The Status and Associated Factors of Successful Aging among Older Adults Residing in Longevity Areas in China

Objective This study aims to assess the status of successful aging （SA） in longevity areas in China and explore multiple factors associated with SA among the young-old and oldest-old. Methods A total of 2296 elderly people aged 65 and older were interviewed in the longevity areas sub-sample of the Chinese Longitudinal Healthy Longevity Survey （CLHLS） in 2012. Baseline assessments included a researcher-administered questionnaire, physical examination, and laboratory testing. A logistic regression model was used to identify factors associated with SA. Results The prevalence of SA was 38.81% in the CLHLS in 2012. There were significant differences between ages groups, with SA compromising 56.85% among _〉65 years group and 20.31% among 〉100 years group （X2trend=126.73, P〈O.01）. The prevalence of SA among females was 33.59%, which was significantly lower than that among males （45.58%） （X2gender=33.65, P〈0.05）. In the regression analysis, having anemia ~OR=0.744, 95% CI： 0.609-0.910）, poor lifestyle （OR=0.697, 95% CI： 0.568-0.854）, poor sleep quality （OR=0.558, 95% CI： 0.456-0.682）, and central obesity （OR=0.684, 95% CI： 0.556-0.841） were the main factors associated with SA. The promoting SA rate decreased as age increased, and the group of 65-79 years had higher odds than the other age group. Conclusion Preventing central obesity, improving sleep quality and promoting healthy lifestyle may contribute to achieve SA among the elderly.

Correlation of An Ultrasonic Scoring System and Intraoperative Blood Loss in Placenta Accreta Spectrum Disorders: A Retrospective Cohort Study

Objective This study aims to investigate the correlation of an ultrasonic scoring system with intraoperative blood loss(IBL) in placenta accreta spectrum(PAS) disorders.Methods A retrospective cohort study was conducted between January 2015 and November 2019.Clinical data for patients with PAS have been obtained from medical records. Generalized additive models were used to explore the nonlinear relationships between ultrasonic scores and IBL. Logistic regressions were used to determine the differences in the risk of IBL ≥ 1,500 m L among groups with different ultrasonic scores.Results A total of 332 patients participated in the analysis. Generalized additive models showed a significant positive correlation between score and blood loss. The amount of IBL was increased due to the rise in the ultrasonic score. All cases were divided into three groups according to the scores(low score group: ≤ 6 points, n = 147;median score group: 7-9 points, n = 126;and high score group: ≥ 10 points, n = 59). Compared with the low score group, the high score group showed a higher risk of IBL≥ 1,500 m L [odds ratio, 15.09;95% confidence interval(3.85, 59.19);P ≤ 0.001] after a multivariable adjustment.Conclusions The risk of blood loss equal to or greater than 1,500 m L increases further when ultrasonic score greater than or equal to 10 points, the preparation for transfusion and referral mechanism should be considered.

Associations of Sarcopenia, Handgrip Strength and Calf Circumference with Cognitive Impairment among Chinese Older Adults

Objective To evaluate the associations of sarcopenia,handgrip strength and calf circumference with cognitive impairment among Chinese older adults.Methods Totally 2,525 older adults were recruited from the Healthy Aging and Biomarkers Cohort Study.Cognitive impairment was assessed by the Chinese Mini-Mental State Examination.Handgrip strength was calculated from the means of the right and left hand values.Calf circumference was measured at the site of maximum circumference of the non-dominant leg.The formula developed by Ishii was used to define sarcopenia.Multiple logistic regression was performed to evaluate the associations of sarcopenia,handgrip strength,and calf circumference with cognitive impairment.Results The prevalence of cognitive impairment was 34.36%.The adjusted odds ratio(OR)for cognitive impairment in individuals with sarcopenia was 2.55[95% confidence interval(95%CI):1.86-3.50].Compared with individuals in the first quartile(Q1)of calf circumference,the adjusted ORs in the second,third,and fourth quartiles(Q_(2),Q_(3),and Q_(4))were 0.75(95% CI:0.58-0.96),0.59(95% CI:0.44-0.79),and 0.62(95% CI:0.45-0.8),respectively.Compared with individuals in Q1 of handgrip strength,the adjusted ORs for Q_(2),Q_(3),and Q_(4) were 0.49(95%CI:0.38-0.62),0.31(95% CI:0.23-0.41),and 0.30(95%CI:0.21-0.44),respectively.Conclusion Sarcopenia,identified by low handgrip strength and low calf circumference,was positively associated with cognitive impairment.

Gender Differences in the Prevalence of Overweight and Obesity,Associated Behaviors,and Weight-related Perceptions in a National Survey of Primary School Children in China

Objective To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children. Methods Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders. Results Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio （OR） 2.30, 95% CI 2.00 to 2.65] and rural areas （OR = 1.85, 95% CI 1.55 to 2.20）. Girls reported healthier diets （e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85） whereas boys consumed fried food （OR = 1.21, 95% CI 1.06 to 1.38） and sugar-sweetened drinks more often （OR = 1.49, 95% CI 1.34 to 1.65）. Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers （OR = 1.35, 95% CI 1.09 to 1.68）, less educated fathers （OR = 0.79, 95% CI 0.63 to 0.99）, and if they frequently consumed carbonated drinks （OR = 1.48, 95% CI 1.07 to 2.05）. Conclusion Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls.

Inaccuracy of Self-reported Low Sodium Diet among Chinese: Findings from Baseline Survey for Shandong & Ministry of Health Action on Salt and Hypertension(SMASH) Project

This study was aimed to evaluate the agreement between the self-reported sodium intake level and 24-h urine sodium excretion level in Chinese. The 24-h urine collection was conducted among 2112 adults aged 18-69 years randomly selected in Shandong Province, China. The subjects were asked whether their sodium intake was low, moderate, or high. The weighted kappa statistics was calculated to assess the agreement between 24-h urine sodium excretion level and self-reported sodium intake level. One third of the subjects reported low sodium intake level. About 70% of the subjects had mean 24-h sodium excretion 〉9 g/d, but reported low or moderate sodium intake.

Prevalence and Correlates of Elevated Blood Pressure in Chinese Children Aged 6-13 Years: a Nationwide School-Based Survey

Objective To estimate the prevalence of elevated blood pressure（EBP） in Chinese children and identify individual and family factors associated with EBP. Methods A nationwide cross-sectional study was conducted in 2010 using stratified cluster sampling. Participants＇ blood pressure was measured, and their parents completed a questionnaire on personal and family characteristics. Prevalence and correlates of EBP were assessed. Results Among a total of 24,333 participants, 20.2% of boys and 16.3% of girls had EBP. The prevalence of EBP increased with the ascending trend of waist circumference, Waist-to-height ratio, and body mass index. The adjusted prevalence ratios（aP Rs） for obese boys and girls were 2.50 and 2.97, respectively. Fewer urban boys（16.2%） had EBP than rural boys（21.7%）. Boys with a family history of hypertension were 12% more likely to have EBP. Children whose mothers received a college education tended to have lower likelihood of EBP; with an aP R was 0.85 among boys and 0.78 among girls. Conclusion EBP is common among obese students and those who have a family history of hypertension. A negative association between mothers＇ education levels and EBP risk in children was found.

Alcohol Cessation in Late Life is Associated with Lower Risk of Cognitive Impairment among the Older Adults in China

Objective Evidence regarding alcohol consumption and cognitive impairment is controversial.Whether cessation of drinking alcohol by non-dependent drinkers alters the risk of cognitive impairment remains unknown.This study prospectively evaluated the potential association between the history of lifetime alcohol cessation and risk of cognitive impairment.Methods This study included 15,758 participants age 65 years or older,selected from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)that covered 23 provinces in China.Current alcohol use status,duration of alcohol cessation,and alcohol consumption before abstinence were self-reported by participants;cognitive function was evaluated using Mini-mental State Examination(MMSE).Causespecific hazard models and restricted cubic splines were applied to estimate the effect of alcohol use on cognitive impairment.Results Among the 15,758 participants,mean(±SD)age was 82.8 years(±11.9 years),and 7,199(45.7%)were males.During a mean of 3.9 years of follow-up,3,404 cases were identified as cognitive impairment.Compared with current drinkers,alcohol cessation of five to nine years[adjusted HR,0.79(95%CI:0.66-0.96)]and more than nine years[adjusted HR,0.82(95%CI:0.69-0.98)]were associated with lower risk of cognitive impairment.Conclusion A longer duration of alcohol cessation was associated with a lower risk of cognitive impairment assessed by MMSE.Alcohol cessation is never late for older adults to prevent cognitive impairment.

High Sensitivity C-Reactive Protein Associated with Different Health Predictors in Middle-Aged and oldest old Chinese

Objective To describe the distribution of plasma high sensitivity C-reactive protein （hsCRP） and explore the relationship between hsCRP and metabolic risk factors among residents living in longevity areas of China. Methods 268 individuals aged between 40 and 59 years and 506 individuals aged over 90 years were selected from 5 longevity areas of China to participate in a cross section longitudinal cohort study. The participants were interviewed with general health related questionnaire to collect their demographic, behavioral and lifestyle data, as well as their chronic conditions, and meanwhile their physical and biomedical parameters including waist circumference （WC）, blood pressure （BP）, hsCRP, plasma lipids, and fasting blood glucose （FBG） were measured. Results The median of hsCRP was 0.99 mg/L in the middle-aged group and 2.76 mg/L in the oldest old group. No significant gender difference was observed between the above two groups. Among the oldest old individuals, 36.56% had an hsCRP level 〉3.0 mg/L. The prevalence of high hsCRP was 26.79% in the middle-aged group. The results of stepwise multiple linear regression analyses showed that HDL-C was independently associated with In （hsCRP） concentration in the middle-aged group, whereas In （TG）, HDL-C and FBG were correlated after adjustment for gender, study site, smoking, drinking, education and BMI in the oldest old group. Conclusion HDL-C is a stronger predictor of elevated hsCRP than other metabolic factors in the middle-aged population. For the oldest old persons, high TG, low HDL-C, and FBG predict elevated plasma hsCRP.

Urinary Creatinine Concentrations and Its Explanatory Variables in General Chinese Population:Implications for Creatinine Limits and Creatinine Adjustment

Objective The study aimed to analyze the applicability of the World Health Organization’s exclusionary guidelines for Urinary creatinine(Ucr)in the general Chinese population,and to identify Ucr related factors.Methods We conduct a cross-sectional study using baseline data from 21,167 participants in the China National Human Biomonitoring Program.Mixed linear models and restricted cubic splines(RCS)were used to analyze the associations between explanatory variables and Ucr concentration.Results The geometric mean and median concentrations of Ucr in the general Chinese population were 0.90 g/L and 1.01 g/L,respectively.And 9.36%samples were outside 0.3-3.0 g/L,including 7.83%below the lower limit and 1.53%above the upper limit.Middle age,male,obesity,smoking,higher frequency of red meat consumption and chronic kidney disease were associated significantly with higher concentrations of Ucr.Results of the RCS showed Ucr was positively and linearly associated with body mass index,inversely and linearly associated with systolic blood pressure,diastolic blood pressure,triglycerides level,and glomerular filtration rate,and were non-linearly associated with triiodothyronine.Conclusion The age-and gender-specific cut-off values of Ucr that determine the validity of urine samples in the general Chinese population were recommended.To avoid introducing bias into epidemiologic associations,the potential predictors of Ucr observed in the current study should be considered when using Ucr to adjust for variations in urine dilution.

Stopping Transmission of COVID-19 in Public Facilities and Workplaces:Experience from China

The main transmission routes of Coronavirus Disease 2019(COVID-19)include droplet and contact transmission.Airborne transmission may be possible in specific circumstances and settings in which aerosol-generating procedures are performed^([1]).In2020,more than 83.4 million confirmed cases of COVID-19,including more than 1.8 million deaths.