevalence of its associated renal insufficiency was 15.4% (95% CI: 12.3%-18.4%), and majority of patients (65.8%) were in the early stage. Among the T2DM patients in this survey, the prevalence of renal insufficiency in obese patients was higher than that in patient with the normal body mass index. Logistic regression analysis showed that elder (OR=1.35), central obesity (OR=1.50), hyperuricemia (OR=2.51) were independent risk factors related with renal insufficiency in T2DM patients. Conclusions Renal insufficiency has become one of the important public health problems in T2DM patients. It shows a more urgent need for early prevention and control of CKD to prevent the incidence of end-stage renal disease and related complications in T2DM patients with advanced age, obesity, and hyperuricemia.

This study aimed to investigate the influence of combinating Huangqi with Fuzi on the pharmacokinetics of six Aconitum alkaloids, i.e. aconitine (AC), hypaconitine (HA), mesaconitine (MA), benzoylaconine (BAC), benzoylhypaconine (BHA) and benzoylmesaconine (BMA). The plasma concentrations of the drugs were determined by LC-MS for dose response and time dependent curves. The pharmacokinetic parameters were calculated by DAS 3.3, and SPSS 12.0 was used to analyze the differences of main pharmacokinetic parameters between the two groups. Comparing with Fuzi group, the AUC_0-t and AUC_0-∞ of six alkaloids in Fuzi-Huangqi group was significantly decreased, the CL_z/Fof six alkaloids except HA was significantly increased; the C_max was decreased and the t_max was prolonged in 3 monoester alkaloids, and the apparent volume of distribution of BMA and MA (V_z/F) increases. These data indicated that Huangqi can inhibit the absorption of aconite alkaloids, induce the distribution of aconite alkaloids to the whole body, and accelerate the elimination of aconite alkaloids. The animal experiment scheme in this study has been approved by the Experimental Animal Ethics Committee of Jiangxi University of Traditional Chinese Medicine.