Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder

Background:The Canadian 24-hour movement behavior(24-HMB)guidelines suggest that a limited amount of screen time use,an adequate level of physical activity(PA),and sufficient sleep duration are beneficial for ensuring and optimizing the health and quality of life(QoL)of children and adolescents.However,this topic has yet to be examined for children and adolescents with autism spectrum disorder(ASD)specifically.The aim of this cross-sectional observational study was to examine the associations between meeting 24-HMB guidelines and several QoLrelated indicators among a national sample of American children and adolescents with ASD.Methods:Data were taken from the 2020 U.S.National Survey of Children’s Health dataset.Participants(n=956)aged 617 years and currently diagnosed with ASD were included.The exposure of interest was adherence to the 24-HMB guidelines.Outcomes were QoL indicators,including learning interest/curiosity,repeating grades,adaptive ability,victimization by bullying,and behavioral problems.Categorical variables were described with unweighted sample counts and weighted percentages.Age,sex,race,preterm birth status,medication,behavioral treatment,household poverty level,and the educational level of the primary caregivers were included as covariates.Odds ratio(OR)and 95%confidence interval(95%CI)were used to present the strength of association between adherence to 24-HMB guidelines and QoL-related indicators.Results:Overall,452 participants(45.34%)met 1 of the 3 recommendations,216(22.65%)met 2 recommendations,whereas only 39 participants(5.04%)met all 3 recommendations.Compared with meeting none of the recommendations,meeting both sleep duration and PA recommendations(OR=3.92,95%CI:1.639.48,p<0.001)or all 3 recommendations(OR=2.11,95%CI:1.034.35,p=0.04)was associated with higher odds of showing learning interest/curiosity.Meeting both screen time and PA recommendations(OR=0.15,95%CI:0.040.61,p<0.05)or both sleep duration and PA recommendations(OR=0.24,95%CI:0.070.87,p<0.05)was associated with lower odds of repeating any grades.With respect to adaptive ability,participants who met only the PA recommendation of the 24-HMB were less likely to have difficulties dressing or bathing(OR=0.11,95%CI:0.020.66,p<0.05)than those who did not.For participants who met all 3 recommendations(OR=0.38,95%CI:0.150.99,p=0.05),the odds of being victimized by bullying was lower.Participants who adhered to both sleep duration and PA recommendations were less likely to present with severe behavioral problems(OR=0.17,95%CI:0.040.71,p<0.05)than those who did not meet those guidelines.Conclusion:Significant associations were found between adhering to 24-HMB guidelines and selected QoL indicators.These findings highlight the importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the QoL of children with ASD.

Interdialytic 24-Hours Ambulatory Blood Pressure versus Dialysis Unit Blood Pressure for the Diagnosis of Electrocardiographic-Left Ventricular Hypertrophy in Chronic Hemodialysis Black Patients

Background and Aim: In hemodialysis patients, 24-hours interdialytic ABPM better detects TOD than dialysis unit blood pressure. Therefore, the present study was aimed to assess the diagnostic performance of 24-hours ABPM vs. dialysis unit BPs for the diagnosis of ECG-LVH in steady state chronic hemodialysis black patients. Methods: From March 31 to September 30, 2018, interdialytic ABPM was performed after a mid-week hemodialysis session for 24 hours using a Spacelab 90207 ABPM monitor in the non-access arm in 45 stable chronic hemodialysis black patients (age ≥ 20 years, hemodialysis for at least 3 months and informed consent) attending 3 hemodialysis centers in Kinshasa. Ambulatory BP was recorded every 20 minutes during the day (6 AM to 10 PM) and every 30 minutes during the night (10 PM to 6 AM). ECG-LVH was defined using Cornell product criteria. ROC curve method was used to assess the performance of dialysis unit BPs vs. interdialytic 24-hours ABPM in diagnosing ECG-LVH. P 0.05 defined the level of statistical significance. Results: Whatever the method of BP measurement, all the SBP values were related to ECG-LVH with similar AUC and overlapping 95% CI;however, they were not significantly different from each other. 24-hours interdialytic ambulatory SBP (AUC 0.748;95% CI 0.58 - 0.94) had the highest area under the curve. Conclusion: The present study showed that although all the two BP measurement methods equally detected ECG-LVH, 24-hours ABPM tended to have the highest diagnostic performance.

The nurses’ voice of working in a newly established community based 24-hour support center for people with psychiatric disabilities

This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.

The correlation of spot urinary protein-to-creatinine ratio with 24-h urinary protein excretion in various glomerulopathies

BACKGROUND Proteinuria is an important and well-known biomarker of many forms of kidney injury.Its quantitation is of particular importance in the diagnosis and management of glomerular diseases.Its quantification can be done by several methods.Among these,the measurement of 24-h urinary protein excretion is the gold standard method.However,it is cumbersome,time-consuming,and inconvenient for patients and is not completely foolproof.Many alternative methods have been tested over time albeit with conflicting results.Among the latter,the measurement of urine protein-to-creatinine ratio(uPCR)in singlevoided urinary samples is widely used.The majority of studies found a good correlation between uPCR in single urine samples with 24-h urinary protein estimation,whereas others did not.AIM To investigate the correlation of spot uPCR with 24-h urinary protein estimation in patients suffering from different forms of glomerulopathies at a single largevolume nephrological center in Pakistan.METHODS This cross-sectional,observational study was conducted at the Department of Nephrology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan from September 2017 to March 2018.All newly presenting adult patients with proteinuria who were being investigated for suspected glomerulonephritis and persistent proteinuria with ages between 18 to 60 years were enrolled.All patients were given detailed advice regarding 24-h urine collection starting at 7:00 AM for total protein and creatinine excretion estimations.A spot urine sample was collected the next day at the time of submission of a 24-h urine sample for measuring uPCR along with a blood sample.The data of patients were collected in a proforma.SPSS version 20.0 was used for statistical analysis.RESULTS A total of 157 patients were included.Their mean age was 30.45±12.11 years.There were 94(59.8%)males and 63(40.2%)females.The mean 24-h urinary protein excretion was 3192.78±1959.79 mg and the mean spot uPCR was 3.16±1.52 in all patients.A weak but significant correlation was observed between spot uPCR and 24-h urinary protein excretion(r=0.342,P=0.01)among all patients.On subgroup analysis,a slightly better correlation was found in patients older than 47 years(r=0.78),and those with body mass index>25 kg/m2(r=0.45).The Bland and Altman's plot analysis comparing the differences between spot uPCR and 24-h protein measurement also showed a wide range of the limits of agreement between the two methods.CONCLUSION Overall,the results from this study showed a significant and weakly positive correlation between spot uPCR and 24-h urinary protein estimation in different forms of glomerulopathies.The agreement between the two methods was also poor.Hence,there is a need for careful interpretation of the ratio in an unselected group of patients with kidney disease.

The lived experience of a 24-hour support center for persons with psychiatric disabilities: Making me feel almost like an ordinary person

This study illuminates nine psychiatric disabled persons’ lived experience of a newly established community-based service center open around the clock. This new 24-hour support center (SC) was established in 2011 in a Swedish community to better match and facilitate the disabled persons’ needs. In order to illuminate the disabled person’s experiences individual interview was performed. A phenomenological-hermeneutical method inspired by Paul Ricoeur was used to interpret the texts. After a naive reading, a structural analysis revealed two themes: 1), becoming aware of myself as a person, and 2) having a lifeline and belongingness. The comprehensive understanding was interpreted as meaning “Making me feel almost like an ordinary person”, which incorporated the person’s past with their present together with a direction for the future and hope for a more fulfilling life.

Esophageal manometry and 24-hour pH monitoring in esophagus surgery:28-year Chinese experience in a single center

Objective To retrospectively review the experience of esophageal manometry and 24-hour pH monitoring in e-sophagus surgery. Methods From 1982 to 2010,patients with unspecific chest pain and undergone esophageal surgery were received esophageal manometry and 24-hour pH monitoring. Results Among the patients with

金水宝胶囊对糖尿病肾病患者糖代谢及24 h蛋白尿水平的影响

目的探讨金水宝胶囊对糖尿病肾病(DN)患者糖代谢及24 h蛋白尿水平的影响。方法选取2019年9月至2020年9月本院收治的82例DN患者作为研究对象,按照随机数字表法分为对照组与观察组,每组41例。对照组给予厄贝沙坦治疗,观察组给予金水宝胶囊治疗,比较两组临床疗效、糖代谢指标[空腹血糖(FBG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PBG)]、24 h蛋白尿水平及不良反应发生情况。结果观察组治疗总有效率为92.68%,高于对照组的75.61%,差异有统计学意义(P<0.05)。治疗前,两组FBG、HbA1c、2 h PBG水平比较差异无统计学意义;治疗3个月后,两组FBG、HbA1c、2 h PBG均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组24 h蛋白尿水平比较差异无统计学意义;治疗3个月后,两组24 h蛋白尿水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论金水宝胶囊能明显改善DN患者糖代谢水平,减少蛋白尿,降低不良反应发生率,值得临床推广应用。

晨尿蛋白／尿肌酐比值和24h尿蛋白定量的相关性分析

目的探讨晨尿蛋白／尿肌酐比值可否替代24h尿蛋白定量，监测尿蛋白的排泄情况。方法选取住院肾脏病患者136例，共272例尿标本，将晨尿蛋白／尿肌酐与24h尿蛋白定量进行相关性分析；采用ROC曲线分析确定晨尿蛋白／尿肌酐比值相对于24h尿蛋白定量分别大于0．15g、1．00g和3．00g的最佳诊断点。结果晨尿蛋白／尿肌酐比值与24h尿蛋白定量呈显著正相关（r=0．83，P〈0．01）；24h尿蛋白定量≥0．15g、1．00g和3．00g时，临床诊断敏感性和特异性最佳点分别为晨尿蛋白／尿肌酐比值≥0．20g／gcr，≥0．95g／ger和≥2．92g／gcr。结论晨尿蛋白／尿肌酐比值可替代24h尿蛋白定量，监测肾脏病患者尿蛋白排泄情况。

Research progress of 24-hour movement behaviors in chronic non-communicable disease

Chronic non-communicable diseases(NCDs)represent a significant impediment to improve life expectancy and remain a focal point in global public health and disease prevention efforts.24-hour movement behaviors,which include sleep,sedentary behavior(SED),and physical activity,underscore the inherent connections between different daily activities and the comprehensive impact of overall movement patterns on health.Evidence suggested that modifying patterns of 24-hour movement behaviors can aid in preventing and attenuating the progression of NCDs.This study systematically delineated the concept,evolution,analytical methods,and intrinsic associations of 24-hour movement behaviors,emphasizing their pivotal role in the prevention and management of NCDs such as obesity,mental disorders,cardiovascular diseases,diabetes,and renal diseases.Future research endeavors should focus on refining methodologies,broadening study populations,developing research tools,and exploring precise intervention strategies and interdisciplinary approaches to comprehensively enhance the effectiveness of NCDs prevention and management from a temporal perspective.Such efforts are poised to provide substantive guidance and support for public health practices.

肿瘤标记物在原发性肾脏疾病患者中的血清学浓度改变

目的:了解24 h尿蛋白定量、血浆白蛋白、肌酐清除率(Ccr)水平对原发性慢性肾脏病患者血清甲胎蛋白(AFP)、癌胚抗原(CEA)、糖蛋白抗原19-9(CA19-9)和糖蛋白抗原125(CA-125)血清浓度的影响。方法:测定92例非透析慢性肾脏病患者上述4种肿瘤标记物血清浓度,根据其Ccr、24 h尿蛋白定量以及血浆白蛋白浓度进行分组,并对数据进行统计学分析。结果:24 h尿蛋白定量和血浆白蛋白浓度对血清CA125水平有显著影响,尿蛋白定量增加及血浆白蛋白浓度降低者血清CA125 均值升高。不同蛋白尿或Ccr组以上其他3种肿瘤标记物的血浓度无明显差异。结论:尿蛋白定量增加和血浆白蛋白降低的慢性肾病患者,其血浆CA125浓度升高时并不一定提示恶性肿瘤,Ccr、24 h尿蛋白定量、血浆白蛋白水平对AFP、CEA、CA19-9无明显影响。

补中益气汤对阿霉素诱导的大鼠肾病的作用

以阿霉素肾病大鼠模型为研究对象,采用了血液生化学和组织病理学方法,分析了补中益气汤对阿霉素肾病的作用和可能的机制.Wistar雄性大鼠60只,随机分为对照组(n=10)、模型组(n=10)、激素组(n=10)和补中益气汤低剂量组(n=10)、中剂量组(n=10)和高剂量组(n=10).采用阿霉素二次尾静脉注射法(首次6mg/kg,二次3mg/kg)制作阿霉素肾病的大鼠模型.在阿霉素注射后7,21,42d将大鼠置于代谢笼中分别收集24h尿液,测定24h尿蛋白.末次给药后,眼眶取血检测肾功能指标,包括肌肝SCR(serum creatine)和尿素氮BUN(blood urea nitrogen);处死大鼠并观察肾组织病理改变.结果表明:补中益气汤可以显著减少尿蛋白的排泄并缓解肾皮质上皮细胞的病理学改变.这提示补中益气汤对阿霉素大鼠能够通过改善尿蛋白的排泄,缓解肾脏病理改变,从而起到对肾脏的保护作用.

加味清心莲子饮治疗阿霉素肾病综合征大鼠的实验研究

目的:探讨加味清心莲子饮对阿霉素肾病综合征大鼠的疗效及对尿蛋白、血液生化指标、炎症介质的影响。方法:利用尾静脉注射阿霉素建立大鼠肾病综合征模型,分别给予泼尼松灌胃和加味清心莲子饮灌胃,同时设置对照组、模型组。实验过程中对大鼠进行一般形态学观察,每周检测24 h蛋白尿;实验末采血分离血清,对血清中清蛋白(ALB)、总蛋白(TP)、三酰甘油(TG)、胆固醇(TC)、血尿素氮(BUN)、血清肌酐(Scr)水平进行检测;利用ELISA法对血清炎症介质白细胞介素-1β(IL-1β)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)水平进行检测。结果:模型组的24 h尿蛋白水平与对照组比较,差异有统计学意义(P<0.01)。给药后,激素组、中药组大鼠24 h尿蛋白含量均明显降低(均P<0.01)。与对照组比较,模型组血清TG、TC、BUN、Scr水平均明显升高(均P<0.01);血清ALB、TP水平均明显降低(均P<0.01)。给药后,激素组、中药组血清TG、TC、BUN、Scr水平均降低(均P<0.01,P<0.05);血清ALB、TP水平均明显升高(均P<0.01)。与对照组比较,模型组血清IL-1β、IL-8、TNF-α、MCP-1水平均升高(均P<0.05);给药后,激素组、中药组血清IL-1β、IL-8、TNF-α、MCP-1水平均降低(均P<0.05)。结论:加味清心莲子饮能够治疗阿霉素肾病综合征,作用机制为调节炎症介质的表达,改善病理损伤,恢复肺、脾、肾脏的功能。

螺内酯联合福辛普利对2型糖尿病肾病蛋白尿的影响

目的探讨螺内酯联合福辛普利治疗2型糖尿病肾病的安全性及其对蛋白尿的影响。方法 60位2型糖尿病肾病患者随机平均分为对照组和治疗组,对照组予福辛普利10 mg/d治疗,治疗组在对照组用药基础上加用螺内酯20 mg/d治疗,试验持续12周,定期测量患者血压、生化指标及24 h尿蛋白定量。结果与对照组比较,治疗组24 h尿蛋白下降更显著(P<0.01),无肾小球滤过率下降、血钾上升及低血压发生。结论适度剂量的螺内酯能加强血管紧张素转化酶抑制剂(ACEIs)对糖尿病肾病的阻滞作用。

糖尿病肾病动态血压模式的特点及其与尿蛋白的关系

目的 :观察糖尿病肾损害不同时期患者的血压模式的变化 ,及其在糖尿病肾病发生机制中所起的作用。方法 :分别选取血糖稳定、临床血压正常的 、 、 期 2型糖尿病肾损害患者 ,进行动态血压测定 ,观察他们日夜血压模式的特点并与正常对照组进行对比。结果 :实验组患者的共同特点为夜间血压的升高及非勺型曲线的出现率增高 ,且后者与尿蛋白的水平成正相关。结论 :糖尿病肾损害患者的血压模式的改变 ,先于血压的升高及尿蛋白的明显增多 ,提示自主神经功能的受损 ,是糖尿病肾病的发病机制之一。

尿蛋白在子痫前期诊断中的价值

血压升高和尿蛋白轻度升高一直是子痫前期诊断的基本条件。但越来越多的研究表明尿蛋白定性不再是子痫前期诊断的必要条件,且与子痫前期病情和母儿预后的相关性也存在争议。因此,本文对近期的文献及相关指南进行综述,探讨尿蛋白在子痫前期中的诊断及病情评估中的价值及与母儿预后的相关性。

小剂量雷公藤多甙联合低分子肝素钠治疗慢性肾小球肾炎临床观察

目的探讨小剂量雷公藤多甙联合低分子肝素钠治疗慢性肾小球肾炎的临床疗效。方法将64例慢性肾小球肾炎患者分为3组。在常规治疗基础上,实验组予小剂量雷公藤多甙联合低分子肝素钠治疗;对照组Ⅰ予小剂量雷公藤治疗;对照组Ⅱ予低分子肝素钠治疗。分别检测患者治疗前及治疗12周后肾功能、血清白蛋白、24h尿蛋白定量、尿中红细胞、肝功能、血常规及血粘度、血脂,并进行比较。结果3组患者治疗前后肾功能、血清白蛋白、尿蛋白及尿红细胞差异有统计学意义;实验组治疗后血清白蛋白、尿蛋白及尿红细胞水平与对照组Ⅰ、Ⅱ治疗后差异有统计学意义。结论小剂量雷公藤多甙联合低分子肝素钠治疗慢性肾小球肾炎,疗效显著,药物毒副作用小。

厄贝沙坦联合肾炎康复片治疗慢性肾炎蛋白尿疗效观察

目的将厄贝沙坦与肾炎康复片联用治疗方案实施于慢性肾炎蛋白尿患者中,观察和评定临床疗效。方法选取2016年3月—2018年4月本医院纳入的70例慢性肾炎蛋白尿患者作为研究对象,按照硬币法,将其分为两组,每组各35例。对照组采用厄贝沙坦治疗,试验组采用厄贝沙坦联合肾炎康复片治疗,统计两组患者的相关指标。结果试验组患者的治疗总有效率、治疗后24小时尿蛋白测定值均优于对照组患者,差异具有统计学意义(P <0.05)。结论对慢性肾炎蛋白尿患者开展厄贝沙坦与肾炎康复片联合治疗展示较优临床疗效。

加味黄芪赤风汤治疗IgA肾病蛋白尿临床研究

目的:探讨加味黄芪赤风汤治疗IgA肾病蛋白尿的临床疗效及药理机制。方法:选取IgA肾病蛋白尿患者32例,采用随机数字表法分为对照组和观察组各16例。对照组给予替米沙坦治疗,观察组给予加味黄芪赤风汤治疗。结果:治疗3个月后,两组血肌酐水平比较无统计学意义(P>0.05);观察组24 h尿蛋白水平、中医证候积分均优于对照组(P均<0.05)。结论:加味黄芪赤风汤可有效降低IgA肾病尿蛋白水平和中医证候积分,对血肌酐水平无明显影响。

尿蛋白联合脐动脉血流监测对妊娠期高血压的应用价值

目的探讨尿微量白蛋白与肌酐比、24 h尿蛋白、脐动脉血流监测在妊娠期高血压患者中的应用价值。方法选取2014年3月—2017年12月云南省第三人民医院产科收治的193例妊娠期高血压病患者。根据发病程度分组,65例妊娠期高血压患者为Ⅰ组、62例轻度子痫前期患者为Ⅱ组,66例重度子痫前期患者为Ⅲ组,同期选取60例正常孕晚期妇女作为对照组。采集尿液样本,采用ELISA法测定尿微量白蛋白和肌酐水平,计算2者比值;采用邻苯三酚红钼法检测24 h尿蛋白;采用彩色多普勒超声检查患者脐动脉血流收缩期最大血流速度与舒张末期血流速度比值(S/D)及阻力指数(RI)。统计患者妊娠结局,分析各个指标对不良妊娠结局的预测价值。结果对照组、Ⅰ组、Ⅱ组、Ⅲ组的尿微量白蛋白/肌酐、24 h尿蛋白、脐动脉S/D值及RI值依次升高,且任意2组之间的差异均有统计学意义(P<0.05)。Ⅱ组宫内窘迫、早产及总不良妊娠结局的发生率高于Ⅰ组和对照组,Ⅲ组胎盘早剥、产后出血、宫内窘迫、新生儿缺血缺氧性脑病、早产及总不良妊娠结局的发生率均高于Ⅰ组和对照组,差异均有统计学意义(P<0.05)。ROC曲线结果显示,尿微量白蛋白/肌酐、24 h尿蛋白、脐动脉S/D值及RI值对患者的不良妊娠结局均有较好的预测价值,ROC曲线下面积(AUC)分别为0.823、0.734、0.813和0.776。结论尿微量白蛋白/肌酐、24 h尿蛋白、脐动脉S/D值和RI值对妊娠期高血压患者的不良预后具有预测价值。

血清胱抑素C早期诊断糖尿病肾病的价值

目的探讨血清胱抑素C（Cys-C）在糖尿病肾病（DN）患者中的变化和临床应用价值。方法选取符合Mogensen原则中Ⅲ、Ⅳ期的75例DN患者作为研究对象（观察组）,根据24 h尿白蛋白排泄率（UAER）及尿蛋白由高到低分为A、B、C三组各25例,另选择门诊健康体检者28例作为对照组,测定所有入选对象的血清Cys-C、肌酐（Cre）、尿素氮（BUN）、空腹血糖（FBG）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和糖化血红蛋白（Hb Alc）等指标。结果观察组的FBG、Hb Alc、Cys-C、Cre和BUN水平显著高于健康对照组（P〈0.05或0.01）,HDL-C水平显著低于健康对照组（P〈0.01）。观察组的TC、TG和LDL-C与健康对照组比较差异无统计学意义（P〉0.05）。观察组（A＋B＋C组）中三项指标检测阳性率分别为76.0%（57/75）、65.3%（49/75）和62.7%（47/75）,差异无统计学意义（χ2=3.4314,v=2,P=0.1798）。C组三项指标的检测阳性率分别为36%、12%和8%,差异有统计学意义（χ~2=7.5527,v=2,P=0.0229）,进一步两两比较发现,C组Cys-C检测的阳性率高于Cre和BUN的阳性率（均P〈0.05）。观察组患者24 h UAER水平与Cys-C、Cre和BUN之间均存在正相关关系（r分别为0.95、0.86和0.68,均P〈0.01）。结论血清Cys-C是反映肾小球损伤的重要标志物,其能够更早、更准确、更敏感地监测肾脏的损伤情况,对DN的发生、发展及预后有一定的参考价值。