Chinese General Practice

General Practice in Medicine—Reflections of Lancet's Iconic Texts at Its Millstone of 200 Anniversary (2) : Lan McWhinney's General Practice as an Academic Discipline

YANG Hui

2024, 27(03): 0-C1. DOI: 10.12114/j.issn.1007-9572.2024.A0002

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Chinese Expert Consensus on the Construction Standardization of Psycho-cardiology Outpatient

Psychosomatic Medicine Society of the Chinese Medical Association, Cardiovascular Disease Prevention and Rehabilitation Committee of Chinese Association of Rehabilitation Medicine, DING Rongjing, LIU Yuanyuan, YUAN Lixia, WANG Yibo, LI Zhongyan

2024, 27(03): 253-261. DOI: 10.12114/j.issn.1007-9572.2023.0499

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Clinically, patients with cardiovascular disease widely have psycho-psychological problems, which interact with each other and aggravate the disease state. Psycho-cardiology is a discipline formed by the intersection and integration of cardiology and psychology, which emphasizes the attention to cardiovascular diseases and the mental state of patients. Experts from the Psycho-cardiology Group of the Psychosomatic Medicine Society of the Chinese Medical Association formulated Chinese Expert Consensus on the Construction Standardization of Psycho-cardiology Outpatient after reviewing literature and conducting discussions, in order to improve the diagnosis and treatment capacity of psycho-cardiology in China, promote medical institutions at all levels to set up psycho-cardiology outpatient, and continuously improve the medical service system of psycho-cardiology in China.

Recent Advances of Metformin in Treatment of Diabetic Nephropathy

DENG Yuxuan, HUANG Xuejun, JIANG Yanxia

2024, 27(03): 262-267. DOI: 10.12114/j.issn.1007-9572.2023.0578

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Diabetic nephropathy is one of the most common complications of diabetic microangiopathy, which significantly reduces the quality of life of diabetic patients and is the main cause of end-stage renal failure. As one of the main drugs in the treatment of diabetes mellitus, metformin plays a vital role in the treatment of diabetic nephropathy. In recent years, studies have found that metformin can not only lower blood sugar through a variety of mechanisms, but also prevent diabetic kidney disease from developing into end-stage renal failure. Several studies have found that metformin has clinical efficacy in the treatment of diabetic nephropathy, and drug safety in patients should be evaluated by glomerular filtration rate. This review summarizes the results of the clinical effects and mechanism of metformin in the treatment of diabetic nephropathy, aiming to better understand the therapeutic effect of metformin on diabetic nephropathy, and provide reference for the treatment of diabetic nephropathy.

Research Progress of Correlation and Underlying Mechanisms between Metabolic Syndrome and Alzheimer's Disease

LI Yaping, LI Xia

2024, 27(03): 268-272. DOI: 10.12114/j.issn.1007-9572.2023.0393

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Recent studies have identified a trend toward cognitive decline and even progression to dementia in patients with metabolic syndrome (MetS), and Alzheimer's disease (AD) is the most important subtype of dementia. In reviewing the correlation between cognitive impairment due to MetS and development of AD in previous studies, this paper highlights the growing body of data that supports MetS as a whole as well as its components of hypertension and hyperglycemia as risk factors for AD, whereas insulin resistance, neurologic chronic inflammation, and adipokine disorders play important roles in the pathogenesis. Since there are now no viable treatment alternatives available to stop or reverse the degenerative progression of AD, it is expected to provide scientific evidence for a comprehensive strategy for early prevention and treatment of AD by targeting relatively curable MetS for intervention.

Advances in Coronary Microvascular Dysfunction and Metabolic Syndrome

ZHU Chunlin, GAO Jie

2024, 27(03): 273-279. DOI: 10.12114/j.issn.1007-9572.2023.0250

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Coronary microvascular dysfunction (CMD) and metabolic syndrome (MetS) have attracted much attention recently due to the adverse effects on cardiovascular system. CMD is a potential factor leading to myocardial ischemia, which is closely related to the occurrence, progression and poor prognosis of cardiovascular diseases. MetS is a group of metabolic diseases caused by a combination of genetic and environmental factors. There is an association between CMD and MetS, understanding the complex interactions between the two diseases is essential for developing effective prevention and treatment strategies. This article aims to review the development of MetS and CMD, and the relationship of the components of MetS with CMD, as well as the diagnosis, treatment and future research directions of these diseases.

Menopause or Chronologic Aging? A Prospective Cohort Study on Risk Factors for Coronary Heart Disease in Middle-aged Women

YANG Mukun, JIA Xiaoxiang, REN Zhenghong, GU Bei, BAI Wenpei

2024, 27(03): 280-285. DOI: 10.12114/j.issn.1007-9572.2023.0306

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Background

Menopause will cause series of pathophysiologic changes and long-term complications (coronary heart disease, cerebrovascular disease, osteoporosis, etc.), among which coronary heart disease is a major health threat.

Objective

To investigate the effects of menopausal status and aging on common risk factors for coronary heart disease (CHD) in middle-aged women, such as increased carotid intima-media thickness (CIMT), hypertension, dyslipidemia, diabetes, and obesity.

Methods

A total of 556 healthy premenopausal women aged 45 to 54 years who received regular physical examinations at the physical examination center of Beijing Shijitan Hospital affiliated to Capital Medical University in 2018 were initially selected, with 89 excluded according to relevant criteria, and 467 women were finally included as study subjects. The included subjects were divided into the pre-menopausal group (n=176) and postmenopausal group (n=291) according to whether they were postmenopausal during a 3-year follow-up period. Changes in BMI, waist circumference, blood glucose, blood pressure, blood lipids and other indicators were monitored, inter- and intra-group comparisons were performed before and after the follow-up period. Multivariate Logistic regression analysis was used to explore the effects of menopausal status and age on the incidence of risk factors for coronary heart disease in middle-aged women.

Results

The average age of 467 subjects was (47.6±2.3) years old. Compared with baseline, waist circumference, uric acid (UA), total cholesterol (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) levels increased, fasting blood glucose (FBG) level decreased after 3 years (P<0.05). The results of inter-group comparison showed that there was no significant difference in waist circumference, BMI, TG, FBG and high density lipoprotein cholesterol (HDL-C) levels between the two groups after three years (P<0.05) ; the levels of UA, TC and LDL-C in the menopausal group were higher than those in the pre-menopausal group, and the difference was statistically significant (P<0.05). The results of intra-group comparison showed that the waist circumference in the two groups after 3 years was higher than baseline (P<0.05) ; the levels of UA, TC and TG in the pre-menopausal group after 3 years were higher than the baseline (P<0.05) ; the levels of UA, TC, TG and LDL-C in the postmenopausal group after 3 years were higher than the baseline (P<0.05). Multivariate Logistic regression analysis showed that age ≥50 years old was a high-risk factor for increased CIMT in middle-aged women (OR=2.475, 95%CI=1.049-5.838, P=0.038) .

Conclusion

The changes in waist circumference and TG in middle-aged women are mainly affected by age, the changes of LDL-C are mainly affected by menopausal status, and the changes of TC and UA are affected by both menopausal status and increased age. Age ≥50 years is a high risk factor for increased CIMT in middle-aged women, and the changes of metabolic indicators such as UA, TC and LDL-C precede changes in CIMT after menopause.

Study on the Correlation of Serum Interleukin-6 and Fasting Blood Glucose with Coronary Heart Disease and Adverse Cardiovascular Events

LIN Xiaomei, ZUMURETI Abudukiyimu, MA Chunhui, XU Mengge, MA Juxing, LI Xia

2024, 27(03): 286-292. DOI: 10.12114/j.issn.1007-9572.2023.0403

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Background

Coronary heart disease (CHD) is one of the major public health burdens in the world. Although treatment strategies have been developed, but CHD remains a leading cause of morbidity and mortality worldwide. The diagnosis of CHD mainly relies on coronary angiography or contrast-enhanced computed tomography. However, due to the lack of equipment in primary hospitals, early diagnosis and prognosis judgment are relatively difficult. Therefore, the search for relatively simple and easy-to-obtain laboratory indicators is conducive to providing basis for primary care physicians to diagnose and treat CHD.

Objective

To investigate the correlation of serum interleukin-6 (IL-6) and fasting blood glucose (FPG) levels with the degree and clinical classification of coronary stenosis, number of lesions and adverse cardiovascular events in patients with CHD.

Methods

CHD patients admitted to the Fifth Affiliated Hospital of Xinjiang Medical University from September to November 2020 were included as the study objects, and their general data and laboratory test results were collected. According to Gensini score criteria, the patients were divided into the mild stenosis group (group A, Gensini score≤33.25 points, n=40) and moderate and severe stenosis group (group B, Gensini score>33.25 points, n=40) based on the Gensini scoring criteria. According to the results of coronary angiography results, patients were divided into the single-vessel lesion group (n=28), double-vessel lesion group (n=21) and multi-vessel lesion group (number of lesion branch≥3, n=31) based on the number of lesions. According to the clinical classification, patients were divided into stable angina group (n=34) and acute coronary syndrome group (n=46). Spearman rank correlation analysis was used to explore the relationship of serum IL-6, FPG with relevant data of patients. Survival curves of patients were plotted using the Kaplan-Meier method, and the comparison of survival curves was performed by Log-rank test. Univariate and multivariate Cox proportional hazard regression analyses were used to explore the factors influencing the risk of adverse cardiovascular events in patients with CHD. The receiver operating characteristic (ROC) curve of IL-6 predicting the occurrence of adverse events was plotted.

Results

IL-6 and FPG in group A were lower than those in group B, IL-6 in the multi-vessel lesion group was higher than that in the single-vessel lesion group, FPG was higher than that in double-vessel lesion group, and IL-6 and FPG in acute coronary syndrome group was higher than that in stable angina group, with statistical significance (P<0.05). Spearman rank correlation analysis showed that serum IL-6 was correlated with clinical type, number of coronary lesions, Gensini score, gender, triglyceride (TG) and FPG, and FPG was correlated with clinical type, number of coronary lesions, Gensini score, age and IL-6 (P<0.05). The patients were divided into IL-6>45.8 ng/L group (n=39) and IL-6≤45.8 ng/L group (n=41) according to the median IL-6 expression level (45.8 ng/L), and the upper limit of normal FPG (6.1 mmol/L) was used as the grouping standard to divide the patients into FPG>6.1 mmol/L group (n=36) and FPG≤6.1 mmol/L group (n=44). Log-rank test results showed that the incidence of adverse cardiovascular events in IL-6>45.8 ng/L group was higher than that in IL-6≤45.8 ng/L group (76.9% vs. 36.6%; χ²=16.075, P < 0.001), FPG>6.1 mmol/L group had a higher incidence of adverse cardiovascular events than FPG≤6.1 mmol/L group (69.4% vs. 45.5%; χ²=4.292, P=0.038). Multivariate Cox proportional hazard regression analysis showed that IL-6 was a significant factor in adverse cardiovascular events in patients with CHD (HR=2.396, 95%CI=1.203-6.054, P<0.05). The area under ROC curve of IL-6 for predicting adverse cardiovascular events was 0.769 (95%CI=0.658-0.880), the best optimal value was 40.97 ng/L, with the sensitivity and specificity of 0.867 and 0.683.

Conclusion

Serum IL-6 and FPG levels are associated with CHD and its poor prognosis. Serum IL-6 is an independent risk factor for adverse cardiovascular events in patients with CHD.

Correlation between Serum Uric Acid to High-density Lipoprotein Cholesterol Ratio and Metabolic Syndrome in Middle-aged and Elderly Population in China

WU Ruipeng, PENG Cheng, YUAN Bingkun, ZHANG Mengjun, LI Wenyuan

2024, 27(03): 293-299. DOI: 10.12114/j.issn.1007-9572.2023.0290

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Background

The prevalence of metabolic syndrome (MS) among the middle-aged and elderly population in China increases with age, serum uric acid to high density lipoprotein cholesterol ratio (UHR) is closely associated with various metabolic diseases, however, there are few studies on the relationship between UHR and MS in middle-aged and elderly people.

Objective

To explore the correlation between UHR and MS in middle-aged and elderly people in China, and evaluate the predictive value of UHR for MS.

Methods

This study used public data from the 2015 China Health and Retirement Longitudinal Survey (CHARLS) and included 9 233 subjects. General data, physical examination indexes and blood biochemical examination indexes were collected from the study subjects and their UHR was calculated. The subjects were divided into the non-MS group (n=7 006) and MS group (n=2 227) according to whether they had MS. At the same time, the subjects were divided into the Q1 group (UHR≤7.32%, n=2 308), Q2 group (7.32%<UHR≤9.45%, n=2 307), Q3 Group (9.45%<UHR≤12.20%, n=2 310) and Q4 group (UHR>12.20%, n=2 308) according to the level of the quartiles of UHR. Pearson correlation analysis was used to explore the correlation between UHR and metabolic indexes. The relationship between UHR and MS was studied by multivariate Logistic regression analysis. The receiver operating characteristic (ROC) curves for the risk of MS predicted by UHR in the overall and by different genders were plotted separately and the areas under the ROC curve (AUC) were calculated.

Results

The average age of the subjects was (60.3±9.6) years. The proportion of females, age, urban household proportion, history of hypertension, diabetes and dyslipidemia, proportion of taking lipid-lowering drugs, glycated hemoglobin, C-reactive protein, triglyceride (TG), total cholesterol (TC), fasting plasma glucose (FPG), SUA, systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI, waist circumference (WC) and UHR in the MS group were higher than the non-MS group, while HDL-C, low-density lipoprotein cholesterol (LDL-C) and estimated glomerular filtration rate (eGFR) were lower than those in the non-MS group, and there were statistically significant differences in education level, smoking and alcohol consumption between the two groups (P<0.05). With the increase of UHR level, the detection rates of MS, central obesity, hyperglycemia, hypertension, hypertriglyceridemia and low HDL-C in Q1-Q4 groups showed an increasing trend (P_trend<0.01). There were significant differences in BMI, WC, SBP, DBP, TG, HDL-C, LDL-C, TC, FPG, eGFR and C-reactive protein among Q1-Q4 groups (P<0.01). The results of Pearson correlation analysis showed that UHR was positively correlated with TG, FPG, DBP, SBP, BMI and WC (P<0.01), and negatively correlated with HDL-C (P<0.01). After gender stratification, UHR in males and females were positively correlated with TG, FPG, DBP, SBP, BMI and WC (P<0.01), and negatively correlated with HDL-C (P<0.01). Multivariate Logistic regression analysis showed that compared with the Q1 group, there was an increased risk of MS prevalence in the male Q4 group (OR=3.385, 95%CI=1.778-6.444, P<0.01) and female Q4 group (OR=2.886, 95%CI=1.991-4.184, P<0.01). ROC curve analysis showed that the AUC for UHR predicting MS for the study population was 0.735 (95%CI=0.723-0.746), the AUC for UHR predicting MS for male group was 0.773 (95%CI=0.757-0.790). the AUC for UHR predicting MS for female group was 0.750 (95%CI=0.735-0.766) .

Conclusion

There was a positive correlation between the increased UHR level and risk of MS among the middle-aged and elderly population in China, UHR closely correlates to MS and its components, UHR might serve as a risk factor and demonstrated good predictive value for MS in middle-aged and elderly people.

Correlation of lncRNA NEAT1 and miRNA-182-5p with the Risk of Liver Fibrosis in Type 2 Diabetes Mellitus Patients with MAFLD

HE Jia, LI Yongping, WEI Feng, LIU Meilan, WU Yaling, SHAO Longge

2024, 27(03): 300-307. DOI: 10.12114/j.issn.1007-9572.2023.0368

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Background

With the incidence of chronic metabolic diseases rising by year, which has threatened the national health, the study of non-coding RNA and endocrine metabolism-related diseases has become a research hotspot at home and abroad, while lncRNA NEAT1 and miRNA-182-5p in type 2 diabetes mellitus (T2DM) combined with metabolic-related fatty liver disease (MAFLD) has been rarely reported.

Objective

To investigate the mechanism and clinical significance of lncRNA NEAT1 and miRNA-182-5p in the development of liver fibrosis in T2DM patients with MAFLD.

Methods

A total of 236 T2DM patients admitted to the endocrinology department of the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology from October 2021 to June 2022 were included as the study subjects, and 49 healthy people were included as the healthy control group. General information and laboratory test results of the subjects were collected. Visceral fat area (VFA) and subcutaneous fat area (SFA) were measured. Peripheral blood was collected and lncRNA NEAT1, miRNA-182-5p were determined. T2DM patients were divided into the T2DM with non-MAFLD group (n=82) and T2DM with MAFLD group (n=154). T2DM with MAFLD group was further divided into the low-risk subgroup (n=55), medium-risk subgroup (n=69) and high-risk subgroup (n=30) according to the liver fibrosis index (FIB-4). In addition, healthy people were selected as the healthy control group (n=49). Spearman rank correlation analysis was used to explore the correlation of lncRNA NEAT1 and miRNA-182-5p expression levels in the high-risk subgroup of liver fibrosis, and multilevel ordinal Logistic regression was used to explore the influencing factors of liver fibrosis risk in T2DM patients with MAFLD.

Results

Age, neck circumference (NC), fasting blood glucose (FPG) and glycosylated hemoglobin (HbA_1c) in the healthy control group were lower than those in the T2DM with non-MAFLD and T2DM with MAFLD groups, the albumin (Alb) in the healthy control group was higher than that in the T2DM with non-MAFLD and T2DM with MAFLD groups (P<0.05). BMI, waist circumference (WC), VFA, SFA, homeostatic model assessment for insulin resistance (HOMA-IR), triglyceride (TG), serum uric acid (SUA) and lncRNA NEAT1 in the T2DM with MAFLD group were higher than those in the healthy control group and T2DM with non-MAFLD group, platelet count (PLT) was lower than that of the healthy control group and T2DM with non-MAFLD group, total cholesterol (TC) was lower than that of the healthy control group (P<0.05). HOMA-IR and lncRNA NEAT1 in the T2DM with non-MAFLD groups were higher than those in the healthy control group, miRNA-182-5p was higher than that in the healthy control group and T2DM with MAFLD group, alanine aminotransferase (ALT) and aspartate transferase (AST) were lower than those in the healthy control group and T2DM with MAFLD group (P<0.05). VFA, SFA, AST and lncRNA NEAT1 in the low-risk subgroup were lower than those in the medium-risk subgroup and high-risk subgroup, PLT and miRNA-182-5p were higher than those in the medium-risk subgroup and high-risk subgroup, BMI, WC and NC were lower than those in the high-risk subgroup, TC was higher than that in the high-risk group of liver fibrosis (P<0.05). PLT and miRNA-182-5p in the medium-risk subgroup were higher than the high-risk subgroup, AST and lncRNA NEAT1 were lower than those in the high risk group (P<0.05). Spearman rank correlation analysis showed that lncRNA NEAT1 was significantly negatively correlated with miRNA-182-5p in the high-risk subgroup of liver fibrosis (r_s=-0.438, P<0.05). The results of multilevel ordinal Logistic regression analysis showed that lncRNA NEAT1 (OR=1.326, 95%CI=1.087-1.616), VFA (OR=1.019, 95%CI=1.006-1.033), miRNA-182-5p (OR=0.083, 95%CI=0.027-0.257), PLT (OR=0.956, 95%CI=0.942-0.970), AST (OR=1.048, 95%CI=1.022-1.075) were the risk factors of liver fibrosis in T2DM patients with MAFLD.

Conclusion

Peripheral blood lncRNA NEAT1 and miRNA-182-5p are closely related to the complicated liver fibrosis in T2DM patients with MAFLD, providing a new basis for the early prediction, diagnosis and treatment of the disease.

Influencing Factors of Overanticoagulation at Initial Stage of Warfarin Anticoagulation Therapy in Patients with Atrial Fibrillation

FAN Caixia, LI Jiao, WEI Yanjin, GUO Dequn, LIU Cunfei, LI Zhengrong, QIU Shi

2024, 27(03): 308-314. DOI: 10.12114/j.issn.1007-9572.2023.0431

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Background

Atrial fibrillation (AF) is an important risk factor for stroke, cardiovascular disease and all-cause mortality with high prevalence, and appropriate anticoagulant therapy is the core of preventing AF-related stroke. Warfarin is still the main anticoagulant at present, but the therapeutic window of warfarin is narrow, fixed dose of warfarin can easily lead to excessive coagulation or insufficient anticoagulation at the initial stage of treatment. There are few previous clinical studies on overanticoagulation of warfarin.

Objective

To analyze the epidemiological and clinical characteristics of overanticoagulation in patients with AF at the initial stage of warfarin anticoagulation therapy, and explore the influencing factors of overanticoagulation.

Methods

The study was a single-center retrospective cohort study. A total of 552 patients with AF treated with warfarin 2.5 mg/d admitted to Linyi City's Hospital from January 2017 to December 2022 were included as the study subjects. The clinical data of patients were collected, including age, gender, body mass, type of AF (non-valvular/valvular), comorbidities (hypertension, diabetes, hypoproteinemia, transaminase abnormalities, heart failure), combined medication (number of combined drugs, combined antibiotics, combined amiodarone), the laboratory test results before treatment were also collected, including serum albumin (Alb), serum creatinine (Scr), serum alanine aminotransferase (ALT) and serum aspartate aminotransferase (AST) levels, as well as international normalized ratio (INR) before treatment and INR after 7 days of treatment. Patients were divided into the overanticoagulation group (INR>3.0, n=122) and non-overanticoagulation group (INR≤3.0, n=430) according to whether INR>3.0 after 7 days of warfarin therapy. The data of patients between the two groups were compared, univariate and multivariate Logistic regression analysis was used to explore the influencing factors of overanticoagulation in the initial stage of warfarin anticoagulation therapy.

Results

The age, proportion of female, valvular atrial fibrillation, hypoproteinemia, transaminase abnormalities, number of combined drugs, proportion of combined amiodarone and AST of patients in the overanticoagulation group were higher than those in the non-overanticoagulation group, and the body mass, hypertension, diabetes, Alb and ALT were lower than those in the non-overanticoagulation group (P<0.05). Multivariate Logistic regression analysis showed age≥65 years (OR=1.954, 95%CI=1.243-3.073, P=0.004), body mass≤63 kg (OR=2.967, 95%CI=1.841-4.783, P<0.001), number of combined drugs>5 (OR=1.976, 95%CI=1.175-3.323, P=0.010), and Scr≥91 μmol/L (OR=2.087, 95%CI=1.222-3.561, P=0.007) were independent risk factors for overanticoagulation at the initial stage of warfarin anticoagulation in patients with AF, while diabetes (OR=0.424, 95%CI=0.191-0.939, P=0.034) was a protective factor for overanticoagulation at the initial stage of warfarin anticoagulation therapy in patients with AF.

Conclusion

Age≥65 years, body mass≤63 kg, number of combined drugs>5, Scr≥91 μmol/L may be risk factors for overanticoagulation at the initial stage of warfarin anticoagulation therapy in patients with AF, while diabetes may be a protective factor at the initial stage of warfarin anticoagulation therapy in patients with AF. INR should be closely monitored in patients on warfarin anticoagulation with advanced age, low body mass, multiple drug combinations and elevated Scr level.

Non-pharmacological Integrated Interventions in Older Adults with Mild Cognitive Impairment: a Single Case Pilot Study

WANG Ying, DONG Zhixiao, YANG Kehu

2024, 27(03): 315-321. DOI: 10.12114/j.issn.1007-9572.2023.0395

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Background

Cognitive impairment can lead to a decline in cognitive function, depression, and loneliness, as well as decreased self-efficacy and quality of life in older adults.

Objective

To investigate the effects of non-pharmacological integrated interventions on cognitive function, depression, loneliness, self-efficacy, and quality of life in older adults with mild cognitive impairment.

Methods

Based on risk factors for cognitive impairment, a non-pharmacological integrated intervention program was developed in five dimensions of cognitive training, physical exercise, emotional management, social connection, and healthy lifestyle habits. Using a single-subject A-B-A experimental design, a 3-month intervention, which was conducted once a week for 60 minutes, was performed in three elderly individuals with mild cognitive impairment from June to December 2021. The Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale-15 (GDS-15), 12-item Short Form Health Survey (SF-12), General Self-Efficacy Scale (GSES), and De Jong Gierveld Loneliness Scale (DJGLS) were administered to the 3 older adults at baseline, 3 months of the intervention, and 3 months after the intervention, to assess the scores of each scale from the 5 dimensions of cognitive function, self-efficacy, quality of life, depression, and loneliness, the changes in the scores were analyzed. A semi-structured interview was conducted 3 months after the intervention to evaluate the intervention effects in terms of cognitive function, quality of life, depression, self-efficacy, and loneliness dimensions.

Results

The 3 older adults included in the study were 74, 70, 73 years old, all married, living with their spouses and grandchildren. The three older adults had MoCA scores of 21, 22, and 24 at baseline, 28, 26, and 27 at 3 months of intervention, and 25, 19, and 23 at 3 months after intervention; GSES scores were 25, 30, and 27 at baseline, 29, 29, and 30 at 3 months of intervention, and 28, 31, and 28 at 3 months after intervention. SF-12 scores were 69, 32, and 51 at baseline, 81, 81, and 83 at 3 months of intervention, and 78, 38, and 59 at 3 months after intervention. The GDS-15 scale scores were 4, 8, and 2 at baseline, 2, 6, and 1 at 3 months of intervention, and 1, 8, and 4 at 3 months after intervention. The DJGLS scores were 8, 7, and 8 at baseline, 5, 5, and 4 at 3 months of intervention, and 5, 5, and 7 at 3 months after intervention. Semi-structured interview data indicated improvement in all five dimensions of cognitive function, quality of life, depression, loneliness, and self-efficacy of the subjects.

Conclusion

For older adults with mild cognitive impairment, it is of great significance to perform a non-pharmacological integrated intervention in terms of cognitive training, physical exercise, emotional management, social connection, and healthy lifestyle habits. The MoCA, SF-12, GDS-15, and DJGLS scores of older adults with mild cognitive impairment improved at 3 months of intervention, while the GSES scores improved at 3 months after intervention. GSES scores were not as effective after the intervention. All dimension scores showed a decreasing trend at 3 months after the intervention.

A Path Analysis of the Effect of Childhood Socioeconomic Status on Cognitive Function in Middle-aged and Older Adults

HUANG Xiaotong, WANG Qiong, LIU Chen, HOU Xiaochun, XU Xinrui, WU Bingyi, YANG Xiao

2024, 27(03): 322-327. DOI: 10.12114/j.issn.1007-9572.2023.0359

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Background

The effects of childhood experiences on the health of middle-aged and older adults has become a research hotspot. However, the effects and pathways of childhood experiences on cognitive function in middle-aged and older adults still remain unclear.

Objective

To analyze the effect of childhood socioeconomic status on cognitive function in middle-aged and older adults from a whole life cycle perspective, and explore promotion strategies for cognitive function in middle-aged and older adults.

Methods

The China Family Panel Studies (CFPS) for 2010, 2012, and 2020 was used to construct a multiple mediated-effects model to investigate the mediating pathways of the effect of childhood socioeconomic status on cognitive function in middle-aged and older adults. Pearson correlation analysis was used to analyze the relationship between various indicators.

Results

A total of 1 034 middle-aged and older adults with an average age of (62.33±9.89) years were included in this study. The childhood socioeconomic status score was (0.000±0.797), education level score was (1.970±1.111), social participation score was (1.150±0.967), depression status score was (5.960±4.681), and cognitive score was (0.000±1.000). Childhood socioeconomic status was positively correlated with education level, social participation, and cognitive function in middle-aged and older adults (P<0.05), and negatively correlated with depressive status (P<0.05). The results of Multiple mediation model regression analysis showed that childhood socioeconomic status had no significant direct effects on cognitive function of middle-aged and older adults (β=0.054, t=1.400, P=0.162), education level, social participation, and depression status significantly affected cognitive function in middle-aged and older adults (β=0.335, t=11.622, P<0.05; β=0.064, t=2.166, P<0.05; β=-0.019, t=-3.154, P<0.05) when controlled for age, gender, urban/rural, chronic disease prevalence, and medical service utilization. The results of the mediation effect test showed that education level and social participation significantly affected cognitive function in the middle-aged and older adults (95%CI=0.141-0.223; 95%CI=0.001-0.019). There was a statistically significant chain mediated effect of education level and social participation (95%CI=0.001-0.017), as well as education level and depression status (95%CI=0.001-0.008) .

Conclusion

Education level is the resource pathway through which childhood socioeconomic status affects cognitive function in middle-aged and older adults; social participation is a conditional path through which childhood socioeconomic status affects cognitive function in the middle-aged and older adults; depression is a risk factor affecting cognitive function in middle-aged and older adults. Based on the life course theory, attention should be paid to the effect of childhood socioeconomic status from multiple levels of individual, family, and society, to develop cognitive function promotion strategies for the middle-aged and older adults.

Correlations of Cognitive Function with Insomnia Severity, Serum Levels of 25-hydroxy Vitamin D₃ and Tumor Necrosis Factor-α in Elderly Patients with Chronic Insomnia

WU Zixing, HU Xin, TAO Shimeng, HE Youjun, CAI Chuanyun, JIANG Wei

2024, 27(03): 328-334. DOI: 10.12114/j.issn.1007-9572.2023.0291

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Background

As one of the most common diseases in the elderly, chronic insomnia is often accompanied by cognitive impairment and seriously affects the quality of life of the elderly. The biological mechanism of cognitive impairment in elderly patients with chronic insomnia still remains unclear.

Objective

To investigate the correlation of cognitive function with insomnia severity, serum 25-hydroxy vitamin D₃ [25 (OH) D₃], tumor necrosis factor-α (TNF-α) in elderly patients with chronic insomnia.

Methods

A total of 105 elderly patients with chronic insomnia in the 901th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from June 2020 to June 2022 were selected as the research subjects. Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS-15) and Generalized Anxiety Disorder Scale (GAD-7) were tested before enrollment. The patients were divided into 32 cases in the mild insomnia group, 38 cases in the moderate insomnia group and 35 cases in the severe insomnia group according to the PSQI score. Photoplethysmography (PPG) was used to assess the objective sleep quality of patients, monitor the total sleep time, sleep latency, sleep efficiency and arousal times; the cognitive function of patients was evaluated by Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Serum levels of 25 (OH) D₃ and TNF-α were detected by enzyme-linked immunosorbent assay.

Results

The sleep latency, arousal times and the level of TNF-α in the severe insomnia group were higher than those in the mild and moderate insomnia groups, with lower total sleep time in the severe insomnia group compared to the mild insomnia group and lower sleep efficiency compared to the mild and moderate insomnia groups (P<0.05) ; sleep latency in the moderate insomnia group was higher than that in the mild insomnia group, with lower sleep efficiency compared to the mild insomnia group (P<0.05). MMSE and MoCA scores were lower in the severe insomnia group than the mild insomnia and moderate insomnia groups, and lower in the moderate insomnia group than the mild insomnia group (P<0.05). Serum TNF-α level was higher and 25 (OH) D₃ level was lower in the severe insomnia group than the mild and moderate insomnia groups (P<0.05) ; serum TNF-α level was higher in the moderate insomnia group than the mild insomnia group, and 25 (OH) D₃ level was lower than the mild insomnia group (P<0.05). Spearman correlation analysis results showed that MMSE and MoCA scores were positively correlated with total sleep time, sleep efficiency and 25 (OH) D₃ level (P<0.05), and negatively correlated with insomnia severity, sleep latency, arousal times and TNF-α level (P<0.05) .

Conclusion

Cognitive impairment in elderly patients with chronic insomnia may be associated with insomnia severity, reduced serum 25 (OH) D₃ level and elevated TNF-α level.

Qizhuhuaji Formula in the Treatment of Precancerous Lesion of Hepatocellular Carcinoma: a Randomized Controlled Study

NING Lin, SUN Jianguang

2024, 27(03): 335-342. DOI: 10.12114/j.issn.1007-9572.2022.0859

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Background

Hepatocellular carcinoma (HCC) is characterized by high morbidity and mortality. Early diagnosis and timely intervention in the precancerous stage can effectively reduce the incidence of HCC, which is of great significance for its prevention and treatment. Modern medical treatment of precancerous lesions of HCC has problems such as difficulties to grasp the timing of intervention and single treatment method, traditional Chinese medicine (TCM) may be a simple and effective new approach to prevent and treat precancerous lesion of HCC.

Objective

To observe the clinical efficacy and safety of Qizhuhuaji formula in the treatment of precancerous lesion of HCC (liver-depression and spleen-deficiency, phlegm and blood stasis syndrome) .

Methods

Patients with precancerous lesion of HCC who met the TCM syndrome type "liver-depression and spleen-deficiency, phlegm and blood stasis syndrome" admitted in the hepatology clinic of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Weihai Hospital of Traditional Chinese Medicine and Taian Hospital of Traditional Chinese Medicine from October 2019 to March 2020 were included as the study subjects. General information (gender, age, history of HBV-related cirrhosis, family history of HCC, history of alcohol consumption for more than 10 years), the TCM syndrome score, liver function indicators [alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB), glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) ], tumor marker indexes [alpha-fetoprotein (AFP), alpha-fetoprotein variants-L3 (AFP-L3), des-γ-carboxy-prothrombin (DCP) ], imaging indexes (lesion type, lesion nature, lesion length diameter), safety indexes and adverse reactions were collected. The 64 patients who met the inclusion criteria and completed the study were divided into the observation group (n=34) and the control group (n=30) using the random number tables. The patients in the control group were treated with conventional therapy such as antiviral, anti-inflammatory and liver-protective therapy; the observation group was treated with conventional therapy combined with Qizhuhuaji formula. The treatment course was 48 weeks, and the follow-up period was 48 weeks after drug withdrawal. The incidence of HCC and complications in the treatment cycle and follow-up period of the two group were observed, and the differences in the improvement indexes of TCM syndrome (TCM syndrome scores, total effective rate), liver function indicators, tumor marker indexes, imaging indexes (lesion length diameter, lesion stability rate, lesion improvement rate), and safety index (safety rate) between the two groups before and after treatment.

Results

After treatment, the TCM syndrome scores, ALT, AST, TBIL, GGT, ALP, and AFP-L3 were lower than those before treatment in both groups, and the ALB level was higher than that before treatment (P<0.05) ; the DCP value and lesion length-diameter of patients in the observation group were lower than those before treatment (P<0.05) ; the comparison results between the two groups showed that the TCM syndrome scores, AST, and ALP values in the observation group were lower than those in the control group, and the ALB value was higher than that in the control group (P<0.05). The total effective rate of TCM syndrome in the observation group (91.2%) was higher than that in the control group (63.3%) at the end of the treatment cycle (P<0.05) ; there was no statistically significant differences (P>0.05) in the rates of lesion improvement (35.3%) and lesion stability (50.0%) in the observation group compared with the control group (20.0%, 43.3%). There was no statistically significant difference in the incidence of HCC between the observation group (8.8%) and the control group (16.7%) at the end of the follow-up period (P>0.05) ; the incidence of complications (8.8%) in the observation group was lower than that of the control group (30.0%) (P<0.05). Regarding the safety indexes, 2 cases in the observation group showed mild adverse reactions and 3 cases in the control group showed mild adverse reactions, no abnormal safety indexes were observed in both groups, there was no statistically significant difference (P>0.05) in the safety rate between the observation group (94.1%) and the control group (90.0%) .

Conclusion

The treatment of precancerous lesions of HCC (liver depression and spleen deficiency, phlegm and blood stasis syndrome) with Qizhuhuaji formula has better clinical efficacy and higher safety in improving TCM syndrome, improving liver function, shrinking lesion nodules, reducing the incidence of long-term HCC and complications of liver cirrhosis.

A Randomized Controlled Study on Gehu Tiaozhi Decoction Intervening Patients with Metabolic Syndrome

ZHENG Rong, LIU Zhidong, WANG Miao, ZHANG Xiao, CHEN Junlan, ZHOU Shigao

2024, 27(03): 343-347. DOI: 10.12114/j.issn.1007-9572.2023.0065

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Background

About a quarter of the world's population suffers from metabolic syndrome (MetS). In recent years, the prevalence of MetS in China has also increased year by year, posing a serious threat to life and health. Traditional chinese medicine has the advantages of multi-target and multi-link in the treatment of MetS, but there is a lack of high-quality randomized controlled studies and real-world studies in clinical practice.

Objective

To observe the effects of Gehu Tiaozhi Decoction on waist circumference (WC), body weight, body fat percentage (BFP) and glucose and lipid metabolism in patients with MetS.

Methods

From June 2021 to November 2022, 84 patients with MetS were prospectively selected from the outpatient department and inpatient department of LongHua Hospital Shanghai University of Traditional Chinese Medicine. The subjects were randomly divided into Gehu group (42 cases) and control group (42 cases). The patients in the Gehu group were treated with Gehu Tiaozhi Decoction (Pueraria lobamle radix 6 g, Dendrobium officinale 6 g). The patients were fasted once in the morning and once in the evening, 1 bag each time, taken orally for 8 weeks. The control group was treated with placebo granules. The patients were fasted once in the morning and once in the evening, 1 bag each time, taken orally for 8 weeks. During the intervention, the two groups of patients were given the same health education (including dietary regimen and exercise prescription guidance). After 8 weeks of intervention, the WC, body weight, BMI, BFP, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and fasting blood glucose (FBG) were compared between the two groups.

Results

Finally, 41 patients in the Gehu group and 41 patients in the control group completed the 8-week intervention study. No statistically significant differences of WC, body weight, BMI or BFP was found between the two groups before treatment (P>0. 05). The differences of WC, body weight, BMI and BFP between the two groups before and after treatment were statistically significant (P<0.05). No statistically significant differences of TG, TC, HDL-C, LDL-C or FBG was found between the two groups before treatment (P>0. 05). The differences of TG, TC and FBG between the two groups before and after treatment were statistically significant (P<0.05). During the treatment period and after the end of follow-up, there were no serious adverse reactions in either group.

Conclusion

Gehu Tiaozhi Decoction can better improve the WC, body weight, BMI, BFP, TG, TC and FBG of MetS patients, and has good safety.

Effect of Simiao Decoction on Vitamin D System and Neutrophil Extracellular Traps in Rats with Rheumatoid Arthritis

LUO Shuman, ZHU Xing, CHEN Shuai, LI Wen, DONG Youqing, HE Changlu, ZHOU Yan, CHEN Yunzhi

2024, 27(03): 348-356. DOI: 10.12114/j.issn.1007-9572.2023.0328

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Background

As China enters the period of accelerated development of population aging, the proportion of rheumatoid arthritis cases is increasing, causing a serious burden on society and families. The active ingredients in simiao decoction have improved effect, but there is a lack of relevant studies to analyze the action and mechanism of prescriptions.

Objective

To observe the intervention effect of simiao decoction on rats with rheumatoid arthritis established by collageninduced arthritis and its effect on vitamin D system and neutrophil extracellular traps (NETs) .

Methods

From November 2021 to January 2023, 70 SD female rats were selected. The rats were randomly divided into the blank group (control group), model group (model group), methotrexate group (MTX group), vitamin D group (VD group), Simiao decoction low-dose group (SMT-L group), Simiao decoction medium-dose group (SMT-M group) and Simiao decoction high-dose group (SMT-H group) by random number table method, with 10 rats in each group. The rat model of synovial arthritis was established by collagen induction method and the gavage treatment was started 7 d after modeling. The degree of ankle swelling was assessed, and the arthritis index (AI) score of rats in each group the levels of interleukin 6 (IL-6), 25-hydroxyvitamin D₃ [25 (OH) D₃], NETs in serum of rats and the expression levels of 24-hydroxylase (CYP24A1), 1-α hydroxylase (CYP27B1), MPO, vitamin D receptor (VDR) and elastase (NE) in synovial tissue of joint were measured.

Results

The degree of ankle swelling in the control, MTX, VD, SMT-L, SMT-M and SMT-H groups was lower than that in the model group on day 7, the degree of ankle swelling in the model group was higher than the control group, the SMT-M group was higher than the model group on day 14, the degree of ankle swelling in the model group was higher than the control and MTX groups and lower than the VD, SMT-L, SMT-M and SMT-H groups on day 21, the degree of ankle swelling in the control, MTX, VD, SMT-L, SMT-M and SMT-H groups was higher than the model group, and the difference was statistically significant (P<0.05). The AI score of rats in the SMT-H group was lower than that in the model group on day 14, the AI score in the MTX, VD, SMT-L and SMT-H groups was lower than that in the model group on day 21, the score of rats in the MTX, VD, SMT-L, SMT-M, and SMT-H groups was lower than that in the model group on day 28, the difference was statistically significant (P<0.05). Immunohistochemical results showed significant differences in the expression levels of MPO and TNF-α in synovial tissue among the 7 groups (P<0.05), MPO and TNF-α in the model group were higher than those in the control group, while MPO and TNF-α in the MTX, VD and SMT-H groups were lower than those in the model group, TNF-α in the SMT-M group was lower than that in the model group, and the difference was statistically significant (P<0.05). IL-6 and NETs in the model group were higher than those in the control group, and 25 (OH) D₃ was lower than that in the control group. IL-6 and NETs in the MTX, VD and SMT-H groups were lower than those in the model group, and 25 (OH) D₃ was higher than that in the model group. NETs in the SMT-M group were lower than those in the model group, and the difference was statistically significant (P<0.05). CYP24A1 in the model group was higher than that in the control, MTX, VD, SMT-M and SMT-H groups, while CYP27B1 and VDR in the model group were lower than those in the control, MTX, VD, SMT-M and SMT-H groups, MPO was higher than that of the control, MTX, VD, SMT-L, SMT-M and SMT-H groups, and NE was higher than the control, VD, SMT-M and SMT-H groups, and the difference was statistically significant (P<0.05) .

Conclusion

Simiao decoction may inhibit the formation of NETs by regulating the vitamin D system, thereby treating RA.

A Systematic Review of Risk Prediction Models for Diabetic Foot Development

LIN Lingjun, GUO Jun, WANG Junwei, GAO Yang, CHEN Huiying, WAN Yongli

2024, 27(03): 357-363. DOI: 10.12114/j.issn.1007-9572.2023.0451

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Backgroud

Diabetic foot is a common complication of diabetes patients, most of whom are seriously ill with rapid disease progression. A well-performing risk prediction model for the development of diabetic foot can help healthcare professionals to identify high-risk patients and take early interventions.

Objective

To systematically review the risk prediction models for diabetic foot, and provide reference for the construction and optimization of the model.

Methods

PubMed, Cochrane Library, Embase, Web of Science, CNKI and Wanfang Data were searched to collect the related studies on risk prediction models for diabetic foot from inception to May 15th, 2022. Two reviewers independently screened the literature, extracted data and evaluated the quality of models using prediction model risk of bias assessment tool (PROBAST). Meta-analysis of the predictors in the model was performed using Stata 17.0 software.

Results

A total of 13 papers were included, containing 13 models, 12 of which had AUC>0.7. Model calibration was performed on 7 models and 8 models were validated. PROBAST results showed that 1 of the 13 included papers was at low risk of bias and the remaining 12 were at high risk of bias; for model applicability, only 1 was of low applicability. The results of Meta-analysis showed that age (OR=1.13, 95%CI=1.04-1.24), glycated hemoglobin (OR=1.56, 95%CI=1.26-1.94), foot ulcer history (OR=5.93, 95%CI=2.85-12.37), previous amputation (OR=7.79, 95%CI=2.74-22.17), diminished sensitivity of the monofilament test (OR=1.59, 95%CI=1.42-1.78), foot fungal infection (OR=6.14, 95%CI=1.71-22.01), and kidney disease (OR=2.09, 95%CI= 1.65-2.65) were independent influencing factors for diabetic foot (P<0.05) .

Conclusion

The risk prediction models for diabetic foot was still inadequate, and the future risk prediction model should focus on age, glycated hemoglobin level, foot ulcer history, amputation history, monofilament test sensitivity, foot fungal infection and kidney disease.

Prevalence and Trends for Post-stroke Fatigue in China: a Meta-analysis

XUE Chao, LI Juan, FANG Qian, YU Jie, HAO Mingqing

2024, 27(03): 364-374. DOI: 10.12114/j.issn.1007-9572.2023.0414

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Background

Post-stroke fatigue (PSF) has a significant impact on patients' prognostic recovery and is an independent risk factor for stroke recurrence and post-stroke death. Therefore, understanding the current epidemiological status of PSF is of great significant in promoting stroke prevention and treatment in China.

Objective

To systematically evaluate the current situation and development trend of PSF in China, in order to provide a reference basis for the relevant departments to formulate targeted stroke prevention and treatment strategies.

Methods

PubMed, Web of Science, Embase, CNKI, Wanfang Data, VIP, and CBM were searched by computer to collect cross-sectional studies on the prevalence of PSF in China from inception to 2023-05-20. Meta-analysis was performed using Stata 16.0 software after 2 investigators independently screened the literature, extracted information and evaluated the risk of bias of the included studies.

Results

A total of 57 cross-sectional studies involving 19 provinces/autonomous regions/municipalities directly under the central government and special administrative regions of China, with a total sample size of 13 621 individuals, including 5 764 individuals with PSF. Meta-analysis showed that the prevalence of PSF in China was 43.5% (95%CI=40.0%-47.0%). The results of subgroup analysis showed that the prevalence was 38.4% (95%CI=34.3%-42.5%) for men and 45.2% (95%CI=40.7%-49.7%) for women by gender grouping; the prevalence was 40.0% (95%CI=32.3%-48.0%) for those under 60 years of age, 67.9% (95%CI=54.2%-80.1%) for those aged 60-75 years by age grouping and 71.9% (95%CI=48.9%-90.5%) for those aged 75 years and above; the prevalence was 40.0% (95%CI=35.0%-45.2%) in North China, 41.0% (95%CI=29.5%-53.0%) in Northeast China, 49.5% (95%CI=43.1%-55.8%) in East China, 40.3% (95%CI=34.9%-45.8%) in Central China, 40.0% (95%CI=28.4%-52.2%) in South China, 59.3% (95%CI=54.0%-65.0%) in Southwest China, and 46.2% (95%CI=38.3%-54.2%) in Northwest China by regional grouping; the prevalence was 56.3% (95%CI=42.8%-69.4%) for hemorrhagic stroke and 40.0% (95%CI=36.7%-43.4%) for ischemic stroke by stroke nature grouping; the prevalence was 41.4% (95%CI=37.0%-45.8%) for acute phase and 46.4% (95%CI=40.8%-52.1%) for recovery phase by stroke duration grouping; the prevalence was 56.0% (95%CI=43.7%-67.9%) for elementary school and below, 46.7% (95%CI=39.6%-53.8%) for junior high school, 46.8% (95%CI=40.3%-53.4%) for senior high school, and 43.6% (95%CI=35.7%-51.6%) for college and above by education level grouping; the prevalence was 45.8% (95%CI=40.8%-50.9%) for those with a spouse and 53.6% (95%CI=47.4%-59.8%) for those without a spouse by marital status; the prevalence was 45.0% (95%CI=33.2%-57.0%) for those who were employed and 53.8% (95%CI=40.1%-67.2%) for those who were unemployed or retired by work status grouping; the prevalence was 41.8% (95%CI=38.3%-45.3%) for those who applied the Fatigue Severity Scale (FSS), 65.8% (95%CI=57.1%-74.0%) for those who applied the Check List Individual Strength (CIS), 50.5% (95%CI=44.6%-56.5%) for those who applied the Chinese version of the Neurological Fatigue Index for Stroke (NFI-stroke), 52.7% (95%CI=43.1%-62.1%) for those who applied the Chinese version of the Fatigue Assessment Scale (C-FAS), and 48.9% (95%CI=43.6%-54.2%) for those who applied the Mental Fatigue Self-Rating Scale (MFS). Additionally, in terms of age distribution, the prevalence of PSF in China increased gradually with age (χ²_trend=87.081, r=0.209, P<0.01) ; in terms of cultural background, the trend of correlation between the prevalence of PSF in China and education level was not statistically significant (χ²_trend=0.333, P=0.564) ; and in terms of spatial distribution, the prevalence of PSF (40.0%-59.3%) varied significantly among the seven regions of the country (χ²=122.615, P<0.01), and the prevalence of PSF (23.3%-74.2%) also varied significantly among 19 provincial-level administrative regions in China (χ²=504.294, P<0.01) ; from the perspective of the publication time, the prevalence of PSF in China fluctuated in 32.4% to 53.9% from January 2013 to May 2023 (χ²_trend=48.011, P<0.01) .

Conclusion

The results of this study have shown a high overall prevalence of PSF in China, with significant differences among regions and provinces. The highest prevalence was found in Southwest China and Guizhou Province, whereas the lowest prevalence was observed in North China, South China, and Tianjin City. Additionally, PSF was found to be more prevalent among certain groups, including females, advanced age, no spouse, low education level, unemployed or retired work status, recovery phase of stroke, and hemorrhagic stroke.

Research on the Construction and Application of Health and Nutrition Survey Databases in China, the United States, and Korea

WEI Kuikui, GONG Haowen, LIU Yuxiu, WANG Yan, LIU Mengdan, ZHANG Manting, YU Xihui

2024, 27(03): 375-380. DOI: 10.12114/j.issn.1007-9572.2023.0256

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The health and nutrition survey databases of China, the United States, and Korea are all focused on national health and nutrition surveillance, which have become important public resources for data mining in recent years. The construction status, brief histories, sampling methods, and survey contents of the three health and nutrition survey databases were compared and analyzed, it was found that the main difference lies in the types of study design, with cohort study used in China, cross-sectional survey used in both the United States and Korea. Then, the database-based publication volume and research hotspots were visually analyzed and found that the upward trend is more prominent in the United States, the research hotspots of the three databases were consistent with the themes of the health and nutrition survey. Finally, the construction and application of the databases were discussed and recommendations were made, which was expected to provide a path for relevant researches and better encourage the generation of scientific evidence.

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