Objective: To investigate the coexistence of comorbidity of myopia, overweight/obesity and depressive symptoms among middle school students in Quzhou and its associated factors, so as to provide evidence for integrated prevention and control of common multiple health issues in students. Methods: From September to November 2023, a total of 5 867 middle school students from 6 counties (cities and districts) in Quzhou City were selected by stratified random cluster sampling. Physical and visual examinations were conducted, and the Center for Epidemiological Studies - Depression Scale (CES-D) along with a questionnaire on health status and influencing factors were completed. Multivariate Logistic regression was used to analyze the related factors of coexistence of myopia, overweight/obesity, and depressive symptoms among middle school students, and a nomogram model was constructed based on the results. Results: A total of 161 middle school students in Quzhou City were identified as having comorbid myopia, overweight/ obesity and depressive symptoms, with a detection rate of 2.74%. The results of multivariate Logistic regression analysis showed that the coexistence of myopia, overweight/obesity and depressive symptoms increased among middle school students with older age ( OR =1.11), a greater number unhealthy dietary behaviors (1,2,≥3; OR =2.40, 2.70, 4.63), insufficient sleep( OR =1.78) and alcohol consumption ( OR =2.11)(all P <0.05). Compared with no homework after class, those whose homework duration after class was 1 to < 2 hour had a lower risk of comorbidity of myopia, overweight/obesity and depressive symptoms ( OR =0.53, P <0.05). The results of the nomogram model showed that the AUC (95% CI ) was 0.71 (0.67-0.74). Conclusions The coexistence of myopia, overweight/obesity and depressive symptoms among middle school students in Quzhou City is related to age, sleeping, alcohol consumption, poor dietary behavior and the duration of after school homework. The nomogram model can assist in the early screening and intervention of multiple health issues among students.

BACKGROUND: The FAVOR (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients with Coronary Artery Disease) III China trial demonstrated that percutaneous coronary intervention (PCI) lesion selection using quantitative flow ratio (QFR) measurement, a novel angiography-based approach for estimating fractional flow reserve, improved two-year clinical outcomes compared with standard angiography guidance. This study aimed to assess the cost-effectiveness of QFR-guided PCI from the perspective of the current Chinese healthcare system. METHODS: This study is a pre-specified analysis of the FAVOR III China trial, which included 3825 patients randomized between December 25, 2018, and January 19, 2020, from 26 centers in China. Patients with stable or unstable angina pectoris or those ≥72 hours post-myocardial infarction who had at least one lesion with a diameter stenosis between 50% and 90% in a coronary artery with a ≥2.5 mm reference vessel diameter by visual assessment were randomized to a QFR-guided strategy or an angiography-guided strategy with 1:1 ratio. During the two-year follow-up, data were collected on clinical outcomes, quality-adjusted life-years (QALYs), estimated costs of index procedure hospitalization, outpatient cardiovascular medication use, and rehospitalization due to major adverse cardiac and cerebrovascular events (MACCE). The primary analysis calculated the incremental cost-effectiveness ratio (ICER) as the cost per MACCE avoided. An ICER of ¥10,000/MACCE event avoided was considered economically attractive in China. RESULTS: At two years, the QFR-guided group demonstrated a reduced rate of MACCE compared to the angiography-guided group (10.8% vs . 14.7%, P <0.01). Total two-year costs were similar between the groups (¥50,803 ± 21,121 vs . ¥50,685 ± 23,495, P = 0.87). The ICER for the QFR-guided strategy was ¥3055 per MACCE avoided, and the probability of QFR being economically attractive was 64% at a willingness-to-pay threshold of ¥10,000/MACCE avoided. Sensitivity analysis showed that QFR-guided PCI would become cost-saving if the cost of QFR were below ¥3682 (current cost: ¥3800). Cost-utility analysis yielded an ICER of ¥56,163 per QALY gained, with a 53% probability of being cost-effective at a willingness-to-pay threshold of ¥85,000 per QALY gained. CONCLUSION: In patients undergoing PCI, a QFR-guided strategy appears economically attractive compared to angiographic guidance from the perspective of the Chinese healthcare system. TRIAL REGISTRATION ClinicalTrials.gov , NCT03656848.
Humans ; Cost-Benefit Analysis ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Angiography/methods* ; Middle Aged ; Aged ; Coronary Artery Disease/surgery* ; Quality-Adjusted Life Years ; Fractional Flow Reserve, Myocardial/physiology*

Objective·To analyze the epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort.Methods·The study subjects were selected from the Shanghai community elderly cohort established from February to August 2019,with a total of 17 948 people.The study subjects were divided into 4 groups according to self-reported presence or absence of tumors and/or cardiovascular diseases during the baseline survey:tumor-free and non-cardiovascular disease group,single cardiovascular disease group,single tumor group and tumor cardiovascular disease co-occurrence group.The differences among the four groups of subjects were collected and compared in terms of demographic characteristics and physiological indicators,daily living habits(smoking,drinking tea,drinking coffee,drinking carbonated drink,drinking alcohol,sedentary time,physical activity level and sleep quality),past medical history,psychological status(depression and anxiety)and dietary compliance.Results·Among the study subjects,60.1%of tumor patients were complicated with cardiovascular diseases.The differences among the four groups of subjects in age,gender,educational level,pre-retirement occupation,waist circumference,hip circumference and body mass index were statistically significant(all P<0.05).Compared with the tumor-free and non-cardiovascular disease group,the single cardiovascular disease group,single tumor group and tumor cardiovascular disease co-occurrence group all exhibited lower proportions of smoking and high physical activity levels(all P<0.05),and higher proportion of sedentary time exceeding 4 h/d and poor sleep quality(all P<0.05);the proportion of subjects with past medical histories including hyperlipidemia,peripheral vascular disease,endocrine system disease,respiratory system disease,urinary system disease and digestive system disease of the single cardiovascular disease group and the tumor cardiovascular disease co-occurrence group was higher(all P<0.05),and the proportion of subjects with depression and anxiety was also higher(all P<0.05).Furthermore,compared with the tumor-free and non-cardiovascular disease group,the single cardiovascular disease group had lower compliance rates of poultry,fish,fruit and liquid milk(all P<0.05).Among the four groups,only the compliance rate of vegetable intake exceeded 50%,while the compliance rates of poultry,fish,fruit,liquid milk and tubers were all below 20%.Conclusion·In the elderly population of Shanghai communities,over half of malignant tumor patients are concomitant with cardiovascular diseases.Unhealthy daily habits are prevalent among those with cardiovascular diseases,tumors and tumor-cardiovascular disease co-occurrence.The intake of many foods in the elderly of the community do not reach the levels recommended by Chinese Dietary Guidelines.

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

Objective To evaluate the health-related quality of life (HRQoL) in children with β-thalasse-mia major and their parents,and to analyze its affecting factors.Methods PedsQLTM 4.0 generic core scale and a demographic questionnaire were used to assess HRQoL in 45 children with β-thalassemia major and their parents,which were between 5 and 12 years old,had received blood transfusion in Chengdu Women and Children's Central Hospital during 2016.Results The total summary score of patients' HRQoL was (74.58 ± 7.29) score,in which,the social functioning subscale score was the highest,and school functioning subscale score was the lowest.The total summary score of parents' HRQoL was (64.43 ± 11.54) score,and the difference was statistically significant (P ＜ 0.05).Parents' s core of the psychosocial health [(69.03 ± 12.24) score],the emotional functioning [(67.78 ± 12.67)score]and the School functioning [(57.92 ± 11.61) score]were significantly lower than those of children[(78.19 ±13.42) score,(83.75 ±9.05) score,(69.58 ± 10.30) score],and the differences were statistically significant(all P ＜0.05).The HRQoL of children was positively correlated with onset age of anemia and hemoglobin (Hb) level before transfusion (r =0.771,0.824,all P ＜ 0.01),but which was negatively correlated with iron chelation therapy (r =-0.573,P ＜ 0.01).In contrast,gender,frequency of blood transfusions during the previous 3 months,the type of blood transfusion and iron chelation treatment were not significantly related to HRQoL among these patients.All of these factors were not related to the HRQoL of their parents(P ＞ 0.05).A multiple regression analysis revealed that the HRQoL of children with β-thalassemia major was significantly correlated with onset age of anemia(P =0.005),Hb level before transfusion (P =0.026) and iron chelation therapy (P =0.000).Conclusions The HRQoL of children with β-thalassemia major and their parents were remarkably low.Comprehensive programs including social support,medical service and psychological care should be provided for these children and their parents.

Objective To investigate the relationship between brachial ankle pulse wave velocity and the incidence of cardio-cerebral events in people aged over 40. Methods Cluster sampling method was used to prospectively study 4 380 residents aged over 40 in Guiyang City District from May to August in 2011. Data of ba-PWV were collected. The follow-up examination was conducted from July to November of 2014. According to ba-PWV values, participants were divided into three groups:<14 m/s (control, n=1 039) group, 14-17.9 m/s group (n=1 393) and≥18 m/s group (n=809). Multi-factor Logistic regression model was used to analyze the relationship between ba-PWV values and risk factors of cardio-cerebral events. Results After three-year follow-up, a total of 3 241 participants were included in the final analysis. The cardio-cerebral events were identified in 63 (2.0%) cases, which were 0.6%, 2.2%and 3.2%in control group, 14-17.9 m/s group and≥18 m/s group. The value of ba-PWV increased significantly in those two groups compared with that of normal group. Logistic regression analysis showed that the incidence rates of cardiovascular and cerebralvascular events in 14-17.9 m/s group and≥18 m/s group were 2.777 (1.123-6.864) and 2.786 (1.032-7.526) times of control group after adjusting age, gender, systolic blood pressure, risk factors of diabetes, hypertension and blood lipids. Conclusion There is higher incidence rate of cardio-cerebral events in people aged over 40 in higher ba-PWV group. The value of Ba-PWV can be used to predict the occurrence of cardio-cerebral events.

Objective To evaluate the effects of age factors on the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block in patients.Methods Twenty patients of both sexes,aged ≥ 18 yr,weighing 50-75 kg,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,scheduled for elective lower extremity surgery,were divided into 2 groups (n=10 each) according to age:young and middle-aged group (18-59 yr) and elderly group (≥ 60 yr).Combined lumbar plexus-sciatic never block was performed using an ultrasonic instrument and a nerve stimulator.Lumbar plexus block was performed with 0.5％ ropivacaine 30 ml.Sciatic never block was performed with 2％ lidocaine 10 ml plus 0.75％ ropivacaine 10 ml.Before administration and at 5,10,15,20,30,45,60,120,180 and 360 min after administration,blood samples were collected from the radial artery for determination of the blood concentration of ropivacaine by high-performance liquid chromatography.The area under the concentrationtime curve,maximum concentration (Cmax),time to C terminal elimination half-life and clearance were calculated.Results Compared with young and middle-aged group,the blood concentration of ropivacaine was significantly decreased at 5-45 min after administration,the Cmax was significantly decreased,terminal elimination half-life was significantly prolonged (P＜0.05),and no significant change was found in area under the concentration-time curve,the time to C and clearance in elderly group (P＞ 0.05).Conclusion Age factors can affect the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block,and both absorption and metabolism of ropivacaine are slower in elderly patients than in young and middle-aged patients.

Objective To investigate the relationship between the serum dehydroepiandrosterone sulfate ( DHEAS) level and bone mineral density ( BMD) in aged women. Methods Two hundred and seven elderly women aged 60-84 years were enrolled in the study. Acquisition histories, including age, body mass index, and blood pressure were recorded. Serum steroid hormones ( DHEAS, testosterone, estradiol, and cortisol) and bone metabolic markers:β-C-terminal telopeptide of type Ⅰ collagen (β-CTx ) , osteocalcin, and total procollagen type Ⅰ N propeptide ( TPINP) were determined. The BMD was also determined. The enrolled subjects were divided into 3 groups according to T values(T>-1. 0 s、-2. 5 s

Objective To investigate the relationship between serum uric acid level and body fat depots as well as the possible influencing factors of the relationship in type 2 diabetic patients.Methods Five hundred and thirty two patients hospitalized for type 2 diabetes were recruited in this study.According to serum uric acid,the subjects were classified into normal uric acid group (group NUA,n =426) and high uric acid group ( group HUA,n =106 ).Anthropometry ( BMI,waist circumference,hip circumference and WHR),serum uric acid level,blood glucose,renal function and lipid levels were compared between the two groups.Results Serum uric acid level was closely related to body fat distribution:(1) in group HUA,WHR,BMI,BUN,SCr and TG were significantly higher than that of group NUA ( [ 0.94 ± 0.07 ] vs.[ 0.91 ± 0.07 ],[ 26.91 ± 3.90 ]kg/m2 vs.[23.84 ±3.80] kg/m2,[8.66 ±5.94] mmol/L vs.[6.29 ±3.64] mmol/L,[93.9 ± 67.6 ] μmol/Lvs.[63.9 ± 20.6 ] μmol/L,[ 2.65 ± 1.92 ] mmol/L vs.[ 1.86 ± 1.46 ] mmol/L,respectively; all P ＜ 0.05 ] ;while HDL-C was lower in Group HUA than in group NUA ( [ 1.09 ± 0.32 ] mmol/L vs.[ 1.24 ± 0.45 ] mmol/L,P ＜0.05).(2) Multiple regression analysis revealed that the serum uric acid levels were positively correlated with BMI,SCr,and TG ( b =0.201,0.500,0.153,respectively,P ＜ 0.05 ),but negatively correlated with HbA(1)c and HDL-C ( b =- 0.168 and - 0.121,P ＜ 0.05 ).Conclusion In patients with type 2 diabetes,serum uric acid levels are closely related with the BMI and Glucose/lipid metabolism,which suggests that body weight control is as important as the uric acid lowering treatment in patients with type 2 diabetes to cut the risks of cardiac and vascular diseases.

Objective To evaluate the sensitivity and specificity of BP180NC16a-ELISA in the diagnosis of bullous pemphigoid (BP). Methods A multi-center, randomized, double-blind, parallel-controlled study was conducted. Sera were collected from 106 patients with clinically confirmed active BP and 106 control subjects including patients with non-BP bullous diseases, scleroderma, psoriasis or systemic lupus erythematosus,late pregnant women and healthy blood donors. BP180NC16a-ELISA was performed on these sera. The IgG antibody levels measured by ELISA kit were compared with those measured by indirect immunofluorescence (IIF) test. Results Of the 106 BP sera, 81 were positive for BP180NC16a-ELISA with a sensitivity of 76.4%,83 for ⅡF test with a sensitivity of 78.3%. Among the 106 control serum samples, 95 were negative for BP180NC16A-ELISA with a specificity of 89.6%, and 102 for ⅡF test with a specificity of 96.2%. There was no significant difference between the two tests in dignostic sensitivity and specificity for BP (both P ＞ 0.05).Conclusion BP180NC16A-ELISA may serve as an adjuvant tool for the diagnosis of BP.