Objective:To explore the feasibility of actively screening patients with chronic obstructive pulmonary disease (COPD) among inpatients in county territory-level hospitals based on the collection of comorbidity-related diseases and questionnaire surveys.Methods:This study was a cross-sectional study. From April 1, 2023, to November 30, 2023, a total of 1 392 inpatients who met the screening criteria in county territory-level hospitals within the Western Medical Group of Baiyun District, Guangzhou, were included in the study. General information, disease data, and COPD screening data of the patients were collected. A total of 1 392 questionnaires were distributed, all of which were returned and included in the analysis. Descriptive analysis, comparative analysis, and association rule mining were conducted, including the distribution of general information, distribution of common comorbidity-related diseases in COPD, distribution of questionnaire screening and pulmonary function test results, comparison of screening results based on comorbidity-related diseases grouping, comparison of screening results based on questionnaire screening results grouping, comparison of screening results based on smoking total score grouping, and association rules between screening results and pulmonary function test results and other research data.Results:Among the 1 392 study subjects, 334 cases (24.0%) had a positive self-screening questionnaire for COPD, 44 cases (13.2%) completed pulmonary function tests, and 17 cases (38.6%) were diagnosed with COPD. The positive rate of the screening questionnaire among inpatients was lowest in surgical patients without comorbidity-related diseases and highest in male patients with single/multiple comorbidity-related diseases and symptoms of chronic respiratory system diseases. The group with multiple comorbidity-related diseases had a significantly higher positive rate in the screening questionnaire than the group with single comorbidity-related diseases and the group without comorbidity-related diseases. Only 13.2% of inpatients with a positive screening questionnaire completed pulmonary function tests, with residents covered by medical insurance with multiple comorbidity-related diseases, including cardiovascular diseases, having the lowest rate, and patients with symptoms of chronic respiratory system diseases and single comorbidity-related diseases having the highest rate.Conclusions:Based on the collection of comorbidity-related diseases and questionnaire surveys, it is feasible to actively screen COPD patients among inpatients in county territory-level hospitals. However, efforts are needed to further increase the proportion of inpatients with positive screening questionnaires undergoing pulmonary function tests.

Objective:To compare the clinical characteristics of patients with chronic obstructive pulmonary disease (COPD) and cardiovascular diseases between smokers and non-smokers.Methods:In this retrospective cross-sectional study, a total of 735 patients with COPD and comorbid cardiovascular disease who were hospitalized in the Department of Respiratory and Critical Care Medicine of Peking University Third Hospital from January 1, 2017 to August 1, 2022 were enrolled, and were divided into a smoking group (603 cases) and a non-smoking group (132 cases) according to whether or not they had ever smoked. Clinical data, blood counts, C-reactive protein, procalcitonin, echocardiography, comorbidities, hospitalization costs and outcomes were compared between the two groups. Propensity score matching method was used to balance the baseline information between smoking patients and non-smoking patients for further paired analysis. Data were statistically analyzed using t-test, chi-square test, and rank sum test. Results:The percentage of females was significantly higher in patients in the nonsmoking group than in those in the smoking group (65.9% vs 13.6%, P<0.001), and body mass index (BMI) was also significantly higher than in those in the smoking group [(24.4±4.7) vs (23.5±4.4) kg/m 2, P=0.022]. Inflammation indicators neutrophil-to-lymphocyte ratio (NLR) [3.8 (2.2, 8.1) vs 4.9 (2.9, 8.3), P=0.018], C-reactive protein [1.3(0.5, 8.1) vs 7.9(1.1, 35.1) mg/L, P=0.001] were lower in the non-smoking group than in the smoking group. The ratio of early transmitral flow velocity to early mitral annular velocity (E/Em) values were significantly higher in the smoking group than in the nonsmoking group [10(7, 12) vs 8(7, 10) P=0.030]. The cardiovascular disease composition was dominated by hypertension with a lower percentage of combined coronary heart disease in the nonsmoking group than in the smoking group (22.0% vs 35.0%, P=0.034). The two groups were similar in terms of cost during hospitalization and mortality indicators. Conclusions:Among patients with COPD, smokers exhibit higher levels of systemic inflammation, greater cardiac involvement, and an increased risk of ICU admission than non-smokers. Therefore, they require enhanced daily health management and management during hospitalization.

Objective:To investigate the clinical features of patients with chronic obstructive pulmonary disease (COPD) and serum-positive specific IgE (SIgE).Methods:This study was a retrospective cohort study. A total of 105 stable COPD patients with allergic features and completed serum SIgE testing were included, and all of them were from Capital Medical University, Beijing Tong Ren Hospital from September 2022 to October 2023. Those with at least one positive result of SIgE testing were classified as positive SIgE COPD group, and those with negative SIgE were classified as negative SIgE COPD group. There were 32 cases (30.5%) in the positive SIgE COPD group and 73 cases (69.5%) in the negative SIgE COPD group. Differences in laboratory tests, pulmonary function, chronic obstructive pulmonary symptom scores, incidence of severe acute exacerbation events in the past year, and drug therapy were compared between the two groups. The risk factors for positive SIgE COPD were analyzed, and the best predictive value for the diagnosis of positive SIgE COPD was analyzed using the area under the curve (AUC) of receiver operating characteristic (ROC).Results:Compared with the negative SIgE COPD group, the percentage of positive SIgE COPD group with rhinitis, sinusitis, sinusitis with nasal polyps, eczema, and a history of drug or food allergy were higher (all P<0.05) and the percentage of those who had quit smoking were higher ( P<0.05); the percentage of IgE above normal thresholds, the level of IgE, the percentage of peripheral blood eosinophil (EOS%), the count of EOS, and fractional exhaled nitric oxide (FeNO) were higher (all P<0.05), and the percentage of those who had severe and above severe Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) pulmonary function classification were higher, while the percentage of forced expiratory volume in one second (FEV 1% predicted), 25% maximal expiratory flow (MEF 25%) and MEF 75/25% were lower, and FEV 1/FVC was higher (all P<0.05). The positive SIgE COPD group had higher modified British medical research council (mMRC) scores and COPD assessment test (CAT) scores, and a higher incidence of severe acute exacerbation events over the past year (all P<0.05), and the use of short-acting β 2 receptor agonists (SABA) or short-acting muscarinic antagonist (SAMA), inhaled corticosteroid (ICS), theophylline and oral hormone therapy were more frequent (all P<0.05). EOS% ( OR=1.252, 95% CI: 1.039-1.508) was a risk factor for SIgE positivity in COPD ( P<0.05), and having quit smoking ( OR=0.385, 95% CI: 0.197-0.751) was a protective factor ( P<0.05). The AUC value of the ROC curve of EOS%>2.5% for the diagnosis of SIgE positivity was 0.647 (95% CI: 0.543-0.752), with a sensitivity and specificity of 52.8% and 73.1%, respectively. Conclusions:Positive SIgE COPD has sever clinical symptoms, high risk of acute exacerbation and deficiencies in treatment. The elevate of EOS% is a risk factor for the development of positive SIgE in COPD patients; positive SIgE COPD meets the diagnostic criteria for allergic COPD phenotype, and EOS% over 2.5% is suggestive of the clinical detection of allergic COPD phenotype.

Objective:To analyze the current prevalence of pre-diabetes (PDM) and its relationship with overweight and obesity in an adult health check-up population.Methods:This study was a cross-sectional and retrospective cohort study and was applied using whole-cluster random sampling method. A total of 491 379 adults who underwent health check-ups at the Health Management Centre of Sichuan Provincial People′s Hospital from January 2017 to July 2023 were selected to analyze the epidemiological characteristics of PDM and overweight-obesity, as well as the trend of change over time. A retrospective cohort study was conducted on 19 001 of the subjects who underwent≥3 health check-ups and did not have diabetes and PDM at baseline, and the relationships between body mass index, waist circumference and the risk for developing PDM were analyzed using Cox proportional risk regression models. And the dose-response relationship between body mass index, waist circumference and the risk for developing PDM was analyzed using restricted cubic spline regression (RCS).Results:Of the 491 379 cases included in the cross-sectional study, 275 084 were male and 216 295 were female, 163 158 cases were under 40 years old, and 328 221 cases were 40 years old and above; the total prevalence of PDM was 19.41% in 2017-2023, with an overall increasing trend. Of the 19 001 people included in the cohort study, a total of 2 487 (13.09%) new cases of PDM were identified at the end of follow-up. After adjusting for confounding factors, overweight ( HR=1.150, 95% CI: 1.047-1.263), obesity ( HR=1.335, 95% CI: 1.149-1.552) and abdominal obesity ( HR=1.218, 95% CI: 1.105-1.342) were risk factors for PDM. The risk of PDM rised with the increase of body mass index (>22.9 kg/m 2, Pnon-linear=0.973) and waist circumference (>80 cm, Pnon-linear=0.830), with a linear dose-response mode. In different gender and age groups, it was found the greater the body mass index (>24.1 kg/m 2 for men,>21.5 kg/m 2 for women;>23.3 kg/m 2 for age≥40 years,>24.1 kg/m 2 for age<40 years) and waist circumference (>85 cm for men, >73 cm for women; >82 cm for age ≥40 years, >85 cm for age <40 years), the higher the risk of PDM. Conclusions:The prevalence of PDM is on the rise in the adult health check-up population. To prevent PDM, it is necessary to control the body mass index and waist circumference to a lower level than the overweight and obesity standards.

Objective:To analyze the correlation between body fat distribution measured by quantitative CT (QCT) and body mass index in adults receiving physical examination.Methods:It was a cross-sectional study. From January to December 2021, 3 205 adults undergoing physical examination who met the inclusion criteria and underwent chest CT and QCT examination in the health management discipline of Henan Provincial People′s Hospital were selected as the research objects. The general data were collected; and the subcutaneous fat area, visceral fat area, total abdominal fat area, liver fat content, abdominal obesity and fatty liver detection rate were measured by QCT. According to body mass index, the subjects were divided into normal group (18.5-<24.0 kg/m 2, 1 343 cases), overweight group (24.0-<28.0 kg/m 2, 1 427 cases) and obesity group (≥28.0 kg/m 2, 435 cases). One-way analysis of variance and χ2 test were used to compare the differences of QCT indexes among the three groups. Pearson and Spearman correlation analysis were used to evaluate the correlation between QCT indexes and body mass index. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic effect of QCT on obesity and fatty liver. Results:Subcutaneous fat area, visceral fat area, total abdominal fat area, liver fat content, abdominal obesity and fatty liver detection rate in obese group were all significantly higher than those in overweight group and normal group [males, (147.60±46.44) vs (104.33±27.68), (73.46±22.65) cm 2; (297.46±54.70) vs (229.40±53.12), (159.57±49.68) cm 2; (445.06±70.24) vs (333.73±62.91), (233.02±61.87) cm 2; 11.30% (7.90%, 15.55%) vs 8.75% (6.50%, 11.70%), 6.60% (4.80%, 8.70%); 100.0% vs 96.0%, 64.0%; 92.9% vs 86.7%, 73.3%; females, (213.96±48.61) vs (155.85±35.31), (107.24±31.01) cm 2; (185.41±43.88) vs (142.48±41.75), (96.56±36.50) cm 2; (399.37±68.07) vs (298.33±56.86), (203.80±57.53) cm 2; 9.80% (6.90%, 13.30%) vs 7.30% (5.05%, 9.80%), 5.40%(3.50%, 7.20%); 96.4% vs 74.8%, 28.9%; 87.3% vs 75.6%, 56.5%], and were all positively correlated with body mass index (males, r/ rs=0.709, 0.738, 0.831, 0.402, 0.464, 0.225; females, r/ rs=0.798, 0.695, 0.841, 0.416, 0.605, 0.276) (all P<0.001). In both male and female subjects, the detection rates of obesity based on QCT were significantly higher than those based on body mass index (male, 86.9% vs 16.6%; female, 49.3% vs 8.9%), and the detection rates of fatty liver based on QCT were significantly higher than those based on ultrasound (male, 83.6% vs 57.1%; female, 65.2% vs 27.6%) (all P<0.001). ROC curve showed that when the visceral fat area of 142 cm 2 was used as the cut-off value for the diagnosis of obesity in male subjects, the sensitivity and specificity was 100% and 15.8%, respectively; and when the cut-off value of liver fat content 5.0% was used to diagnose fatty liver, the sensitivity and specificity was 88.9% and 25.1%, respectively. When the visceral fat area of 115 cm 2 was set as the cut-off value for the diagnosis of obesity in female subjects, the sensitivity and specificity was 96.4% and 55.3%, respectively; when the liver fat content of 5.0% was set as the cut-off value for the diagnosis of fatty liver, the sensitivity and specificity was 83.7% and 43.2%, respectively. Conclusions:The indexes of abdominal fat and liver fat measured by QCT in adults receiving physical examination are all positively correlated with body mass index. The effect of QCT in the diagnosis of obesity and fatty liver are both better than body mass index and ultrasound.

Objective:To analyze the effect of individualized exercise intervention on weight loss and improvement of metabolic indexes in individuals with metabolic syndrome (MS).Methods:This study was a randomized controlled trial. A total of 1 200 MS patients who underwent health examinations in the Beijing Aerospace General Hospital Healthy Management Center from 2019 to 2022 were selected as the research subjects. The patients were randomly divided into the experimental group (600 cases) and the control group (600 cases) by random number table. Based on the patient′s physical fitness data, a 3-month personalized exercise intervention was implemented for the experimental group, which included aerobic exercise 3 to 4 times/week combined with resistance exercise≥2 times/week, and MS-related health examinations were given too. The control group only received physical examination. Paired t-test was used to compare the changes in weight and metabolic-related indicators before and after the intervention in the two groups. Two-sample t-test was used to compare the differences in intervention effects between groups. The effect of personalized exercise intervention on weight loss and improvement of metabolic indicators in the MS population was analyzed. Results:After the intervention, the weight, body mass index, waist-to-hip ratio, resting heart rate, systolic blood pressure, diastolic blood pressure, fasting glucose, low-density lipoprotein, total cholesterol esters, and triglyceride levels in the experimental group were all significantly lower than those before [(72.5±12.9) vs (74.2±13.6) kg, (27.3±3.5) vs (27.9±3.5) kg/m2, 0.87±0.08 vs 0.91±0.08, (71±7) vs (74±9) times/min, (131±11) vs (138±14) mmHg (1 mmHg=0.133 kPa), (80±8) vs (85±9) mmHg, (6.0±1.1) vs (6.9±1.6) mmol/L, (2.78±0.78) vs (3.12±0.77) mmol/L, (4.62±1.04) vs (5.22±0.97) mmol/L, (1.36±0.42) vs (2.59±2.01) mmol/L], but the high-density lipoprotein level was significantly higher than that before [(1.31±0.31) vs (1.27±0.29) mmol/L] (all P<0.05). The weight, body mass index, waist-to-hip ratio, systolic blood pressure, low-density lipoprotein, total cholesterol esters, and triglyceride levels after the intervention in the control group were all significantly higher than those before [(68.1±5.9) vs (67.1±5.9) kg, (25.3±2.4) vs (24.9±2.4) kg/m2, 0.83±0.07 vs 0.82±0.06, (127±12) vs (125±12) mmHg, (3.50±1.45) vs (3.20±1.21) mmol/L, (5.50±1.80) vs (5.30±1.52) mmol/L, (1.59±0.82) vs (1.40±0.65) mmol/L], but the high-density lipoprotein level was significantly lower than that before the intervention [(1.28±0.28) vs (1.38±0.28) mmol/L] (all P<0.05). The intervention effects on weight, body mass index, waist-to-hip ratio, heart rate, systolic blood pressure, diastolic blood pressure, glucose, high-density lipoprotein, low-density lipoprotein, total cholesterol and triglycerides levels in the experimental group were all significantly better than those in the control group [(-1.4±13.3) vs (1.0±5.9) kg, (-0.6±3.5) vs (0.4±2.4) kg/m2, -0.04±0.08 vs 0.01±0.06, (-3±8) vs (0±7) times/min, (-7±12) vs (2±12) mmHg, (-5±9) vs (0±8) mmHg, (-0.9±1.4) vs (0±0.5) mmol/L, (0.04±0.30) vs (-0.10±0.28) mmol/L, (-0.34±0.77) vs (0.30±1.34) mmol/L, (-0.60±1.00) vs (0.20±1.66) mmol/L, (-1.23±1.45) vs (0.19±0.74) mmol/L ] (all P<0.001). Conclusion:Individualized exercise intervention can effectively promote weight loss and improve metabolic-related indicators in MS patients.

Objective:To analyze the protective effect of weight-loss based exercises on the knee joints of patients with simple obesity.Methods:This study was a randomized controlled trial, 60 patients with simple obesity who met the inclusion and exclusion criteria and treated at the Affiliated Panyu Central Hospital of Guangzhou Medical University from April 2021 to April 2022 were selected as subjects. The patients were randomly divided into a power bicycle group (weight-loss, 30 cases) and a moving treadmill training group (non-weight-loss, 30 cases) using the random envelope method. High intensity interval exercise training was conducted in the hospital: slow warm-up for 1 minute, followed by rapid exercise for 3 minutes, and then rest for 1 minute. Repeated this cycle twice to form one set, and to perform 3 sets per session, 5 times per week, for a continuous training of 12 weeks. In addition, patients were not allowed to participate in other sports activities, and they should maintain their original dietary habits and patterns unchanged. Body mass index and body fat percentage were measured before and after treatment, and the cases with knee pain were recorded. The volume of knee cartilage was measured using magnetic resonance imaging. The local skin temperature of the knee was measured using an electronic thermometer before and after each training session. The t-tests, Pearson-tests and Mann-Whitney U tests were used to compare the differences in the above indicators between two groups before and after intervention to analyze the protective effect of weight-loss based exercise on the knee joints of patients with simple obesity. Results:There was no statistically significant difference in baseline data such as gender, age, height, and weight between the two groups before the intervention (all P>0.05). After the intervention, the body mass index, percentage of body fat, and knee cartilage volume of both groups were significantly lower than before the intervention, and the incidence of knee pain and local skin temperature of knee were significantly higher than before the intervention (all P<0.001). The incidence of the knee pain, reduction in knee cartilage volume, and elevation in local skin temperature in the power cycling group were all significantly lower than those in the moving treadmill training group [16.67% vs 100%, 0.12 (0.05, 0.27) vs 1.68 (1.15, 2.21) cm 3, (0.17±0.09) vs (0.64±0.15)℃, respectively] (all P<0.001). And there was no statistically significant difference in body mass index and body fat percentage between the two groups (both P>0.05). Conclusion:The weight-loss based exercise has a protective effect on the knee joint of patients with simple obesity, which can avoid a reduction in volume of knee cartilage and elevation in local skin temperature, and reduce the occurrence of pain.

Objective:To Investigate the prevalence of cancer related muscle disorder (CRMD) in hospitalized lung cancer patients, and to identify the possible risk factors.Methods:This study was a cross-sectional study. The study enrolled 259 patients without missing data who met the inclusion and exclusion criteria from 347 lung cancer patients who were non-repeated hospitalized in the Department of Respiratory and Critical Care Medicine of Peking Union Medical College Hospital from March 2023 to August 2023. Bioimpedance analysis was used to measure muscle mass in patients, and dietary information was collected using the food frequency questionnaire. Disease information and laboratory test results were obtained by consulting Hospital Information System. According to AWGS 2019, patients were divided into five groups: possible sarcopenia (PS), sarcopenia (S), severe sarcopenia (SS), low muscle mass (LMM), and non-muscle disorder (non-MD). The analysis of variance, Kruskal-Wallis test, and χ 2 test were used to compare differences in baseline data, energy and macronutrient intake, and laboratory test indicators among different groups, and ordered logistic regression analysis was applied for multivariate analysis to identify the influencing factors of CRMD in lung cancer patients. Results:This study included 259 hospitalized lung cancer patients who met the inclusion and exclusion criteria. The prevalence of CRMD among 259 patients was 64.5%, PS was 27.4%, S was 13.5%, SS was 14.3%, and LMM was 5.4%. plant protein intake ( OR=0.969, 95% CI: 0.942-0.996) and regular exercise ( OR=0.485, 95% CI: 0.269-0.869) were found to be protective factors for CRMD in hospitalized lung cancer patients, while age ( OR=1.056, 95% CI: 1.013-1.101), weight loss of more than 5% in the last six months ( OR=4.546, 95% CI: 1.363-15.563), and diabetes ( OR=2.342, 95% CI: 1.137-4.866) were identified as risk factors. Conclusion:The prevalence of CRMD in hospitalized lung cancer patients is relatively high, and is closely related to age, weight changes, exercise, comorbidities, and dietary intake.

Objective:To explore the influence of points system management on the career development of medical staff in health management discipline.Methods:Using a cross-sectional study design, medical staff in the health management discipline of tertiary hospitals in China were selected as the research objects from February 1 to March 1, 2024 through questionnaire star convenience sampling and snowball sampling, and their general information, performance appraisal satisfaction, professional identity, burnout, professional benefit, professional career management and other information were collected, and the correlation and influencing factors among them were explored. A total of 423 questionnaires were distributed, and 402 (95.0%) valid questionnaires were collected.Results:A total of 207 (51.5%) medical staff had job burnout, and 257 (63.9%) of them had medium or below level of professional identity. There were positive correlations among performance appraisal satisfaction, professional identity, career benefit and professional career management. There was a negative correlation between burnout and performance appraisal satisfaction ( r=-0.439), professional identity ( r=-0.356), career benefit ( r=-0.584), and professional career management ( r=-0.185) (all P<0.05). Higher age, working time, monthly income level, title level, position level, understanding of performance appraisal system, satisfaction with feedback results and application satisfaction were the protective factors of burnout, and under the points-based system, the scores of performance appraisal satisfaction, professional identity, career benefit, and professional career management were higher, and the differences were statistically significant (all P<0.05). A total of 310 medical staff (77.1%) believed that performance appraisal had a motivating effect on them. Conclusion:The performance appraisal of the point system has a good motivating effect on the medical staff of the health management discipline, and is closely related to professional identity, burnout, professional benefit, and professional career planning.

Objective:To analyze the distribution of body fat with quantitative computed tomography (QCT) in people with normal body mass index (BMI).Methods:A cross-sectional study was conducted in the physical examination population who underwent chest CT and QCT examination in the Department of Health Management, Henan Provincial People′s Hospital from January to December in 2021, and 1 395 physical examination subjects who met the inclusion criteria were selected as the research subjects. The subjects were divided into five groups according to their age. The general data of the subjects were collected. The total abdominal fat area (TFA), visceral fat area (VFA), subcutaneous fat area (SFA), total abdominal muscle area (TMA) and muscle fat content (MFC) in the subjects were measured by QCT. One-way analysis of variance, Welch test and Kruskal-Wallis test were used to compare the above QCT measurement indexes between the two genders among different age groups with normal BMI. Pearson correlation analysis was used to analyze the correlation between VFA and sarcopenia indexes. Multivariate linear regression was used to analyze the relationship between VFA and linear correlation variables in the related indicators of sarcopenia.Results:There were significant differences in TFA, VFA, TMA and SMI among different age groups in subjects with normal BMI (all P<0.05). Pearson correlation analysis showed that VFA was negatively correlated with TMA in some age groups (male: 18-39 years group: r=-0.351; 40-49 years group: r=-0.278; 60-69 years group: r=-0.245; female:40-49 years group: r=-0.251; 50-59 years group: r=-0.270;≥70 years group: r=-0.391; all P<0.01); it was negatively correlated with SMI (male: 18-39 years group: r=-0.352; 40-49 years group: r=-0.340; 50-59 years group: r=-0.266; 60-69 years group: r=-0.316; female: 40-49 years group: r=-0.240; 50-59 years group: r=-0.284; all P<0.001); it was positively correlated with MFC (male: 18-39 years group: r=0.342; 40-49 years group: r=0.291; female: 50-59 years group: r=0.133; 60-69 years group: r=0.284; all P<0.05). Multivariate linear regression analysis showed that VFA was independently and negatively correlated with SMI in both men and women after adjusting for age interference factors (male B=-1.881, t=-6.025, P<0.001; female B=-0.603, t=-2.887, P=0.004), and it was independently positively correlated with MFC (male B=1.230, t=4.271, P<0.001;female B=0.893, t=3.836, P<0.001). There was an independent negative correlation between VFA and TMA in male subjects ( B=0.263, t=2.478, P=0.013). Conclusions:VFA is correlated with TMA, SMI and MFC in people with normal BMI. Regardless of gender, SMI has a negative effect on VFA, and MFC has a positive effect on VFA.