Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-02-20 Cooperative journals: 《中国全科医学》
Abstract： Background Cardiovascular disease（CVD）is the leading cause of death in China and the world as a whole，and lipid metabolism disorder is the key factor for this disease. A comprehensive understanding of the prevalence of dyslipidemia in children and adolescents can contribute to the early prevention of dyslipidemia in adulthood. Objective To systematically evaluate the status quo of the prevalence of dyslipidemia in Chinese children and adolescents. Methods Cross#2;sectional studies on the morbidity rate of dyslipidemia among Chinese children and adolescents and published from 2015 to July 2023 were retrieved from databases of CBM，CNKI，Wanfang，VIP，Embase，Web of Science and The Cochrane Library. Processes of literature screening，data extraction and risk bias analysis were performed by two researchers. A meta-analysis was performed by taking advantage of Stata 17.0. Results 34 cross-sectional studies were collected and a total of 134438 children and adolescents were involved. Results of the meta-analysis indicated that the overall morbidity rate of dyslipidemia in Chinese children and adolescents was 19%（95%CI=16%-21%），and the morbidity rates of high cholesterol（TC），high triacylglycerol（TG），high low-density lipoprotein cholesterol（LDL-C），low high-density lipoprotein cholesterol（HDL-C） were 6%（95%CI=5%-7%），9%（95%CI=6%-12%），4%（95%CI=3%-5%）and 10%（95%CI=7%-13%）respectively. Regarding time distribution，the detection rate of dyslipidemia was fluctuant and showed a decreasing trend； the detection rate of high TC and high LDL-C showed an increasing trend in general，but it fell slightly in 2023； the detection rate of high TG and low HDL-C fluctuated greatly： the detection rate of high TG gradually decreased from 2018 to 2022 and rebounded slightly in 2023. The results of subgroup analysis showed that，concerning age，the overall morbidity rate of dyslipidemia in children and adolescents and that of high TC showed an ascending tendency with the increasing of age（10% and 2% for those aged from 3 to 6，17% and 10% for those aged from 7 to 11，and 27% and 14% for those aged from 12 to18），the morbidity rate of lowered HDL-C was higher among 12-to-18-year olds（21%）than among 7-to-11-year olds（9%），and the morbidity rate of high TC among 3-to-6-year olds（9%）was higher than that among 7-to-11-year olds and 12-to-18-year-olds（4% and 3%）. Concerning region，the morbidity rates of high TG and low HDL-C were higher in the West（15% and 5%）than those in the East（5% and 7%），and the morbidity rates of high TC and high LDL-C were higher in the East（7% and 6%）than in the West（3% and 2%）. Concerning BMI，the morbidity rates of dyslipidemia，high TG and high LDL-C were higher in obese children and adolescents （48%，18%，25%，and 7%）than in overweight（27%，6%，9%，and 4%）and normal children and adolescents（15%， 4%，3%，and 3%）. Conclusion The morbidity rate of dyslipidemia in Chinese children and adolescents is relatively high and varied across the age，region and BMI of children and adolescents. Due to the limitation of the number and quality of included studies，more high-quality studies are needed to be conducted to further validate these findings.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-02-20 Cooperative journals: 《中国全科医学》
Abstract： Background Chronic kidney disease has become a major global concern，and the prevalence of kidney disease in China is the highest in the world. About 89.5% of patients require hemodialysis. In recent years，the prevalence of frailty in maintenance hemodialysis（MHD）patients has risen significantly，seriously affecting the quality of life and prognosis of patients. Objective To explore the prevalence of frailty and the influencing factors of maintenance hemodialysis patients in China through Meta-analysis. Methods Cross-sectional and cohort studies on the prevalence and influencing factors of frailty in Chinese MHD patients were systematically searched in CNKI，VIP，CBM，Wanfang Data，Web of Science，PubMed， Cochrane Library，Embase，and CINAHL databases. The search deadline was from the respective databases to July 2023. Literature screening，data extraction and quality assessment were performed independently by two researchers. Stata 15.0 was used for meta-analysis. Results Thirty-two papers were included，and including 6 746 patients，among which 2 566 experienced frailty，involving 37 influencing factors. Meta-analysis showed that the prevalence of frailty in MHD patients in China was 37.4%（95%CI=30.3%-44.5%）. Age（OR=1.09，95%CI=1.06-1.13），age>60 years（OR=3.81，95%CI=2.31- 6.30），female（OR=2.13，95%CI=1.47-3.08），living alone（OR=2.42，95%CI=1.22-4.80），sleep（OR=1.28， 95%CI=1.08-1.50），depression（OR=1.97，95%CI=1.26-3.08），age on dialysis（OR=3.25，95%CI=1.82-5.79），social support（low level）（OR=1.99，95%CI=1.39-2.86），comorbidities（OR=1.79，95%CI=1.40-2.30），malnutrition（OR=1.17， 95%CI=1.07-1.28），Charlson comorbidity index（CCI）（OR=1.32，95%CI=1.01-1.71），C-reactive protein（CRP） （OR=1.15，95%CI=1.09-1.21），hemoglobin（Hb<110 g/L）（OR=2.70，95%CI=1.67-4.36），comorbid diabetes （OR=2.16，95%CI=1.48-3.16），comorbid cerebrovascular disease（OR=2.66，95%CI=1.85-3.82），comorbid coronary heart disease（OR=3.50，95%CI=2.15-5.70） were risk factors for frailty MHD；economic income （OR=0.02，95%CI=0.01- 0.14），social support（high level）（OR=0.86，95%CI=0.76-0.97），well nutrition （OR=0.47，95%CI=0.26-0.85）， ability to perform activities of daily living（ADL）（OR=0.80，95%CI=0.70-0.91），serum albumin（ALB）（OR=0.84， 95%CI=0.77-0.91），Hb ≥ 110 g/L（OR=0.70，95%CI=0.54-0.90），25-hydroxyvitamin D［25-（OH）VD］（OR=0.69， 95%CI=0.49-0.98） were protective factors for MHD frailty. Conclusion The prevalence of frailty in MHD patients in China is at a high level，in which age，female，living alone，economic income，sleep，depression，age on dialysis，social support， comorbidities，nutritional risk scores，ADL，CCI，CRP，ALB，Hb，25-（OH）VD，comorbid diabetes mellitus，comorbid cerebrovascular disease，and comorbid coronary heart disease are mainly factors influencing of MHD frailty patients in China， and in the future，there is a need for early screening and intervention to slow down or avoid the occurrence of hemodialysis frailty in patients.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-07-06 Cooperative journals: 《中国全科医学》
Abstract： Background The presence of insomnia symptoms reduces the quality of life of perimenopausal women and increases their risk of developing other diseases. Currently，there are numerous non-pharmacological interventions available to improve perimenopausal insomnia symptoms，with disagreement as to which intervention is most effective. Objective To evaluate the efficacy of non-pharmacological interventions in improving perimenopausal insomnia symptoms using a network meta-analysis. Methods In March 2022，Cochrane Library，PubMed，EmBase，Web of Science，CNKI，Wanfang Data Knowledge Service Platform，VIP and CBM were searched for the randomized controlled trials（RCTs）on the improvement of perimenopausal insomnia symptoms by non-pharmacological interventions from inception to March 2022. Two investigators independently screened the literature，extracted data，and evaluated the risk of bias of the included literature using the RCT bias risk assessment tool recommended by the Cochrane Manual of Systematic Review 5.1.0. A Bayesian network meta-analysis was performed on the overall response rate to the improvement of perimenopausal insomnia symptoms，as well as improvement in Pittsburgh Sleep Quality Index Scale（PSQI）score，Kupperman score and estradiol（E2）level under different non pharmacological interventions by using R 4.1.3 software and the GeMTC package. Results A total of 44 RCTs including 3386 patients were selected，involving 12 non-pharmacological interventions（moxibustion，electroacupuncture，acupoint pressing with beans，scraping，fire dragon pot，thumbtack needle，massage，warm acupuncture，bee acupuncture，acupoint embedding，music therapy，acupuncture）. The results of meta-analysis showed that moxibustion，electroacupuncture，and acupuncture were superior to sedative-hypnotic western drugs in overall response rate to the improvement of perimenopausal insomnia symptoms（P<0.05），and moxibustion was identified as the most probable superior intervention. Moxibustion，electroacupuncture，scraping，and acupuncture were superior to sedative-hypnotic western drugs（P<0.05），moxibustion was more effective than warm acupuncture（P<0.05）in the improvement of PSQI score and identified as the most probable superior intervention. There was no significant difference in the improvement of Kupperman score and E2 level among different interventions（P>0.05），with scraping emerging and acupuncture as the most probable superior intervention，respectively. Conclusion Current evidence demonstrates that moxibustion is superior in overall response rate to the improvement of perimenopausal insomnia symptoms and PSQI score in perimenopausal women，while scraping is superior in improving Kupperman score and acupuncture has advantages in improving E2 level，however，further validation of this conclusion is needed by conducting more high-quality studies.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-07-04 Cooperative journals: 《中国全科医学》
Abstract： Background China has entered a comprehensive aging society，and stroke is the primary cause of death and disability among adults in China，post-stroke cognitive impairment has become an important cause for long-term disability and quality of life decline in stroke patients. Objective To analyse and clarify the prevalence and influencing factors of cognitive impairment in elderly stroke patients by Meta-analysis. Methods CNKI，Wanfang Data Knowledge Service Platform，VIP，China Biology Medicine disc（CBM），PubMed，Embase，Cochrane Library，and Web of Science were searched by computer to collect cohort，case-control，and cross-sectional studies on influencing factors of cognitive impairment in elderly stroke patients from inception to 2023-02-12. After independent screening of the literature and data extraction by two investigators，the quality of the literature was assessed and a Meta-analysis of the prevalence and influencing factors of cognitive impairment in elderly stroke patients in China was performed using Stata 14.0 software. Results A total of 46 papers were included，with 3，281 cases of cognitive impairment and 27 influencing factors involved. The Meta-analysis results showed that the prevalence of cognitive impairment in elderly stroke patients in China was 42.4%〔95%CI（36.6%，48.3%〕；female〔OR=4.167，95%CI（1.937，8.967），P<0.001〕，hypertension〔OR=2.824，95%CI（2.292，3.481），P<0.001〕，systolic blood pressure〔OR=1.572，95%CI（1.444，1.711），P<0.001〕，diabetes mellitus〔OR=3.344，95%CI（2.611，4.284），P<0.001〕，hyperlipidemia 〔OR=2.228，95%CI（1.091，4.547），P=0.028〕，carotid plaque 〔OR=2.544，95%CI（1.076，6.014），P=0.033〕，infarction location of frontal lobe〔OR=1.615，95%CI（1.167，2.235），P=0.004〕，infarction location of temporal lobe〔OR=1.739，95%CI（1.246，2.427），P=0.001〕，multiple cerebral infarction〔OR=2.583，95%CI（2.009，3.321），P<0.001〕，encephalanalosis 〔OR=2.943，95%CI（1.938，4.469），P<0.001〕，homocysteine （Hcy）〔OR=2.209，95%CI（1.656，2.948），P<0.001〕，hyperhomocysteinemia〔OR=3.043，95%CI（2.092，4.426），P<0.001〕，high-sensitivity C-reactive protein （hs-CRP）〔OR=4.331，95%CI（1.756，10.685），P=0.001〕，and National Institutes of Health Stroke Scale （NIHSS）score >10〔OR=1.977，95%CI（1.320，2.961），P=0.001〕 were risk factors for cognitive impairment in elderly stroke patients in China. Conclusion The prevalence of cognitive impairment in elderly stroke patients in China was high （42.4%），and female，hypertension，systolic blood pressure，diabetes mellitus，hyperlipidemia，carotid plaque，infarction location of frontal lobe and temporal lobe，multiple cerebral infarction，encephalanalosis，Hcy，hyperhomocysteinemia，hs-CRP，and NIHSS score >10 were risk factors for cognitive impairment in elderly stroke patients in China.
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