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1.
Aging Clin Exp Res ; 2021 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-34855152

RESUMO

BACKGROUND AND AIMS: Stroke is currently the leading cause of death in China; however, the past decade has produced no new epidemiological studies of stroke. Therefore, the current study aimed to compare the prevalence and risk factors of stroke between 2010 and 2019. METHODS: A comparative study was used to analyze the prevalence of risk factors for stroke in a population aged 65 years or older between 2010 and 2019. Demographic characteristics, risk factors, medical history, and other clinical characteristics were collected for all participants via door-to-door interviews and inpatient hospital records. RESULTS: The standardized prevalence of stroke was 7.9% in 2010 and 14.2% in 2019 (p < 0.001). The prevalence of stroke was significantly higher in men than in women (p < 0.05) for all age groups. The risk factors of stroke were being male, hypertension, and diabetes mellitus in both 2010 and 2019. When comparing the risk factors between 2010 and 2019, these risk factors were statistically significantly more strongly associated with stroke in 2019 than in 2010. CONCLUSION: The current study suggests that the prevalence of stroke increased nearly by twofold in a population aged 65 years or older within the past 10 years. Hypertension, diabetes mellitus, and being male were the primary risk factors. In addition, these factors were more significantly associated with stroke in 2019 compared to 2010.

2.
Front Aging Neurosci ; 13: 724990, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34720990

RESUMO

Background: Elevated plasma total homocysteine (tHcy) level, a known risk factor for vascular disease, is reported to be an independent risk factor for cognitive impairment and Alzheimer's disease (AD) in most studies. tHcy may also be associated with dementia with Lewy bodies (DLB). Objective: To investigate the association between plasma tHcy levels and DLB or AD. Methods: This is a case-control study including 132 DLB patients, 264 AD patients, and 295 age-matched healthy controls. We used multivariate logistic regression model to analyze the data with adjustments for confounding variables. Results: The highest tHcy tertile (>13.9 µmol/L) was significantly independently associated with DLB [adjusted odds ratio (OR): 4.65, 95% confidence interval (CI): 1.95-11.10, P = 0.001] and AD (adjusted OR: 1.82, 95% CI: 1.02-3.23, P = 0.041) compared to the lowest tertile (<10.7 µmol/L). The cumulative frequency plots showed a shift in the distribution of the tHcy concentrations to higher values in patients with DLB compared to AD. The mean tHcy levels were stable and not altered by the duration of cognitive impairment prior to the collection of blood samples from DLB patients. Conclusion: Elevated plasma tHcy levels were independently associated with DLB, and the association was stronger for DLB than for AD. The lack of a relationship between tHcy levels and symptom duration may refute these observed associations being a consequence of DLB, and future longitudinal studies will be required to confirm whether tHcy plays a causative role in DLB.

3.
J Alzheimers Dis ; 2021 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-34744079

RESUMO

BACKGROUND: Dementia and hyperhidrosis (HH) are common in the elderly while there is little research to investigate the association between them. OBJECTIVE: To clarify a possible association between HH and dementia in population of adults ≥65 years old in China. METHODS: A cross-sectional survey for elderly adults ≥65 years old was conducted from April to December 2019. A total of 5,958 participants were analyzed after two phases investigation. Goodness-of-fit tests (Pearson and deviance) were used to estimate the dispersion parameter and examine the adequacy of the models. Logistic and linear regression analyses were used to evaluate the association between HH and dementia. RESULTS: The overall prevalence of all-cause dementia was 10.17%, that of dementia with Lewy bodies (DLB) was 1.41%, and HH was 14.97%. Prevalence rates of HH were higher in participants with dementia and DLB. There was a significant positive relationship between HH duration and MMSE score (r = 0.207, p < 0.001, Durbin-Watson test = 1.806). Participants with HH were 1.275 (95% CI: 1.015-1.601, p = 0.037) times to have dementia, and 3.616 (95% CI: 2.267-5.767, p < 0.001) times to suffer from DLB than those without HH. Pearson and deviance chi square tests did not indicate overdispersion (p > 0.05 in the logistic regression models). CONCLUSION: HH was common in the Chinese population ≥65 years old. It can increase the risk of dementia, particularly in DLB, in the elderly. It is important to improve the awareness of HH among dermatologists and neurologists.

4.
Neuroepidemiology ; 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34758470

RESUMO

OBJECTIVE: Few data are available on the current prevalence of Parkinson's disease in China. The aim of this study was to determine the prevalence of Parkinson's disease in Chinese individuals aged 65 years and older and to analyze associated risk factors. METHODS: We performed a population-based cross-sectional survey with a multistage cluster sampling design. Residents aged 65 and over were drawn from 11 urban districts and 10 rural counties across China. Data were entered into spreadsheets, and imported and analyzed using Statistical Package SPSS 24. RESULTS: We identified 151 patients with Parkinson's disease among 8124 residents aged 65 and over, including 75 men (49.67%) and 76 women (50.33%). The overall prevalence of PD in the study population was 1.86% (95% confidence interval [CI]: 1.6%-2.2%), and the standardized prevalence of PD was 1.60%. The crude prevalence in men (2.12%) was higher than in women (1.66%), and standardized prevalence in urban areas (1.98%) was higher than in rural areas (1.48%). Logistic regression analysis showed that independent risk factors for PD were older age, heavy metal or pesticide exposure (odds ratio [OR]=3.83; 95% CI: 2.021-7.256), urban residence (OR=1.307; 95% CI: 1.041-1.642), rapid eye movement sleep behavior disorder (OR=1.450; 95% CI: 1.021-2.059), and heart disease (OR=2.431; 95% CI: 1.481-4.990). Conclusion:The prevalence of Parkinson's disease in individuals aged 65 and older in China has not increased significantly in recent years. The prevalence of Parkinson's disease is higher in men than in women and higher in urban areas than in rural areas.

5.
Artigo em Inglês | MEDLINE | ID: mdl-34813411

RESUMO

RATIONALE: It remains unknown whether long-term ozone exposure can impair lung function. OBJECTIVES: To investigate the associations between long-term ozone exposure and adult lung function in China. METHODS: Lung function results and diagnosis of small airways dysfunction (SAD) were collected from a cross-sectional study, China Pulmonary Health Study (N=50,991). We used multivariate linear and logistic regression models to examine the associations of long-term ozone exposure with lung function parameters and SAD, respectively, adjusting for demographic characteristics, individual risk factors, and longitudinal trend. We then performed a stratification analysis by chronic obstructive pulmonary disease (COPD). MEASUREMENTS AND MAIN RESULTS: We observed each 1-standard deviation (SD, 4.9 ppb) increase in warm-season ozone concentrations was associated with a 14.2 mL/s [95% confidence interval (CI): 8.8, 19.6] decrease in forced expiratory flow at 75th percentile of vital capacity and a 29.5 mL/s (95% CI: 19.6, 39.5) decrease in mean forced expiratory flow between the 25th and 75th percentile of vital capacity. The odds ratio of SAD was 1.09 (95% CI: 1.06, 1.11) for a 1-SD increase in warm-season ozone concentrations. Meanwhile, we observed a significant association with a decreased ratio of expiratory volume in 1 second to forced vital capacity (FEV1/FVC) but not with FEV1 or FVC. The association estimates were greater in the COPD group than in the non-COPD group. CONCLUSION: We found independent associations of long-term ozone exposure with impaired small airways function and higher SAD risks, while the associations with airflow obstruction were weak. COPD patients appear to be more vulnerable.

6.
Artigo em Inglês | MEDLINE | ID: mdl-34729814

RESUMO

BACKGROUND: Marital status may have an impact on the elderly population's health, but few studies in China discussed about the association between marital status and cognitive impairment. OBJECTIVE: To investigate the relationship between marital status and cognitive impairment. To compare the influences of marital status on dementia between men and women. METHODS: This study was based on a representative national cross-sectional epidemiological survey in China. We randomly selected 13 provinces and municipalities and included 19,276 participants aged 65 years or older in our study. Data was collected by interviewing the participants about their sociodemographic characteristics, and neuropsychological testing was administered to the participants by neurologists. To analyze the association between marital status and cognitive impairment, multiple logistic regression was based on a series of models. RESULTS: Among the 19,276 subjects, about 77.2% were married, 1.6% were single, 21.2% were divorced/separated or widowed. The odds ratios (OR) of dementia were higher in single (OR: 2.13, CI: 1.53-2.97; p < 0.001), divorced/separated/widowed when they were ≤55 years old (OR: 1.75, CI: 1.30-2.35; p < 0.001), and divorced/separated/widowed when they were >55 years old (OR: 1.16, CI: 1.03-1.31; p < 0.001) participants than in married ones. Divorced/separated/widowed ≤55 men had about 2.75 times increase in dementia risk than married men. CONCLUSION: People with long-term divorced/separated/widowed status would be associated to cognitive impairment more than those with short-term divorced/separated/widowed status. Men may be affected by marriage disruption more than women in terms of increasing the risk of dementia.

7.
Anal Methods ; 13(40): 4739-4746, 2021 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-34558572

RESUMO

In this paper, a hydrophobicity-switchable deep eutectic solvent was evaluated for the first time as an efficient extractant in the effervescence-assisted dispersive liquid-liquid microextraction method combined with the solidification of floating droplets for HPLC determination of anthraquinones in fried Cassiae semen tea infusions. Prepared from choline chloride and octanoic acid, the deep eutectic solvent could be switched between hydrophobic and hydrophilic forms by pH adjustment. The dispersion of the extractant was assisted by in situ CO2 produced from the effervescence reaction between H2SO4 and Na2CO3 without using any organic solvent or auxiliary equipment. Owing to the low melting/freezing point and low density compared with water, the extractant was solidified in an ice bath for the convenience of complete separation with the sample matrix. Some important parameters, such as species, molar ratio and volume of deep eutectic solvent, species and volume of effervescent agents were optimized to achieve the best extraction efficiency. Under the optimal conditions, extraction recoveries were obtained for four anthraquinones in the range of 91.1% to 111.9%. Relative standard deviations for intraday and interday precision were less than 3.3% and 4.0%, respectively. Greenness assessment demonstrated that the proposed method was greener than other reported methods for the determination of anthraquinones.


Assuntos
Microextração em Fase Líquida , Antraquinonas , Cromatografia Líquida de Alta Pressão , Interações Hidrofóbicas e Hidrofílicas , Sêmen , Solventes , Chá
8.
Front Oncol ; 11: 619781, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34381701

RESUMO

Background: This study aims to assess the feasibility of a novel metallic segmented transcordal stent modified with three-dimensional (3D) printing for treating inoperable malignant laryngotracheal stenosis and the tolerability of the stent. Methods: This was a retrospective study. The stents were individually customized with the aid of 3D printing model based on the anatomic features of each patient's airway. The stent was composed of two separate segments that corresponded to the larynx and the upper trachea. The stents were barrel-shaped at the proximal end to prevent migration. The proximal end of the stent was located slightly above the vocal cord. The technical and clinical success of stenting procedure, patient tolerability, and stent-related complications of patients were evaluated. Results: Ten patients with dyspnea caused by malignant laryngotracheal stenosis underwent implantation of such stents. Technical and clinical success of the stenting procedure were achieved in all patients. For all patients, basic communication in life could be maintained by speaking softly. During follow-up, one patient showed intolerance to the stent, and the stent was retrieved 2 weeks after stenting. Stent migration was found in one patient, and the position of the stent was readjusted. Granulation tissue proliferation was found in two patients and was treated with cryotherapy by bronchoscopy. There were no deaths associated with stenting. Conclusions: The individually customized metallic segmented transcordal stent is feasible and tolerable for patients with inoperable malignant laryngotracheal stenosis. The implantation of this stent may serve as a novel alternative treatment for patients who are not suitable for surgery or tracheotomy.

9.
Environ Int ; 156: 106707, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34182192

RESUMO

The associations of long-term exposure to various constituents of fine particulate matter (≤2.5 µm in aerodynamic diameter, PM2.5) air pollution with lung function were not clearly elucidated in developing countries. The aim was to evaluate the associations of long-term exposure to main constituents of PM2.5 with lung function in China. This is a nationwide, cross-sectional analysis among 50,991 study participants from the China Pulmonary Health study. Multivariable linear regression models were used to obtain differences of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow (PEF), and forced expiratory flow at 25-75% of exhaled FVC (FEF25-75%) associated with an interquartile range (IQR) change of PM2.5 or its constituents. Residential annual PM2.5 levels varied from 26 µg/m3 to 92 µg/m3 (average: 53 µg/m3). An IQR increase of PM2.5 concentrations was associated with lower FEV1 (19.82 mL, 95% CI: 11.30-28.33), FVC (17.45 mL, 95% CI: 7.16-27.74), PEF (86.64 mL/s, 95% CI: 59.77-113.52), and FEF25-75% (31.93 mL/s, 95% CI: 16.64-47.22). Black carbon, organic matter, ammonium, sulfate, and nitrate were negatively associated with most lung function indicators, with organic matter and nitrate showing consistently larger magnitude of associations than PM2.5 mass. This large-scale study provides first-hand epidemiological evidence that long-term exposure to ambient PM2.5 and some constituents, especially organic matter and nitrate, were associated with lower large- and small- airway function.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , China , Estudos Transversais , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Volume Expiratório Forçado , Humanos , Pulmão , Material Particulado/análise
10.
Ann Palliat Med ; 10(4): 4262-4272, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33832294

RESUMO

BACKGROUND: Since the coronavirus disease 2019 (COVID-19) emerged in Wuhan, China, it has become a global public health emergency. Besides conventional care, pulmonary rehabilitation (PR) is an equally important treatment for patients with COVID-19 suffering from respiratory, physical and psychological disease. The aim of this study is to investigate the role of PR on the inpatients with severe COVID-19. METHODS: This study was a self-pre- and post-control prospective clinical trial, which totally recruited 31 inpatients confirmed COVID-19 by RT-PCR. They were performed 3-week PR. The demographic data, medical records, symptoms, laboratory findings and chest computed tomographic (CT) scans of patients were collected at baseline. The effect of PR was assessed by questionnaires before PR as well as after 2- and 3-week PR. RESULTS: After 3-week PR and treatment, neutrophil percentage decreased, while lymphocyte percentage and lymphocyte count increased (before vs. 2 weeks after PR respectively: P=0.001; P=0.001; P<0.0001). Besides, CRP and procalcitonin reduced significantly (before vs. after respectively: P<0.0001; P=0.023). Patients' oxygen intake decreased and oxygen saturation increased significantly. Meanwhile, PR relieved the patients' symptoms of cough and dyspnea, improved the patients' self-care ability, physical fitness and mental state significantly. Activities of daily living (ADL) score increased and Modified Medical Research Council Dyspnea Scale (mMRC) decreased after PR. CONCLUSIONS: PR can relieve symptoms, enhance health-related quality of life, improve respiratory muscle function and alleviate disease-related anxiety and depression of severe patients with COVID-19. PR should be provided throughout the diseases management process, regardless of whether the patient is hospitalized or at home.


Assuntos
Atividades Cotidianas , COVID-19 , China , Humanos , Prognóstico , Estudos Prospectivos , Qualidade de Vida , SARS-CoV-2
11.
BMC Neurol ; 21(1): 144, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33789600

RESUMO

BACKGROUND: Lewy body dementia (LBD), consisting of dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), is the second most common type of neurodegenerative dementia in older people. The current study aimed to investigate the clinical characteristics of LBD in Chinese memory clinics. METHODS: A total of 8405 dementia medical records were reviewed, revealing 455 patients with LBD. Demographic data, neuropsychological scores, and the scale for Medial Temporal lobe Atrophy (MTA) were then analyzed from nine memory clinics in the China Lewy Body Disease Collaborative Alliance. RESULTS: The clinical proportion of LBD among the subjects and among all dementia types was 5.4% (4.9-5.9%) and 7.3% (6.7-8.0%), respectively, with a mean onset age of 68.6 ± 8.4 years. Patients with DLB comprised 5.6% (n = 348, age of onset 69.1 ± 8.3), while PDD comprised 1.7% (n = 107, age of onset 66.7 ± 8.8) of all dementia cases. There were slightly more males than females with DLB (n = 177, 50.9%) and PDD (n = 62, 57.9%). Patients with DLB had a poorer performance compared to those with PDD on the MMSE (16.8 ± 7.1 vs. 19.5 ± 5.7, p = 0.001), the MoCA (11.4 ± 6.6 vs. 14.0 ± 5.8, p<0.001), the CDR (1.8 ± 0.7 vs. 1.6 ± 0.7, p = 0.002), and the MTA (1.8 ± 0.7 vs. 1.2 ± 0.6, p = 0.002). Diagnostic differences for LBD exist among the centers; their reported proportions of those with DLB ranged from 0.7 to 11.4 and those with PDD ranged from 0.0 to 2.9%. CONCLUSIONS: Variations of diagnoses exists in different regions and the clinical proportion of LBD is likely to be underestimated in China and other regions.


Assuntos
Doença por Corpos de Lewy/diagnóstico , Doença por Corpos de Lewy/epidemiologia , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Doença por Corpos de Lewy/patologia , Masculino , Pessoa de Meia-Idade , Prevalência
12.
Medicine (Baltimore) ; 100(13): e25343, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33787634

RESUMO

ABSTRACT: This study was carried out to estimate the incidence and to determine socio-demographic risk factors for dementia among individuals residing in rural northern China.The current prospective, population-based study was conducted between 2011 and 2016. Follow-up interviews were conducted annually from 2014 to 2016. The study involved 1511 dementia-free individuals aged 60 years or above from rural China. Standard criteria were used to make diagnoses for dementia and Alzheimer disease (AD).At least one follow up survey was completed with 1181 study participants. At the 5-year follow-up, 127 individuals had developed dementia, 75 had developed AD, and 32 had developed vascular dementia (VaD). With a total of 5649.2 risk years for the sample, the estimated incidence rates per 1000 person-years were 22.48 (95% CI: 18.62, 26.35) for dementia and 13.28 (95% CI: 10.29, 16.26) for AD. Incidence rates for dementia and AD increased with age across the 10-year age groups. Poor education (illiteracy) was an independent risk factor for both AD and VaD. Being engaged in social activities was an independent protective factor for VaD.The incidence of dementia in rural China was found to be higher than previously reported. Incidence of dementia increased with age, and AD was the most frequent type of dementia. Poor education was associated with a higher risk of VaD and AD. Engagement in social activities was an independent protective factor for VaD.


Assuntos
Doença de Alzheimer/epidemiologia , Demência Vascular/epidemiologia , População Rural/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico , China/epidemiologia , Demência Vascular/diagnóstico , Escolaridade , Feminino , Seguimentos , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Fatores de Risco , Fatores Sexuais , Participação Social
13.
J Chromatogr Sci ; 59(9): 887-897, 2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-33529307

RESUMO

In this paper, a deep eutectic solvent (DES)-based effervescence-assisted dispersive liquid-liquid microextraction method was proposed for the determination of four synthetic colorants in beverages by high-performance liquid chromatography. In this method, DES synthesized from choline chloride and phenol was used as extractant. The dispersion of DES was assisted by in situ CO2 produced from the effervescence reaction between NaH2PO4 and Na2CO3 without using any organic solvent or auxiliary equipment. Furthermore, phase separation occurred naturally in the presence of the salt products of effervescence reaction, without the addition of any other salting out reagents. Some important parameters, such as species, molar ratio and volume of DES, composition and amount of effervescent agents, were optimized to achieve the best extraction efficiency. Under the optimal conditions, extraction recoveries were obtained for the analytes in the range of 83.5-114.8%. The limits of detection were in the range of 0.6-3.0 ng/mL. Relative standard deviations for intra- and interday precision were <4.68 and 6.08%, respectively. This simple, rapid, cost-effective and environmentally friendly method has been successfully applied to the analysis of synthetic colorants in 10 kinds of beverage samples.

14.
J Clin Neurosci ; 82(Pt A): 186-191, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33317730

RESUMO

To explore the demographic characteristics and main types of memory impairment in the Memory Clinic of China and to provide references for future research. Demographic, cognitive, and etiological data of 2,742 cognitive impairment (CI) patients who were in the Memory Clinic at Tianjin Huanhu Hospital from January 2011 to October 2018 were analyzed. The main subtypes of CI were AD (38.33%), MCI (19.55%), VaD (8.57%), FTLD (7.37%) and DLB/PDD (5.91%). The mean age was 68.5 ± 9.97, with 82.13% older than 60 years. There were slightly more females (50.58%) than males (49.42%). There were a relatively equal number of patients who were educated less than (55.12%) and more than nine years (44.88%). Most patients (82.91%) were married and only 23.63% patients had a family history of CI. CI occurred primarily in the elderly, namely those who were between 60 and 79 years old. More than half of those with AD, DLB, PDD, and FTLD were categorized at mild or moderate levels. The bvFTD (n = 127, 62.9%) was the primary subtype of FTLD. Standardized diagnostic procedures, detailed neuropsychological assessments, molecular biology tests, and follow-ups are important for the early diagnosis and treatment of cognitive impairment diseases.


Assuntos
Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/psicologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer , China , Transtornos Cognitivos/diagnóstico , Feminino , Humanos , Doença por Corpos de Lewy , Masculino , Transtornos da Memória , Pessoa de Meia-Idade , Testes Neuropsicológicos
15.
Int J Chron Obstruct Pulmon Dis ; 15: 2477-2486, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33116464

RESUMO

Objective: The aim of this study was to explain "obesity paradox" in chronic obstructive pulmonary disease (COPD) by evaluating the effect of body mass index (BMI) on lung function in Chinese patients with COPD. Methods: A total of 1644 patients diagnosed with COPD were recruited from four Chinese tertiary hospitals and were divided into four groups including underweight, normal weight, overweight and obese according to BMI classification standard. The medical data of these patients were collected and used for the multiple linear regression analyses. Results: After adjustment for age, sex, educational level, economic status, smoking status, alcohol consumption, duration of COPD history, events of acute exacerbation in previous year, hypertension, diabetes mellitus, cardiovascular disease, cerebrovascular disease and osteoporosis, BMI had a curvilinear correlation with the forced expiratory volume in the first second (FEV1) in patients with Global Initiative for Obstructive Lung Disease (GOLD) 1-2 grade (first-order coefficient ß, 0.09; 95% CI, 0.03-0.16; second-order coefficient ß, -0.002; 95% CI, -0.003--0.001; P<0.01). However, BMI had a positive correlation with FEV1 in patients with GOLD 3-4 grade (ß, 0.01; 95% CI, 0.008-0.017; P<0.01) when BMI was used as a quantitative variable. When BMI was used as a qualitative variable, only FEV1 in overweight group with GOLD 1-2 grade was significantly higher than that of normal weight group (P<0.01). Interestingly, both overweight and obese groups had higher FEV1 in GOLD 3-4 grade compared with normal weight group (ß, 0.06; 95% CI, 0.02-0.11; ß, 0.11; 95% CI, 0.04-0.18; P<0.01). The effect of BMI on predicted percentage of FEV1 (FEV1%) was similar to that of FEV1 in different GOLD grades. Conclusion: Obesity only had a protective effect on lung function in COPD patients with GOLD 3-4 grade rather than GOLD 1-2 grade. Trial Registry: ClinicalTrials.gov, No.: NCT03182309, URL: www.clinicaltrials.gov.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Volume Expiratório Forçado , Humanos , Pulmão , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia
16.
COPD ; 17(5): 523-532, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32901534

RESUMO

Whether there are increased rates of chronic diseases associated with the combination of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) overlap syndrome (OVS) has not been determined. The purpose of this study was to assess the prevalence of five comorbidities in COPD and OVS patients. A total of 968 patients with confirmed COPD were included in this study. Participants were requested to fill out a questionnaire involving their basic information and medical history. All subjects underwent one overnight polysomnography and were then divided into an OVS group or a COPD only group according to their apnea-hypopnea index. The prevalence of hypertension, diabetes, cardiovascular disease, arrhythmia and cerebrovascular disease were compared and risk factors for comorbidities in COPD patients were identified. Compared with the COPD only group, the prevalence of hypertension was significantly higher in the OVS group, however, the prevalence rates of the other four kinds of diseases were not statistically different between the two groups. In COPD patients, the prevalence of hypertension increased with the severity of OSA and the prevalence of arrhythmia increased with airflow limitation severity. Risk factors for OSA in patients with COPD included BMI, FEV1%, Epworth Sleepiness Scale score and the Sleep Apnea Clinical Score. OSA was an independent risk factor for hypertension. The other risk factors for hypertension in COPD patients included age, BMI, CAT score and alcohol consumption. Age, lower FEV1% may be risk factors for arrhythmia. OVS patients were associated with a high prevalence rate of hypertension, while OSA was an independent risk factor for hypertension.


Assuntos
Hipertensão/epidemiologia , Doença Pulmonar Obstrutiva Crônica/complicações , Apneia Obstrutiva do Sono/complicações , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/epidemiologia , Transtornos Cerebrovasculares/diagnóstico , Transtornos Cerebrovasculares/epidemiologia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipertensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Polissonografia , Prevalência , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Testes de Função Respiratória , Apneia Obstrutiva do Sono/diagnóstico
17.
World J Clin Cases ; 8(12): 2603-2609, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32607338

RESUMO

BACKGROUND: Anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis is a common type of autoimmune encephalitis characterized by complex clinical signs and variable imaging manifestations. The pathogenesis of the disease is unclear. Syphilis is an infectious disease caused by Treponema pallidum that can invade the nervous and immune systems and cause systemic symptoms. There are few reports of anti-NMDAR encephalitis with syphilis, and the association between them is unknown; both diseases are related to immune system damage. We report a case of anti-NMDAR encephalitis with syphilis. CASE SUMMARY: A 32-year-old man was admitted to our hospital with complaints of cognitive decline, diplopia, and walking instability during the previous 6 mo. He developed dysarthria, difficulty swallowing, and involuntary shaking of his head, neck, and limbs during the month prior to presentation. Cranial magnetic resonance imaging showed symmetrical abnormal signals in the pons, midbrain, and bilateral basal ganglia, and inflammatory demyelination was considered. The diagnosis of syphilis was confirmed based on the syphilis diagnosis test and the syphilis rapid test. He was given anti-syphilis treatment, but the above symptoms gradually worsened. Anti-NMDAR antibody was positive in cerebrospinal fluid but was negative in serum. Due to the cerebrospinal fluid findings, anti-NMDAR encephalitis was a consideration. According to the patient's weight, he was treated with intravenous methylprednisolone 1 g QD for 5 d, with the dose gradually decreased for 6 mo, and immunoglobulin 25 g QD for 5 d; his symptoms improved after treatment. CONCLUSION: This case shows that anti-NMDAR encephalitis may be combined with syphilis, which should be recognized to avoid misdiagnosis and treatment delay.

18.
Mol Brain ; 13(1): 102, 2020 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641146

RESUMO

Parkinson's disease (PD) is the second most common neurodegenerative disease, and mild cognitive impairment (MCI) is a well-established risk factor for the development of dementia in PD. A growing body of evidence suggests that low expression of glucocerebrosidase (GBA) promotes the transmission of α-synuclein (α-Syn) interpolymers and the progression of PD. However, how GBA mutations affect the pathogenesis of PD via abnormal aggregation of α-Syn is unclear, and no clinically valid PD-MCI genetic markers have been identified. Here, we first located a GBA eQTL, rs12411216, by analysing DHS, eQTL SNP, and transcription factor binding site data using the UCSC database. Subsequently, we found that rs12411216 was significantly associated with PD-MCI (P < 0.05) in 306 PD patients by genotyping. In exploring the relationship between rs12411216 and GBA expression, the SNP was found to be associated with GBA expression in 50 PD patients through qPCR verification. In a further CRISPR/Cas9-mediated genome editing module, the SNP was identified to cause a decrease in GBA expression, weaken enzymatic activity and enhance the abnormal aggregation of α-Syn in SH-SY5Y cells. Additionally, using an electrophoretic mobility shift assay, we confirmed that the binding efficiency of transcription factor E2F4 was affected by the rs12411216 SNP. In conclusion, our results showed that rs12411216 regulated GBA expression, supporting its potential role as a PD-MCI genetic biomarker and highlighting novel mechanisms underlying Parkinson's disease.


Assuntos
Disfunção Cognitiva/enzimologia , Disfunção Cognitiva/genética , Glucosilceramidase/genética , Doença de Parkinson/enzimologia , Doença de Parkinson/genética , Linhagem Celular Tumoral , Disfunção Cognitiva/complicações , Fator de Transcrição E2F4/metabolismo , Glucosilceramidase/metabolismo , Humanos , Modelos Biológicos , Doença de Parkinson/complicações , Fosforilação , Polimorfismo de Nucleotídeo Único/genética , Agregados Proteicos , Ligação Proteica , alfa-Sinucleína/metabolismo
19.
Biosens Bioelectron ; 165: 112278, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32729466

RESUMO

Parkinson Disease (PD) is the second-most common neurodegenerative disorder in the population. Recent researches indicated that hsa-microRNA 5010-3p (miR-5010) and hsa-microRNA 331-5p (miR-331) were significantly important for the detection of PD. So, in this work, a kind of high fluorescence quenching probe-based reverse fluorescence enhancement lateral flow test strip (rLFTS) was constructed to realize the synchronous detection of miR-5010 and miR-331. The formation of black hole quencher 2 (BHQ2) coating gold nanoparticles (AuNPs) effectively enhanced the fluorescence quenching property of the probes so as to significantly improve the detection sensitivity. This rLFTS also coupled with "invading stacking primer" (IS-primer) isothermal amplification reaction (ISAR) to accomplish rapid, sensitive, specific, and synchronous detection of PD-associated microRNA (miRNA). The whole detection time was shorter (35 min), and the limit-of-detection (LOD) reached to fM level. For the high accuracy diagnosis of PD, the synchronous determination of miR-5010 and miR-331 was successfully realized on one rLFTS by labeling fluorescent molecules to different T-line. This rLFTS also allowed for miRNA detection in total microRNA extracts from whole blood samples of PD patients, which performed important value in PD diagnosis and biomedical research.


Assuntos
Técnicas Biossensoriais , Nanopartículas Metálicas , MicroRNAs , Doença de Parkinson , Ouro , Humanos , MicroRNAs/genética , Doença de Parkinson/diagnóstico , Doença de Parkinson/genética
20.
Lancet Respir Med ; 8(11): 1081-1093, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32598906

RESUMO

BACKGROUND: Small airway dysfunction is a common but neglected respiratory abnormality. Little is known about its prevalence, risk factors, and prognostic factors in China or anywhere else in the world. We aimed to estimate the prevalence of small airway dysfunction using spirometry before and after bronchodilation, both overall and in specific population subgroups; assess its association with a range of lifestyle and environmental factors (particularly smoking); and estimate the burden of small airway dysfunction in China. METHODS: From June, 2012, to May, 2015, the nationally representative China Pulmonary Health study invited 57 779 adults to participate using a multistage stratified sampling method from ten provinces (or equivalent), and 50 479 patients with valid lung function testing results were included in the analysis. We diagnosed small airway dysfunction on the basis of at least two of the following three indicators of lung function being less than 65% of predicted: maximal mid-expiratory flow, forced expiratory flow (FEF) 50%, and FEF 75%. Small airway dysfunction was further categorised into pre-small airway dysfunction (defined as having normal FEV1 and FEV1/forced vital capacity [FVC] ratio before bronchodilator inhalation), and post-small airway dysfunction (defined as having normal FEV1 and FEV1/FVC ratio both before and after bronchodilator inhalation). Logistic regression yielded adjusted odds ratios (ORs) for small airway dysfunction associated with smoking and other lifestyle and environmental factors. We further estimated the total number of cases of small airway dysfunction in China by applying present study findings to national census data. FINDINGS: Overall the prevalence of small airway dysfunction was 43·5% (95% CI 40·7-46·3), pre-small airway dysfunction was 25·5% (23·6-27·5), and post-small airway dysfunction was 11·3% (10·3-12·5). After multifactor regression analysis, the risk of small airway dysfunction was significantly associated with age, gender, urbanisation, education level, cigarette smoking, passive smoking, biomass use, exposure to high particulate matter with a diameter less than 2·5 µm (PM2·5) concentrations, history of chronic cough during childhood, history of childhood pneumonia or bronchitis, parental history of respiratory diseases, and increase of body-mass index (BMI) by 5 kg/m2. The ORs for small airway dysfunction and pre-small airway dysfunction were similar, whereas larger effect sizes were generally seen for post-small airway dysfunction than for either small airway dysfunction or pre-small airway dysfunction. For post-small airway dysfunction, cigarette smoking, exposure to PM2·5, and increase of BMI by 5 kg/m2 were significantly associated with increased risk, among preventable risk factors. There was also a dose-response association between cigarette smoking and post-small airway dysfunction among men, but not among women. We estimate that, in 2015, 426 (95% CI 411-468) million adults had small airway dysfunction, 253 (238-278) million had pre-small airway dysfunction, and 111 (104-126) million had post-small airway dysfunction in China. INTERPRETATION: In China, spirometry-defined small airway dysfunction is highly prevalent, with cigarette smoking being a major modifiable risk factor, along with PM2·5 exposure and increase of BMI by 5 kg/m2. Our findings emphasise the urgent need to develop and implement effective primary and secondary prevention strategies to reduce the burden of this condition in the general population. FUNDING: Ministry of Science and Technology of China; National Natural Science Foundation of China; National Health Commission of China.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Broncopatias/epidemiologia , Broncopatias/etiologia , Broncodilatadores/administração & dosagem , Obesidade/complicações , Fumar/efeitos adversos , Adulto , Distribuição por Idade , Broncopatias/diagnóstico , Broncopatias/tratamento farmacológico , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Testes de Função Respiratória , Medição de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Fumar/epidemiologia , Espirometria , Capacidade Vital/fisiologia , Adulto Jovem
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