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Background The contribution of geriatric health examination services of national essential public health services to the detection of abnormal health conditions in the elderly and the awareness of examination results of the elderly has been rarely reported in the current studies. Objective To investigate the abnormal detection of several common diseases including abnormal blood pressure, abnormal blood glucose, overweight and obesity, anemia, fatty liver disease, gallstones or cholecystitis in the health examination of the older adults aged 65 years and above. Methods The older adults aged 65 years and above who visited 20 primary care institutions in 5 cities of 3 provinces in eastern, central and western China were selected as study subjects (excluding those with unclear health examination results in this year) from November to December 2019 by using a multi-stage stratified sampling method, and divided into the general older adults (without hypertension or diabetes), older adults with hypertension, older adults with diabetes. A one-on-one questionnaire survey was conducted on all respondents (The questionnaire included the general demographic characteristics of the respondents and the abnormal detection in the health examination of the elderly) . Results Among 3 018 older adults, 2 033 (67.36%) reported abnormalities in the health examination. There were statistically significant differences in the abnormal detection rates of health examination for the older adults with different types of residence, population, and household registration (P

Objective To establish a risk prediction model for frailty in patients with inflammatory bowel disease and verify its prediction effect. Methods A classic sampling method was used to collect samples from 360 patients with inflammatory bowel disease who were hospitalized in the Department of Gastroenterology of Peking Union Medical College Hospital from July 2021 to November 2021. According to the evaluation results of the FRAIL Scale (FS), patients were divided into two group: frail group and non-frail group. The differences of demographic factors and disease related factors between the two categories of patients were compared. Randomized number method was used to divide the model group and verification group at a ratio of 8∶2. Logistic regression analysis was used to establish a risk prediction model. Hosmer-Lemeshow χ2 was used to test the prediction model fitting effect, and receiver operator characteristic curve (ROC curve) was drawn. Area under ROC curve (AUC) and Youden index were calculated to evaluate the differentiation ability of the prediction model. Results The incidence of frailty in patients with inflammatory bowel disease was 16.6%. Age (OR=1.041), emaciation (OR=10.135), several times of exercise per month (OR=0.345), ulcerative colitis (OR=2.952), quality of life (OR=0.979), family care index (OR=1.629), depression (OR=1.194) and sleep disorders (OR=1.158) were independent influencing factors (P

Background Patients with diabetic foot undergoing endovascular therapy for lower extremity arterial disease exhibit poor outcomes and a high mortality rate. It is unclear whether malnutrition assessed by geriatric nutritional risk index (GNRI) is associated with clinical outcomes in these patients. Objective To investigate the association of baseline malnutrition assessed by GNRI and clinical outcomes of endovascular therapy for lower extremity arterial disease in patients with diabetic foot. Methods Ninety-five patients who were admitted in Department of Endocrinology, Sun Yat-sen Memorial Hospital due to diabetic foot and lower extremity arterial disease were included from January 2011 to December 2016. All of them received endovascular therapy and followed up for two years. Baseline GNRI was assessed, and divided into three levels: normal nutrition (43 cases) , mild malnutrition (31 cases) and moderate to severe malnutrition (21 cases) . Clinical characteristics were collected, including sex, age, diabetes duration, smoking, body mass index, prevalence of cardiovascular and cerebrovascular diseases, diabetic foot classification, systolic and diastolic blood pressure, and blood test results containing white blood cell count, platelet count, lymphocyte count, neutrophil count, neutrophil-to-lymphocyte ratio, hemoglobin, fasting blood glucose, glycosylated hemoglobin, total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol, albumin, creatinine, and estimated glomerular filtration rate. The primary endpoint was all-cause mortality, and the secondary endpoint was major lower extremity amputation. The Kaplan-Meier curve was used for survival analysis. Univariate and multivariate Cox proportional hazards regression analysis were analyzed to evaluate the risk factors of all-cause mortality. Results Fifty-two cases (54.7%) were assessed with malnutrition (GNRI≤98) . Normal nutrition, mild malnutrition, and moderate to severe malnutrition patients had significant differences in average body mass index, leukocyte count, neutrophil count, neutrophil-to-lymphocyte ratio, hemoglobin, triglyceride and albumin (P98) was higher than that in malnutrition group (GNRI≤98) . Baseline GNRI-assessed malnutrition may be an independent risk factor for all-cause mortality in diabetic foot patients with lower extremity arterial disease treated by endovascular therapy, so assessing and improving the nutritional status may better improve the clinical outcome of these patients.

BackgroundThe national essential public health services (NEPHS) , which have been implemented since 2009, may be the largest population-based intervention practice for Chinese patients with diabetes currently. It is important to understand the utilization and management effect of such services in diabetic population over this period of more than 10 years of development.ObjectiveTo understand the utilization and management effect of NEPHS as well as their association in Chinese type 2 diabetics.MethodsBy use of multi-stage stratified sampling, 1 527 type 2 diabetics (≥35 years old) were selected from 20 community (township) health centers in 10 districts (counties) of 5 cities in eastern, central and western China during November to December 2019. Sociodemographic characteristics, utilization and management effect of NEPHS in these patients were collected by face-to-face surveys with a self-designed questionnaire.ResultsAccording to the survey, patients' self-reported rates of creating health records, use of health records, undergoing standardized blood glucose tests, and receiving standard follow-ups were 90.34% (1 375/1 522) , 52.80% (725/1 373) , 83.69% (1 262/1 508) , and 90.18% (1 377/1 527) , respectively. Household follow-ups and hospital follow-ups accounted for 29.24% (443/1 515) and 61.06% (925/1 515) of the total last follow-ups, respectively. The analysis of management effect showed that patients' self-reported rates of home-based self-monitoring blood glucose and regular medication in the past 6 months were 53.57% (818/1 527) , and 89.26% (1 363/1 527) , respectively. The rates of patients who were satisfied with glycemic control, and overall medical services assessed in the last follow-up were 65.23% (996/1 527) , and 95.15% (1 453/1 527) , respectively. In those≥65 years old, the prevalence of home-based self-monitoring blood glucose differed significantly by the creation of health records and Chinese medicine services (P

BACKGROUND: By expressing double‐stranded RNA (dsRNA) in potato plastids targeting the β‐Actin (ACT) gene of the Colorado potato beetle (CPB), transplastomic plants can trigger the beetle's RNA interference response to kill the CPB larvae. High expression of dsACT driven by rrn16 promoter (Prrn) in the leaf chloroplasts of transplastomic plants confers strong resistance to CPB. However, there are still residual amounts of dsRNA in the tubers, which are unnecessary for CPB control and may raise a potential food exposure issue. RESULTS: In order to reduce dsRNA accumulation in the tubers while maintaining stable resistance to CPB, we selected two promoters (PrbcL and PpsbD) from potato plastid‐encoded rbcL and psbD genes and compared their activities with Prrn promoter for dsRNA synthesis in the leaf chloroplasts and tuber amyloplasts. We found that the dsACT accumulation levels in leaves of transplastomic plants St‐PrbcL‐ACT and St‐PpsbD‐ACT were significantly reduced when compared to St‐Prrn‐ACT, but they still maintained high resistance to CPB. By contrast, a few amounts of dsACT were still accumulated in the tubers of St‐PrbcL‐ACT, whereas no dsACT accumulation in tubers was detectable in St‐PpsbD‐ACT. CONCLUSION: We identified PpsbD as a useful promoter to reduce dsRNA accumulation in potato tubers while maintaining the high resistance of the potato leaves to CPB. © 2023 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

This cross-sectional study aimed to investigate the association between non-alcoholic fatty liver disease (NAFLD) and atherosclerotic cardiovascular disease (ASCVD), a global public health concern. A total of 9044 out of 10,104 adults from Guangzhou, China, were included in the analysis. We utilized the fatty liver index (FLI), a noninvasive indicator of NAFLD, and the pooled cohort equations (PCE) based on the 2013 ACC/AHA Guideline, the China-PAR model, and the Framingham Risk Score to assess the 10-year ASCVD risk. The results demonstrated a significant association between FLI and 10-year ASCVD risk (p < 0.001). Adjusted for age, individuals with high FLI (≥60) had an odds ratio of 3.91 (95% CI 2.52–6.08) compared to those with low FLI (<30). These findings persisted after adjusting for metabolic indicators. Notably, this association was consistently observed across all three risk prediction models: the PCE model, the China-PAR model, and the Framingham Risk Score. In conclusion, our study provides evidence supporting FLI as a reliable indicator of increased 10-year ASCVD risk in Chinese NAFLD patients. FLI serves as a valuable marker for early detection of ASCVD, highlighting its potential in clinical practice for risk assessment and prevention strategies. [ABSTRACT FROM AUTHOR]

Background: The prevalence of inflammatory bowel disease (IBD) is rapidly increasing in China. Beyond disease management, frailty is an important predictor of adverse outcomes in IBD patients, which has not been well investigated. This study aimed to assess frailty status and explore the impact factors in IBD inpatients. Methods: A total of 372 IBD inpatients were recruited from July 2021 to November 2021 at Peking Union Medical College Hospital. All the participants were surveyed by face-to-face questionnaires, including demographic characteristics, disease conditions, lifestyle, psychology, social support, and frailty. The impact factors of frailty were further assessed by multinomial logistic regression analysis. Results: The participants' median age was 31.00 (Q1: 24.00, Q3: 40.00) years. The overall prevalence of prefrailty and frailty in IBD patients was 59.4% (n = 221) and 14% (n = 52), respectively, and was higher for frailty in females (17.2%) than in males (12.3%). Increased body mass index (odds ratio (OR) 0.917; 95% confidence interval (CI) 0.860–0.978), increased erythrocyte sedimentation rate (OR 1.039; 95% CI: 1.002–1.077), sleep impairment (OR 5.160; 95% CI: 2.394–11.119), and depression (OR 9.480; 95% CI: 3.602–24.949) were independently significantly correlated with prefrailty (p < 0.05). Increased body mass index (OR 0.744; 95% CI: 0.654–0.848), increased erythrocyte sedimentation rate (OR 1.052; 95% CI: 1.011–1.096), sleep impairment (OR 5.832; 95% CI: 2.092–16.260), and depression (OR 10.041; 95% CI: 2.740–36.793) were independently significantly correlated with frailty. Among the factors, whether for frailty or prefrailty, the strongest impact factor was depression. Conclusions: IBD inpatients are prone to frailty. Comprehensive management focused on the prevention of frailty is warranted to improve the overall prognosis. [ABSTRACT FROM AUTHOR]

Background: Extensive observational evidence put forward the association between psychiatric disorders and type 2 diabetes mellitus (T2DM). However, causal relationships between these two diseases required further research. Thus, we evaluated the bidirection casual effect between five psychiatric disorders and T2DM using two‐sample mendelian randomization (MR). Methods: By selecting single nucleotide polymorphisms associated with T2DM and five psychiatric disorders (attention‐deficit hyperactivity disorder (ADHD), major depressive disorder (MDD), schizophrenia, anxiety disorder and panic disorder), a bidirectional two‐sample MR was applied to evaluate causality between these diseases. The inverse‐variance weighted (IVW) method was used as the primary analysing approach for estimating possible causal effects. MR‐Egger and weighted median were also conducted to verify the results. The funnel plot, Cochran's Q test and MR‐Egger intercept test were used for sensitivity analyses. In addition, potential mediators were investigated by risk factor analyses. Results: Genetic susceptibilities of ADHD and MDD would increase the risk of T2DM (ADHD: OR = 1.14, 95%CI 1.08–1.20; p=5.7×10−6; MDD: OR = 1.22, 95%CI 1.09–1.36; p=0.0004). In addition, genetic predisposition to T2DM was also associated with ADHD (OR = 1.09, 95%CI 1.04–1.14; p = 0.0004). Several risk factors of T2DM were implicated in the above causal associations, including smoking, high body mass index, waist‐to‐hip ratio and elevated serum triglycerides. Conclusion: Our studies indicated a causal effect of ADHD and MDD on increasing the risk of T2DM, which was potentially mediated by smoking and obesity‐related phenotypes. Meanwhile, we found a causal effect of T2DM on ADHD. Thus, prevention strategies for T2DM should also include mental health and vice versa. [ABSTRACT FROM AUTHOR]