August 2020, Volume 23，No23 Abstracts
Author：尹鹏 Source：CGP Published： [07-01] views： 453
Community-based Management Recommendations of Patients with Decompensated Liver Cirrhosis CHEN Juan，YIN Xuehong，MENG Qinghua*
Beijing Youan Hospital，Capital Medical University，Beijing 100069，China
*Corresponding author：MENG Qinghua，Chief physician；E-mail：email@example.com
【Abstract】 Based on the review of the 2018 EASL Clinical Practice Guidelines for the Management of Patients with Decompensated Cirrhosis，we discussed community-based diagnostic and therapeutic management of decompensated cirrhosis patients，hoping to help general practitioners to make rational management decisions and deliver preventive interventions benefiting the prognosis and quality of life when managing such patients.
【Key words】 Decompensated cirrhosis；Complications；Management；Practice Guidelines；General Practice
Application and Challenge of Novel Oral Anticoagulants in Patients with Nonvalvular Atrial Fibrillation LIU Yue1，2，REN Yirong1，2，ZHU Huolan1，2，WANG Fang1，2*
1.Beijing Hospital/National Center of Gerontology，Beijing 100730，China
2.Graduate School of Peking Union Medical College，Beijing 100005，China
*Corresponding author: WANG Fang，Chief physician，Doctoral supervisor；E-mail: firstname.lastname@example.org
【Abstract】 Risk assessment and prevention of stroke is an important part of comprehensive management of atrial fibrillation，the most common cardiac arrhythmia.Anticoagulation therapy is one intervention that can effectively reduce the incidence of atrial fibrillation-related stroke.Novel oral anticoagulants（NOACs）take effect by specifically blocking the key link in the development of clotting cascade，namely，the action of thrombin（coagulation factor Ⅱa） or coagulation factor Ⅹa，to inhibit the final stage of the coagulation pathway.NOACs，with the advantages of using a fixed dose，rapid oral absorption，small food-drug interactions，and using without monitoring routine coagulation indices，have become a hot research theme recently.This paper introduces the advances in clinical research and application of NOACs in atrial fibrillation，it is found that NOACs has the advantages of good efficacy and high safety，so as to guide clinical treatment.
【Key words】 Atrial fibrillation；Novel oral anticoagulants；Anticoagulant therapy；Review
Literature Review and Consideration of Factors Influencing Colorectal Cancer Screening in China AN Jinhui1，SUN Zhiping2，LI Yuntao1，LU Xuemei1，JI Guozhong1*
1.Department of General Practice，the Second Affiliated Hospital of Nanjing Medical University，Nanjing 210011，China
2.Health Management Center，the Second Affiliated Hospital of Nanjing Medical University，Nanjing 210011，China
*Corresponding author：JI Guozhong，Chief physician，Professor，Doctoral supervisor；E-mail：email@example.com
【Abstract】 Background In China，the incidence of colorectal cancer is gradually increasing across the country，as is the case with the disease burden of colorectal cancer.However，the rate of early colorectal cancer screening and adherence to the screening are both low in residents.Objective To identify the influencing factors of colorectal cancer screening，to provide scientific evidence for developing better screening strategies.Methods CNKI，Wanfang Data，VIP，CBM，PubMed and other databases were searched from inception to May 31，2019 for cross-sectional studies about factors affecting the adherence to colorectal cancer screening.Data extraction and quality assessment were performed.Qualitative meta-analysis was used to analyze the factors influencing the adherence to colorectal cancer screening.Results A total of 21 studies were included，involving 178 196 residents.Quality assessment score was 2 to 8.The results suggested that lack of knowledge about colorectal cancer and colorectal cancer screening and other cognitive factors，fear of screening and screening-related complications or discomfort and other psychological factors，distrust of community hospitals or receiving no relevant doctor's advice and other community hospital-related factors，and cost of screening were the main factors associated with low adherence to screening.Conclusion To improve the adherence to colorectal cancer screening，suggested facilitators include strengthening publicity and education，building the general practitioner-specialist screening team，developing a follow-up and response system，and providing government-insurance-enterprise-community-family combined interventions，and promoting sigmoidoscopy.
【Key words】 Colorectal neoplasms；Screening；Compliance；General practitioner
Efficacy and Mechanism of Simvastatin for Hematoma Absorption in an in Vitro Mouse Model of Intracerebral Hemorrhage WANG Ruonan1，ZHAO Dexi2*，LIU Liming2，NIU Ping2，CUI Yan3，WU Jiuru4
1 School of TCM，Changchun University of Chinese Medicine，Changchun 130000，China
2 Encephalopathy Department，Affiliated Hospital of Changchun University of Chinese Medicine，Changchun 130000，China
3.School of Basic Medical Sciences，Changchun University of Chinese Medicine，Changchun 130000，China
4.School of Acupuncture and Massage，Changchun University of Chinese Medicine，Changchun 130000，China
*Corresponding author：ZHAO Dexi，Chief physician，Professor；E-mail：firstname.lastname@example.org
【Abstract】 Background Simvastatin（SIM）is often clinically used for secondary prevention of cardio-cerebrovascular disease，but its effect on endogenous absorption of hematoma after intracerebral hemorrhage is still unclear.Objective To study the efficacy and mechanism of SIM for endogenous absorption of hematoma in a mousse model of BV-2 encephalorrhagia inducted by red blood cells（RBCs）.Methods This experiment was implemented from December 2017 to December 2018.Single-cell suspensions of well-cultured mouse BV-2 cells were prepared，and were divided into blank control group A，model group，SIM groups（0.312 5，0.625 0，1.250 0，2.500 0，5.000 0，10.000 0，20.000 0，40.000 0，and 80.000 0 μmol/L）according to the reagents added.MTT colorimetry was used to detect the effect of different concentrations of SIM on the survival rate of BV-2 cells.Immunofluorescence technique was used to observe the in vitro intracerebral hemorrhage model of RBCs phagocytosed by BV-2 cells.After modeling， it was divided into blank group（200 μ l MEM complete medium），model group（blank group + RBC），SIM group（model group + SIM）.Flow cytometry was used to examine the effect of BV-2 cells on removing RBCs.Western blot was used to measure the effect of SIM on the expression levels of CD47，CD36，toll-like receptor 4（TLR4），peroxisome proliferator-activated receptor γ（PPARγ）and nuclear factor erythroid 2-related factor 2（NRF2）.Results MTT assay found that SIM≥5 μmol/L had a significant inhibitory effect on BV-2 cells（P<0.05）.Immunofluorescence microscopy showed that RBCs were phagocytosed by BV-2 cells in all groups except the blank control group，indicating that the in vitro mouse model of intracerebral hemorrhage was successfully developed.Flow cytometry revealed that SIM groups had more RBCs phagocytosed by microglia cells compared with the model group（P<0.05）.Western blot found that compared with the blank group，the expression levels of CD47，CD36，TLR4，PPARγ and NRF2 in the model group were significantly up-regulated（P<0.05），and in SIM groups，the expression levels of CD36，PPARγ and NRF2 were also significantly up-regulated，but those of CD47 and TLR4 were down-regulated significantly（P<0.05）.Conclusion SIM may effectively promote the endogenous removal of the hematoma in a mousse model of BV-2 cells encephalorrhagia inducted by RBCs.The action mechanism may be related to the restrain of the expression of CD47 and TLR4 proteins，and the upregulation of the expression of CD36，PPARγand NRF2 proteins.
【Key words】 Cerebral hemorrhage；Simvastatin；BV-2 microglia；Glial cell；Endogenous removal of hematoma；Cardiovascular diseases
Effect of Scavenger Receptor CD36 Gene Defect on Ambulatory Blood Pressure Rhythm and Metabolic Parameters in Patients with High-normal Blood Pressure ZHANG Aijun，GUO Hongwei，FENG Qiong，YANG Fang*
Department of Cardiology，Wuchang Hospital，Wuhan 430063，China
*Corresponding author: YANG Fang，Associate chief physician；E-mail: email@example.com
【Abstract】 Background With the change of arterial blood pressure rhythm and its absolute value，patients with high-normal blood pressure still have the risk of atherosclerotic cardiovascular diseases under the influence of associated metabolic factors.The CD36 gene defect of the scavenger receptor is related to the occurrence of various atherosclerotic cardiovascular diseases，so it is necessary to reveal the relationship between high-normal blood pressure and CD36 gene defect.Objective To compare the 24-hour ambulatory blood pressure parameters and metabolic parameters between patients with high-normal blood pressure accompanied by CD36 gene defect and those with normal CD36 gene，in order to explore the effect of CD36 gene defect on blood pressure and metabolism in patients with high-normal blood pressure.Methods A total of 200 patients who were diagnosed with high-normal blood pressure for the first time in the Department of Cardiology of Wuchang Hospital from October 2018 to April 2019 were selected as research subjects.24-hour ambulatory blood pressure monitoring was performed among all patients.Fasting venous blood was collected to detect related metabolic indicators and scavenger receptor CD36 gene defect.Thirty-one patients with high-normal blood pressure and CD36 gene defect were selected as the observation group，and 169 patients with high-normal blood pressure and normal CD36 gene were selected as the control group.Multivariate Logistic regression was used to analyze the influencing factors of CD36 gene defect.Results A total of 31 cases of scavenger receptor CD36 gene defect were detected，and the detection rate was 15.5%.The body mass index（BMI），24-hour mean diastolic blood pressure（24 hDBP），nighttime mean systolic blood pressure （nSBP），24-hour mean arterial pressure （24 hMAP），incidence of non-dipper blood pressure，triacylglycerol （TG），and insulin resistance index （HOMA-IR）in the observation group were significantly higher than those in the control group （P<0.05）.Multivariate Logistic regression analysis showed that BMI 〔OR=5.649，95%CI（4.235，14.376）〕，24 hMAP 〔OR=5.836，95%CI（4.459，15.132）〕，non-dipper blood pressure〔OR=6.228，95%CI（5.876，16.812）〕，TG 〔OR=4.348，95%CI（2.247，10.168）〕，and HOMA-IR 〔OR=4.134，95%CI（1.630，5.245）〕 were independent influencing factors of scavenger receptor CD36 gene defect in patients with high-normal blood pressure（P<0.05）.Conclusion The incidence of scavenger receptor CD36 gene defect in patients with high-normal blood pressure is 15.5%.The blood pressure and metabolism may have an effect on scavenger receptor CD36 gene defect in patients with high-normal blood pressure.
【Key words】 Scavenger receptor；CD36；Gene defect； High-normal blood pressure；Ambulatory blood pressure rhythm；Average arterial pressure；Metabolic index；Root cause analysis
Associations of Serum Adropin Level with Severity of Coronary Artery Disease and Slow Flow in Patients with Non-ST-elevation ACS LU Zhifeng，CHEN Ximing*，WANG Shixiang
Department of Cardiovascular，the Third Affiliated Hospital of Guangzhou Medical University，Guangzhou 510150，China
*Corresponding author：CHEN Ximing，Chief physician，Professor；E-mail：firstname.lastname@example.org
【Abstract】 Background At present，the severity of coronary artery lesions is mainly assessed by invasive coronary angiography-based SYNTAX score，and it is hard to predict slow flow during PCI.Finding a biomarker to accurately predict high-risk coronary lesions and the occurrence of slow flow has become one of the hot spots in cardiovascular research.Objective The present study is an analysis of the relationship of serum Adropin level with the severity of coronary artery disease （CAD） as well as slow flow during PCI in patients with non-ST-elevation acute coronary syndrome （NSTE-ACS）.Methods A total of 280 participants，240 with NSTE-ACS underwent PCI and 40 individuals with normal coronary angiography （control group） were prospectively enrolled during March 2016 to June 2018.According to the SYNTAX score，patients with NSTE-ACS were divided to high-risk subgroup （SYNTAX score≥33），medium-risk subgroup （22<SYNTAX score<33），and low-risk subgroup （SYNTAX score ≤ 22）.The clinical data and serum Adropin level of all participants were collected.Univariate and multivariate regression analyses were performed to assess the relationship between Adropin level and SYNTAX score.ROC curve analysis of Adropin was carried out to explore its value in predicting high SYNTAX score（≥33） in NSTE-ACS patients.The corrected TIMI frame count （CTFC） was calculated for patients with slow flow during PCI，and the relationship between Adropin and CTFC was analyzed by Pearson correlation analysis.Results The serum Adropin level differed significantly across three subgroups of NSTE-ACS〔high-risk subgroup （2 357±821）ng/L，medium-risk subgroup （2 899±756）ng/L，and low-risk subgroup （3 177
±913）ng/L〕，and the control group 〔（3 688±966）ng/L〕（P<0.001）.Pearson correlation analysis showed that the serum Adropin level was negatively correlated with SYNTAX score（r=-0.701，P<0.001）.Multivariate Logistic regression analysis showed that low serum Adropin level was an independent predictor of high SYNTAX score（≥33） in NSTE-ACS patients〔OR=0.999，95%CI（0.998，1.000），P=0.007〕.The serum Adropin cut-off value at admission for predicting high SYNTAX score （≥33） based on ROC curve analysis was determined to be 2 295 ng/L，with a sensitivity of 84.4% and a specificity of 92.5%〔AUC=0.958，95%CI（0.936，0.980）〕.38 patients （15.8%） suffered from slow flow during PCI and had a lower mean Adropin level compared with control group （P=0.002）.Pearson correlation analysis showed that the serum Adropin level was negatively correlated with CTFC（r=-0.796，P<0.001）.Conclusion In patients with NSTE-ACS，serum Adropin level is negatively correlated with SYNTAX score.Low serum Adropin can predict high risk NSTE-ACS patients.Slow flow is more likely to occur in NSTE-ACS patient with lower serum Adropin level during PCI.
【Key words】 Acute coronary syndrome；Adropin；SYNTAX score；Slow flow；PCI；Correlation analysis；Sensitivity；Specificity
Comparative Study of Relationships of Pain with Dyskinesia and Quality of Life in Patients with Parkinson's Disease and Vascular Parkinsonism YANG Haiting，YOU Heyang，YANG Chen，WU Lei*，DING Xiaoling*
Anhui Provincial Hospital Affiliated to Anhui Medical University，Hefei 230032，China
*Corresponding authors：WU Lei，Associate chief physician；E-mail：email@example.com
DING Xiaoling，Chief physician；E-mail：firstname.lastname@example.org
【Abstract】 Background Parkinson's disease （PD） is a progressive neurodegenerative disease，which is the third leading cause of death in the elderly.In recent years，an increasing number of studies have found that non-motor symptoms in PD especially pain seriously affect the quality of life，to which clinicians should pay more attention and then give reasonable treatment to relieve the psychological pressure of these patients and their families.Objective To perform a comparative analysis of the relationships of pain with dyskinesia and quality of life in PD and vascular parkinsonism （VaP） patients.Methods Participants receiving outpatient or inpatient treatment were recruited from Anhui Provincial Hospital Affiliated to Anhui Medical University were enrolled from January 2017 to January 2019，including 65 with PD and 65 with VaP.General data were collected.The King's Parkinson's Disease Pain Scale （KPPS），UPDRS-Ⅲ 〔Motor Examination，part 3 of the Unified Parkinson's Disease Rating Scale （UPDRS-Ⅲ）〕，Hospital Anxiety and Depression Scale （HADS），and 39-item Parkinson's Disease Questionnaire （PDQ-39） were used to measure the item of pain，level of dyskinesia，prevalence of anxiety and depression，and quality of life，respectively，in all patients.Hoehn and Yahr （HY） Scale was used to assess the stage of PD.Results Compared with PD patients，VaP patients had greater mean age and BMI，higher prevalence of hypertension and diabetes，higher mean UPDRS-Ⅲ score，but shorter mean duration of disease，lower mean KPPS score and lower incidence of pain（P<0.05）.Compared with PD patients with pain，VaP patients with pain had greater mean age，lower mean duration of disease，and lower prevalence of pain occurring in the shoulder，back and neck （P<0.05），pain occured more freguently in shoulder back and lumbar in PD while lower limds and lumbar in VaP（P<0.05）.The motor symptoms were relieved by dopaminergic drugs （mainly levodopa） in all PD patients with pain，but only in 72.4% （n=21） of VaP patients with pain.Compared with PD patients without pain，PD patients with pain had higher mean disease severity level，UPDRS-Ⅲ score，anxiety score，depression score，and PDQ-39 score （P< 0.05）.VP patients with pain had lower mean BMI and higher mean PDQ-39 score than those without （P<0.05）.Conclusion Patients with PD and VaP both are prone to pain.The more severe the motor symptoms and emotional disorders are，the more likely they will suffer from pain and the worse quality of life they will have.Clinicians should strengthen their understanding of pain in these diseases and standardize the pain management to improve patients' quality of life.
【Key words】 Parkinson disease；Vascular parkinsonism；Pain；Movement disorders；Anxiety；Depression；Quality of life；Degenerative diseases
Clinical and Pathological Characteristics of ANCA-associated Vasculitis in Elderly Patients with Renal Immune Complex Deposition LIN Mengjie1，BAI Peijin2*，CHEN Shizhi2，ZHANG Jun2，LI Yinan2，DING Xin1*，HE Jinxuan3，ZHANG Yong4*
1.Department of Pathology，Zhongshan Hospital，Xiamen University，Xiamen 361000，China
2.Department of Nephrology，the First Affiliated Hospital of Xiamen University，Xiamen 361000，China
3.Department of Nephrology，Zhongshan Hospital，Xiamen University，Xiamen 361000，China
4.Department of Nephrology，the 900th Hospital of Joint Logistic Support Force，PLA，Fuzhou 350025，China
*Corresponding authors: BAI Peijin，Attending doctor；E-mail: email@example.com
DING Xin，Associate chief physician；E-mail: firstname.lastname@example.org
ZHANG Yong，Associate chief physician；E-mai1: email@example.com
【Abstract】 Background ANCA-associated vasculitis（AAV） is very common in elderly people and typically affects the kidneys，manifesting as acute glomerulonephritis.The pathological characteristics of renal involvement are segmental necrotizing glomerulonephritis and crescentic nephritis.Previously，immunofluorescence examination was recommended to detect the deposition of oligoimmune complexes.However，in recent years，immune complex deposition in AAV detected by kidney immunofluorescence is not rare.Few studies have examined AAV with immune complex deposition in China.In elderly people，the clinical and pathological characteristics of the pathogenesis of AAV with immune complex deposition，as well as the response to treatment，are not completely clear.Objective To explore the clinical and pathological characteristics of AAV with renal immune complex deposition in elderly patients.Methods We performed a retrospective analysis of 56 AAV patients diagnosed by clinical pathology in Department of Nephrology，Zhongshan Hospital，Xiamen University，the First Affiliated Hospital of Xiamen University，and the 900th Hospital of Joint Logistic Support Force between January 2009 and December 2018.According to the status of immune complex deposition detected by immunofluorescence test and electron microscopy，we assigned 14 with immune complex deposition and 42 with oligoimmunocomplex deposition to immune complex deposition group，and oligoimmunocomplex deposition group，respectively.Both groups were treated with hormones and immunosuppressive agents.We compared the clinical manifestations，multiple system involvement，laboratory results，renal pathological characteristics and treatment response between the groups.Results There were no significant differences between the two groups in sex ratio，mean age，course of disease and BAVAS score，ANCA type distribution，prevalence of kidney，lung，skin，joint muscle and the central nervous system，serum BUN，Hb，ALB level，prevalence of crescents >50%，necrosis of glomerular capillary loop，and glomerulosclerosis（P>0.05）.The levels of Scr，24-h urinary protein，the number of crescent bodies，and interstitial fibrosis in the immune complex deposition group were higher than those in the oligoimmune complex group（P<0.05）.After 6 months of treatment，the remission rate was 9/14 in the immune complex deposition group and 76.2%（32/42） in the oligoimmune complex group，showing no significant difference（χ2=0.273，P=0.601）.Conclusion Kidney pathology in elderly AAV patients with immune complex deposition often shows more serve renal damage as well as more crescents with a greater degree of interstitial fibrosis.
【Key words】 ANCA-associated vasculitis；Elderly；Renal pathology；Immunocomplex；Nephritis
Correlation between Advanced Glycation End Products and Progression of Osteonecrosis of the Femoral Head PANG Fengxiang1，CHEN Xiaojun1，HE Xiaoming1，SHEN Yingshan1，YANG Fan1，GONG Shuidi1，CHEN Lixin1，LI Weifeng1，FANG Bin2，3，4，HE Wei2，4，WEI Qiushi2，4*
1.First Clinical Medical College，Guangzhou University of Chinese Medicine，Guangzhou 510405，China
2.No.3 Orthopaedic Department，the First Affiliated Hospital of Guangzhou University of Chinese Medicine，Guangzhou 510405，China
3.No.5 Orthopaedic Department，the First Affiliated Hospital of Guangzhou University of Chinese Medicine，Guangzhou 510405，China
4.Hip Joint Research Center，Guangzhou University of Chinese Medicine，Guangzhou 510405，China.
*Corresponding author：WEI Qiushi，Associate professor；E-mail：firstname.lastname@example.org
【Abstract】 Background Osteonecrosis of femoral head（ONFH） is a refractory orthopedic disease.Due to delayed early diagnosis and rapid collapse process，many patients may inevitably undergo total hip arthroplasty.Therefore，it is of great practical significance to find a scientific method to diagnose ONFH.Objective To analyze the plasma advanced glycation end products（AGEs） in patients with ONFH（ARCOⅡ-Ⅳ） and to study its correlation with the development of ONFH.Methods ONFH inpatients（consisting of ARCO Ⅱ，Ⅲand Ⅳ based on imaging data） and healthy adult physical examinees were recruited from No.3 Orthopaedic Department，and Physical examination Center，the First Affiliated Hospital of Guangzhou University of Chinese Medicine，respectively，during June to December 2016.ELISA-detected plasma AGEs were compared between ONFH inpatients and healthy controls，and were compared in ONFH inpatients by causes of ONFH，ARCO stage，pre- and post-collapse stages.Results The mean plasma AGEs concentration in ONFH inpatients〔（2.87±0.73）mg/L〕 was greater than that of the healthy controls〔（2.33±0.94）mg/L〕（t=3.692，P<0.001）.The AGEs concentration varied significantly among ARCOⅡ，Ⅲand Ⅳ patients（P<0.05）.Those with ARCOⅡshowed lower mean AGEs concentration than those with ARCOⅣ（P<0.05）.The AGEs concentration also varied significantly among the patients either at pre-collapse or post-collapse stage of ONFH（P<0.05）.Furthermore，the AGEs concentration changed significantly according to the causes of ONFH（P<0.05）.In particular，patients with trauma-induced ONFH had higher mean AGEs concentration than those with alcohol-induced，steroid-induced or idiopathic ONFH（P<0.05）.According to the results of Spearman correlation analysis，AGEs concentration was positively correlated with ARCO stage（rs=0.274，P=0.007）.ROC curve analysis showed that the AUC of AGEs in idnetifying the collapse of ONFH was 0.651（0.567，0.729），with 72.45% sensitivity and 59.09% specificity when the cut-off value was determined as 2.419 mg/L.Conclusion Plasma AGEs concentration is closely related to the progress of ONFH，which may be used as a reference for diagnosis of ONFH and disease monitoring.
【Key words】 Femur head necrosis；Advanced glycation end products；ARCO staging；Diagnosis；Biomarkers；Disease monitoring；Sensitivity；Specificity
Immune Reconstitution in Adult HIV/AIDS Patients after Long-term Antiretroviral Therapy TAN qing1，2，ZHOU Zhonghui2，YAN Dongmei1，LIU Huanxia1，HE Shenghua1*
1.Department of Infection，Public Health Clinical Center of Chengdu，Chengdu 610000，China
2.Department of Infection，Affiliated Hospital of North Sichuan Medical College，Nanchong 637000，China
*Corresponding author： HE Shenghua，Chief physician；E-mail：email@example.com
【Abstract】 Background Antiretroviral therapy （ART） prolongs the life expectancy of people living with human immunodeficiency virus（HIV）/ acquired immune deficiency syndrome（AIDS）.However，there are limited data on the long-term immune reconstitution in such patients after ART.The ratio of CD4+ T lymphocytes （CD4 cells） to CD8+ T lymphocytes （CD8 cells） has been used as a crucial marker for the assessment of immune status in recent years.Understanding post-ART immune reconstitution evaluated by immune markers（including CD4∶CD8 ratio） in such patients is of great importance，which provides clinicians with reference indicators for the management and treatment of this disease.Objective To investigate the immune reconstitution after ART in HIV/AIDS patients.Methods Participants were 98 HIV/AIDS outpatients consecutively recruited from Department of Infectious Diseases，Public Health Clinical Center of Chengdu in July 2014.All of them received 48-month ART using a regimen based on tenofovir disoproxil，lamivudine and efavirenz.Clinical data were collected，among which immune markers at baseline，and at the end of the 6th，12th，24th，36th，and 48th months of treatment were analyzed in detail.Correlation analysis was performed on the CD4∶CD8 ratio at the endpoint event.Results At baseline，and at 6，12，24，36，and 48 months after ART，CD4 cell count，CD8 cell count，CD4 cell recovery rate，CD4∶CD8 ratio，CD4∶CD8 ratio normalization rate and rate of T cells with multiple reconstitutions were all significantly different（P<0.05）.CD4∶CD8 ratio differed significantly across time points（at baseline，and at 6，12，24，36，and 48 months after ART） in the subgroup of patients with baseline CD4 cell count ≤200 cells/μl，201-349 cells/μl，or ≥350 cells/μl （P<0.001）.The rates of CD4∶CD8 ratio normalization at baseline and at each follow-up time point of post-ART showed no significant differences （P>0.05）.At the end of ART，the rates of CD4 cell count ≥500 cells/μl，CD4∶CD8 ratio normalization，and T cells with multiple reconstitutions were 59.8% （58/97），22.7% （22/97），and 19.6% （19/97），respectively.The CD4∶ CD8 ratio at 48 months after ART was positively correlated with baseline CD4 cell count （rs=0.269，P=0.01），and baseline CD4∶ CD8 ratio （rs=0.592，P<0.001），and was negatively correlated with baseline CD8 cell count （rs=-0.355，P<0.001），but was independent of age （rs=0.129，P=0.21），time from diagnosis to ART initiation （rs=-0.141，P=0.17），and viral load （rs=0.145，P=0.15）.Conclusion HIV/AIDS patients with long-term ART still had poor immune reconstitution.The CD4∶ CD8 ratio was related to the baseline immune level，but needs to be verified by large-sample and long-term studies.
【Key words】 HIV；Acquired immunodeficiency syndrome；CD4-positive T-lymphocytes；CD8-positive T-lymphocytes；CD4-CD8 ratio；Immune reconstitution
Effects of Chronic Disease Burden on Anxiety and Depression in Elderly Patients WANG Zhen1，2，SUN Jing3，ZHANG Youyang1，LI Yuhang1，MA Xiaoyu1，MA Wenlin1，3，LU Lijuan3*
1.Tongji University School of Medicine，Shanghai 200082，China
2.Department of General Practice，Nanjing Jiangning Hospital，Nanjing 211100，China
3.Department of Geriatric Medicine，Tongji Hospital of Tongji University，Shanghai 200065，China
*Corresponding author：LU Lijuan，Intermediate Nurse-in-charge；E-mail：firstname.lastname@example.org
【Abstract】 Background Studies have shown that chronic diseases are closely related to psychological emotions.Most previous studies focused on the relationship between individual chronic diseases and anxiety and depression，and there is a lack of systematic research on the relationship between chronic disease burden and anxiety and depression in elderly patients.Objective To explore the relationship between chronic disease burden and anxiety and depression in elderly patients.?Methods From March to June in 2018，103 elderly patients were enrolled continuously from the Department of Geriatric Medicine in Tongji Hospital.Chronic disease burden was measured with Charlson Comorbidity Index （CCI）.CCI scores≤3 indicated low chronic disease burden.CCI scores>3 indicated high chronic disease burden.Anxiety was measured with the Generalized Anxiety Disorder-7 （GAD-7）.Depression was measured with the Patient Health Questionnaire-9 （PHQ-9）.The incidence of anxiety and depression in elderly patients with different degrees of chronic disease burden was compared.Results The GAD-7 scores ranged from 0 to 21 with a mean of （3.7±4.8）.PHQ-9 scores ranged from 0 to 25 with a mean of （5.3±5.3）.The results of assessments showed that a total of 42 （40.8%） patients exhibited symptoms of depression；28 （27.2%） patients exhibited symptoms of anxiety；and 22 （21.4%） patients exhibited comorbid anxiety and depression.Low disease burden group had 54（52.4%）cases，while high disease burden group contained 49 （47.6%）cases.There was no significant difference of anxiety and depression in two groups （P>0.05）.There was no significant difference in the incidence of anxiety and depression between patients with different genders and age （P>0.05）.Conclusion There is a high incidence of anxiety and depression in the elderly inpatients，so the medical staffs need to pay more attention to their mental health.In our study，no significant correlation was found between the disease burden of elderly inpatients and anxiety and depression，so we suspect that negative emotions have little impact on the elderly patients with multiple chronic diseases.
【Key words】 Chronic disease；Burden of illness；Anxiety；Depression；Charlson comorbidity index；Aged
Effect of Problem-solving Therapy on Anxiety，Depression and Self-management Ability in Patients with Gestational Diabetes Mellitus JIA Zhihui1，2，ZHANG Xianxian1，2，ZHANG Boya1，2，ZHANG Lixia1*，CHENG Yuanzun1
1.The Second Affiliated Hospital of Zhengzhou University，Zhengzhou 450014，China
2.Academy of Medical Sciences，Zhengzhou University，Zhengzhou 450052，China
*Corresponding author：ZHANG Lixia，Associate professor；E-mail：email@example.com
【Abstract】 Background The incidence of anxiety，depression and other adverse emotions in women with gestational diabetes mellitus（GDM）is significantly higher than that of those without，which seriously affects the physical and mental health and disease progression.Problem-solving therapy（PST）is a six-step cognitive-behavioral intervention that increases positive cognitive，emotional，and behavioral changes，but its use in women with GDM has been less reported.Objective To investigate the effect of PST on the self-management ability，pregnancy-related anxiety and depression in women with GDM.Methods From August 2018 to May 2019，100 women with GDM undergoing regular prenatal examination in the Second Affiliated Hospital of Zhengzhou University were selected by convenient sampling，and were divided into control group and observation group（50 cases in each） by a table of random numbers，receiving routine prenatal guidance and management of GDM，and routine prenatal guidance and management of GDM in combination with PST，respectively.The intervention effect was evaluated by comparing post-8-week intervention BMI，fasting blood glucose（FBG），2-h postprandial blood glucose（2hPG），self-management ability assessed by Self-management Ability Questionnaire for Gestational Diabetes Mellitus Patients（SMQGDM），anxiety level assessed by the Pregnancy-specific Anxiety Questionnaire（PAQ），and depression level assessed by Self-rating Depression Scale（SDS） with the baseline status.Results During the study，6 cases were excluded due to loss to follow-up（3 in each group），the other 94 who completed this study were finally included.After intervention，the observation group showed lower mean levels of FBG and 2 hPG，and lower mean scores of PAQ and SDS，and higher mean scores of related knowledge，beliefs and attitudes，social support，self-management methods and behaviors，and higher mean total score of SMQGDM compared with the control group（P<0.05）although these aspects were similar in both groups before the intervention（P>0.05）.Conclusion PST may help to improve the self-management ability，and glycemic control，and reduce pregnancy-related anxiety and depression levels of GDM patients.
【Key words】 Gestational；Gestational diabetes；Problem-solving-therapy；Anxiety；Depression；Self-management ability
Effect of Information-Motivation-Behavioral Skills Model-based Health Education in Parents of Children with Depressive Disorders LU Heli1*，SUN Weiming2，DONG Xiangli1，GUO Ming1，HUANG Xiaoqin1，XU Xi1，HU Feihu1
1.Department of Psychosomatic Medicine，the Second Affiliated Hospital of Nanchang University，Nanchang 330006，China
2.Department of Rehabilitation Medicine，the First Affiliated Hospital of Nanchang University，Nanchang 330006，China
*Corresponding author: LU Heli，Attending physician；E-mail: firstname.lastname@example.org
【Abstract】 Background The impairment of depressive disorders is difficult to understand appropriately due to atypical manifestations commonly found in the diseased teenagers，as well as insufficient awareness of the disease in the diseased teenagers and their family members as well as the society.Even if some want to receive treatment，they often could not obtain standard treatment due to the impeding by their family members.Objective To explore the effect of information-motivation-behavioral skills（IMB） model-based health education among the parents of depressive disorder teenagers.Methods The parents of 90 teenagers with depressive disorders treated in Department of Psychosomatic Medicine，the Second Affiliated Hospital of Nanchang University were sampled from June 2018 to December 2018，and were randomly divided into group A （n=45，routine health education） and group B （n=45，IMB model-based health education）.The Zung Self-rating Anxiety Scale（SAS），Zung Self-rating Depression Scale（SDS） and Self-perceived Burden Scale（SBS） were used to investigate the prevalence of anxiety and depression，and level of self-perceived burden，respectively，at baseline and at the end of the 12-week intervention.A self-designed questionnaire was used to assess the knowledge of depressive disorders at the end of intervention.Results The mean standard scores of SAS and SDS decreased obviously in both groups after intervention（P<0.05），and greater declines were found in group B （P<0.05） although the baseline levels in the two groups were similar（P>0.05）.At baseline，there were no significant differences in the mean scores of physical burden，economic burden，emotional burden，family burden，social burden and psychological burden induced by caring between the two groups（P>0.05），but the mean scores of these 6 types of burdens were lowered more significantly in group B after intervention（P<0.05）.Furthermore，the mean scores of these 6 types of burdens declined obviously in both groups after intervention（P<0.05）.The post-intervention mean scores of levels of knowledge of depressive disorders，family management techniques and subsequent consultation criteria in group B were all higher than those in group A（P<0.05）.Conclusion The IMB model-based health education may improve the negative emotions，levels of self-perceived burden，knowledge of depressive disorders，and skills of depressive management in parents of teenagers with depressive disorders.Moreover，the family management plan for the teenagers made by the parents may also be improved，and the level of intention of receiving further treatment of the teenagers may be increased，too.
【Key words】 Depressive disorder；Information-motivation-behavioral skills model；Adolescent；Family relations；Health education
Research Advance of Anxiety and Depression in Patient with Percutaneous Coronary Intervention WANG Juan1，2，ZHANG Yulong 1，2，ZHONG Yi1，2，LIU Zhiwei 1，2，LI Wenzheng 2，3，XIA Lei 1，2，QIAN Guangbing1，4，LIU Huanzhong 1，2*
1.Department of Psychiatry，Chaohu Hospital of Anhui Medical University，Chaohu 238000，China
2.Anhui Psychiatric Center，Chaohu 238000，China
3.Department of Psychiatry，Hefei Fourth People's Hospital，Hefei 230000，China
4.Department of Cardiology，Chaohu Hospital of Anhui Medical University，Chaohu 238000，China
*Corresponding author：LIU Huanzhong，Doctoral supervisor，Chief physician；E-mail：email@example.com
【Abstract】 The psychological status of patients with coronary atherosclerotic heart disease（CAD） often changes greatly after percutaneous coronary intervention（PCI），but less attention has been paid to it by clinicians.This study summarized the research progress of anxiety and depression in patients with PCI.The epidemiology，risk factors，adverse effects and intervention measures were reviewed respectively.The incidence of anxiety and depression in patients with PCI was high and was highest in perioperative period，and the emotional symptoms of most patients were not relieved for a long time.Postoperative depression could even increase the long-term mortality，but postoperative anxiety may reduce the long-term mortality.Patients with anxiety and depression associated with PCI should choose appropriate intervention methods for the early intervention according to their actual situation.
【Key words】 Coronary atherosclerotic heart disease；Percutaneous coronary intervention；Anxiety；Depression
High- and Low-viscosity Cement Vertebroplasty for Osteoporotic Vertebral Compression Fractures：a Systematic Review of 36 Randomized Controlled Clinical Trials ZHAO Jinlong1，2，PAN Jianke2，3，HUANG Hetao1，2，HAN Yanhong1，2，ZENG Lingfeng2，3，LIANG Guihong2，3，LIN Jiongtong1，2，LI Jiahui1，2，WU Ming1，2，HOU Senrong1，2，LIU Jun2，3*
1.The Second Clinical Medical College，Guangzhou University of Chinese Medicine，Guangzhou 510405，China
2.Bone and Joint Degeneration and Injury Research Team，Guangdong Academy of Traditional Chinese Medicine，Guangzhou 510120，China
3.The Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Traditional Chinese Medicine，Guangzhou 510120，China
*Corresponding author:LIU Jun，Professor，Doctoral supervisor；E-mail:firstname.lastname@example.org
【Abstract】 Background Vertebroplasty，represented by PVP and PKP，has been widely accepted for the treatment of osteoporotic vertebral compression fracture（OVCF），but bone cement leakage is still a problem in clinical practice.Although systematic reviews have pointed out that high-viscosity bone cement has high safety and good clinical efficacy，it still lacks a systematic evaluation of clinical randomized controlled trials（RCTs） with a large sample to provide a strong evidence-based basis.Objective To further evaluate the efficacy and safety of high- and low-viscosity bone cement in the treatment of OVCF by meta-analysis，update evidence-based data of systematic evaluation，and analyze more detailed intraoperative and postoperative evaluation indicators.Methods Six databases （PubMed，Cochrane Library，OVID，CNKI，Wanfang Data，VIP） were searched were searched for RCTs about OVCF treated with high-viscosity cement vertebroplasty（experimental group） and low-viscosity cement vertebroplasty（control group） included from inception to July 2019.Cochrane Collaboration's tool was used to make a quality assessment.Stata 12.0 was used to perform meta-analysis.Results 36 RCTs with a total of 3 216 cases were included，including 1 624 in the experimental group and 1 592 in the control group.The overall quality was moderate.Meta-analysis showed that the mean visual analogue scale （VAS） scores of the experimental group were lower than those of the control group at 2 days，3 days，1 week，1，3，and 12 months after surgery〔SMD=-0.43，95%CI（-0.64，-0.22），P=0.042；SMD=-0.53，95%CI（-0.80，-0.26），P<0.05；SMD=-0.26，95%CI（-0.49，-0.03），P=0.042；SMD=-0.66，95%CI（-0.86，-0.47），P<0.05；SMD=-1.27，95%CI（-2.02，-0.51），P=0.001；SMD=-0.73，95%CI（-1.20，-0.27），P=0.002〕.The mean Oswestry Disability Index （ODI） was lower in the experimental group than in the control group at 2 days，3 months，and 12 months〔SMD=-0.28，95%CI（-0.51，-0.05），P=0.018；SMD=-1.18，95%CI（-1.98，-0.38），P=0.004；SMD=-0.47，95%CI（-0.86，-0.08），P=0.017〕.But the mean ODI showed no significant difference between the two groups at 1 week and 1 month postoperatively〔SMD=-0.23，95%CI（-0.77，0.32），P>0.05；SMD=-0.44，95%CI（-1.14，0.25），P=0.214〕.There was no significant difference in Cobb angle between the two groups at 1 month postoperatively〔SMD=-1.01，95%CI（-2.41，0.40），P=0.16〕.The mean Cobb angle at 3 months and 12 months after operation was smaller in the experimental group than in the control group〔SMD=-1.78，95%CI（-2.90，-0.65），P=0.002；SMD=-0.70，95%CI（-1.15，-0.25），P=0.002〕.The mean JOA scores of the experimental group at 1 month and 3 months after operation were higher than those of the control group〔SMD=1.15，95%CI（0.81，1.49），P<0.001；SMD=0.39，95%CI（0.08，0.71），P=0.015〕.There was no significant difference between the two groups in the mean SF-36 score〔SMD=1.13，95%CI（-0.19，2.82），P=0.088〕.The compression rate of the anterior margin of the injured vertebrae and the midline compression rate of the injured vertebra were lower than those of the control group〔SMD=-2.31，95%CI（-3.71，-0.92），P=0.001；SMD=-1.27，95%CI（- 2.33，-0.20），P=0.02〕；but there was no significant difference in compression ratio of the posterior of the injured vertebrae between the two groups〔SMD=-0.01，95%CI（-0.38，-0.36），P=0.956〕.There was no significant difference in the amount of postoperative bleeding between the two groups〔SMD=-1.36，95%CI（-3.01，0.29），P=0.106〕.The mean operative time of the experimental group was shorter than that of the control group〔SMD=-0.92，95%CI（-1.58，-0.26），P=0.006〕.There was no significant difference in the mean amount of bone cement injected between the two groups〔SMD=-0.44，95%CI（-0.93，0.06），P=0.082〕.The mean intraoperative fluoroscopy times of the experimental group was less than that of the control group〔SMD=-0.86，95%CI（-1.32，0.39），P<0.001〕.The cement leakage rate of the experimental group was lower than that of the control group〔RR=0.39，95%CI（0.33，0.47），P<0.001〕.Funnel plot of the cement leakage showed that the RCTs were basically in the confidence interval，and the left and right parts were basically symmetrical，indicating that there may be no publication bias.Conclusion The meta-analysis shows that the use of high-viscosity bone cement for vertebroplasty in the treatment of OVCF can significantly shorten the operative time，reduce the times of intraoperative X-ray fluoroscopy，significantly alleviate postoperative pain and improve level of daily life activities.It has a better effect on improving the shape and function of the injured vertebrae.And there is sufficient evidence supporting that the leakage rate of high-viscosity cement is significantly lower than that of low-viscosity cement.
【Key words】 Fractures，compression；Osteoporotic fractures；Cementoplasty；High viscosity bone cement；Low viscosity bone cement；Systematic evaluation；Meta-analysis
Effect of Moxibustion with Ramie Threads Processed with the Zhuang Medicine on Serum Uric Acid and Joint Function in Patients with Gouty Arthritis: a Meta-analysis DENG Kaifeng1，CHEN Rilan2，LI Shuzhen2，ZHU Shengwang1，YAN Jiaxing1，GAO Qianqian1，MA Yinglu1，ZHU Ying2*
1.Guangxi University of Chinese Medicine，Nanning 530001，China
2.Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine，Nanning 530011，China
*Corresponding author: ZHU Ying，Chief physician，Professor，Master supervisor；E-mail: email@example.com
【Abstract】 Background A large number of clinical studies have shown that moxibustion with ramie threads processed with the Zhuang medicine（MRTPZM） can achieve good efficacy with low risk of adverse reactions in gouty arthritis patients.However，the effect of this therapy lacks of supports from multi-center and large-sample clinical studies.Objective To perform a systematic meta-analysis of the clinical efficacy and safety of MRTPZM in gouty arthitis patients.Methods The databases of CNKI，Wanfang Data Knowledge Service Platform，VIP，PubMed，EMBase and Cochrane Library were searched from inception to September 2019 for randomized controlled trials（RCT） about gouty arthritis patients treated with MRTPZM（treatment group） versus those with other therapies（control group）.Data extraction from and quality assessment of the included RCTs were performed.RevMan 5.3 as used to carry out meta-analysis.Results A total of 10 RCT in Chinese were included，and 5 of them were high-quality，other 5 were low-quality assessed by the Jadad Scale.Meta-analysis showed that the treatment group had higher overall response rate and cure rate，as well as greater decrease in serum uric acid and joint swelling and pain score〔OR=4.62，95%CI（2.69，7.94），P<0.000 01；OR=2.39，95%CI（1.37，4.16），P=0.002；SMD=-0.62，95%CI（-0.83，-0.40），P<0.000 01；MD=-2.51，95%CI（-3.38，-1.64），P<0.000 01〕，and lower incidence of adverse reactions〔OR=0.18，95%CI（0.11，0.31），P<0.000 01〕than the control group.Analysis of the overall response rate，cure rate，pre- and post-treatment differences in serum uric acid and joint swelling and pain score as well as the mild asymmetrical funnel plot of adverse reactions suggested that there was a possibility of publication bias.Reversal effect model-based analysis of the aforementioned 5 parameters revealed that these parameters were not reversed，which indicated that the results of the study are highly credible.Conclusion MRTPZM may effectively reduce the serum uric acid and relieve the level of joint swelling and pain to some extent with low risk of adverse reactions，indicating it has a good short-term efficacy in gouty arthritis patients.Due to limited sample size and possible bias in the included RCT，more standardized RCT are needed to verify the conclusion of this study.
【Key words】 Gouty arthritis；Thread-point moxibustion；Uric acid；Treatment outcome；Randomized controlled trial；Meta-analysis
Clinical Application of Genvoya? in Adult HIV/AIDS Patients TAN Qing1，2，ZHOU Zhonghui2，HE Shenghua1*
1.Department of Infection，Public Health Clinical Center of Chengdu，Chengdu 610000，China.
2.Department of Infection，Affiliated Hospital of North Sichuan Medical College，Nanchong 637000，China.
*Corresponding author：HE Shenghua，Chief physician；E-mail：firstname.lastname@example.org
【Abstract】 With the advent and widespread application of antiretroviral therapy（ART），AIDS has become a chronic controllable disease.AIDS is still a incurable disease and patients need to take their drugs for life.With the continuous updating of ART drugs，ensuring the antiviral effect and choosing drugs that are easy to take，have small adverse reactions，are safe and well tolerated is crucial to improving the quality of life of patients.Genvoya?，namely elvitegravir（EVG） / cobicistat（COBI） / emtricitabine（FTC） / tenofovir alafenamide（TAF），a combination of four drugs in a single tablet，abbreviated as E / C / F / TAF，has been approved by the US，EU and China Food and Drug Administration for AIDS treatment.This article focused on Genvoya?'s metabolic mechanism，clinical research，drug interactions and adverse reactions，and research on drug resistance in order to improve the comprehensive understanding of the drug by clinicians and patients.
【Key words】 AIDS；Antiretroviral therapy；Genvoya?；Elvitegravir（EVG）；cobicistat（COBI）；emtricitabine（FTC）；tenofovir alafenamide（TAF）
Application and Research Progress of Ozone in Clinical Pain Medicine WEI Yingcheng*，LIANG Xiaohang，WU Xiaomei，HUANG Yecheng，QIN Xiyang，YANG Xian，ZHANG Xueping，WU Xi，YAN Jie，JIANG Jinwen，JIANG Bingyi，WU Xiayuan
Guigang Hospital of Traditional Chinese Medicine，Guigang 537100，China
*Corresponding author：WEI Yingcheng，Chief physician；E-mail：email@example.com
【Abstract】 Ozone is an allotrope of oxygen，which has been used in clinic because of its strong oxidizing properties.With the deepening of research on the mechanism of action of ozone，ozone therapy technology has been widely used in clinical practice，especially in the field of clinical pain medicine.This paper reviews the application and research of medical ozone in pain medicine to further explore the mechanism of medical ozone in the treatment of pain and formulate systematic medical ozone treatment criteria and evaluation indicators in order to improve the efficacy as well as reduce technical risks，which provides a reference for future clinical research of medical ozone.
【Key words】 Pain；Ozone；Application；Research；Review
Indications and Precautions of Intrathecal Drug Infusion Devices for the Treatment of Cancer Pain ZHAO Rui，YANG Liqiang*
Department of Pain Management，Xuanwu Hospital Capital Medical University，Beijing 100053，China
*Corresponding author：YANG Liqiang，Chief physician，Associate professor；E-mail：firstname.lastname@example.org
【Abstract】 Cancer is one of the refractory diseases threatening human life.Advanced cancer is often accompanied by pain，known as cancer pain，which is a major problem that afflicts and reduces the quality of life of such patients.With the deepening of the research on subarachnoid drug diffusion，intrathecal infusion has been applied to the treatment of this disease.Among them，IT drug delivery（IDD） devices are widely used in clinical practice.On the basis of reviewing the recent studies on the indications，clinical effects，contraindications，precautions and economic factors，we summarized the application status of IDD devices in cancer pain，and concluded that when using IDD devices，it is necessary to weigh the advantages and disadvantages，respect patients' intention，and reduce the cost as much as possible.
【Key words】 Carcinoma；Pain；intrathecal infusion；Intrathecal infusion drug delivery devices；Morphine；Indications；Contraindications；Clinical effects；Complications；Health economics
Prevalence Survey of Overweight，Obesity and Central Obesity among Community-living Residents in Beijing's Pinggu District ZHAO Zihou1，KONG Xiangshuang2，WANG Lianying2，GUO Guangxia2，LI Yufeng2*
1.The First Clinical Medical College，Nanjing Medical University，Nanjing 211166，China
2.Pinggu Hospital，Beijing Friendship Hospital，Capital Medical University，Beijing 101200，China
*Corresponding author: LI Yufeng，Chief physician；E-mail: email@example.com
【Abstract】 Background Overweight and obesity have been proved to be important risk factors of chronic diseases such as diabetes，hypertension，arteriosclerotic cardiovascular disease and tumor.According to the latest data，the total number of overweight and obesity population in China is close to 1/4 of the total population.Timely knowing the prevalence of overweight and obesity in different regions may provide theoretical basis for formulating prevention and control strategies of obesity and other chronic diseases.Objective To investigate the prevalence of overweight，obesity and central obesity in community-living residents in Pinggu District of Beijing，to provide a science-based strategy for local control of obesity-related diseases as early as possible.Methods This study was conducted between June 2013 and September 2014 in a multistage random sample of community-living residents（aged 25-75 years old） from Pinggu District by Pinggu Hospital，Beijing Friendship Hospital，Capital Medical University and Peking University People's Hospital.Data including sex，age，place of residence，overweight（24 kg/m2≤BMI <28 kg/m2），obesity（28 kg/m2≤BMI<35 kg/m2），severe obesity（BMI≥35 kg/m2） and central obesity（waistline≥
90 cm for men，≥85 cm for women） were collected，and the prevalence of the latter three was calculated.The data were weighted for statistical analysis by sex and age group as well as geographical residence with the reciprocals of the ratios of sex，age group，and geographical residence as weights.Results A total of 4 002 cases participated in the questionnaire survey and all of them（100.00%） responded effectively.After weighting，the total cases numbered 436 519，and the prevalence of overweight，obesity，severe obesity，and central obesity was 39.64%（173 023/436 519） 〔95%CI（39.49%，39.78%）〕，26.30%
（114 808/436 519） 〔95%CI（26.16%，26.43%）〕，1.87%（8 180/436 519） 〔95%CI（1.82%，1.91%）〕，and 47.00%
（205 140/436 519） 〔95%CI（46.85%，47.14%）〕，respectively.Men had higher prevalence of overweight，but lower prevalence of obesity，severe obesity，and central obesity compared with women（P<0.05）.The prevalence of overweight，obesity，severe obesity and central obesity differed significantly according to age groups（P<0.05）.Urban residence was associated with higher prevalence of overweight obesity and central obesity but lower prevalence of severe obesity（P<0.05）.Multivariate Logistic regression analysis showed that age and residence were independent influencing factors of central obesity（P<0.05）.Conclusion The prevalence of obesity，overweight and central obesity in community-living residents in this district is high，which is higher than that of the national level.Age and residence affect the occurrence of central obesity.As the risk of central obesity increases with age，the prevention of central obesity should be paid more attention in men since young and middle adulthood，and in women since the menopause（over 45 years old）.Middle-aged and young people are the key populations for the prevention and control of overweight，obesity and central obesity.
【Key words】 Overweight；Obesity；Obesity，abdominal；Central obesity；Epidemiology；Data collection；Beijing
Prevalence and Influencing Factors of Albuminuria among 50-60-year-old Community-dwelling Adults YUE Xiaodong1，SHEN Jinhua1，HUANG Aimin1，WANG Danjing1，PU Jianping1，SHEN Chunfeng1，CHE Dan2，XU Zhong2*，HUANG Min2
1.Suzhou Xiangcheng District Second People's Hospital，Suzhou 215143，China
2.Suzhou Municipal Hospital （East Campus），Suzhou 215001，China
*Corresponding author: XU Zhong，Associate chief technician；E-mail: firstname.lastname@example.org
【Abstract】Background Microalbuminuria detection has been widely used in screening and monitoring renal function impairment in ever-increasing chronic kidney disease patients.Studies have shown that albuminuria is an independent predictive factor of the prognosis （including death） of diabetes，hypertension，cardiovascular disease，and kidney damage.Therefore，it is necessary to screen albuminuria in high-risk groups，such as diabetic，hypertensive，and elderly people，as well as those with family history of kidney damage.Objective To investigate albuminuria prevalence and related clinical and lifestyle risk factors in 50-60-year-old adults from 6 communities in Suzhou's Xiangcheng District.Methods Participants were 652 50-60-year-old adults from 6 communities in Suzhou's Xiangcheng District.Their physical examination data between May and June，2018，were collected from Suzhou Xiangcheng District Second People's Hospital，including anthropometrical and routine blood parameters，microalbuminuria and creatinine in first-morning urine，and the ratio between （Abbott C8000 automatic biochemical analyzer measured） albumin and creatinine （ACR）.Albuminuria was diagnosed with the criterion of ACR≥2.88 mg/mmol，the cutoff point determined by ROC curve analysis.Albuminuria prevalence was estimated，and its influencing factors were identified by multivariate Logistic regression.Results ACR ranged 0.29-26.72 mg/mmol in the participants.110 （16.9%） with ACR≥2.88 mg/mmol and 542 （83.1%） with ACR<2.88 mg/mmol were included in albuminuria group，and control group，respectively.There were no significant differences between the groups in exercise status，salt preference and BMI （P>0.05），but the difference in smoking status was obvious （P<0.05）.Albuminuria group showed higher female ratio，prevalence of hypertension and diabetes，and higher average levels of systolic and diastolic blood pressure，triacylglycerol，and fasting blood glucose，but lower average creatinine level compared with the control group （P<0.05）.Albuminuria prevalence did not vary according to exercise status and salt prevalence （P>0.05），but varied by sex，prevalence of hypertension，diabetes and smoking（P<0.05）.Multivariate Logistic regression analysis showed that hypertension，diabetes and smoking were independent influencing factors for albuminuria （P<0.05）.Conclusion The prevalence of albuminuria is high in community population aged 50-60 years in this district.Female is associated with higher prevalence.Hypertension，diabetes and smoking in men are the risk factors for albuminuria.
【Key words】 Albuminuria；Community health services；Root cause analysis；Kidney diseases；Albumin；Aged；Cross-sectional studies