Association of the Healthy Dietary Index 2020 and its components with chronic respiratory disease among U.S. adults.

Background: Chronic respiratory disease is an important public health problem in the United States and globally. Diet, an important part of a healthy lifestyle, is also relevant to chronic respiratory health. We aimed to explore the relationship between overall dietary quality and the risk of chronic respiratory disease (CRD), include chronic bronchitis (CB), emphysema and asthma. Method: A total of 4,499 United States adults were extracted from the National Health and Nutrition Examination Survey (NHANES) in 2017-2018. Diet quality was assessed using 2 day, 24 h dietary recall data and quantified as the Healthy Diet Index (HEI)-2020 score. Binary logistic regression models, restricted cubic splines (RCS) and generalized additive modeling (GAM), the weighted quartile sum (WQS) and qgcom models were used to assess the relationship between HEI-2020 scores and risk of CB, emphysema and asthma. Results: High HEI-2020 scores are associated with low risk of chronic respiratory disease (CB: 0.98, 0.97-0.99; emphysema: 0.98, 0.97-0.99; asthma: 0.98, 0.97-0.99) and consistent results across different dietary variable categorization (Tertile: CB: 0.58, 0.42-0.81; asthma: 0.51, 0.35-0.74; Quartile: CB: 0.57, 0.34-0.97; asthma: 0.56, 0.36-0.86) and different weighting models. Negative dose-response relationship between dietary quality and risk of chronic respiratory disease also shown in RCS and GAM models. The WQS and qgcom models also showed a healthy mixing effect of dietary components on respiratory disease, with high-quality proteins, vegetables, and fruits making the heaviest contributions. Conclusion: Higher HEI-2020 scores were associated with lower risk of CB, emphysema, and asthma. Following Dietary Guidelines for Americans 2020-2025 could support enhanced respiratory health.

Effects of dexmedetomidine, propofol and etomidate on the intraoperative wake-up in the cerebral functional area under the guidance of entropy index.

Objective: The study observed the efficacy and safety of dexmedetomidine, propofol and etomidate on brain functional areas in patients undergoing wake-up brain surgery under the guidance of entropy index. Methods: Sixty patients undergoing wake-up brain surgery on brain functional areas were enrolled, and randomly divided into three groups: dexmedetomidine group (group D), propofol group (group P) and etomidate group (group E), 20 in each. The vital signs, entropy indices of each time point, wake-up time, wake-up quality and adverse reaction in the wake-up period were observed and compared. Results: There were no differences in the duration of wake-up, duration of anesthesia, duration of surgery and postoperative wake-up time between the three groups (P> 0.05). The wake-up quality in group D was significantly better than group P and group E (P <0.05), group P was better than group E (P <0.05). The incidence of adverse events in group D was lower than that in groups P and E (P <0.05). The incidence of adverse events in group P was lower than that in group E (P <0.05). Conclusion: Under the guidance of entropy index, anesthesia induced by dexmedetomidine, propofol and etomidate combined with remifentanil can safely and effectively be used to the wake-up brain functional areas surgery, but the wake-up quality with use of dexmedetomidine is highest, and the incidence of adverse events is the lowest during wake-up period.