Factors influencing quality of life in Chinese patients with dementia: a systematic review

Background:Dementia is a group of nervous system diseases characterized by progressive cognitive decline,leading to a loss of self-care ability and a decline in well-being.This places a significant burden on the global healthcare system,with Chinese patients accounting for approximately one-quarter of the world’s dementia cases.Therefore,it is crucial to identify factors that impact the quality of life(QOL)among elderly Chinese individuals with dementia.Method:To achieve this,we conducted a comprehensive search of several databases,including PubMed,Embase,Web of Science,the Cochrane Library,China National Knowledge Infrastructure,Wanfang Data,China VIP Database and China Biomedical Literature Database.We reviewed cross-sectional studies from the inception of these databases until March 27,2022.QOL outcomes were assessed using standardized scales in the studies included in this review.Results:The search yielded a total of 1,235 relevant articles,from which we finally included 21 cross-sectional studies and one longitudinal study after rigorous quality assessment.Among these,10 studies were classified as high quality,while 12 were classified as fair quality.Through our analysis,we identified 28 patient-rated QOL factors and 14 caregiver-rated QOL factors.These factors were categorized into three groups:patient,disease-related and caregiver.Factors commonly found to influence patient-rated QOL included age,education,marital status,depression,self-care ability,dementia severity,cognitive function,behavioral and psychological symptoms of dementia and caregiver burden.Similarly,factors commonly influencing caregiver-rated QOL included economic status,depression,self-care ability,dementia severity,cognitive function,behavioral and psychological symptoms of dementia and caregiving time.Conclusion:This review clarifies the factors that influence the QOL of Chinese individuals with dementia.When implementing interventions,it is crucial to consider the differences between patient-rated QOL and caregiver-proxy-rated QOL,as well as their respective influencing factors.

Symptomatic COVID-19 in University Students: A School-Wide Web-Based Questionnaire Survey during the Omicron Variant Outbreak

Aim: To detect risk and preventive factors associated with the Omicron variant infection in university students, a combination of a web-based survey and multivariate logistic regression analysis was introduced as the front-line initiatives by the school health practitioners. Design: Questionnaire survey. Methods: The school-wide web-based questionnaire survey was conducted among our university students as a part of the annual health check-up in April, 2023. The positive outcome was confined to the first symptomatic COVID-19 onset during the Omicron variant outbreak. Results: In this self-administered survey, risk or protective associations were merely estimated statistically in university students (n = 5406). In measured factors, karaoke and club/group activities could maintain the statistical significance in adjusted odds ratios (ORs) as relative risk factors, and science course, measles/ rubella (MR) vaccination, and COVID-19 vaccination remained as relative protective factors in adjusted OR analyses. Club/group activities with member gathering and karaoke sing-along sessions in university students may frequently have WHO’s three Cs. These risk factors are still important topics for the infection control of COVID-19 in university students. Together with some recent reports from other researchers, the significant protective role of MR vaccine in our survey warrants further clinical investigation. If the breakthrough infection continuously constitutes the majority of infection, real data in test-negative case-control or web-based questionnaire design continue to be important for statistical analysis to determine the minimal requirement of our strategies which may be equivalent to or replace COVID-19 vaccines.

Risk factors for overuse injuries in short-and long-distance running: A systematic review

Purpose:The aim of this study was to review information about risk factors for lower extremity running injuries in both short-distance(mean running distance-20 km/week and-10 km/session)and long-distance runners(mean running distance>20 km/week and>10 km/session).Methods:Electronic databases were searched for articles published up to February 2019.Prospective cohort studies using multivariable analysis for the assessment of individual risk factors or risk models for the occurrence of lower extremity running injuries were included.Two reviewers independently selected studies for eligibility and assessed risk of bias with the Quality in Prognostic Studies Tool.The GRADE approach was used to assess the quality of the evidence.Results:A total of 29 studies were included:17 studies focused on short-distance runners,11 studies focused on long-distance runners,and 1 study focused on both types of runners.A previous running-related injury was the strongest risk factor for an injury for long-distance runners,with moderate-quality evidence.Previous injuries not attributed to running was the strongest risk factor for an injury for short-distance runners,with high-quality evidence.Higher body mass index,higher age,sex(male),having no previous running experience,and lower running volume were strong risk factors,with moderate quality evidence,for short-distance runners.Low-quality evidence was found for all risk models as predictors of runningrelated injuries among short-and long-distance runners.Conclusion:Several risk factors for lower extremity injuries have been identified among short-and long-distance runners,but the quality of evidence for these risk factors for running-related injuries is limited.Running injuries seem to have a multifactorial origin both in short-and long-distance runners.

Breastfeeding and genetic factors in the etiology of inflammatory bowel disease in children

Inflammatory bowel disease is a chronic,debilitating disorder of the gastrointestinal tract.The etiology of inflammatory bowel disease has not been elucidated,but is thought to be multifactorial with both environmental and genetic influences.A large body of research has been conducted to elucidate the etiology of inflammatory bowel disease.This article reviews this literature,emphasizing the studies of breastfeeding and the studies of genetic factors,particularly NOD2 polymorphisms.

Pre-B-cell colony-enhancing factor as a target for protecting against apoptotic neuronal death and mitochondrial damage in ischemia

Focal ischemic stroke（FIS）results from the lack of blood flow in a particular region of the brain and accounts for about 80%of all human strokes.Although tremendous efforts have been made in translational research,the treatment strategies are still limited.Tissue plasminogen activator is the only FDA-approved drug currently available for acute stroke treatment,

Risk factors of COVID-19 infection among policemen: A case-control study

Objective:To investigate the risk factors and protective measures of COVID-19 among policemen in an eastern state of India.Methods:This case-control study was conducted in Bihar,located in the eastern part of India.In total,6 confirmed COVID-19 cases(the case group)and 11 negative contacts of these cases(the control group)of Bihar Military Police participated in the study.Results:All subjects were male with a median age of 51(range:23-60)years.Among these 6 confirmed cases,5 cases were asymptomatic.One third(33.3%)of the case group and the majority(90.9%)of the control group reported maintenance of physical distance of at least 1 meter with others all the time,which was significantly different(P=0.028).There was no other statistically significant difference between the case group and the control group.Conclusions:Physical distancing is the most effective public health measure to control contagious diseases like COVID-19,especially in the absence of an effective vaccine in police settings.

Identifying survival protective factors for chronic dialysis patients with surgically confirmed acute mesenteric ischemia

BACKGROUND Mesenteric ischemia is significantly more common in end-stage kidney disease patients undergoing chronic dialysis than in the general population and is associated with high morbidity and mortality. However, reports on prognostic factors in this population are limited.AIM To elucidate the in-hospital outcomes of acute mesenteric ischemia in chronic dialysis patients and to analyze protective factors for survival.METHODS The case data of 426 chronic dialysis patients who were hospitalized in a tertiary medical center for acute mesenteric ischemia over a 14-year period were retrospectively reviewed. Of these cases, 103 were surgically confirmed, and the patients were enrolled in this study. A Cox regression analysis was used to evaluate the protective factors for survival.RESULTS The in-hospital mortality rate among the 103 enrolled patients was 46.6%.Univariate analysis was performed to compare factors in survivors and nonsurvivors, with better in-hospital outcomes associated with a surgery delay(defined as the time from onset of signs and symptoms to operation) < 4.5 d, no shock, a higher potassium level on day 1 of hospitalization, no resection of the colon, and a total bowel resection length < 110 cm. After 1 wk of hospitalization, patients with lower white blood cell count and neutrophil counts, higher lymphocyte counts, and lower C-reactive protein levels had better in-hospital outcomes. Following multivariate adjustment, a higher potassium level on day 1 of hospitalization(HR 1.71, 95%CI 1.19 to 2.46;P = 0.004), a lower neutrophil count(HR 0.91, 95%CI 0.84 to 0.99;P = 0.037) at 1 wk after admission, resection not involving the colon(HR 2.70, 95%CI 1.05 to 7.14;P = 0.039), and a total bowel resection length < 110 cm(HR 4.55,95%CI 1.43 to 14.29;P = 0.010) were significantly associated with survival.CONCLUSION A surgery delay < 4.5 d, no shock, no resection of the colon, and a total bowel resection length <110 cm predicted better outcomes in chronic dialysis patients with acute mesenteric ischemia.

Meta-analysis of risk factors for PTDM after renal transplantation in China in the past 10 years

Objective:To systematically evaluate the main risk factors of post-transplant diabetes mellitus(PTDM)after renal transplantation in China in the past 10 years.Methods:CNKI,Wanfang,VIP,and PubMed were searched to collect the related literatures on risk factors of PTDM after renal transplantation published by Chinese scholars from January 2010 to October 2020.The data were extracted and Meta-analysis was performed by Revman 5.3 software.Results:A total of 18 case-control studies were included,involving 5458 patients.There were 1106 PTDM cases after kidney transplantation and 4352 cases without PTDM after kidney transplantation.Meta-analysis results showed age[MD=6.09,P<0.00001],gender[OR=1.22,P=0.02],family history of diabetes[OR=5.56,P<0.0001],source of donor kidney[OR=1.87,P<0.0001],BMI[MD=1.76,P<0.00001],HBV infection[OR=2.52,P=0.04],HCV infection[OR=2.55,P<0.0001],CMV infection[OR=1.81,P=0.008],Cyclosporin A[OR=0.51,P=0.04],tacrolimus[OR=2.34,P=0.003],acute rejection[OR=2.72,P<0.00001],and smoking history[OR=2.01,P=0.0006]were associated with PTDM after renal transplantation in China.Conclusion:Age,gender,family history of diabetes,source of kidney donors,BMI,HBV,HCV,CMV,tacrolimus,acute rejection,and smoking history are risk factors for PTDM after kidney transplantation in China.Cyclosporin A is protective factors of PTDM after kidney transplantation in China.These factors are worthy of attention by relevant clinical workers in our country.

The Phytochemical Profile and Photoprotective Potential of Bark and Leaves of Erythrina velutina Willd.—A Medicinal Species from the Caatinga Region of Brazil

The use of medicinal plants as therapeutic and economic resources has been on the rise in recent years. In Brazil, however, increasing doubt is being cast on the quality of these products, owing to the prevalence of adulteration and fraud. Solar radiation can cause serious damage to human skin, as a result, mostly, of ultraviolet light, which is a cause of skin cancer. Photoprotective substances are capable of absorbing, reflecting, or refracting ultraviolet radiation and thus protecting skin from exposure to sunlight. The present study aimed to characterize samples and examine the phytochemical profile and photoprotective potential of bark and leaves of Erythrina velutina Willd. The samples underwent five extraction methods using 80% ethanol. The phenolic content was measured using spectrophotometry. Antioxidant activity was examined using the DPPH and the photoprotective properties of the plant extracts were assessed using the method developed by Mansur. There was a quantitative difference in some groups of metabolites, with higher levels of tannin in the bark and of flavonoids in the leaves. The latter showed greater DPPH free radical scavenging capacity than the bark, although higher levels of SPF were obtained from the bark, with no statistically significant differences between methods. The results indicate that Erythrina velutina Willd. has potential as a photoprotector.

Prenatal and postnatal factors associated with sudden infant death syndrome:an umbrella review of meta-analyses

Background Comprehensive quantitative evidence on the risk and protective factors for sudden infant death syndrome(SIDS)effects is lacking.We investigated the risk and protective factors related to SIDS.Methods We conducted an umbrella review of meta-analyses of observational and interventional studies assessing SIDS-related factors.PubMed/MEDLINE,Embase,EBSCO,and Google Scholar were searched from inception until January 18,2023.Data extraction,quality assessment,and certainty of evidence were assessed by using A Measurement Tool Assessment Systematic Reviews 2 following PRISMA guidelines.According to observational evidence,credibility was graded and classified by class and quality of evidence(CE;convincing,highly suggestive,suggestive,weak,or not significant).Our study protocol was registered with PROSPERO(CRD42023458696).The risk and protective factors related to SIDS are presented as equivalent odds ratios(eORs).Results We identified eight original meta-analyses,including 152 original articles,covering 12 unique risk and protective factors for SIDS across 21 countries/regions and five continents.Several risk factors,including prenatal drug exposure[eOR=7.84(95%CI=4.81–12.79),CE=highly suggestive],prenatal opioid exposure[9.55(95%CI=4.87–18.72),CE=suggestive],prenatal methadone exposure[9.52(95%CI=3.34–27.10),CE=weak],prenatal cocaine exposure[4.38(95%CI=1.95–9.86),CE=weak],prenatal maternal smoking[2.25(95%CI=1.95–2.60),CE=highly suggestive],postnatal maternal smoking[1.97(95%CI=1.75–2.22),CE=weak],bed sharing[2.89(95%CI=1.81–4.60),CE=weak],and infants found with heads covered by bedclothes after last sleep[11.01(95%CI=5.40–22.45),CE=suggestive],were identified.On the other hand,three protective factors,namely,breastfeeding[0.57(95%CI=0.39–0.83),CE=non-significant],supine sleeping position[0.48(95%CI=0.37–0.63),CE=suggestive],and pacifier use[0.44(95%CI=0.30–0.65),CE=weak],were also identified.Conclusions Based on the evidence,we propose several risk and protective factors for SIDS.This study suggests the need for further studies on SIDS-related factors supported by weak credibility,no association,or a lack of adequate research.

Equivalent protection factor of bi-layer ceramic metal structures

With increasing ballistic threat levels,there is ever more demand on developing ceramic armor designs with improved performance.This paper presents finite element simulations that investigate the performance of silicon carbide ceramic with steel 4340 backing material and titanium alloy,graphite as buffer layers when subjected to normal and oblique impacts by a tungsten alloy long rod projectile(LRP).Depth of penetration from experimental measurements is compared with simulations to confirm the validity of constitutive,failure model parameters.Titanium alloy cover plate and graphite interface weak layer laterally spread the impact shock away from the SiC tile and reduces the amplification of the stress accumulation at the front surface of the SiC tile.The dwelling time increases before it penetrates into ceramic armor.Further,using AUTODYN®numerical simulations detailed parametric study is carried out to identify the minimum areal density armor for a given ballistic limit velocity.The equivalent protection factor for the bi-layer armor is a simple function of the cosine of the angle of impact.

Dyeing of Polyester and Nylon with Semi-synthetic Azo Dye by Chemical Modification of Natural Source Areca Nut

Various azo compounds(Modified dyes)have been synthesised by chemical modification of areca nut extract(epicate-chin),a plant-based Polyphenolic compound to get semi-synthetic dyes.Three different primary amines namely p-nitro aniline,p-anisidine and aniline,were diazotized to form their corresponding diazonium salts which were further coupled with an areca nut extract.Preliminary characterization of the areca nut extract and the resultant azo compounds(Modified dyes)was carried out in terms of melting point,solubility tests,thin layer chromatography,UV-Visible and FTIR spectroscopy.These modified dyes were further applied on polyester and nylon fabrics and%dye exhaustion was evaluated.Dyed fabrics were further tested for their fastness properties such as wash fastness,rubbing fastness,light fastness and sublimation fastness.The results of the fastness tests indicate that,all the three modified dyes have good dyeability for polyester and nylon fabrics.The dyed fabrics were also tested for ultraviolet protection factor which showed very good ultraviolet protection.

Molecular forms of trefoil factor 1 in normal gastric mucosa and its expression in normal and abnormal gastric tissues

AIM： To study the molecular forms of trefoil factor 1 （TFF1） in normal gastric mucosa and its expression in normal and abnormal gastric tissues （gastric carcinoma, atypical hyperplasia and intestinalized gastric mucosa） and the role of TFF1 in the carcinogenesis and progression of gastric carcinoma and its molecular biological mechanism underlying gastric mucosa protection. METHODS： The molecular forms of TFF1 in normal gastric mucosa were observed by Western blot. The expression of TFF1 in normal and abnormal gastric tissues （gastric carcinoma, atypical hyperplasia and intestinalized gastric mucosa） was also assayed by immunohistochemical method. The average positive AO was estimated by Motic Images Advanced 3.0 software. RESULTS： Three patterns of TFF1 were found in normal gastric mucosa： monomer, dimmer, and TFF1 compound whose molecular weight is about 21 kDa. The concentration of TFF1 compound was the highest among these three patterns. TFF1 was expressed mainly in epithelial cytoplasm of the mucosa in gastric body and antrum, especially around the nuclei. The closer the TFF1 to the lumen, the higher the expression of TFF1, The expression of TFF1 in peripheral tissue of gastric carcinoma （0.51 ± 0.07） was higher than that in normal gastric mucosa （0.44 ± 0.06, P 〈 0.001）. The expression of TFF1 in gastric adenocarcinoma was positively related to the differentiation of adenocarcinoma. The lower the differentiation of adenocarcinoma was, the weaker the expression of TFF1. No TFF1 was expressed in poorlydifferentiated adenocarcinoma. The expression of TFF1 in moderately-well differentiated adenocarcinoma （0.45 ± 0.07） was a little lower than that in normal mucosa （P 〉 0.05）. The expression of TFF1 in gastric mucosa with atypical hyperplasia （0.57 ± 0.03） was significantly higher than that in normal gastric mucosa （P 〈 0.001）. No TFF1 was expressed in intestinalized gastric mucosa. There was no statistically significant difference between the expressions of TFFI in gastric mucosa around the intestinalized tissue （0.45 ± 0.07） and normal gastric mucosa （P 〉 0.05）. CONCLUSION： TFF1 is expressed mainly in epithelial cytoplasm of the mucosa in gastric body and antrum. Its main pattern is TFF1 compound, which may have a greater biological activity than monomer and dimer. The expression of TFF1 in peripheral mucosa of gastric ulcer is higher than that in mucosa 5 cm beyond the ulcer, indicating that TFF1 plays an important part in protection and restitution of gastric mucosa. The expression of TFF1 is increased in peripheral tissues of gastric carcinoma and gastric mucosa with atypical hyperplasia, but is decreased in cancer tissues, implying that TFF1 may be related to suppression and differentiation of carcinoma. The weaker expression of TFF1 in poorly-differentiated carcinoma may be related to the destruction of glands and cells in cancer tissues and the decrease in secretion of TFF1.

A tribute to Dr.Frank I Tovey on his 90th birthday

This paper pays a tribute to Dr.Frank I Tovey on his 90th birthday which happens on September 1,2011,and briefly describes the major findings in his research career and contributions as follows.The geographical prevalence of duodenal ulceration is related to staple diets.Unrefined wheat and maize,soya,certain pulses and millets are associated with a low prevalence while refined wheat,maize and rice,yams,cassava and green banana with a high prevalence.Predominant foodstuffs from low prevalence areas are ulceroprotective in rat peptic ulcer models.The protective activity lies in the lipid fraction present in these foodstuffs.The lipid fraction also promotes ulcer healing,is active both orally and intramuscularly and is ulceroprotective against nonsteroidal anti-inflammatory drugs(NSAIDs).The phospholipids and phytosterols present in the lipid have been identified to be responsible for this protective activity.The combination of phospholipids and phytosterols may be of value in the prevention and treatment of duodenal ulceration and protection against the ulcerogenic effect of NSAIDs.

Smoking and Alzheimer's disease among Mongolian and Han Chinese aged 55 years and over living in the Inner Mongolia farming area of China

Residents aged 55 years or older from 27 communities and two settlements in Xilingol League of Inner Mongolia were selected for participation in an Alzheimer＇s disease epidemiological investigation from June 2008 to June 2009, including 3 259 Mongolians and 5 887 Han Chinese. The Mongolian subjects in the Alzheimer＇s disease group were at age of 55 years or older （on average）, and more of them were male, illiterate and/or had a history of coronary artery disease and/or diabetes compared with the Mongolian subjects in the non-Alzheimer＇s disease group. The Han Chinese subjects in the AIzheimer＇s disease group were at age of 55 years or older （on average） and more of them were women, illiterate and/or had a history of coronary artery disease, and less of them had a history of alcohol consumption compared with the non-Alzheimefs disease group. Non-conditional multivariate stepwise logistic regression identified that male gender, increasing age and having a history of diabetes and/or coronary heart disease were associated with higher odds of Alzheimer＇s disease among Mongolians while having an educational background was associated with lower odds （OR = 0.259, 95%C/0.174-0.386）. Among the Han Chinese subjects, male gender, increasing age and having a history of coronary heart disease and/or hypertension was associated with higher odds of Alzheimer＇s disease, while having an educational background was associated lower odds （OR = 0.271, 95%C/0.192-0.381）. The results also indicated that extremely heavy smoking may be a risk factor for Alzheimer＇s disease in Mongolian males aged over 55 years. There was no significant difference in smoking habits between the Mongolian and Han Chinese subjects with Alzheimer＇s disease.

Inhibition of epidermal growth factor receptor signaling protects human malignant glioma cells from hypoxia - induced cell death

Epidermal growth factor receptor(EGFR)signaling has become an importanttarget for drug development becauseEGFR signaling enhances tumor cell proliferation,migration,and invasion and inhibits apoptosis.However,theresults of clinical trials using EGFR inhibitors in patients with solid tumors have been disappointing.Here,wereport a protective effect of the EGFR inhibitors AG1478 and PD153035 against cell death induced by acute hy-poxia,which contrasts with their proapoptotic effects under normoxia.Under hypoxic conditions,both agents re-

Protection Performance Evaluationof the Respirators and PersonalExposure Measurement in aBelgian Viscose Rayon Factory

This paper presents the evaluation results of protective performance of the respirators (full face supplied-fresh air respirators and half-mask active charcoal filter) and personal exposure measurement (Infacepiece sampling) in a Belgian viscose rayon factory. With in-facepiece sampling technique and personal sampling method, we measured the CS2 concentrations inside and outside of the different respirators. We found two kinds of the respirators have significant effect on decreasing the CS2 exposure level for the subject, especially for the spinners. Full face supplied-fresh air respirator have good protective effect for the spinners and have limit protection for the high exposure job although the PF value is more than 10. It still need to improve more. In-facepiece sampling for all the subjects exposed to CS2 in the factory found most subjects have exposed to low CS2 concentration, most exposure levels were under the control range, but sulfuror are high exposure, the exposure level is higher than ACGIH TLV value.

Assessment of flavonoid-rich extracts from dark peels of Ficus carica L.fruits for cosmeceutical and antimicrobial applications

Background:Exploring natural sources to identify new active ingredients for cosmeceutical and pharmaceutical applications is of interest to many researchers.Methods:Flavonoid-rich extracts from dark Ficus carica peels were investigated in the present study.Extracts were prepared from the peels of four dark cultivars(Bakor Noir,Bouankik,Azenjer and Tazegaght)using acidified methanol.The antimicrobial activity of the extracts was evaluated by the agar well diffusion assay followed by the minimal inhibitory concentration determination using the microdilution method against Gram-positive and Gram-negative pathogenic bacteria and two fungi.Cosmeceutical properties were evaluated by measuring antioxidant activity,ultraviolet absorption characteristics and sun protection factor values.The antioxidant activity of the extracts was measured using aβ-carotene-linoleic acid system.The toxicity of the extracts was assessed using a brine shrimp lethality assay.Results:The extracts contained high amounts of phenolic compounds(3.85–8.63 g/100 g),mainly flavonoids(up to 5 g/100 g).Multiple antibacterial activities were recorded against Gram-positive and Gram-negative bacteria,with the best actions against Bacillus subtilis(minimal inhibitory concentration=156.25µg/mL),Staphylococcus aureus and Pseudomonas aeruginosa(minimal inhibitory concentration=312.5µg/mL),but no antifungal activity was recorded.Azenjer extract showed high inhibition of lipid oxidation evaluated by theβ-carotene bleaching assay with a half-maximal inhibitory concentration of 88.84µg/mL.All extracts showed absorption peaks in the ultraviolet range and Azenjer and Tazegaght extracts at 25 mg/mL presented sun protection factor values>15.The brine shrimp toxicity assay results revealed lethal concentration of 50%values greater than 2,000µg/mL,indicating the safety of the extracts.Conclusion:Therefore,Ficus carica peel extracts could be considered original ingredients with potential applications in the formulation of antibacterial drugs and skincare products.

Increasing prevalence and influencing factors of childhood asthma: a cross-sectional study in Shanghai, China

Background Asthma has been a global problem,especially in children.We aim to evaluate the contemporary prevalence and influencing factors of asthma among children aged 3–7 years in Shanghai,China.Methods A random sample of preschool children was included in this study.The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma.Multivariable logistic regression models were used to evaluate the associations between independent variables and childhood asthma.Results Of 6389 preschool children who were invited to take part in this study,6163(response rate:96.5%)completed the questionnaire and were included in the analysis.The overall prevalence of asthma was 14.6%which increased more than six folds from 2.1%in 1990.Being male,younger age,preterm delivery,being born in spring or autumn,being delivered by elective cesarean section without indication,miscarriage,high socioeconomic status,having allergy history,and exposure to passive smoking,latex paint,and dust were potential risk factors for childhood asthma.Spending more time outdoors(>30 min/day),having indoor plants,and cleaning rooms more frequently were potential protective factors.Conclusions The prevalence of childhood asthma in Shanghai has increased dramatically during the past three decades.The findings about risk and protective factors of childhood asthma could be used to develop appropriate strategies to prevent and control childhood asthma in Shanghai and in other similar metropolitan cities.

Associations of early-life factors and indoor environmental exposure with asthma among children:a case-control study in Chongqing,China

Background Childhood asthma has substantial effects on children’s health.It is important to identify influencing factors in early life in the development of childhood asthma.We aim to evaluate the effects of early-life factors and indoor environmental exposure on childhood asthma in Chongqing,China.Method We designed a case-control study to enrol children with asthma aged 3 to<14 years old and controls in Chongqing,China.The“Children’s Early Life and Indoor Environment Survey”was used to collect the early-life factors and indoor environmental exposure of foetuses in utero and of infants during the first 3 years of life.A multivariate logistic regression model was used to evaluate the association between independent variables and childhood asthma and the interaction of early-life factors and environmental exposure.Results A total of 160 asthma cases and 247 controls were included in this study.The mean ages of the cases and controls were 5.53±1.88 and 5.72±2.34 years,respectively(P=0.192).Early-life factors and indoor environmental exposure were independently associated with childhood asthma.Infectious diseases of the respiratory system in children under 3 years old[adjusted odds ratio(OR)=5.76,95%confidence interval(CI)2.49-13.30],bedroom air conditioner use(adjusted OR=4.61,95%CI 1.45-14.64),and bedroom dampness/mould(adjusted OR=2.98,95%CI 1.54-5.75)ranked as the three most significant exposures associated with the risk of childhood asthma.Other factors associated with an increased risk of childhood asthma included second-hand smoke exposure in early life(adjusted OR=1.93,95%CI 1.24-3.00),neonatal pneumonia(adjusted OR=1.90,95%CI 1.05-3.42)and maternal allergic diseases during pregnancy(adjusted OR=2.13,95%CI 1.10-4.10).The interaction effects of child second-hand smoke exposure with other covariates were not found to be statistically significant.Conclusions Early-life factors and indoor environmental exposure are closely related to childhood asthma in Chongqing,China.Further interventions and management in the early life of children should be considered to prevent and control childhood asthma in Chongqing and similar cities.