The prevalence of mild cognitive impairment and its etiological subtypes in elderly Chinese

BackgroundEpidemiologic studies on mild cognitive impairment (MCI) are limited in China.MethodsUsing a multistage cluster sampling design, a total of 10,276 community residents (6096 urban, 4180 rural) aged 65 years or older were evaluated and diagnosed with normal cognition, MCI, or dementia. MCI was further categorized by imaging into MCI caused by prodromal Alzheimer's disease (MCI-A), MCI resulting from cerebrovascular disease (MCI-CVD), MCI with vascular risk factors (MCI-VRF), and MCI caused by other diseases (MCI-O).ResultsThe prevalences of overall MCI, MCI-A, MCI-CVD, MCI-VRF, and MCI-O were 20.8% (95% confidence interval [CI] = 20.0–21.6%), 6.1% (95% CI = 5.7–6.6%), 3.8% (95% CI = 3.4–4.2%), 4.9% (95% CI = 4.5–5.4%), and 5.9% (95% CI = 5.5–6.4%) respectively. The rural population had a higher prevalence of overall MCI (23.4% vs 16.8%, P < .001).ConclusionsThe prevalence of MCI in elderly Chinese is higher in rural than in urban areas. Vascular-related MCI (MCI-CVD and MCI-VRF) was most common.     

Potential Overtreatment and Undertreatment of Type 2 Diabetes Mellitus in Long-Term Care Facilities: A Systematic Review

ObjectiveTo investigate the prevalence, outcomes, and factors associated with potential glycemic overtreatment and undertreatment of type 2 diabetes mellitus (T2DM) in long-term care facilities (LTCFs).DesignSystematic review.Setting and ParticipantsResidents with T2DM and aged ≥60 years living in LTCFs.MeasuresArticles published between January 2000 and September 2020 were retrieved following a systematic search of MEDLINE, EMBASE, Cochrane Library, CINAHL plus, and gray literature. Inclusion criteria were the reporting of (1) potential overtreatment and undertreatment quantitatively defined (implicitly or explicitly) based on hemoglobin A1c (HbA1c) and/or blood glucose; (2) prevalence, outcomes, and associated factors of potential glycemic overtreatment and undertreatment; and (3) the study involved residents of LTCFs.ResultsFifteen studies were included. Prevalence of potential overtreatment (5%–86%, n = 15 studies) and undertreatment (1.4%–35%, n = 8 studies) varied widely among facilities and geographical locations, and according to definitions used. Prevalence of potential overtreatment was 16%–74% when defined as treatment with a glucose-lowering medication in a resident with ≥1 hypoglycemia risk factor or serious comorbidity, together with a HbA1c <7% (n = 10 studies). Potential undertreatment was commonly defined as residents on glucose-lowering medication having HbA1c >8.5% and the prevalence 1.4%–14.8% (n = 6 studies). No studies prospectively measured resident health outcomes from overtreatment and undertreatment. Potential overtreatment was positively associated with use of oral glucose-lowering medications, dementia diagnosis or dementia severity, and/or need for assistance with activities of daily living (n = 2 studies). Negative association was found between potential overtreatment and use of insulin/combined insulin and oral glucose-lowering medication. No studies reported factors associated with potential undertreatment.Conclusions and ImplicationsThe prevalence of potential glycemic overtreatment and undertreatment varied widely among residents with T2DM depending on the definition(s) used in each study. Longitudinal studies examining associations between glycemic management and health outcomes, and the use of consensus definitions of overtreatment and undertreatment are required to establish findings about actual glycemic overtreatment and undertreatment in LTCFs.     

放射治疗对乳腺癌患者外周血免疫系统相关指标的影响

目的:研究分析放射治疗对乳腺癌患者免疫系统相关指标的影响.方法:选取在医院就诊的6例病理诊断为乳腺癌Ⅱ～Ⅲ期患者,将所有患者放射治疗前(0 Gy)静脉血样本定义为对照组、放射治疗20 Gy和50 Gy照射后静脉血样本分别定义为20 Gy组和50 Gy组,于放射治疗10次后、25次后采集不同放射治疗累积剂量24 h后静脉...     

Effects of trophic 2,2′, 4,4′-tetrabromodiphenyl ether (BDE-47) exposure in Oreochromis niloticus: A multiple biomarkers analysis

Polybrominated diphenyl esters are emerging environmental contaminants with few toxicological data, being a concern for the scientific community. This study evaluated the effects of BDE-47 on the health of Oreochromis niloticus fish. The animals were exposed to three doses of BDE-47 (0, 0.253, 2.53, 25.3 ng g⁻¹) every 10 days, for 80 days. The BDE-47 affected the hepatosomatic and gonadosomatic index in female and the condition factor by intermediate dose in both sexes. The levels of estradiol decreased and the T4 are increased, but the vitellogenin production was not modulated in male individuals. Changes in AChE, GST, LPO and histopathology were observed while the integrated biomarker response index suggests that the lowest dose of BDE-47 compromised the activity of antioxidant enzymes. The oral exposure to BDE-47 in environmental concentrations is toxic to O. niloticus and the use of multiple biomarkers is an attribution in ecotoxicology studies and biomonitoring programs.     

青岛市男性新型毒品滥用人群艾滋病病毒感染及危险行为调查

目的 了解山东省青岛市新型毒品滥用者使用新型毒品的情况、性行为特征及HIV感染状况。方法 采用横断面调查设计,2015-2016年在青岛市依托MSM社会组织和社区中男性新型毒品滥用者志愿者,滚雪球法招募男性新型毒品滥用者,样本量估计为933人。收集其吸毒、性行为,检测HIV、梅毒、HCV抗体,检测新型毒品滥用情况。采用EpiData 3.1软件建立数据库、SAS 9.4软件进行统计分析。结果 共招募1 034人,MSM组431人（占41.7%）和非MSM组603人（占58.3%）。与非MSM组相比,MSM组年龄较低,未婚比例较高,文化程度较高。最近6个月用过冰毒的比例MSM组和非MSM组分别为49.7%（214/431）和100.0%（603/603）,用过零号胶囊的比例分别为66.8%（288/431）和0.0%。最近6个月与多人共用毒品者的比例MSM组和非MSM组分别为87.9%（379/431）和97.7%（588/602）（χ²=39.84,P<0.01）。最近6个月使用毒品后发生性行为从未使用安全套的比例,非MSM组（47.5%,285/600）高于MSM组（7.4%,32/430）（χ²=190.10,P<0.01）。最近6个月使用新型毒品后发生多人性行为的比例,MSM组和非MSM组分别为78.1%（335/429）和5.5%（33/600）（χ²=573.73,P<0.01）。MSM组的和非MSM组的HIV抗体阳性率、梅毒抗体阳性率、HCV抗体阳性率分别为2.1%和0.2%、3.3%和6.3%、0.0%和0.3%。结论 青岛市男性新型毒品滥用人群中有较高比例的多人共同吸毒,在有男男性行为的新型毒品滥用人群中,使用毒品后的群体性行为发生率高,HIV抗体阳性率较高,安全套使用率低,应重点加强对这部分亚人群的干预。     

艾滋病疫情估计与预测方法研究进展

近年来,由于艾滋病监测系统的不断完善以及监测资料来源的多样性,艾滋病疫情估计与预测方法已成为了解艾滋病流行状况及预测发展趋势的重要工具,为此国内外学者采用了多种方法对艾滋病疫情进行了估计与预测。本研究对目前常用艾滋病疫情估计与预测方法的基本原理、适用条件、应用、优点及局限性进行综述,为疫情估计方法的选择与应用提供参考。     

90Y树脂微球治疗患者尿液中90Y放射性活度检测和分析

目的研究患者接受90Y树脂微球选择性内放射治疗(SIRT)后48 h内所排泄尿液中90Y的放射性活度, 为术后患者排泄物的管理提供建议。方法收集3名患者在术后0～24 h和24～48 h两个时间段内排泄的尿液, 并对尿液中的90Y放射性活度进行检测和分析。结果 3名患者术后0～24 h和24～48 h尿液中的90Y放射性活度排泄量分别为(1 266±258)kBq/GBq和(140±106)kBq/GBq, 90Y放射性活度浓度分别为(640±113)kBq/L和(53±12)kBq/L。结论 90Y树脂微球治疗术后肝癌患者0～24 h排泄尿液中的90Y放射性活度比24～48 h高。术后患者可通过增加排泄尿量的方式来加速排出体内游离的90Y;患者住院期间的排泄物应按照HJ 1188-2020《核医学辐射防护与安全要求》的要求处理。     

中国35岁及以上人群缺血性心血管病10年发病风险预测

目的 评估我国≥35岁人群缺血性心血管病10年发病风险。方法 2010年在全国31个省(自治区、直辖市)和新疆生产建设兵团的162个监测点,采用多阶段分层整群随机抽样方法,调查≥18岁成年人98712名,抽取其中≥35岁无缺血性心血管病史者共计67214人为调查对象,通过体格测量和相关指标实验室检测,以及面对面问卷调查收集吸烟情况,高血压、糖尿病和心血管病患病情况。采用国人缺血性心血管病10年发病危险度评估表预测缺血性心血管病10年发病风险。结果 我国≥35岁无缺血性心血管病史人群的缺血性心血管病10年发病风险预测得分为5.1(95%CI:4.9~5.2),平均危险度为4.2%(95%CI:4.0%~4.4%)。其中缺血性心血管病10年发病危险为高危者占8.5%(95%CI:7.8%~9.2%),男性(12.1%,95%CI:11.1%~13.0%)明显高于女性(4.9%,95%CI:4.4%~5.5%)(P<0.05),农村人群(8.8%,95%CI:7.8%~9.7%)高于城市人群(8.1%,95%CI:7.2%~8.9%)(P<0.05);10年发病风险为中危和低危者比例分别为19.1% (95%CI:18.2%~20.0%)和72.4%(95%CI:70.9%~73.9%)。随着教育水平提高或收入增加,缺血性心血管病10年发病风险为高危和中危者的比例均有所下降(P<0.05),而低危者的比例上升(P<0.05)。结论 我国≥35岁人群中有8.5%在未来10年发生缺血性心血管病的可能性超过10%,其中尤为应关注男性、农村、教育水平较低、收入较低人群。     

1982年与2012年中国6~17岁儿童蔬菜水果摄入比较

目的  分析1982年与2012年我国6~17岁儿童蔬菜水果摄入量及其变化特征。方法  以1982年全国营养调查18 237名与2012年中国居民营养与健康状况监测中的5 819名6~17岁儿童为对象,分别用称重记账法与3 d 24 h膳食调查法收集儿童食物摄入情况,分析并比较两个年份学龄儿童的蔬菜与水果摄入量及达到WHO推荐摄入量的情况。结果  学龄儿童蔬菜摄入量从1982年的300.4 g下降到2012年的185.8 g(Z=45.9, P＜0.001);学龄儿童水果摄入量由1982年的28.2 g增加到2012年的45.9 g(Z=36.8, P＜0.001)。学龄儿童蔬菜水果总摄入量达到WHO推荐量80%及以上的比例由1982年的42.2%下降到2012年的21.6%(χ² =809.9, P＜0.001)。1982年和2012年,男生蔬菜摄入量均高于女生,且随年龄增长而升高;水果摄入量均为城市儿童高于农村儿童。结论  2012年与1982年相比,我国6~17岁儿童蔬菜摄入量下降较多,水果摄入量有所增加,2012年与1982年儿童蔬菜与水果摄入量均不足,建议采取综合干预措施提高儿童蔬菜与水果的消费,促进其健康成长。