An Investigation of the Association between Metabolic Syndrome and Osteoporosis Based on Chinese Health Examination Data

Objective Because of the limited number of studies and small sample sizes,whether metabolic syndrome(MS)leads to the occurrence and progression of osteoporosis and the possible underlying mechanisms require further investigation.This study aimed to investigate the association between MS and osteoporosis,along with its influencing factors.Methods This observational cross-sectional study included 139,470 individuals aged≥18 years who underwent health examinations from September 2014 to March 2022.Based on bone mineral density(BMD)screening results,the participants were categorized into a suspected osteoporosis or non-osteoporosis group(control).Participants were further divided into those who met 0 MS criteria,1 MS criterion,2 MS criteria,and≥3 MS criteria(MS group).Participants who had undergone health examinations at least twice formed the follow-up cohort;a self-matched analysis was performed on those with follow-up periods≥5 years and unchanged MS grouping.Results Several examination indicators in the suspected osteoporosis group showed statistically significant differences compared with the control group.The proportion of suspected osteoporosis in the MS group was significantly increased compared with that in the 0 MS criteria group(odds ratio[OR]:1.215,Z=29.11,P<0.001,95%confidence interval:1.199-1.231).After adjusting for age,sex,smoking,and alcohol consumption,the 2 MS criteria group and MS group still had OR values>1(P<0.001).In the follow-up cohort,the proportion of suspected osteoporosis increased gradually with an increase in the number of MS criteria met at baseline and during each follow-up visit(P<0.05),with the highest proportion observed in the MS group.However,the proportion of suspected osteoporosis did not increase significantly over time in the different MS groups(P>0.05).In the follow-up cohort,the proportion of individuals transitioning from normal BMD to suspected osteoporosis was higher in the MS group after≥5 years of follow-up compared with the group meeting 0 MS criteria(0.08%versus 1.15%,χ^(2)=10.76,P=0.001).There was no significant difference in BMD values for the 0 MS criteria group after 5 years(P>0.05),whereas the other three groups experienced a significant decrease in BMD values after 5 years(P<0.05).Conclusion MS is an independent risk factor for osteoporosis,and the effect of risk factors related to MS on osteoporosis may exceed that of aging alone.The specific mechanisms warrant further investigation.

Low skeletal muscle mass is associated with non-alcoholic fatty liver disease in Korean adults： the Fifth Korea National Health and Nutrition Examination Survey

BACKGROUND： Sarcopenia and non-alcoholic fatty liver dis- ease （NAFLD） share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skel- etal muscle mass is differentially associated with NAFLD by gender in Korean adults. METHODS： We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index （SMI） was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index （FLI） 〉60 in the absence of other chronic liver disease. RESULTS： Among the included subjects, 18.3% （SE： 1.4%） in men and 7.0% （SE： 0.7%） in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, inde- pendent of other metabolic and lifestyle parameters in both genders [males： odds ratio （OR）=1.35; 95% confidence inter- val （CI）： 1.17-1.54; females： OR=1.36; 95% CI： 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males （OR-1.50; 95% CI： 1.22-1.84） than in males less than 45 years of age （OR=1.25; 95% CI： 1.02-1.52） and in premenopausal females （OR=l.50; 95% CI： 1.12-2.03） than in postmenopausal females （OR-1.36; 95% CI： 1.20-1.54）.CONCLUSIONS： Low SMI is associated with the risk of FLI- defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ ac- cording to age group or menopausal status. Further studies are warranted to confirm this relationship.

An enrichment model using regular health examination data for early detection of colorectal cancer

Objective: Challenges remain in current practices of colorectal cancer(CRC) screening, such as low compliance,low specificities and expensive cost. This study aimed to identify high-risk groups for CRC from the general population using regular health examination data.Methods: The study population consist of more than 7,000 CRC cases and more than 140,000 controls. Using regular health examination data, a model detecting CRC cases was derived by the classification and regression trees(CART) algorithm. Receiver operating characteristic(ROC) curve was applied to evaluate the performance of models. The robustness and generalization of the CART model were validated by independent datasets. In addition, the effectiveness of CART-based screening was compared with stool-based screening.Results: After data quality control, 4,647 CRC cases and 133,898 controls free of colorectal neoplasms were used for downstream analysis. The final CART model based on four biomarkers(age, albumin, hematocrit and percent lymphocytes) was constructed. In the test set, the area under ROC curve(AUC) of the CART model was 0.88 [95%confidence interval(95% CI), 0.87-0.90] for detecting CRC. At the cutoff yielding 99.0% specificity, this model’s sensitivity was 62.2%(95% CI, 58.1%-66.2%), thereby achieving a 63-fold enrichment of CRC cases. We validated the robustness of the method across subsets of test set with diverse CRC incidences, aging rates, genders ratio, distributions of tumor stages and locations, and data sources. Importantly, CART-based screening had the higher positive predictive value(1.6%) than fecal immunochemical test(0.3%).Conclusions: As an alternative approach for the early detection of CRC, this study provides a low-cost method using regular health examination data to identify high-risk individuals for CRC for further examinations. The approach can promote early detection of CRC especially in developing countries such as China, where annual health examination is popular but regular CRC-specific screening is rare.

City Health Examination in China:A Methodology and Empirical Study

National urban planning,construction,and management levels have undergone qualitative changes in China since 2000.Nonetheless,problems caused by rapid urbanization are becoming increasingly prominent.The concept of the city health examination appears to tackle these problems and is being gradually implemented,starting from the implementation of a national strategy and leading to the concrete practice of high-quality urban development.This paper elaborates on the basic philosophy and theory of the city health examination,briefly explains indicator selection and aims,and comprehensively illustrates examination methods.It then describes the empirical research that operationalized the dataset collected from a satisfaction survey administered during the 2020 city health examination.It aims to provide a reference for the standardization,specialization,analysis,and application of the results of the city health examination in China;this may help promote a smooth elimination of‘urban diseases’and allow for the development of high-quality livable cities.This research shows that city residents are generally more satisfied with the landscape features,ecological livability,and security resilience;it also shows that residents are generally more dissatisfied with traffic issues.Residents with different characteristics showed different satisfaction levels toward different indicators.Residents were also shown to be more sensitive to innovation vitality,ecological livability,and health and comfort in considering whether to stay in their current city.

Regional Differences in Specific Health Examination Utilization and Medical Care Expenditures in Japan

Background: Despite having one of the most successful health systems in the world, annual medical expenditures in Japan have been increasing year to year. We sought to clarify regional differences in medical expenditures by analyzing the relationship between the specific health examination coverage and medical care expenditure by prefecture of Japan. Methods: We used data from the National Database of Health Insurance Claims and Specific Health Checkups (NDB) Open Data Japan (2015) and Overview of 2015 National Medical Expenses to compare medical care expenditure per capita and proportions of persons receiving specific health examination between Japan nationally and individual prefectures. Results: National medical expenditures were 42.3 trillion Japanese yen (JPY) (3851 hundred million dollars), with a national per capita rate of JPY347,219 (USD3156). Per capita medical expenditure rates by prefecture ranged from JPY290,900 (USD2645) in Saitama Prefecture to JPY 444,000 (USD4036) in Kochi Prefecture. The proportion of persons receiving specific health examinations was 49.0% for Japan overall and ranged from 39.3% in Hokkaido Prefecture to 63.4% in Tokyo Prefecture. We observed a significant negative correlation between per capita medical expenditures and the proportion of persons receiving specific health examinations (R = 0.553, p < 0.001). Conclusion: We found a significant negative correlation between per capita medical expenditures and the proportion of persons receiving health examinations: prefectures with lower expenditures tended to have higher rates of medical examinations. Interventions to increase the proportion of persons receiving specific health examinations by prefecture could reduce per capita medical expenditures and reduce prefectural disparities in expenditures.

Association of Health-related Quality of Life with Health Examination and Lifestyles of Government Managers in China

In order to study the association of each item of a health examination and lifestyles with health-related quality of life (HRQoL), a cross-sectional survey by a self-administered questionnaire using the 12-Item Short Form Health Survey (SF-12, version 1) was conducted on 145 government managers that took health examinations in Tongji Hospital, Wuhan, China during 2005. The results showed that the determinations of organic functions including BMI, hemoglobin, blood platelet count, urine protein, urine WBC and lipid metabolism (LDL) were associated with HRQoL. The lifestyle items including age, sex, life satisfaction, drinking alcohol and kind of alcohol drunk, drinking tea, sleep quality and adhering to bedtime, working overtime, work stress were associated with HRQoL in the multiple regression models. Sex, age and life satisfaction were the lifestyle items most closely associated with HRQoL, while LDL, hemoglobin and urine protein were the health examination items most closely associated HRQoL. This study revealed that both lifestyle and health examination items were associated with HRQoL.

Awareness, Practice and Intention to Practice Testicular Self-Examination among Professional Working Males in Ghana

Background: The aetiology of Testicular Cancer (TC) is still unknown to researchers but many of the associated risk factors have been identified. These include family history, age, racial origin, cryptorchidism, urogenital malformations, testicular atrophy, and infertility. Given the lack of scientific data on the causes of the disease, it has been asserted in previous studies that the promotion of awareness and early detection are prerequisites to mitigating risks of metastasis as well as improving survival. This study is to assess the awareness, practice, and intention to practice testicular self-examination among professional working males in Accra. Methods: A quantitative cross-sectional design with a structured research instrument was used to collect data from respondants. The purposive and convenience sampling techniques were used to collect data from 300 men at Accra in Ghana. The study was conducted at two (2) Universities and a Senior High school at Accra in Ghana. The data was then analysed using descriptive statistics, logistic regression, multiple linear regression, and structural equation modeling. Results: From the study findings, 37% of male participants rated their knowledge of testicular self-examination and related symptoms as good, 28% of participants practised testicular self-examination monthly, while 65% of respondents expressed their intention to practice monthly testicular self-examination. The findings from logistic regression demonstrated that level of education, age, and marital status of participants had a significant influence on testicular self-examination. Additionally, the multiple linear regression results revealed knowledge and self-efficacy significantly predict testicular self-examination intention. The path coefficient results from the structural equation model are consistent with results from the regression models. Conclusion: This research is the first to investigate testicular self-examination among men in Ghana. The findings revealed awareness and practice of TSE are low among participants. Therefore, the research findings would improve the expertise of physicians and nurses in providing counsel, intervention, and support for patients at risk of testicular cancer.

Providing Physical and Mental Health Support Using Medical Examination Data and Perceived Health

Without ascertaining workers’ perceived health, it is difficult to achieve behavioral modification even if health guidance is conducted. To investigate physical and mental health support emphasizing “positive health,” we used the Total Health Index (THI) survey with the purpose of elucidating the association between medical examination data and perceived health. After obtaining medical examination data from 90 men, we analyzed their responses to the THI survey. The results suggested that age and abnormal medical examination data are associated with physical and mental complaints. In the analysis by age group, we found that men in their 20s had more complaints of irregularity of daily life on the THI scale. The group who responded that they were not getting enough sleep had higher mean values of total cholesterol and fasting blood sugar. The group who responded that their meals were irregular had higher mean values of Body Mass Index, aspartate aminotransferase, and alanine aminotransferase. As confirmed by the THI, continuously supporting lifestyle improvement is important. The THI of the “health guidance” group indicated fewer physical health complaints and more aggression/extroversion than the “normal” group. In those for whom health guidance was applicable, participants who were “obese” and “hypertensive” had more aggression/extroversion and lesser extent of nervousness. Based on these findings, it was suggested that meaningful, personalized health support can be developed.

Analysis of health examination results of 774 policemen in a city of Hainan Province

Objective: To understand the health status of policemen in a city of Hainan Province, and find out the potential risk factors influencing their health. Methods: Health examination data of 774 policemen was collected, analyzed, and compared between age-groups, gender-groups and marital status-groups by using luster sampling. Results: 760 policemen had at least one abnormal examination (98.19%). The highest abnormality rate was blood lipid examination with 582 persons (75.19%), the second was liver function examination with 433 persons (55.94%), the third was body mass index-examination with 385 persons (49.74%). Among 15 examination items, 10 items in men had higher abnormal rate than those in women;11 items were statistically significant different among three age-groups;4 items in married had higher abnormal rate than those in unmarried. Conclusion: The health condition of policemen in a city of Hainan Province is not so optimistic, the main risk to health comes from lifestyle, and women are in better health condition than men. The older the police are, the worse they are.

The Association of Mercury and ALT with Obesity in Korean Adults Using Data from the Korea National Health and Nutrition Examination Survey for 11 Years(KNHANES 2005,2008-2017)

The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey(KNHANES)for 11 years in 2005 and between 2008 and 2017.The subjects with missing heavy metal blood tests,health interview data,and health examination data were excluded from the study.The study population comprised 1,844 individuals(972 men,and 872 women)who were eligible for inclusion.It was found that obesity and abdominal obesity were associated with an increase in both blood mercury(P<0.001)and alanine aminotransferase(ALT)(P<0.001).After adjusting the confounding factors,those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity(odds ratio 4.46,95%confidence interval 2.23-8.90,P<0.001)as well as abdominal obesity(odds ratio 5.36,95%confidence interval 2.57-11.17,P<0.001).The interrelationship of mercury and ALT with the parameters of body mass index(P for interaction=0.009)and waist circumference(P for interaction=0.012),respectively,have been observed to be significant,suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.

Analysis of risk factors for polypoid lesions of gallbladder among health examinees

AIM: To investigate the prevalence and risk factors of polypoid lesions of gallbladder (PLG) among the health examinees in the Shanghai region, China. METHODS: A total of 11 816 subjects who underwent health examinations in our hospital between August 2010 and February 2011 were analyzed retrospectively. Among them, there were 7174 men and 4642 women. PLG was diagnosed by the real-time ultrasonography. Those with the body mass index (BMI) ≥ 28 were considered to be obese. Blood biochemical indices were detected with the fully automatic biochemical analyzer and hepatitis B surface antigen (HBsAg) was tested by the automated enzyme immunoassay. The correlations between the prevalence of PLG and age, sex, BMI, serum cholesterol (T-Cho), triglycerides (TG),blood sugar, HBsAg, high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), gallstone and fatty liver were investigated. After univariate analysis of 11 variables, stepwise logistic regression analysis was performed to explore the risk factors of PLG. RESULTS: There was a significant difference in sex, T-Cho, HBsAg, HDL-C, LDL-C and fatty liver between the PLG-positive group and the PLG-negative group (332/163 vs 6842/4479, P = 0.003; 22/473 vs 295/11 026, P =0.013; 92/403 vs 993/10 328, P = 0.001; 47/448 vs 332/10 989, P = 0.001; 32/463 vs 381/10 940, P = 0.001; 83/412 vs 3260/8061, P = 0.001). No significant difference was found in the age, BMI, TG, blood sugar and gallstone between the two groups (47.3 ± 26 vs 45.1 ± 33, P = 0.173; 59/436 vs 1097/10 224, P = 0.102; 52/443 vs 982/10 339, P = 0.158; 17/478 vs 295/11 026, P = 0.26; 24/471 vs 395/10 926, P = 0.109). Logistic regression analysis showed that the sex, HBsAg and HDL-C were independent risk factors for the development of PLG in a descending order of HDL-C > HBsAg > sex. CONCLUSION: In healthy people, the male gender, positive HBsAg, and low HDL-C confer higher risks of PLG development.

Cross-sectional study of the association between triglyceride glucose-body mass index and obstructive sleep apnea risk

BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.

Association between high-sensitivity troponin T levels below the ninety-ninth percentile and diabetic kidney disease: A crosssectional study

BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.AIM To investigate the association between hs-TnT levels below the 99th percentile and the presence of diabetic kidney disease(DKD)in patients with diabetes mellitus.METHODS This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004,focusing on adults with type 2 diabetes mellitus.Serum hs-TnT concentrations were evaluated.DKD was defined as impaired glomerular filtration rate(<60 mL/minute/1.73 m^(2)),proteinuria(urinary albumin-to-creatinine ratio of≥30 mg/g),or both conditions in patients with diabetes mellitus.Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD,with the likelihood ratio test being used to evaluate nonlinearity.RESULTS The study included 2505 patients with a mean age of 55.02(standard error:0.72)years,of whom 44.87%were females.Among the participants,909(32.34%)were diagnosed with DKD.Multivariable logistic regression analysis indicated that,compared to the lowest tertile of hs-TnT(<5.93 ng/L),tertile 2(5.94-9.79 ng/L)had an odds ratio of 1.25(95%confidence interval:0.77-2.02,P=0.350),while tertile 3(9.80-21.88 ng/L)had an odds ratio of 2.07(95%confidence interval:1.13-3.80,P=0.022),with a significant trend(P for trend=0.022).Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population(P=0.061 for nonlinearity)and in male(P=0.136 for nonlinearity)and female(P=0.067 for nonlinearity)subgroups.Further stratification and sensitivity analyses yielded consistent conclusions.CONCLUSION Our study findings suggest that in individuals with type 2 diabetes,detectable hs-TnT levels below the 99th percentile are associated with DKD.

A cross-sectional study of the association between dietary inflammatory index and glaucoma prevalence in a US population

AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National Health and Nutrition Examination Survey(NHANES,2005-2008)for a cross-sectional study.DII was calculated from 24-hour dietary recall questionnaire conducted by experienced researchers and data analyzed in R according to the NHANES user guide,“Stratified Multi-stage Probability Sampling”.The relationship between DII and glaucoma was evaluated by multi-factor logistic regression analysis and the existence of a non-linear association examined by restricted cubic spline(RCS)analysis.RESULTS:A total of 5359 subjects were included and the cross-sectional analysis weighted to represent the US population of 109 million.DII was elevated in glaucoma patients(P<0.001)and smoking and alcohol use contributed to significant differences(P<0.001).DII correlated negatively with Healthy Eating Index(HEI)-2015(Spearman rank correlation coefficient,r=-0.49).RCS analysis showed a linear relationship between DII and glaucoma risk(P of non-linear relationship=0.575).CONCLUSION:An increased DII is strongly associated with high risk of glaucoma and diet-induced inflammation should be controlled to delay glaucoma progression.

1100例健康体检人群脉图参数特征研究

目的研究健康体检人群不同性别、年龄、体质的脉图参数特征。方法采用道生体质辨识系统采集1100例健康体检人群的脉图,分析不同性别、年龄、体质人群的脉图参数特征。结果男性主波高度(H1)、重搏波高度(H5)/H1高于女性,重搏前波高度(H3)/H1、降中峡高度(H4)/H1、脉图基线到峰顶高度上1/3处的脉图宽度(W1)/脉动周期(T)低于女性。与19~39岁比,40~60岁、61~80岁人群H1、H3/H1、T、W1/T更高,H5/H1更低;与40~60岁比,61~80岁人群H1、H3/H1、T更高,H5/H1更低。阴虚、痰湿和湿热质人群H1高于平和、阳虚质人群;气虚、阳虚、阴虚质人群H4/H1高于痰湿、湿热质人群;气虚、阴虚、血瘀和气郁质人群H5/H1低于平和、痰湿和湿热质人群;气虚、阴虚质人群W1/T高于平和质人群。结论男性左心室收缩力强、主动脉顺应性好、外周阻力小;年龄越大,动脉血管弹性、主动脉顺应性越差,脉率越慢,40岁和60岁可作为脉图参数变化的分界点;平和质和偏颇质的差异体现在H1、H4/H1、H5/H1、W1/T上,痰湿、湿热质人群脉力强、外周阻力小、主动脉顺应性好。

健康教育对适龄妇女“两癌”检查意愿性干预的效果

乳腺癌和宫颈癌作为女性最常见的恶性肿瘤,严重威胁着女性的生命健康。近年来,随着健康意识的提升和医疗技术的进步,早期筛查成为预防和控制“两癌”的重要手段。然而,由于多种因素的影响,适龄妇女对“两癌”筛查的认知不足,参与意愿性较低。文章旨在综述健康教育对适龄妇女“两癌”检查意愿性干预的效果,探讨其重要性及实施策略,为提高“两癌”筛查率提供参考。

心脏彩超多参数联合检测在老年门诊体检无症状性心肌缺血中的诊断价值研究

目的:评估心脏彩超多参数(左心室射血分数(left ventricular ejection fraction,LVEF)、左心室整体长轴应变(global longitudinal strain,GLS)、心肌收缩早期延迟时间、左心室心肌做功指数(Tei指数))联合检测在老年门诊体检无症状性心肌缺血中的诊断价值。方法:回顾性选取2022年1月至2024年2月在空军军医大学第一附属医院老年门诊体检的95例无症状性心肌缺血患者为研究组,另选取同期95例老年体检健康者为对照组。所有入选对象均进行Philips CX50心脏彩超检查,收集入选对象一般资料及心脏彩超相关参数。Logistic回归分析心脏彩超参数与无症状性心肌缺血的关系。受试者操作特征(ROC)曲线分析各参数单独及联合检测对无症状性心肌缺血的诊断价值。结果:Logistic回归显示,LVEF(OR=0.787,95%CI=0.690~0.898,P<0.001)、左心室GLS(OR=0.362,95%CI=0.223~0.587,P<0.001)、心肌收缩早期延迟时间(OR=1.189,95%CI=1.056~1.338,P=0.004)、左心室Tei指数(OR=13.317,95%CI=1.007~176.105,P=0.013)均为诊断无症状性心肌缺血的独立预测因子。心脏彩超参数LVEF(曲线下面积(AUC)=0.878)、左心室GLS(AUC=0.892)、心肌收缩早期延迟时间(AUC=0.836)、左心室Tei指数(AUC=0.778)均对无症状性心肌缺血具有良好诊断效能,各参数联合检测时AUC可达0.986,灵敏度为96.84%,特异度为92.63%。结论:心脏彩超多参数联合检测可显著提高无症状性心肌缺血的诊断效能,有助于老年门诊体检中无症状性心肌缺血的客观评估与早期筛查。

戊酸雌二醇联合甲硝唑治疗老年阴道炎的临床效果

目的观察戊酸雌二醇联合甲硝唑治疗老年阴道炎的临床效果。方法选取2020年8月—2021年1月宁津县中医院收治的100例老年阴道炎患者,采用掷硬币法分为对照组和观察组各50例。对照组采用甲硝唑片以及甲硝唑栓进行治疗,观察组在对照组用药基础上加用戊酸雌二醇进行治疗。比较两组治疗效果、生化检查指标、阴道卫生状况、不良反应总发生率及随访12个月后的复发率。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,观察组阴道卫生状况优于对照组,差异有统计学意义(P<0.05);治疗后,两组患者的雌二醇(E_(2))、孕酮(P)、一氧化氮(NO)及内皮素-1(ET-1)水平均有所上升,而免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平则下降,且观察组E_(2)、P、ET-1及NO水平均高于对照组,IgG、IgM低于对照组,差异有统计学意义(P<0.05);观察组不良反应总发生率及复发率均低于对照组,差异有统计学意义(P<0.05)。结论老年阴道炎患者采用戊酸雌二醇联合甲硝唑治疗效果较好,能够调节性激素水平、改善微生态环境、抑制病原体生长、增强机体免疫能力,且不良反应少、远期复发风险低。

TyG指数、METS-IR评分与代谢综合征患者预后的关系——一项基于NHANES数据库的研究

目的探讨甘油三酯-葡萄糖乘积指数(TyG)、胰岛素抵抗代谢评分(METS-IR)与代谢综合征(MetS)患者预后的关系。方法我们采用2011—2018年NHANES数据进行队列研究。采用多变量Cox比例风险回归模型评估TyG指数、METS-IR评分与全因病死率关系。并采用限制性四次样条对其非线性相关性进行研究。结果在总人群未经调整模型中表明,全因病死率随着TyG指数上升而增加,且结果显著(模型1:β=0.20,0.27,0.46;P<0.05),但调整后并无显著趋势。在MetS组人群中,无论调整与否,Q2、Q3、Q4组TyG指数与全因病死率均呈显著正相关(模型1:β=0.89,0.90,0.97;模型2:β=0.88,0.98,1.09;模型3:β=0.94,1.07,1.18;P<0.001),说明高TyG指数MetS患者死亡风险上升,且较一般人群更显著。METS-IR评分在Mets组人群中,经调整后,模型2、模型3中Q3、Q4组METS-IR评分与全因病死率呈显著正相关(模型2:β=0.46,0.64;模型3:β=0.41,0.42;P<0.01)。综上,高TyG指数、METS-IR评分与MetS患者死亡风险上升呈显著正相关,且较一般人群更显著。结论研究证实TyG指数、METS-IR评分与全因病死率呈U形相关,相较于非MetS患者,MetS患者死亡事件风险更易随TyG指数、METS-IR评分升高而增大。在诊疗中增加TyG指数、METS-IR评分评估将有助于了解MetS患者风险水平。

脑血管病防治指南(2024年版)

根据《健康中国行动——心脑血管疾病防治行动实施方案(2023-2030年)》有关要求,为进一步推进脑血管病防治工作,指导医疗卫生人员科学规范开展脑血管病防治相关工作,国家卫生健康委员会委托国家神经疾病医学中心(首都医科大学附属北京天坛医院)牵头,组织相关领域专家编写了《脑血管病防治指南(2024年版)》。主要内容包括脑血管病的定义、疾病负担、急救、预防,脑梗死、短暂性脑缺血发作、脑出血、蛛网膜下腔出血、颅内静脉血栓形成的临床管理,脑血管病并发症的处理,脑血管病护理、康复、公众健康教育、自我管理等,供各地推广使用。