1.Health-related quality of life and influencing factors in surgical patients with echinococcosis
Jiusheng WEI ; Wu LIU ; Genxia GAO ; Xiaoyan CHE
Chinese Journal of Endemiology 2025;44(6):477-483
Objective:To study the health-related quality of life (HRQOL) and influencing factors of echinococcosis surgical patients included in the project management in Jingyuan County since the implementation of the Central Transfer Payment for Local Echinococcosis Prevention and Control Project (hereinafter referred to as the Echinococcosis Prevention and Control Project).Methods:Surgical patients included in the management of Echinococcosis Prevention and Control Project in Jingyuan County from January 1, 2009 to December 31, 2022 were selected as study subjects for a door-to-door questionnaire survey to collect basic information, medical treatment and diagnosis, surgical situation, postoperative follow-up and management situation, preoperative and postoperative HRQOL. Multivariate logistic regression was employed to analyze the influencing factors of HRQOL in echinococcosis surgical patients.Results:A total of 111 echinococcosis patients undergoing surgery were included, with a first visit duration [ M ( Q1, Q3)] of 8.0 (5.0, 12.0) years from symptom onset to initial consultation, and a surgical treatment duration of 8.0 (5.0, 12.0) years from diagnosis to surgical intervention. The cure rate based on postoperative efficacy observation was 81.08% (90/111). There was no statistically significant differences in the distribution of preoperative and postoperative mobility, self-care, daily activities, anxiety or depression among echinococcosis patients undergoing surgery ( P > 0.05). However, significant differences were observed in the distribution of pain or discomfort and health status scores ( P < 0.001). The results of ordinal logistic regression analysis showed that preoperative age [≥61 years old, OR (95% CI) = 0.06 (0.01, 0.56), P = 0.014], preoperative concomitant hypertension (grade Ⅱ), diabetes, and heart disease [ OR (95% CI) = 13.15 (1.80, 96.13), 57.69 (2.05, 1 620.13), 10.90 (1.27, 93.90), P < 0.05], initial lesion location in the abdominal cavity and the lesion in two or more locations [ OR (95% CI) = 30.83 (1.05, 902.45), 114.25 (7.24, 1 801.75), P < 0.05] were independent influencing factors for preoperative HRQOL in patients with echinococcosis. Postoperative comorbidities of hypertension (grade Ⅱ) and diabetes [ OR (95% CI) = 42.77 (2.39, 766.21), 901.40 (4.64, 1 740.94), P < 0.05], and postoperative complications [ OR (95% CI) = 130.61 (6.27, 2 722.24), P = 0.002] were independent influencing factors for postoperative HRQOL in patients with echinococcosis. Conclusions:The health status of patients with echinococcosis has significantly improved after surgical treatment. Preoperative factors affecting HRQOL of patients with echinococcosis include age, concomitant hypertension, diabetes, heart disease, and the initial lesion location. Postoperative influencing factors include concomitant hypertension and diabetes, as well as postoperative complications.
2.Correlation between type 2 diabetes and hepatitis B virus infection
Wu LIU ; Tianshuo ZHAO ; Liguo YANG ; Genxia GAO ; Wenli MIAO ; Tongxia ZENG ; Yonglan CHEN ; Lina ZHANG ; Xiaoyan CHE ; Lihong WANG ; Junhan ZHANG ; Bingfeng HAN ; Fuqiang CUI
Chinese Journal of Epidemiology 2025;46(5):833-839
Objective:To analyze the latent prevalence of hepatitis B and type 2 diabetes and their correlation through an observational study.Methods:This study used a case-control design. The cases with diabetes were recruited through the diabetes management system and village doctors, while the controls without diabetes were screened from volunteers recruited by village health clinics. Capillary blood samples were collected from the study participants for the measurement of real-time blood glucose level, and venous blood samples were taken from them for the detections of HBV serological markers. Firth logistic regression model was used to fit the relationship between HBsAg positive status and diabetes status.Results:The study included 1 218 diabetes patients, 62 patients with impaired fasting glucose and 491 cases without diabetes. In the cases without diagnosis of diabetes, 11.15% had impaired fasting blood glucose and 4.43% had diabetes. Among those who reported no or unknown diagnosis of hepatitis B, 1.73% were positive for HBsAg, while 18.80% were positive for both HBV core antibody and surface antibody, indicating latent infection of hepatitis B virus. In the non-diabetes group, 0.81% reported hepatitis B history, and in the diabetes group, 2.76% reported hepatitis B history. After adjustment, the HBsAg positive rate was higher in the diabetes group ( OR=2.90, 95% CI: 1.21-6.91). Conclusions:Both diabetes and hepatitis B exhibited a high degree of latent prevalence. The HBsAg positive rate was significantly higher in those with diabetes than in those without diabetes, indicating a potential correlation. These findings highlighted the importance of strengthened screening and management of comorbidities.
3.Study on the immunogenicity and persistence of different types of hepatitis B vaccines in diabetic patients
Wu LIU ; Tianshuo ZHAO ; Liguo YANG ; Genxia GAO ; Wenli MIAO ; Xiaoyan CHE ; Lihong WANG ; Junhan ZHANG ; Fuqiang CUI
Chinese Journal of Epidemiology 2025;46(8):1409-1416
Objective:Exploration of the immunogenicity and persistence of three different immunization regimens of hepatitis B vaccines in diabetic patients.Methods:Participants with diabetes and non-diabetic individuals were recruited from study sites and assigned to different vaccination regimens: the diabetic group (①D60Yeast0-1: received 60 μg Saccharomyces cerevisiae-derived recombinant HBV vaccine on a 0-1-month schedule; ②D20Yeast0-1-6: received 20 μg Saccharomyces cerevisiae-derived recombinant HBV vaccine on a 0-1-6-month schedule; ③D20CHO0-1-6: received 20 μg Chinese hamster ovary (CHO) cell-derived recombinant HBV vaccine on a 0-1-6-month schedule) and the non-diabetic group (ND20Yeast0-1-6: non-diabetic individuals received 20 μg Saccharomyces cerevisiae-derived recombinant HBV vaccine on a 0-1-6-month schedule). Venous blood samples were collected at 1,12, and 48 months post-full vaccination to measure anti-HBs levels. Differences in immunogenicity between diabetic and non-diabetic groups, as well as among diabetic subgroups, were analyzed.Results:This study enrolled a total of 564 subjects. In the D20CHO0-1-6 group, the seroconversion rate decreased from 90.72% (95% CI: 84.84%-96.60%) at 1 month to 74.23% (95% CI: 65.37%-83.08%) at 48 months, and the antibody geometric mean concentration (GMC) decreased from 676.08 (95% CI: 389.05- 1 148.20) mIU/ml at 1 month to 33.11 (95% CI: 23.44-46.77) mIU/ml at 48 months. In the D20Yeast0-1-6 group, the seroconversion rate declined from 93.81% (95% CI: 89.29%-98.32%) at 1 month to 63.72% (95% CI: 54.71%-72.72%) at 48 months, with antibody GMC dropping from 630.96 (95% CI: 407.40-954.99) mIU/ml to 25.70 (95% CI: 17.78-38.02) mIU/ml over the same period. For the D60Yeast0-1 group, seroconversion rate fell from 82.03% (95% CI: 75.29%-88.77%) to 56.25% (95% CI: 47.54%-64.96%), and antibody GMC decreased from 81.28 (95% CI: 51.29-128.82) mIU/ml to 15.49 (95% CI: 11.75-20.89) mIU/ml between 1 and 48 months. The ND20Yeast0-1-6 group (non-diabetic control) exhibited a higher initial seroconversion rate of 97.56% (95% CI: 94.80%- 100.00%) at 1 month, but it still declined to 76.42% (95% CI: 68.82%-84.03%) at 48 months, with antibody GMC decreasing from 1 318.30 (95% CI: 912.01- 1 905.50) mIU/ml to 34.67 (95% CI: 25.12-47.86) mIU/ml. Multivariate analysis on factors influencing the GMC of antibodies revealed statistically significant differences in antibody GMC between the D20Yeast0-1-6 group and ND20Yeast0-1-6 group at 12 months (a OR=0.73, 95% CI: 0.58-0.93) and 48 months (a OR=0.79, 95% CI: 0.63-0.99) post-vaccination (all P<0.05). As for the diabetic population, when compared with the D20Yeast0-1-6 group, the D60Yeast0-1 group also showed statistically significant differences in antibody GMC at 12 months (a OR=0.57, 95% CI: 0.44-0.74) and 48 months (a OR=0.60, 95% CI: 0.47-0.76)(all P<0.05). Conclusions:The seroconversion rate and antibody GMC gradually decreased over time (1, 12, and 48 months) in the four groups. Diabetic patients showed poor immunogenicity and persistence to hepatitis B vaccines. The immunogenicity and persistence of hepatitis B vaccination in diabetic patients were associated with vaccine type, antigen dose, and vaccination regimen. The CHO cell-recombinant hepatitis B vaccine demonstrated better performance in terms of immunogenicity and persistence among the diabetic population.
4.Correlation between mental health status and metabolic syndrome in health checkup population
Honghai HE ; Xiaolian ZHANG ; Xiaoyan HAO ; Ying CHE ; Wei ZHAO ; Hongli WANG ; Lei TIAN ; Hua WU ; Peng WANG
Chinese Journal of Health Management 2025;19(2):127-133
Objective:To analyze the correlation between mental health status and metabolic syndrome (MetS) in health checkup people.Methods:It was a cross-sectional study, 2 920 participants who received health checkup in the Health Examination Center of Peking University Third Hospital from January 2019 to December 2023 were selected using cluster sampling method. Their general information, physical examination, biochemical indicators, body composition, and self-evaluation scores on the Symptom Checklist-90 (SCL-90) were collected. According to the inclusion and exclusion criteria, a total of 2 813 study subjects were included, and divided into the MetS group and the non-MetS group based on whether they had MetS. The differences in general demographic information, body composition, blood biochemistry, and SCL-90 scores between the two groups were compared. Binary Logistic regression analysis was used to explore the correlation between mental health status and MetS.Results:Of the 2 813 subjects included, 1 576 were males (56.0%) and 1 237 were females (44.0%), with an average age of (41.7±11.0) years, the MetS group had 586 cases (20.8%) and the non-MetS group had 2 227 cases (79.2%). The MetS group had higher levels of age, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), fasting blood glucose, glycosylated hemoglobin (HbA 1c), free thyroxine(FT4), total triiodothyronine (TT3), free triiodothyronine (FT3), waist-to-hip ratio, visceral fat area, body fat percentage, uric acid/creatinine, homocysteine (Hcy), aspartate aminotransferases (AST), and alanine transaminase (ALT) levels, as well as higher scores for somatization, hostility, paranoia, and other factor compared to the non-MetS group (all P<0.05), while high density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR) levels were lower than those in the non-MetS group (all P<0.05). The proportion of male, and the positive rates of SCL-90, somatization, interpersonal sensitivity, hostility, paranoia and other factor in the MetS group were higher than those in the non-MetS group (all P<0.05). Multifactorial analysis showed that individuals with a positive SCL-90 assessment had a 1.34 times higher risk of MetS than those with a negative assessment ( OR=1.34, 95% CI: 1.06-1.68; P=0.014). Among them, individuals with positive somatization ( OR=2.02, 95% CI: 1.25-3.28; P=0.004) and hostility ( OR=1.61, 95% CI: 1.02-2.56; P=0.042) had increased risk of MetS. Conclusion:Poor mental health status increases the risk of MetS.
5.Correlation between normalized grip strength and normal weight obesity in health check-up population
Honghai HE ; Xiaolian ZHANG ; Xiaoyan HAO ; Wei ZHAO ; Peng WANG ; Ying CHE
Chinese Journal of Health Management 2025;19(4):273-278
Objective:To explore the correlation between normalized grip strength (NGS) and normal weight obesity (NWO) in the population undergoing health check-ups.Methods:It was a cross-sectional study. A cluster sampling method was adopted to consecutively select 4 104 subjects who completed general health check-ups, body composition tests, and grip strength tests at the Medical Examination Center of Peking University Third Hospital from January 2019 to December 2023. The general information, physical examination results, biochemical indicators, body composition, and grip strength test results were collected. The subjects were grouped by gender and whether they had NWO (male: NWO group 314 cases, normal control group 690 cases; female: NWO group 834 cases, normal control group 2 266 cases). The differences in various indicators between the NWO group and the normal control group were compared by using t-tests, χ 2 tests, or Mann-Whitney U tests. The subjects were divided into four groups with the quartiles of NGS (Q 1-Q 4 groups), and binary logistic regression analysis was used to explore the correlation between the NGS and NWO. The receiver operating characteristic (ROC) curve was used to evaluate the optimal cut-off point of the NGS for diagnosing NWO. Results:Among the 4 104 subjects included in the analysis, 1 148 (28.0%) had NWO. The risk of NWO in both males and females increased with the decrease of NGS. Compared with the Q 4 group, the risk of NWO in the Q 2 and Q 1 groups of males increased by 2.600 times ( OR=2.600, 95% CI:1.556-4.343) and 4.350 times ( OR=4.350, 95% CI: 2.618-7.229), respectively; the risk of NWO in the Q 3, Q 2, and Q 1 groups of females increased by 2.024 times ( OR=2.024, 95% CI: 1.322-3.099), 4.265 times ( OR=4.265, 95% CI: 2.856-6.371), and 7.395 times ( OR=7.395, 95% CI: 4.991-10.956), respectively (all P<0.05). The optimal cut-off point of the NGS for diagnosing NWO in males and females was 0.636 2 and 0.472 2, respectively. Conclusions:The NGS is negatively correlated with the risk of NWO. Evaluation of the NGS can provide a reference for the early diagnosis and prevention of NWO.
6.Construction and effect evaluation of group health management mode for functional community
Ying CHE ; Gaili HE ; Honghai HE ; Peng WANG ; Lei TIAN ; Wei ZHAO ; Zhenge ZHANG ; Xiaoyan HAO
Chinese Journal of Health Management 2025;19(10):815-822
Objective:To construct a health management mode for functional community groups and evaluate its health management effect.Methods:This study was a non-randomized controlled trial. A cluster sampling method was adopted to select 3 352 subjects who completed three health examinations at the Physical Examination Center of Peking University Third Hospital from January 2022 to October 2024 and received health management for two consecutive years from a certain functional community (an enterprise) in Beijing as the research subjects. A health management mode for functional community groups was constructed, and a cohort of the population was established. A health management platform was built, and the research subjects were included in the health management system. Comprehensive interventions were carried out using multiple methods, including disease risk assessment, daily monitoring and reminders, exercise and nutrition assessment and intervention, personal health consultation, and health science popularization knowledge push. The subjects were classified and analyzed based on general information such as age and gender. The changes in systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were assessed using One-way Repeated Measures Analysis of Variance before the intervention and at 1 and 2 years after the intervention. The changes in triglycerides were assessed using Generalized Estimating Equations before the intervention and at 1 and 2 years after the intervention.Results:The systolic blood pressure, total cholesterol, and LDL-C levels of the total population showed a linear decreasing trend after the intervention (all P0.001). The HDL-C level showed an overall upward trend after the intervention [(1.45±0.32) vs (1.39±0.30) vs (1.47±0.33) mmol/L, F=12.746, P0.001]. However, there was no linear change trend in diastolic blood pressure, fasting blood glucose, and triglycerides after the intervention (all P0.05). The systolic blood pressure, total cholesterol and LDL-C levels of both men and women showed a linear decreasing trend after the intervention. For men, systolic blood pressure [(128.6±16.1) vs (127.6±16.3) vs (126.5±15.5) mmHg (1 mmHg=0.133 kPa); F=33.488, P0.001], total cholesterol [(5.29±1.02) vs (5.07±1.00) vs (4.94±1.03) mmol/L; F=286.525, P0.001], and LDL-C [(3.45±0.86) vs (3.43±0.84) vs (3.33±0.83) mmol/L; F=55.419, P0.001] all decreased. For women, systolic blood pressure [(118.9±15.6) vs (117.5±15.6) vs (117.2±15.8) mmHg; F=34.188, P0.001], total cholesterol [(5.13±0.94) vs (4.96±0.90) vs (4.85±0.90) mmol/L; F=274.080, P0.001], and LDL-C [(3.13±0.79) vs (3.10±0.76) vs (3.10±0.75) mmol/L; F=6.861, P=0.009] also decreased. The HDL-C level of men showed an overall upward trend after the intervention [(1.30±0.26) vs (1.25±0.25) vs (1.32±0.28) mmol/L; F=6.866, P0.05]. For men and women, diastolic blood pressure, fasting blood glucose and triglyceride levels showed no linear change trend after the intervention (all P0.05). The systolic blood pressure and total cholesterol levels of all age groups showed a linear decreasing trend after the intervention(all P0.001). In the 50-59 age group, diastolic blood pressure showed a linear decreasing trend after intervention [(81.6±11.6) vs (80.1±11.6) vs (79.9±11.6) mmHg; F=7.043, P0.05]. In the 40-49 age group, triglyceride showed an overall decreasing trend after intervention [1.29(0.91-2.01) vs 1.27(0.88-1.91) vs 1.27(0.92-1.89) mmol/L; Wald χ 2=10.062, P0.05]. In the 30-39 age group, LDL-C showed a linear decreasing trend after intervention [(3.23±0.80) vs (3.20±0.79) vs (3.19±0.77) mmol/L; F=7.702, P0.05]. In the 40-49 age group, LDL-C also showed a linear decreasing trend after intervention [(3.39±0.84) vs (3.36±0.82) vs (3.30±0.80) mmol/L; F=22.801, P0.001]. In the 50-59 age group, LDL-C showed a linear decreasing trend after intervention [(3.38±0.92) vs (3.32±0.91) vs (3.15±0.88) mmol/L; F=27.920, P0.001]. In the 30-39 age group, HDL-C showed an overall increasing trend after intervention [(1.46±0.33) vs (1.39±0.31) vs (1.48±0.34) mmol/L; F=10.047, P0.05]. In the 40-49 age group, HDL-C also showed an overall increasing trend after intervention [(1.45±0.30) vs (1.40±0.30) vs (1.47±0.32) mmol/L; F=10.118, P0.05]. However, there was no linear change trend in fasting blood glucose and triglyceride levels in all age groups after intervention ( F=1.169, 2.643, 0.663, 0.001, all P0.05). Conclusion:The functional community group health management mode constructed in this study has a good effect.
7.Correlation between type 2 diabetes and hepatitis B virus infection
Wu LIU ; Tianshuo ZHAO ; Liguo YANG ; Genxia GAO ; Wenli MIAO ; Tongxia ZENG ; Yonglan CHEN ; Lina ZHANG ; Xiaoyan CHE ; Lihong WANG ; Junhan ZHANG ; Bingfeng HAN ; Fuqiang CUI
Chinese Journal of Epidemiology 2025;46(5):833-839
Objective:To analyze the latent prevalence of hepatitis B and type 2 diabetes and their correlation through an observational study.Methods:This study used a case-control design. The cases with diabetes were recruited through the diabetes management system and village doctors, while the controls without diabetes were screened from volunteers recruited by village health clinics. Capillary blood samples were collected from the study participants for the measurement of real-time blood glucose level, and venous blood samples were taken from them for the detections of HBV serological markers. Firth logistic regression model was used to fit the relationship between HBsAg positive status and diabetes status.Results:The study included 1 218 diabetes patients, 62 patients with impaired fasting glucose and 491 cases without diabetes. In the cases without diagnosis of diabetes, 11.15% had impaired fasting blood glucose and 4.43% had diabetes. Among those who reported no or unknown diagnosis of hepatitis B, 1.73% were positive for HBsAg, while 18.80% were positive for both HBV core antibody and surface antibody, indicating latent infection of hepatitis B virus. In the non-diabetes group, 0.81% reported hepatitis B history, and in the diabetes group, 2.76% reported hepatitis B history. After adjustment, the HBsAg positive rate was higher in the diabetes group ( OR=2.90, 95% CI: 1.21-6.91). Conclusions:Both diabetes and hepatitis B exhibited a high degree of latent prevalence. The HBsAg positive rate was significantly higher in those with diabetes than in those without diabetes, indicating a potential correlation. These findings highlighted the importance of strengthened screening and management of comorbidities.
8.Study on the immunogenicity and persistence of different types of hepatitis B vaccines in diabetic patients
Wu LIU ; Tianshuo ZHAO ; Liguo YANG ; Genxia GAO ; Wenli MIAO ; Xiaoyan CHE ; Lihong WANG ; Junhan ZHANG ; Fuqiang CUI
Chinese Journal of Epidemiology 2025;46(8):1409-1416
Objective:Exploration of the immunogenicity and persistence of three different immunization regimens of hepatitis B vaccines in diabetic patients.Methods:Participants with diabetes and non-diabetic individuals were recruited from study sites and assigned to different vaccination regimens: the diabetic group (①D60Yeast0-1: received 60 μg Saccharomyces cerevisiae-derived recombinant HBV vaccine on a 0-1-month schedule; ②D20Yeast0-1-6: received 20 μg Saccharomyces cerevisiae-derived recombinant HBV vaccine on a 0-1-6-month schedule; ③D20CHO0-1-6: received 20 μg Chinese hamster ovary (CHO) cell-derived recombinant HBV vaccine on a 0-1-6-month schedule) and the non-diabetic group (ND20Yeast0-1-6: non-diabetic individuals received 20 μg Saccharomyces cerevisiae-derived recombinant HBV vaccine on a 0-1-6-month schedule). Venous blood samples were collected at 1,12, and 48 months post-full vaccination to measure anti-HBs levels. Differences in immunogenicity between diabetic and non-diabetic groups, as well as among diabetic subgroups, were analyzed.Results:This study enrolled a total of 564 subjects. In the D20CHO0-1-6 group, the seroconversion rate decreased from 90.72% (95% CI: 84.84%-96.60%) at 1 month to 74.23% (95% CI: 65.37%-83.08%) at 48 months, and the antibody geometric mean concentration (GMC) decreased from 676.08 (95% CI: 389.05- 1 148.20) mIU/ml at 1 month to 33.11 (95% CI: 23.44-46.77) mIU/ml at 48 months. In the D20Yeast0-1-6 group, the seroconversion rate declined from 93.81% (95% CI: 89.29%-98.32%) at 1 month to 63.72% (95% CI: 54.71%-72.72%) at 48 months, with antibody GMC dropping from 630.96 (95% CI: 407.40-954.99) mIU/ml to 25.70 (95% CI: 17.78-38.02) mIU/ml over the same period. For the D60Yeast0-1 group, seroconversion rate fell from 82.03% (95% CI: 75.29%-88.77%) to 56.25% (95% CI: 47.54%-64.96%), and antibody GMC decreased from 81.28 (95% CI: 51.29-128.82) mIU/ml to 15.49 (95% CI: 11.75-20.89) mIU/ml between 1 and 48 months. The ND20Yeast0-1-6 group (non-diabetic control) exhibited a higher initial seroconversion rate of 97.56% (95% CI: 94.80%- 100.00%) at 1 month, but it still declined to 76.42% (95% CI: 68.82%-84.03%) at 48 months, with antibody GMC decreasing from 1 318.30 (95% CI: 912.01- 1 905.50) mIU/ml to 34.67 (95% CI: 25.12-47.86) mIU/ml. Multivariate analysis on factors influencing the GMC of antibodies revealed statistically significant differences in antibody GMC between the D20Yeast0-1-6 group and ND20Yeast0-1-6 group at 12 months (a OR=0.73, 95% CI: 0.58-0.93) and 48 months (a OR=0.79, 95% CI: 0.63-0.99) post-vaccination (all P<0.05). As for the diabetic population, when compared with the D20Yeast0-1-6 group, the D60Yeast0-1 group also showed statistically significant differences in antibody GMC at 12 months (a OR=0.57, 95% CI: 0.44-0.74) and 48 months (a OR=0.60, 95% CI: 0.47-0.76)(all P<0.05). Conclusions:The seroconversion rate and antibody GMC gradually decreased over time (1, 12, and 48 months) in the four groups. Diabetic patients showed poor immunogenicity and persistence to hepatitis B vaccines. The immunogenicity and persistence of hepatitis B vaccination in diabetic patients were associated with vaccine type, antigen dose, and vaccination regimen. The CHO cell-recombinant hepatitis B vaccine demonstrated better performance in terms of immunogenicity and persistence among the diabetic population.
9.Dynamic Effects of High-Altitude Exposure on Sleep and Mood States and the Underlying Neural Mechanisms
Wanlin HE ; Hailong LI ; Jinli MENG ; Li FENG ; Zan ZHOU ; Yonghong HUANG ; Kejin XIANG ; Hengyan LI ; Xiaomei LI ; Yuanyuan HE ; Xiaoyan LUO ; Lu CHE ; Xiaoqi HUANG
Journal of Sichuan University (Medical Sciences) 2025;56(5):1313-1319
Objective To analyze changes in sleep,mood state,and brain function in healthy populations living in near-sea-level environments before and after exposure to high-altitude environment,and to explore the correlations between regional brain functional changes and variations in sleep and mood states.Methods A total of 45 healthy volunteers were enrolled.The participants came from regions of near-sea-level altitudes and were exposed to the high-altitude environment for a short period of time.The Pittsburgh Sleep Quality Index(PSQI),Zung Self-Rating Depression Scale(SDS),Patient Health Questionnaire-9(PHQ-9),Zung Self-Rating Anxiety Scale(SAS),and Generalized Anxiety Disorder-7(GAD-7)were administered to assess sleep quality as well as depressive and anxiety symptoms at 4 time points—prior to high-altitude exposure,immediately after exposure,one month after returning to low-altitude regions,and three months after returning to low-altitude regions.Resting-state functional magnetic resonance imaging(rs-fMRI)data were collected before and after high-altitude exposure,and regional brain functional parameters,including the amplitude of low-frequency fluctuations(ALFF)and functional connectivity strength,were analyzed.Statistical analyses were performed,including a linear mixed-effects model to evaluate longitudinal changes in scale scores,paired-sample t-tests to compare brain function differences before and after exposure,and Pearson correlation analyses to examine the relationship between brain functional changes and alterations in sleep and mood states.Results Compared with the pre-exposure findings,the participants exhibited significantly increased PSQI scores(8.89±4.41 vs.5.08±2.69,P<0.05)and PHQ-9 scores(3.60±4.19 vs.1.54±2.30,P<0.05)immediately after high-altitude exposure.One month after returning to the low-altitude environment,both sleep and depression scores decreased relative to the findings immediately after exposure(PSQI:3.88±2.13 vs.8.89±4.41,P<0.05;PHQ-9:1.50±2.25 vs.3.60±4.19,P<0.05)and showed no statistically significant difference compared with the pre-exposure findings(P>0.05).Three months after returning to near-sea-level environment,sleep,depression,and anxiety scores were all reduced compared with the findings immediately after exposure(PSQI:3.76±2.31 vs.8.89±4.41,P<0.05;PHQ-9:1.24±2.13 vs.3.60±4.19,P<0.05;SAS:23.84±5.93 vs.27.93±7.05,P<0.05),also showing no significant difference compared with the pre-exposure levels(P>0.05).Brain function analysis revealed that,relative to the pre-exposure levels,ALFF in the bilateral superior temporal gyrus,insula,and dorsolateral prefrontal cortex(DLPFC)increased after high-altitude exposure(P<0.05),and that functional connectivity strength in the DLPFC was also elevated(P<0.05).Furthermore,changes in DLPFC functional connectivity strength were positively correlated with changes in sleep and mood scores(P<0.05).Conclusion High-altitude exposure has a significant impact on the sleep,mood states,and brain function of populations from near-sea-level regions,and DLPFC,in particular,is closely associated with changes in sleep and mood states.The findings of this study provide a theoretical basis for health management and intervention strategies in high-altitude environments.
10.Health-related quality of life and influencing factors in surgical patients with echinococcosis
Jiusheng WEI ; Wu LIU ; Genxia GAO ; Xiaoyan CHE
Chinese Journal of Endemiology 2025;44(6):477-483
Objective:To study the health-related quality of life (HRQOL) and influencing factors of echinococcosis surgical patients included in the project management in Jingyuan County since the implementation of the Central Transfer Payment for Local Echinococcosis Prevention and Control Project (hereinafter referred to as the Echinococcosis Prevention and Control Project).Methods:Surgical patients included in the management of Echinococcosis Prevention and Control Project in Jingyuan County from January 1, 2009 to December 31, 2022 were selected as study subjects for a door-to-door questionnaire survey to collect basic information, medical treatment and diagnosis, surgical situation, postoperative follow-up and management situation, preoperative and postoperative HRQOL. Multivariate logistic regression was employed to analyze the influencing factors of HRQOL in echinococcosis surgical patients.Results:A total of 111 echinococcosis patients undergoing surgery were included, with a first visit duration [ M ( Q1, Q3)] of 8.0 (5.0, 12.0) years from symptom onset to initial consultation, and a surgical treatment duration of 8.0 (5.0, 12.0) years from diagnosis to surgical intervention. The cure rate based on postoperative efficacy observation was 81.08% (90/111). There was no statistically significant differences in the distribution of preoperative and postoperative mobility, self-care, daily activities, anxiety or depression among echinococcosis patients undergoing surgery ( P > 0.05). However, significant differences were observed in the distribution of pain or discomfort and health status scores ( P < 0.001). The results of ordinal logistic regression analysis showed that preoperative age [≥61 years old, OR (95% CI) = 0.06 (0.01, 0.56), P = 0.014], preoperative concomitant hypertension (grade Ⅱ), diabetes, and heart disease [ OR (95% CI) = 13.15 (1.80, 96.13), 57.69 (2.05, 1 620.13), 10.90 (1.27, 93.90), P < 0.05], initial lesion location in the abdominal cavity and the lesion in two or more locations [ OR (95% CI) = 30.83 (1.05, 902.45), 114.25 (7.24, 1 801.75), P < 0.05] were independent influencing factors for preoperative HRQOL in patients with echinococcosis. Postoperative comorbidities of hypertension (grade Ⅱ) and diabetes [ OR (95% CI) = 42.77 (2.39, 766.21), 901.40 (4.64, 1 740.94), P < 0.05], and postoperative complications [ OR (95% CI) = 130.61 (6.27, 2 722.24), P = 0.002] were independent influencing factors for postoperative HRQOL in patients with echinococcosis. Conclusions:The health status of patients with echinococcosis has significantly improved after surgical treatment. Preoperative factors affecting HRQOL of patients with echinococcosis include age, concomitant hypertension, diabetes, heart disease, and the initial lesion location. Postoperative influencing factors include concomitant hypertension and diabetes, as well as postoperative complications.

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