Systemic immune activation shapes stroke outcome

Stroke is a major cause of morbidity and mortality, and activation of the immune system can impact on stroke outcome. Although the majority of research has focused on the role of the immune system after stroke there is increasing evidence to suggest that inflammation and immune activation prior to brain injury can influence stroke risk and outcome. With the high prevalence of co-morbidities in the Western world such as obesity, hypertension and diabetes, pre-existing chronic ‘low-grade’ systemic inflammation has become a customary characteristic of stroke pathophysiology that needs to be considered in the search for new therapies. The importance of the immune system in stroke has been demonstrated in a number of ways, both experimentally and in the clinical setting. This review will focus on the effect of immune activation arising from systemic inflammatory conditions and infection, how it affects the incidence and outcomes of stroke, and the possible underlying mechanisms involved. This article is part of a Special Issue entitled 'Neuroinflammation in neurodegeneration and neurodysfunction'.     

吉林省女性自然绝经年龄及其影响因素的调查分析

目的：了解吉林省女性自然绝经年龄的状况,阐明影响吉林省女性自然绝经年龄的相关因素。方法：采用多阶段分层随机整群抽样方法,在吉林省9个市(州)共32个区/市/县选取18～79岁的23 050名居民进行面对面的问卷调查及体格检查,实际完成有效样本21 435名,共筛选出女性样本11 098名,其中已自然绝经女性4 875名作为本次研究样本。采用复杂加权方法估计平均自然绝经年龄和自然绝经年龄中位数,采用方差分析比较不同出生年份女性自然绝经年龄差异,并应用多元线性回归分析自然绝经年龄的影响因素。结果：吉林省女性平均自然绝经年龄为（49.11
±4.19）岁,自然绝经年龄中位数为50.00岁,自然绝经者4 881名,＜40岁绝经者111名（2.27%）,40～45岁绝经者643名（13.17%）,46～53岁绝经者3 513名（71.97%）,54岁以上绝经者573名（11.74%）,另有41名（0.85%）绝经年龄缺失。不同出生年份（70~79岁为1933-1942年、60～69岁为1943-1952年、57～59岁为1953-1955年）女性自然绝经年龄比较显示,城市和农村不同年份出生女性自然绝经年龄比较差异均有统计学意义(F=16.633,P<0.001;F=7.400,P<0.001),未分地区女性自然绝经年龄比较差异有统计学意义（F=21.178,P<0.001）,经SNK法
比较,3组女性自然绝经年龄两两之间比较差异均有统计学意义（P<0.01）,自然绝经年龄分别为1953-1955年出生组50.38岁、1943-1952年出生组49.51岁、1933-1942年出生组48.81岁;城市不同年份出生女性自然绝经年龄差异有统计学意义（F=16.633,P<0.001）,经SNK-q检验比较,3组女性自然绝经年龄任意2组之间比较差异均有统计学意义(P<0.05),自然绝经年龄分别为 1953-1955年出生组50.77岁、1943-1952年出生组49.73岁和1933-1942年出生组48.85岁;农村不同年份出生女性自然绝经年龄比较差异有统计学意义（F=7.400,P=0.001）,经SNK-q检验比较,1953-1955年出生组与另外2组自然绝经年龄比较差异有统计学意义(P<0.05),自然绝经年龄分别为 1953-1955年出生组50.09岁、1943-1952年出生组49.33岁和1933-1942年出生组48.74岁。多元线性回归分析显示,体质量指数（BMI）、体育锻炼与女性自然绝经年龄呈正相关关系(r=0.089,P＜0.001;r=0.150,P=0.025),吸烟、心理健康状况得分与女性自然绝经年龄呈负相关关系(r=－0.257,P=0.002;r=－0.061,P=0.016)。饮食因素,例如蔬菜、水果、牛奶、豆制品和肉类食用频率与自然绝经年龄无相关性。结论：吉林省不同出生年份的女性平均自然绝经年龄有差异;BMI、吸烟、心理健康状况和体育锻炼可能是女性自然绝经年龄的影响因素。     

吉林省成年居民关节炎患病现况及其影响因素分析

目的：了解吉林省成年居民关节炎的患病现况及其影响因素,为制定有效干预措施提供依据。方法：以吉林省18~79周岁的常住居民为调查对象,采用多阶段分层随机整群抽样的方法,选取吉林省9个市（州）共32个区/市/县的23　050名居民进行面对面的问卷调查及体格检查。采用复杂加权的方法估计关节炎的患病率及95%可信区间(95%CI),并应用Logistic回归分析其相关的影响因素。结果：吉林省成年居民关节炎患病率为7.0%,其95%CI：6.6%~7.3%。不同年龄组的关节炎患病率比较差异有统计学意义（P<0.001）,且65~79岁年龄组患病率高,18~岁年龄组患病率低;农村成年居民关节炎患病率高于城镇成年居民（P<0.001）;女性成年居民关节炎患病率高于男性成年居民（P<0.001）。Logistic回归分析结果,关节炎患病的危险因素包括农村、高龄（65~79岁年龄段人群）、女性、猪牛羊肉及禽肉食用频率少和有慢病家族史,其优势比(OR)和95%CI分别为1.291(1.120~1.486)、22.230(6.864~72.002)、1.752(1.487~2.064)、1.251(1.065~1.470)和1.403(1.231~1.600)。结论：吉林省成年居民关节炎患病率高于以往相关报道,应加强对高龄、女性、农村人口、家庭人均月收入低和有慢性病家族史等群体的健康关注和干预。     

Comprehensive assessment of respiratory complications in patients with common variable immunodeficiency

BackgroundCommon variable immunodeficiency (CVID) is a heterogeneous group of disorders, characterized by recurrent upper and lower respiratory tract infections and some noninfectious clinical complications.ObjectiveTo provide a detailed evaluation of respiratory presentations and complications in a cohort of Iranian patients with CVID.MethodsA retrospective cohort study was conducted on 245 CVID patients who were recorded in the Iranian primary immunodeficiency disorders registry network. Respiratory manifestations were evaluated by reviewing clinical hospital records, immunologic findings, pulmonary function tests (PFT), and high-resolution computed tomography (HRCT) scans.ResultsMost of the patients (n = 208, 85.2%) had experienced at least 1 episode of acute respiratory manifestation, and pneumonia was observed in 31.6 % (n = 77) of cases as a first disease manifestation. During the follow-up, pneumonia, sinusitis, and otitis media were documented in 166 (68.6%), 125 (51.2%), and 103 (42.6%) cases, respectively. Abnormal PFT measurements were documented in 53.8% of patients. Among these patients, 21.5% showed restrictive changes, whereas 18.4% of patients showed an obstructive pattern. Bronchiectasis was the most frequent radiological finding, confirmed in 27.2% of patients. Patients with bronchiectasis were older at the time of immunodeficiency diagnosis (P < .001) and had longer diagnosis delay (P < .001) when compared with patients without bronchiectasis.ConclusionThis study highlights the importance of monitoring the respiratory tract system even in asymptomatic patients. Pulmonary function tests and CT scans are the most commonly used techniques aiming to identify these patients early, aiming to reduce the rate of long-term respiratory complications.     

Interpregnancy interval and disparity in term small for gestational age births between black and white women

Objective: To examine the influence of interpregnancy interval on the elevated risk of term small for gestational age (SGA) births to black women.Methods: This study is a secondary analysis of data from the Delivery Interview Program, a hospital-based cohort study of 12,718 women conducted at the Boston Hospital for Women from 1977 to 1980. The current analysis was limited to black and white parous women who gave birth to term infants during the study and whose last previous pregnancies had also resulted in term, live births. There were 578 black and 3400 white women who met these criteria. The rates of term SGA births for black and white women were calculated according to six interpregnancy intervals (6 or less, 6–12, 12–24, 24–36, 36–60, or longer than 60 months). Multiple logistic regression was used to control for confounding.Results: The overall rate of term SGA births was 6.4% for black women compared with 3.9% for white women (relative risk [RR] 1.7, 95% confidence interval [CI] 1.2, 2.4). Black women were also more likely than white women to have interpregnancy intervals of 6 months or less (9.2% black, 4.8% white; RR 1.9, 95% CI 1.4, 2.6). At every interpregnancy interval, black women had a higher rate of term SGA births than white women. After controlling for interpregnancy interval in a logistic regression analysis, the increased risk of SGA delivery among black women remained unchanged (odds ratio 1.7, 95% CI 1.1, 2.5).Conclusion: Although black women were more likely than white women to have SGA births and short interpregnancy intervals, differences in interpregnancy intervals between the races did not explain the disparity in term SGA births.     

四川省慢性病核心信息知晓情况分析

目的 了解四川省居民慢性病防治核心信息知晓情况及其影响因素,为制定慢性病防控干预策略提供依据.方法 根据国家慢性病防控核心信息知晓情况调查方案,选取四川省开展中国成人慢病营养监测工作的13个监测点共9 428名18岁及以上四川省常住居民作为调查对象.采用方案统一的慢性病防控核心信息知晓情况调查问卷开展调查,问卷内容包括...     

Socioeconomic inequality in screen time frequency in children and adolescents: the weight disorders survey of the CASPIAN IV study

Background

This study aimed to assess the socioeconomic inequality and determinants of screen time (ST) frequency in Iranian children and adolescents.

Methods

This nationwide study was conducted as part of a national school-based surveillance program among 36,486 students consisting of 50.79% boys and 74.23% urban inhabitants, aged 6–18 years, living in urban and rural areas of 30 provinces of Iran. Socioeconomic inequality in ST, including the time spent for ST, watching TV and leisure-time working with computer, was assessed across quintiles of SES using concentration index (C) and slope index of inequality (SII).

Results

Overall, 36,486 students completed the study (response rate 91.25%). Their mean (SD) age was 12.14 (3.36) years. The national estimation of frequency of ST was 31.66% (95% CI 31.16–32.17) with ascending change from 20.80% (95% CI 19.81–21.82) to 36.66% (95% CI 35.47–37.87) from the first to the last quintal of SES. Estimated C value at national level was positive (0.08), which indicate inequality was in favor of low SES groups. Considering the SII values, at national level [? 0.16 (? 0.39, 0.06)], the absolute difference in ST frequency between the bottom and top of the socioeconomic groups had descending trends. In multivariate logistic regression model, family history of obesity, generalized obesity and age were the main significant determinants of prolonged ST, watching TV, and computer working (P < 0.001).

Conclusions

Socioeconomic inequality in ST frequency was in favor of low SES groups. These findings are useful for health policies, better programming and future complementary analyses.

     

1990-2019年北京市和上海市帕金森病的疾病负担分析

目的 本研究旨在分析1990-2019年北京市和上海市帕金森病的疾病负担指标及变化趋势.方法 利用2019年全球疾病负担(GBD)研究数据,使用患病率、死亡率、伤残调整寿命年(DALYs)指标分析北京市和上海市帕金森病的疾病负担现状,并通过1990-2019年的变化率量化上述指标的长期变化趋势.按性别和年龄分层分析北京...     

河北省中老年人代谢综合征患病现状及影响因素

  目的  了解河北省中老年人代谢综合征（metabolic syndrome,MS）的患病现状及影响因素。  方法  利用京津冀地区生活社区自然人群慢性病队列研究数据,分析河北省七个区县4 546名40~80岁居民MS的患病情况,采用多因素Logistic回归分析模型探讨MS患病的相关影响因素。  结果  MS患病率为25.30%,其中男性患病率为28.59%,女性为23.09%;汉族患病率为28.15%,满族为21.07%。MS各组分中,超重肥胖、高血压、高血糖和血脂紊乱的患病率分别为50.99%、46.70%、22.06%和43.16%。多因素Logistic回归分析模型分析结果显示,女性（OR=0.69,95% CI:0.57~0.83,P＜0.001）、满族（OR=0.68,95% CI:0.59~0.79,P＜0.001）和较高的文化程度（相对于小学及以下文化者,高中/初中和大专及以上OR分别为0.83和0.75）是保护因素,高龄（与40~岁年龄组相比,50~岁、60~岁和70~岁年龄组OR分别为1.81、1.76和1.50）是危险因素。  结论  河北省中老年人MS患病率较高,特别是在高龄、男性、汉族和低文化程度人群中。在对人群进行针对性防控的同时应采取积极措施控制体重。