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Objective To analyze the clinical characteristics of thyroid dysfunction induced by camrelizumab in the treatment of classical Hodgkin lymphoma(cHL)and explore the influencing factors.Methods The medical records of cHL patients treated with camrelizumab from January 1st,2017 to December 31st,2020,were collected.The clinical characteristics of thyroid dysfunction induced by camrelizumab were analyzed,and the influencing factors of adverse drug reactions(ADRs)were discussed.Results A total of 47 patients were included,12 patients(25.53%)experiencing thyroid dysfunction after receiv-ing camrelizumab.Among them,3 patients had hypothyroidism,7 had subclinical hypothyroidism,and 2 had subclinical hyperthy-roidism.The severity of ADRs was between grade 1 and 2(mild to moderate).None of the patients with thyroid dysfunction dis-continued camrelizumab.Thyroid dysfunction occurred between 1 and 22 months after camrelizumab treatment,with a median time of 6 months.2 patients with hypothyroidism treated with levothyroxine,the thyroid function returned to normal in 1 patient and was improved in the other.1 patient with subclinical hypothyroidism was treated with levothyroxine with the thyroid function continued to be abnormal.The rest of the 9 patients with thyroid dysfunction received no intervention,and 4 of them returned to normal,and others remained with no obvious change or loss in follow-up.Thyroid dysfunction was associated with baseline thyroid stimulating hormone level(P=0.03).The level of thyroglobulin antibodies and thyroid peroxidase antibodies was increased in 2 patients a-mong 3 patients with moderate thyroid dysfunction.Conclusion The incidence of thyroid dysfunction induced by camrelizum-ab in cHL was high.Camrelizumab-induced thyroid dysfunction was related to TSH baseline level(P=0.03).The severity was between grade 1 and 2,which was related to the level of TgAb and TPOAb.The subtype of thyroid dysfunction was mainly sub-clinical hypothyroidism with a long period.Patients could continue camrelizumab treatment,and the thyroid function of patients with grade 2 hypothyroidism was improved after the treatment with levothyroxine.
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Objective The aim of this study is to analyze the prevalence of depression and anxiety symptoms and its relationship with the socio-economic position(SEP)among the elderly people in Dai rural areas of Jinggu County,Yunnan province.Methods A multi-stage stratified random sampling method was used to conduct a questionnaire survey among 1409 people aged 60 and over in Dai rural areas of Jinggu County,Yunnan Province.The individual SEP index was constructed using the principal component analysis.Results The prevalence of anxiety symptoms,depression symptoms,and mixed anxiety-depressive disorder symptoms was 4.8%,52.0%,and 4.2% among them,2.6%,49.4%,and 2.3% among the males,and 6.8%,54.5%,and 6.0% among the females respectively.Females had the higher prevalence of anxiety symptoms and mixed anxiety-depressive disorder symptoms than males(P<0.05).Elderly people with the higher level of education,annual per capita household income and SEP had the lower prevalence of anxiety symptoms and mixed anxiety-depressive disorder symptoms than their counterparts(both P<0.05).The prevalence of depression symptoms increased with age(P<0.01).The difference in the prevelence of depression symptoms among the elderly people with the different numbers of chronic conditions was statistically significant(P<0.01).The results of multivariate logistic regression analysis showed that the elderly people with lower SEP were more likely to suffer from the anxiety symptoms(OR=0.707,95% CI:0.566~0.883),depression symptoms(OR=0.492,95% CI:0.438~0.552),and mixed anxiety-depressive disorder symptoms(OR=0.602,95% CI:0.469~0.773).Conclusion There are significant socio-economic differences in the prevalence of anxiety symptoms and depression symptoms among the elderly people in Dai rural areas of Jinggu County,Yunnan province.Future mental health interventions should more focus on females,elderly people with advanced age,multiple chronic diseases and low SEP,so as to reduce the occurrence of depression symptoms and anxiety symptoms.
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OBJECTIVES: This study aimed to determine the changing prevalence of clustering of cardiovascular disease (CVD) risk factors across socioeconomic spectra in rural southwest China. DESIGN: Data were collected from two waves of cross-sectional health interviews and examinations among individuals aged ≥35 years in rural China. Anthropometric measurements, blood pressure and fasting blood sugar levels were recorded for each participant. SETTING: This study was conducted in rural Yunnan Province of China. PARTICIPANTS: 8187 individuals in 2011 and 7572 in 2021 consented to participate in this study. RESULTS: From 2011 to 2021, prevalence increased of hypertension (26.1% vs 41.6%), diabetes mellitus (5.9% vs 9.8%), obesity (5.9% vs 12.0%) and central obesity (50.0% vs 58.3%) (p<0.01), while prevalence decreased of current smoking (35.2% vs 29.6%), secondhand smoke exposure (42.6% vs 27.4%) and current drinking (26.6% vs 29.6%) (p<0.01). This decade also saw an increase in the prevalence of participants with clustering of ≥2 (61.8% vs 63.0%) and ≥3 CVD risk factors (28.4% vs 32.2%) (p<0.05). These increasing rates were also observed among subgroups categorised by sex, ethnicity, education level, income level and those ≥45 years of age (p<0.05). In both 2011 and 2021, male participants and participants with a lower education level had higher prevalence of clustering of ≥2 and ≥3 CVD risk factors than their counterparts (p<0.01). Ethnic minority participants and participants with higher annual income had higher prevalence of clustering of CVD risk factors in 2011 but presented opposite associations in 2021 (p<0.01). CONCLUSION: The prevalence of clustering of CVD risk factors increased substantially across all socioeconomic spectra in rural southwest China from 2011 to 2021. Future efforts to implement comprehensive lifestyle interventions to promote the prevention and control of CVD should in particular focus on men, those of Han ethnicity and those with low socioeconomic status.
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Doenças Cardiovasculares , Hipertensão , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Transversais , Etnicidade , Doenças Cardiovasculares/epidemiologia , Prevalência , Grupos Minoritários , China/epidemiologia , Hipertensão/epidemiologia , Análise por Conglomerados , Renda , Obesidade , Fatores de Risco de Doenças Cardíacas , Fatores de Risco , Fatores SocioeconômicosRESUMO
Objective: To describe the trend of tuberculosis (TB) diagnosis in the migrant city Shenzhen, China, and analyze the risk factors of diagnosis delays. Methods: Demographic and clinical information of TB patients from 2011 to 2020 in Shenzhen were extracted. A bundle of measures to enhance TB diagnosis had been implemented since late 2017. We calculated the proportions of patients who underwent a patient delay (>30 days from syndrome onset to first care-seeking) or a hospital delay (>4 days from first care-seeking to TB diagnosis). Multivariable logistic regression was used to analyze the risk factors of diagnosis delays. Results: During the study period, 43,846 patients with active pulmonary TB were diagnosed and registered in Shenzhen. On average, the bacteriological positivity rate of the patients was 54.9%, and this increased from 38.6% in 2017 to 74.2% in 2020. Overall, 30.3 and 31.1% of patients had a patient delay or a hospital delay, respectively. Molecular testing significantly increased bacteriological positivity and decreased the risk of hospital delay. People >35 years old, the unemployed, and residents had a higher risk of delays in both patient care-seeking and hospital diagnosis than younger people, workers, or migrants. Compared with passive case-finding, active case-finding significantly decreased the risk of patient delay by 5.47 (4.85-6.19) times. Conclusion: The bacteriological positivity rate of TB patients in Shenzhen increased significantly but the diagnosis delays were still serious, which may need more attention when active case-finding in risk populations and optimization of molecular testing.
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Tuberculose Pulmonar , Tuberculose , Humanos , Adulto , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Fatores de Risco , China/epidemiologiaRESUMO
Objective: To investigate the association between physical exercise and non-alcoholic fatty liver disease (NAFLD) in people infected with HBV. Methods: The information about the 3 813 participants infected with HBV, including the prevalence of NAFLD, prevalence of physical exercise and other covariates, were collected from the National Science and Technology Major Project of China during 2016-2020. The logistic regression model was used to evaluate the association between physical exercise and NAFLD in HBV infected patients, and subgroup analysis was performed to identify the effect modifiers. Results: A total of 2 259 HBV infected participants were included in the final analysis and 454 (20.10%) had NAFLD. After adjusting for covariates, we found that moderate physical exercise was a protective factor for NAFLD (OR=0.66, 95%CI: 0.46-0.94). Subgroup analysis suggested that the protective effect of moderate physical exercise on NAFLD might be stronger in women (OR=0.61, 95%CI: 0.36-1.01), those <45 years old (OR=0.24, 95%CI: 0.06-0.80), those who had low education level (OR=0.16, 95%CI: 0.04-0.49), those who had low annual income (OR=0.39, 95%CI: 0.16-0.89 for <30 000 yuan RMB; OR=0.64, 95%CI: 0.40-1.00 for 30 000-80 000 yuan RMB), those who had hypertension (OR=0.45, 95%CI: 0.21-0.88), those with BMI ≥24.0 kg/m2 (OR=0.66, 95%CI: 0.43-1.01), those who had more daily fruit or vegetable intake (OR=0.61, 95%CI: 0.38-0.97), those who had more daily meat intake (OR=0.49, 95%CI: 0.23-0.97), and those who had no smoking history (OR=0.66, 95%CI: 0.45-0.95) or passive smoking exposure (OR=0.61, 95%CI: 0.37-0.97). Conclusions: Among HBV infected patients, moderate physical exercise was negatively associated with the prevalence of NAFLD. Women, young people, those who had low education level, those who had low annual income, those with hypertension, those with high BMI, those who had more daily fruit or vegetable and meat intakes, and those who had no smoking history or passive smoking exposure might be more sensitive to the protective effect.
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Humanos , Feminino , Adolescente , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Vírus da Hepatite B , Fatores de Risco , Poluição por Fumaça de Tabaco , Exercício Físico , HipertensãoRESUMO
The fungus Xylaria sp. KYJ-15 was isolated from Illigera celebica. Based on the one strain many compounds (OSMAC) strategy, the strain was fermented on potato and rice solid media, respectively. As a result, two novel steroids, xylarsteroids A (1) and B (2), which are the first examples of C28-steroid with an unusual β- and γ-lactone ring, respectively, along with two new dihydroisocoumarin glycosides, xylarglycosides A (3) and B (4), were identified. Their structures were elucidated by spectroscopic methods, X-ray diffraction and electronic circular dichroism (ECD) experiments. All isolated compounds were evaluated for cytotoxicity, DPPH radical scavenging activity, acetylcholinesterase inhibitory and antimicrobial effect. Compound 1 exhibited potent AChE inhibitory activity with an IC50 value of 2.61 ± 0.05 μmol·L-1. The β-lactone ring unit of 1 is critical for its AChE inhibitory activity. The finding was further confirmed through exploring the interaction of 1 with AChE by molecular docking. In addition, both compounds 1 and 2 exhibited obvious antibacterial activity against Bacillus subtilis with a minimum inhibitory concentration (MIC) of 2 μg·mL-1. Compounds 3 and 4 exhibited antibacterial activities against Staphylococcus aureus with MICs of 4 and 2 μg·mL-1, respectively, which also exhibited DPPH radical scavenging activity comparable to the positive control with IC50 values of 9.2 ± 0.03 and 13.3 ± 0.01 μmol·L-1, respectively.
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Humanos , Acetilcolinesterase , Simulação de Acoplamento Molecular , Antibacterianos , Glicosídeos , Lactonas , DorRESUMO
Objective: To establish a dynamic syndromic surveillance system in the border areas of Yunnan Province based on information technology, evaluate its effectiveness and timeliness in the response to common communicable disease epidemics and improve the communicable disease prevention and control in border areas. Methods: Three border counties were selected for full coverage as study areas, and dynamic surveillance for 14 symptoms and 6 syndromes were conducted in medical institutions, the daily collection of information about students' school absence in primary schools and febrile illness in inbound people at border ports were conducted in these counties from January 2016 to February 2018 to establish an early warning system based on mobile phone and computer platform for a field experimental study. Results: With syndromes of rash, influenza-like illness and the numbers of primary school absence, the most common communicable disease events, such as hand foot and mouth disease, influenza and chickenpox, can be identified 1-5 days in advance by using EARS-3C and Kulldorff time-space scanning models with high sensitivity and specificity. The system is easy to use with strong security and feasibility. All the information and the warning alerts are released in the form of interactive charts and visual maps, which can facilitate the timely response. Conclusions: This system is highly effective and easy to operate in the detection of possible outbreaks of common communicable diseases in border areas in real time, so the timely and effective intervention can be conducted to reduce the risk of local and cross-border communicable disease outbreaks. It has practical application value.
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Humanos , Influenza Humana , Vigilância de Evento Sentinela , Síndrome , China , Telefone CelularRESUMO
Exhaled human breath contains a rich mixture of volatile organic compounds (VOCs) whose concentration can vary in response to disease or other stressors. Using simulated odorant-binding proteins (OBPs) and machine learning methods, we designed a multiplex of short VOC- and carbon-binding peptide probes that detect the characteristic "VOC fingerprint". Specifically, we target VOCs associated with COVID-19 in a compact, molecular sensor array that directly transduces vapor composition into multi-channel electrical signals. Rapidly synthesizable, chimeric VOC- and solid-binding peptides were derived from selected OBPs using multi-sequence alignment with protein database structures. Selective peptide binding to targeted VOCs and sensor surfaces was validated using surface plasmon resonance spectroscopy and quartz crystal microbalance. VOC sensing was demonstrated by peptide-sensitized, exposed-channel carbon nanotube transistors. The data-to-device pipeline enables the development of novel devices for non-invasive monitoring, diagnostics of diseases, and environmental exposures assessment.
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The isotopic fractionation factor and element partition coefficient can be calculated only after the geometric optimization of the molecular clusters is completed. Optimization directly affects the accuracy of some parameters, such as the average bond length, molecular volume, harmonic vibrational frequency, and other thermodynamic parameters. Here, we used the improved volume variable cluster model (VVCM) method to optimize the molecular clusters of a typical oxide, quartz. We documented the average bond length and relative volume change. Finally, we extracted the harmonic vibrational frequencies and calculated the equilibrium fractionation factor of the silicon and oxygen isotopes. Given its performance in geometrical optimization and isotope fractionation factor calculation, we further applied the improved VVCM method to calculate isotope equilibrium fractionation factors of Cd and Zn between the hydroxide (Zn-Al layered double hydroxide), carbonate (cadmium-containing calcite) and their aqueous solutions under superficial conditions. We summarized a detailed procedure and used it to re-evaluate published theoretical results for cadmium-containing hydroxyapatite, emphasizing the relative volume change for all clusters and confirming the optimal point charge arrangement (PCA). The results showed that the average bond length and isotope fractionation factor are consistent with those published in previous studies, and the relative volume changes are considerably lower than the results calculated using the periodic boundary method. Specifically, the average Si-O bond length of quartz was 1.63 Å, and the relative volume change of quartz centered on silicon atoms was - 0.39%. The average Zn-O bond length in the Zn-Al-layered double hydroxide was 2.10 Å, with a relative volume change of 1.96%. Cadmium-containing calcite had an average Cd-O bond length of 2.28 Å, with a relative volume change of 0.45%. At 298 K, the equilibrium fractionation factors between quartz, Zn-Al-layered double hydroxide, cadmium-containing calcite, and their corresponding aqueous solutions were [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text] respectively. These results strongly support the reliability of the improved VVCM method for geometric optimization of molecular clusters.
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The prevalence of chronic obstructive pulmonary disease (COPD) among urban populations is generally lower than rural residents, but the disease burden is still high. We conducted a cross-sectional prevalence survey of COPD among residents aged ≥40 years in an emerging city Shenzhen, China from September 2018 to June 2019. Through multi-stage stratified random sampling, a total of 4157 eligible participants were invited to complete a questionnaire and to take the spirometry test; 3591 with available data were enrolled in the final analysis. Individuals were diagnosed with COPD if the post-bronchodilator FEV1/FVC ratio was less than 0.7. The estimated standardized prevalence of COPD among residents over 40 years old in Shenzhen was 5.92% (95% confidential intervals [CI] 4.05-8.34). Risk factors for COPD included elder age (adjusted odds ratio 1.206, 95% CI 1.120-1.299 per 10-year increase), smoking over 20 pack-years (1.968, 1.367-2.832), history of chronic bronchitis (1.733, 1.036-2.900) or asthma (4.920, 2.425-9.982), and exposure to higher annual minimum concentrations of ambient SO2 (1.156, 1.053-1.270 per 1-µg/m3 increase). Among 280 spirometry-diagnosed patients, most (221, 78.93%) patients were classified as mild COPD (GOLD stage I). This survey found that the prevalence of COPD in Shenzhen is low and most patients had mild symptoms, thus recommended screening using spirometry in primary health care to detect early-stage COPD. Increased risk from the exposure to air pollutants also indicated the urgent need for environmental improvement in city settings.
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Doença Pulmonar Obstrutiva Crônica , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Humanos , Prevalência , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fatores de Risco , EspirometriaRESUMO
BACKGROUND: This study examines the association between socioeconomic and lifestyle factors and the prevalence of hypertension among elderly individuals in rural Southwest China. METHODS: A cross-sectional survey of 4833 consenting adults aged ≥ 60 years in rural regions of Yunnan Province, China, was conducted in 2017. Data on individual socioeconomic status, sleep quality, physical activity level, and family history of hypertension were collected with a standardized questionnaire. Blood pressure, fasting blood glucose, height, weight, and waist circumference were also measured. An individual socioeconomic position (SEP) index was constructed using principal component analysis. Structural equation modelling (SEM) was applied to analyse the association between socioeconomic and lifestyle factors and the prevalence of hypertension. RESULTS: The overall prevalence of hypertension was 50.6% in the study population. Body fat distribution, including measures of obesity and central obesity, had the greatest total effect on hypertension (0.21), followed by family history of hypertension (0.14), biological sex (0.08), sleep quality (- 0.07), SEP (- 0.06), physical inactivity (0.06), and diabetes (0.06). Body fat distribution, SEP, and family history of hypertension had both direct and indirect effects on hypertension, whereas physical inactivity, diabetes, and sleep quality were directly associated with the prevalence of hypertension. Biological sex was indirectly associated with the prevalence of hypertension. CONCLUSIONS: SEP, body fat distribution, physical inactivity, diabetes, and sleep quality critically influence the prevalence of hypertension. Future interventions to prevent and control hypertension should give increased attention to individuals with low SEP and should focus on controlling diabetes and obesity, increasing physical activity levels, and improving quality of sleep among older adults aged ≥ 60 years in rural Southwest China.
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Hipertensão/epidemiologia , Estilo de Vida , Saúde da População Rural , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Adiposidade , Fatores Etários , Idoso , Pressão Sanguínea , China/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Medição de Risco , Fatores de Risco , Comportamento Sedentário , SonoRESUMO
OBJECTIVE: This study aims to test a Chinese cross-cultural adaptation of the English version of the Person-Centred Care Assessment Tool (P-CAT) and evaluate its psychometric properties. DESIGN: P-CAT was translated/back-translated using established procedures before the psychometric evaluation of the Chinese version was made. SETTING: Two hospitals covering urban and suburban areas of Kunming in the Yunnan province of China. PARTICIPANTS: 152 female hospital staff completed the survey. MAIN OUTCOME MEASURES: Construct validity and reliability, including internal consistency and test-retest reliability, were assessed among a sample of hospital staff. RESULTS: The factor analysis resulted in a two-component solution that consisted of two subscales. The corrected item-total correlations for all of the items ranged from 0.14 to 0.44, with six items not meeting the cut-off level for item-total correlation (>0.3). The Chinese P-CAT demonstrated strong reliability, with a Cronbach's alpha of 0.91-0.94 for the scales and a test-retest reliability coefficient of 0.88 for the overall scale scores. The intraclass correlation was 0.92 (95% CI 0.90 to 0.95). CONCLUSION: P-CAT appears to be a promising measure for evaluating staff perceptions of person-centredness in Chinese hospital environments. The results show that P-CAT can be a useful tool for improving the quality of healthcare in terms of person-centred care in the Chinese context.
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Tradução , China , Feminino , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: This study examines ethnic disparities in prevalence and patterns of smoking and nicotine dependence in rural southwest China. DESIGN: This was a cross-sectional design. SETTING: This study was conducted in rural Yunnan Province of China. PARTICIPANTS: 7027 consenting individuals aged ≥35 years among Han majority and four ethnic minority groups (Na Xi, Li Shu, Dai and Jing Po) participated in this study. Information about participants' demographic characteristics as well as smoking habits and an assessment of nicotine dependence with the Fagerstrom Test for Nicotine Dependence (FTND) was obtained using a standard questionnaire. RESULTS: Males had significantly higher prevalence of current smoking than females (64.8% and 44.4%, p<0.01). Among current smokers, the prevalence of nicotine dependence was significantly higher in males compared with females (19.9% and 7.1%, p<0.01). Jing Po men and women had the highest prevalence of current smokers (72.2% vs 23.1%, p<0.01), whereas the highest prevalence of nicotine dependence was found in male Dai current smokers and female Li Shu current smokers (44.8% vs 32.5%, p<0.01). Filtered cigarettes were the most popular form of tobacco used across all five ethnic groups. Over 75% of tobacco users initiated smoking and regularly smoked during adolescence, and those of minority ethnicity smoked regularly at a younger age than those of Han descent (p<0.05). Individuals in all five ethnic groups with higher levels of education had a lower probability of current smoking status (p<0.05), whereas a negative association of level of education with nicotine dependence was only observed in current smokers in the Han majority and Dai ethnic minority groups. Among Han majority current smokers, higher annual household income was associated with a higher risk of nicotine dependence (p<0.05). CONCLUSION: Future interventions to control tobacco use should be tailored to address ethnicity and socioeconomic factors.
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Fumar Cigarros/etnologia , Etnicidade/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Tabagismo/etnologia , Fumar Cachimbo de Água/etnologia , Adulto , China/epidemiologia , Fumar Cigarros/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fumar Cachimbo/epidemiologia , Fumar Cachimbo/etnologia , Prevalência , Classe Social , Uso de Tabaco/epidemiologia , Uso de Tabaco/etnologia , Tabagismo/epidemiologia , Tabaco sem Fumaça , Fumar Cachimbo de Água/epidemiologiaRESUMO
Objective To analyze the sleep quality status and its relationship with cardiovascular disease in rural elderly in Yunnan Province. Methods Multistage stratified random sampling method was used to select 1629 residents aged 60 years and over from Ning Er County in Yunnan province. Each participant received questionnaire survey and physical examination. Multivariate logistic regression analysis was used to analyze the relationship between sleep quality status and cardiovascular disease. Results Among the study population, the overall Pittsburgh Sleep Quality Index (PSQI) score was 7.48±3.89,and was 6.67±3.69 for males and 8.07±3.92 for females. The prevalence of sleep disorder, hypertension, coronary heart disease and stroke were 56.78%, 52.85%, 8.16% and 8.66%, respectively. Females had higher prevalence of sleep disorder than males (62.81% and 48.55%,P<0.001). The elderly with lower annual average family per capital income and bad access to medical services had higher prevalence of sleep disorder than their counterparts (P<0.001).The elderly with sleep disorder was more likely to suffer from hypertension, coronary heart disease and stroke (P<0.05). Conclusion The prevalence of sleep disorder is high in rural elderly in Yunnan Province. Improving sleep quality among the elderly can prevent and control cardiovascular diseases to a certain degree.
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Objective To analyze the relationship between socioeconomic position and prevalence of hypertension, diabetes, coronary heart disease, stroke, chronic obstructive pulmonary diseases (COPD) and multi-morbidity among older adults in rural Yunnan Province. Methods A total of 4 833 older adults aged 60 years and over were selected by multi-stage stratified random sampling method in rural Yunnan Province. Information was acquired from questionnaire and health examination. Principal component analysis was used to construct the socioeconomic comprehensive score. Results The prevalence of hypertension, diabetes, stroke, coronary heart disease, COPD and multi-morbidity in target persons was 50.6%, 10.2%, 6.4%, 5.5%, 5.4% and 16.1% respectively. The prevalence of hypertension and diabetes was much higher in female compared with male (both P<0.05), in contrast the prevalence of COPD was much higher in male than female( 2=5.499, P=0.019)The prevalence of hypertension, stroke, coronary heart disease, COPD and multi-morbidity was increased with age(all P<0.05);Minority ethnic were more likely to develop hypertension, coronary heart disease, COPD and multi-morbidity than Han ethnic(all P<0.05). The results of multivariate logistic regression analysis showed that older adults with lower socioeconomic position had higher probability of suffering from hypertension, coronary heart disease, stroke, COPD and multi-morbidity (all P<0.05). Conclusions There are significant socioeconomic differences between socioeconomic position and prevalence of five major chronic diseases and multi-morbidity among older adults in rural Yunnan province. Older adults with low socioeconomic position should be key population for future prevention and control of chronic diseases.
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Objective To establish a suitable exponential smoothing prediction model for school absentees due to illness, to discuss its application value for predicting school absences due to illness, and to provide a basis for early warning of absence due to illness. Methods Numbers of schools absences by year and month due to illness in 30 primary schools from November 2015 to June 2017 were collected from symptom monitoring system of border county, southern Yunnan and Simple seasonal model, Winters addition model and Winters multiplication model were used to build simulation. The data of July 2017 to December 2017 were used for model validation. The three models were overall compared and evaluated through indicator analysis, statistical analysis and residual diagram analysis. The best model was selected to predict school absences due to illness from January 2018 to March 2018. Results Simple seasonal model, Winters addition model and Winters multiplication model were used to fit the variation trend of number of school absences due to illness in time series. The root mean square error (RMSE) of three models were 445.11, 420.99 and 258.75; R2adj were 0.72, 0.72 and 0.77; R2 were 0.92, 0.93 and 0.98; P values of Ljung-Box Q were 0.54, 0.43 and 0.21. As for prediction method linear trend, Alpha were 0.999, 1.000 and 0.298. The average relative error between predicted value and actual value was 9.62%, 21.90% and 7.52%. Conclusion Winters multiplication model has practical value to predict school absence due to illness and provide scientific basis for early identification of abnormal signals.
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Objective The aim of this study was to analyze the status and influencing factors of public health service utilization in rural patients with severe mental illness in Yunnan province. Methods The main caregivers of patients with severe mental illness in Yunnan province were selected by stratified cluster sampling method. Multivariate logistic regression was used to analyze the influencing factors of public health service utilization. Results A total of 284 cases of rural patients with severe mental illness were investigated, including 144 males (50.7%) and 140 females (49.3%) . The rate of medical file filing, follow-up rate of village doctor, participation rate of free physical examination and health education acceptance rate among patients with severe mental illness were 89.8%, 84.9%, 73.2%and 56.7%respectively (<0.05) . Female patients had higher participation rate of free physical examination than male patients, and patients having work and patients with controlled disease condition and their caregivers had higher rates of health education acceptance rate than their counterparts ( <0.05) . Conclusion Measures should be taken to strengthen the work of medical examination for male patients, and to expand health education activities for patients having no work and patients with uncontrolled disease condition, so as to improve the public health service utilization in rural areas of Yunnan province.
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Objective To analyze the prevalence, awareness, treatment, control and self-management of diabetes among the elderly in Midu County of Yunnan province. Methods A stratified random sampling method was used to carry out on-site questionnaire survey and blood glucose measurement among 1,603 older people aged≥60 in Midu County of Yunnan province. Results The overall prevalence, awareness, treatment and control rate of diabetes among the elderly were 10.11%, 56.17%, 75.82%and 37.36%respectively. The rates of self-monitoring of blood glucose, taking medicine prescribed by doctors and hypoglycemic measures in the last two weeks were 43.96%, 80.22% and 98.90% respectively. People with higher average annual income had higher prevalence of diabetes ( <0.05) . The awareness rate of diabetes in women (67.42%) was significantly higher than that in males (42.47%, <0.01). Self monitoring of blood glucose in patients with house toilet (46.99%) in house was higher than those without toilet (12.50%, <0.05). The higher the level of education, the higher the rate of taking medicine prescribed by doctors ( <0.05) . Patients who do not live alone and have toilet in house have a higher rate of weight control (67.07%and 66.27%) than those living alone and without toilet (22.22%and 25%,<0.05).Conclusions The findings indicate a relatively high prevalence of diabetes and low level of self-management of diabetes among older people in Midu County. It should adopt targeted diabetes health education and intervention according to different characteristics of the population so as to improve their level of diabetes self-management.
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In the present study, three new aconitine-type diterpenoid alkaloids brochyponines A-C (1-3) were isolated from the roots of Aconitum brevicalcaratum. Their structures were established on the basis of extensive spectroscopic analyses (IR, HR-ESI-MS, and 1D and 2D NMR). The NMR data of salt form for compound 1 in CDCl were also measured.