Diet and lifestyle behaviours simultaneously act on frailty: it is time to move the threshold of frailty prevention and control forward.

BACKGROUND: To analyse the association among the simultaneous effects of dietary intake, daily life behavioural factors, and frailty outcomes in older Chinese women, we predicted the probability of maintaining physical robustness under a combination of different variables. METHODS: The Fried frailty criterion was used to determine the three groups of "frailty", "pre-frailty", and "robust", and a national epidemiological survey was performed. The three-classification decision tree model was fitted, and the comprehensive performance of the model was evaluated to predict the probability of occurrence of different outcomes. RESULTS: Among the 1,044 participants, 15.9% were frailty and 50.29% were pre-frailty; the overall prevalence first increased and then decreased with age, reaching a peak at 70-74 years of age. Through univariate analysis, filtering, and embedded screening, eight significant variables were identified: staple food, spices, exercise (frequency, intensity, and time), work frequency, self-feeling, and family emotions. In the three-classification decision tree, the values of each evaluation index of Model 3 were relatively average; the accuracy, recall, specificity, precision, and F1 score range were between 75% and 84%, and the AUC was also greater than 0.800, indicating excellent performance and the best interpretability of the results. Model 3 takes exercise time as the root node and contains 6 variables and 10 types, suggesting the impact of the comprehensive effect of these variables on robust and non-robust populations (the predicted probability range is 6.67-93.33%). CONCLUSION: The combined effect of these factors (no exercise or less than 0.5 h of exercise per day, occasional exercise, exercise at low intensity, feeling more tired at work, and eating too many staple foods (> 450 g per day) are more detrimental to maintaining robustness.

Big data on the prevalence of injury deaths among 187 488 elderly Chinese in the past 20 years (2000-2020): a systematic review and meta-analysis.

BACKGROUND: This study systematically reviewed injury death and causes in the elderly population in China from 2000 to 2020, to prevent or reduce the occurrence of injuries and death. METHODS: The CNKI, VIP, Wan Fang, MEDLINE, Embase, SinoMed, and Web of Science databases were searched to collect epidemiological characteristics of injury death among elderly over 60 years old in China from January 2000 to December 2020. Random effects meta-analysis was performed to pool injury mortality rate and identify publication bias, with study quality assessed using the AHRQ risk of bias tool. RESULTS: (1) A total of 41 studies with 187 488 subjects were included, covering 125 million elderly. The pooled injury mortality rate was 135.58/105 [95%CI: (113.36 to 162.14)/105], ranking second in the total death cause of the elderly. (2)Subgroup analysis showed that male injury death (146.00/105) was significantly higher than that of females (127.90/105), and overall injury mortality increased exponentially with age (R2 = 0.957), especially in those over 80 years old; the spatial distribution shows that the injury death rate in the central region is higher than that in the east and west and that in the countryside is higher than that in the city; the distribution of death time shows that after entering an aging society (2000-2020) is significantly higher than before (1990-2000). (3) There are more than 12 types of injury death, and the top three are falling, traffic accidents, and suicide. CONCLUSIONS: China's elderly injury death rate is at a high level in the world, with more males than females, especially after the age of 80. There are regional differences. The main types of injury death are falling, traffic, and suicide. During the 14th Five-Year Plan period, for accidental injuries and death, a rectification list for aging and barrier-free environments was issued. PROSPERO REGISTRATION: The systematic review was registered in PROSPERO under protocol number CRD42022359992.

Association of ischemic and hemorrhagic strokes hospital admission with extreme temperature in Nanchang, China-A case-crossover study.

Despite consistent evidence of a higher short-term risk of stroke mortality associated with ambient temperature, there are no findings on the association between extreme temperature and stroke. A total of 16,264 stroke hospital admissions were observed in three hospitals of Nanchang between 2008 and 2015. The case-crossover design was utilized for our study. Conditional logistic regression models were used to calculate the odds ratios. Extreme high temperature exposure during the 3days before the stroke was associated with both ischemic (OR=1.18; 95% CI: 1.07-1.36) and hemorrhagic stroke admissions (OR=1.34; 95% CI: 1.26-1.42) as compared to 3-day control periods (1-3days last week before the onset of stroke). Extreme low temperature was associated with hemorrhagic stroke admission (OR=1.42; 95% CI: 1.28-1.58) but not ischemic stroke (OR=1.06; 95% CI: 0.93-1.13). This study suggests that extreme high temperature might be a risk factor for both hemorrhagic and ischemic strokes, and that extreme low temperature might be a risk factor of hemorrhagic stroke. Further studies are necessary in order to clarify this relationship and provide evidence for stroke prevention.

[Comparison of the yearly cycle cosine curve imitative parameters of the clinical features of liver cancer at different longitude and latitude].

OBJECTIVE: To explore whether there exists coincidence of the most appearing time of clinical features of liver cancer at different longitude and latitude, according to the law of field equation and the theory of warpage of space time by Einstein. METHODS: Three regions with different longitude and latitude were selected randomly and sampled. There were 36 items altogether, including 12 clinical items, which were used to imitate the yearly cycle cosine curve. The acorphases and the ratioes of amplitudes and means were compared to justifying whether they were in the same range. RESULTS: All the acorphases of 36 items appeared between -90.1degrees to -207.5 degrees (from april to july), existing in one third of the same range, in which 13 items occurred rhythmly (P<0.05). The image acorphases of liver cancer at the early and middle stage and gamma-glutamyl transpeptidase acorphase appeared between -98.5 degrees to -148.2 degrees (from april to may), in which 5 items occurred rhythmly (P<0.05). CONCLUSION: It is the same mode of the yearly biologcal cycle for liver cancer malignant growth within the most appearing time (from april to july). It will increase the detecting rate of liver cancer at the early and middle stage during this time (especially from april to may).

HMG-CoA reductase inhibitors (statins) and bone mineral density: a meta-analysis.

CONTEXT: The association between 3-hydroxy-3methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) and bone mineral density (BMD) is controversial because of conflicting findings from previous studies. OBJECTIVE AND DESIGN: The purpose of the present study was to evaluate the effect of statins on BMD reported in randomized and non-randomized controlled trials. We searched PubMed and Embase, using text, medical subject headings (MeSH) and keywords "bone mineral density" and "statins" or "HMG-CoA reductase inhibitors". Our last PubMed and Embase queries were updated to August 2012. Data on participants, interventions, and outcomes from each study were abstracted independently by two authors. RESULTS: Five case-control studies, six cohort studies and four randomized controlled trials (RCTs) met the inclusion criteria. Included studies involved 34,877 subjects (3824 in the intervention group and 31,053 in the control group) in 12 different countries with ages ranging from 44 to 66 years. Statins significantly increased BMD at lumbar spine [standardized mean difference (SMD) 0.15, 95% CI 0.09-0.22], total hip (SMD 0.22, 95% CI 0.17-0.27) and femoral neck (SMD 0.19, 95% CI 0.09-0.29). We carried out subgroup analyses on selected populations of the cohorts. Statistically significant increases were also observed in the lumbar spine (SMD 0.12, 95% CI 0.04-0.21), total hip (SMD 0.23, 95% CI 0.17-0.28) and femoral neck BMD (SMD 0.22, 95% CI 0.08-0.36). CONCLUSION: The results of this study suggest that statins may help improve and maintain BMD at the lumbar spine, hip and femoral neck, especially in Caucasians and Asians. It also provides justification for prospective RCTs to evaluate the possible role of statins in BMD in different ethnic populations, such as Latin American and Africans.

Diabetes mellitus and the occurrence of colorectal cancer: an updated meta-analysis of cohort studies.

BACKGROUND: Recently, it has been found that diabetes patients have a higher incidence of colorectal cancer than the general population, but epidemiological studies examining a potential relationship between the two have produced inconsistent conclusions. Thus, we set out to perform a meta-analysis of cohort studies to evaluate the association between diabetes and colorectal cancer. MATERIALS AND METHODS: Using "diabetes," "colorectal cancer," and associated key words, we performed a systematic review of published cohort studies in multiple databases, including MEDLINE, EMBASE, ISI Web of Knowledge databases, OVID, CNKI, CBMD ISC, WANFANG, and CQVIP. We then applied stringent inclusion and exclusion criteria to identify which studies to include in our analysis. STATA version 12.0 software (StataCorp., College Station, TX) was used to conduct statistical analysis, including consolidated statistics calculations, tests for heterogeneity, and publication bias evaluations. RESULTS: We obtained a total of 532 potential articles. In accordance with our inclusion and exclusion criteria, we selected 29 articles for the meta-analysis. The analysis of extracted information indicated that diabetes is a risk factor for the development of colorectal cancer (relative risk 1.22, 95% confidence interval 1.19-1.26). Subgroup analyses by control populations, regions, gender, follow-up time, and colorectal cancer site also support this finding. CONCLUSIONS: The risk of individuals with diabetes to develop colorectal cancer is 1.22 times higher than that of individuals without diabetes. The positive association remains consistent for both men and women and for studies carried out in North America, Europe, and Asia, as well as for different follow-up times.

[Association of metabolic syndrome and colorectal cancer].

OBJECTIVE: To evaluate the association between metabolic syndrome and colorectal cancer. METHODS: A multicenter case-control study was conducted. A total of 1506 cases of colorectal cancer (936 males and 570 females), whose clinical data were complete and aged from 30 to 75, were collected in the Third, First and Second People's Hospital of Jingdezhen between 2000 and 2009. A total of 3354 controls (1766 males and 1588 females) were subjects admitted to the above 3 hospitals as cases with acute non-malignant non-digestive diseases. Multiple logistic regression models were used to analyze the association between metabolic syndrome and its components and colorectal cancer. RESULTS: Forty-eight cases of colorectal cancer (3.2%) and 59 controls (1.8%) were diagnosed as metabolic syndrome. Colorectal cancer risk was increased in cases with metabolic syndrome (OR=1.64, 95% CI:1.14-2.49, P<0.05) and in men with metabolic syndrome (OR=1.92, 95% CI:1.27-3.78, P<0.05), but not in women (P>0.05). As the number of component of metabolic syndrome increased, the risk of colorectal cancer increased in men (P<0.01), but not in women (P>0.05). CONCLUSION: Association between metabolic syndrome and colorectal cancer exists in men, but not in women.

[A case-control study on the risk factors of female infertility].

OBJECTIVE: Understanding the risk factors of female infertility among child-bearing aged women, in Nanchang area. METHODS: A hospital-based matched case-control study was carried out in Nanchang. Matched by age (+/- 2 years old), 383 pairs of cases and controls were recruited and studied. Database was established with EpiData 3.0 software. Both cases and controls were interviewed face to face, with a uniformed questionnaire. Conditional logistic regression model was used for univariate and multivariate analysis on SPSS 11.5 to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Data from multiple conditional logistic regression analysis showed that the risk factors of infertility would include pelvic inflammatory diseases (OR = 7.078, 95% CI: 3.462-14.467), post-abortion complications' history (OR = 3.674, 95% CI: 1.690-7.986), drug treatment history (OR= 23.576,95% CI: 12.324-45.102), dysmenorrhea (OR = 1.622, 95% CI: 1.161-2.266), pain from sexual intercourse (OR = 2.447, 95% CI: 1.201-4.986), monthly frequency of sexual intercourse (OR = 1.416, 95% CI: 1.048-1.913) and mental stress (OR = 2.146, 95% CI: 1.662-2.771). The protective factor of infertility, however, was level of education (OR = 0.522, 95% CI: 0.391-0.696). CONCLUSION: Prevention and treatment of pelvic infection, application of strictly controlled drugs, popularization of awareness on sexual and reproductive health and relief of mental stress would be important measures in decreasing the incidence of infertility.