BACKGROUND Previous studies have demonstrated that dietary factors are involved in irritable bowel syndrome(IBS),but the role of diet was evaluated mostly based on food frequency questionnaire.Whether food categories,...BACKGROUND Previous studies have demonstrated that dietary factors are involved in irritable bowel syndrome(IBS),but the role of diet was evaluated mostly based on food frequency questionnaire.Whether food categories,quantity per time,and intake frequency are different between IBS patients and non-IBS individuals has not been clearly clarified.AIM To explore differences in dietary habits of people with vs without IBS and their correlation with symptom and psychological status.METHODS A total of 220 questionnaires were administered in a community population and the Rome IV criteria was applied to diagnose IBS.The dietary questionnaire used in this study was multidimensional from food categories,quantity per time,and intake frequency,in contrast to“yes or no”classification used in previous studies.Questionnaires including IBS symptom severity scale(IBS-SSS),IBS quality of life,visceral sensitivity index,hospital anxiety and depression score(HADS),and gastrointestinal symptom rating scale were used to assess the participants.Rank sum test was used to compare the quantity per time and intake frequency between IBS patients and non-IBS participants.The correlation between psychological factors and diet was evaluated by Spearman correlation analysis.Logistic regression analysis was used to assess the possible dietary risk factors for IBS.RESULTS In total,203 valid questionnaires were collected(response rate 92.3%).Twentyfive participants met the Rome IV criteria for IBS,including 15(60.0%)women and 10(40.0%)men.Compared with the non-IBS group,the quantity per time and intake frequency of soybean and its products,spicy food,and dry-fried nuts were statistically significant in IBS participants(P<0.05).They were positively associated with IBS-SSS and HADS anxiety and depression scores(P<0.05).Besides,seafood,soft drinks,vegetables,and fruits differed only in quantity per time.The intake frequencies of egg,barbecue,and coarse grain were statistically significant in IBS patients(P<0.05).We also found that the frequency of soybean and its products(≥7 times/week,odds ratio=11.613,95%confidence interval:2.145-62.855,P=0.004)was an independent risk factor for IBS.CONCLUSION Both quantity per time and intake frequency,especially soybean,differ between IBS patients and non-IBS participants.Dietary habits might play potential roles in the pathophysiology of IBS.展开更多
Common buckwheat(Fagopyrum esculentum),a specialty crop in southwest China,is not only used as a supplement to primary grain crops but also to produce beverages,such as tea and wine.To fully exploit the products made ...Common buckwheat(Fagopyrum esculentum),a specialty crop in southwest China,is not only used as a supplement to primary grain crops but also to produce beverages,such as tea and wine.To fully exploit the products made from common buckwheat flower,ultra-performance liquid chromatography–electrospray ionization–tandem mass spectrometry(UPLC–ESI–MS/MS)was conducted to analyze the metabolites in red-(‘Guihong 2’)and white-flowered(‘Fengtian 1’)buckwheat cultivars.A total of 784 metabolites were identified of which flavonoids were the largest group with 191 components,followed by organic acids and derivatives(126),and amino acids and derivatives(95).Besides,dozens of phenylpropanoids,nucleotides and derivates,lipids,alkaloids as well as several kinds of indole derivatives and sterides were detected.Among these rich varieties of metabolites,24 metabolites were only detected in the red flower that mainly included 8 anthocyanins and 6 flavones,while 22 metabolites were only detected in the white flower,which mainly contained 5 lipids,5 flavonoids,and 5 organic acids and derivatives.Our results enrich the metabolites’information of buckwheat and may be helpful for the exploitation of products from common buckwheat flowers.展开更多
BACKGROUND Prediabetes risk assessment models derived from large sample sizes are scarce.AIM To establish a robust assessment model for prediabetes and to validate the model in different populations.METHODS The China ...BACKGROUND Prediabetes risk assessment models derived from large sample sizes are scarce.AIM To establish a robust assessment model for prediabetes and to validate the model in different populations.METHODS The China National Diabetes and Metabolic Disorders Study(CNDMDS)collected information from 47325 participants aged at least 20 years across China from 2007 to 2008.The Thyroid Disorders,Iodine Status and Diabetes Epidemiological Survey(TIDE)study collected data from 66108 participants aged at least 18 years across China from 2015 to 2017.A logistic model with stepwise selection was performed to identify significant risk factors for prediabetes and was internally validated by bootstrapping in the CNDMDS.External validations were performed in diverse populations,including populations of Hispanic(Mexican American,other Hispanic)and non-Hispanic(White,Black and Asian)participants in the National Health and Nutrition Examination Survey(NHANES)in the United States and 66108 participants in the TIDE study in China.C statistics and calibration plots were adopted to evaluate the model’s discrimination and calibration performance.RESULTS A set of easily measured indicators(age,education,family history of diabetes,waist circumference,body mass index,and systolic blood pressure)were selected as significant risk factors.A risk assessment model was established for prediabetes with a C statistic of 0.6998(95%CI:0.6933 to 0.7063)and a calibration slope of 1.0002.When externally validated in the NHANES and TIDE studies,the model showed increased C statistics in Mexican American,other Hispanic,Non-Hispanic Black,Asian and Chinese populations but a slightly decreased C statistic in non-Hispanic White individuals.Applying the risk assessment model to the TIDE population,we obtained a C statistic of 0.7308(95%CI:0.7260 to 0.7357)and a calibration slope of 1.1137.A risk score was derived to assess prediabetes.Individuals with scores≥7 points were at high risk of prediabetes,with a sensitivity of 60.19%and specificity of 67.59%.CONCLUSION An easy-to-use assessment model for prediabetes was established and was internally and externally validated in different populations.The model had a satisfactory performance and could screen individuals with a high risk of prediabetes.展开更多
Background:It is crucial to improve the quality of care provided to ICU patient,therefore a national survey of the medical quality of intensive care units(ICUs)was conducted to analyze adherence to quality metrics and...Background:It is crucial to improve the quality of care provided to ICU patient,therefore a national survey of the medical quality of intensive care units(ICUs)was conducted to analyze adherence to quality metrics and outcomes among critically ill patients in China from 2015 to 2019.Methods:This was an ICU-level study based on a 15-indicator online survey conducted in China.Considering that ICU care quality may vary between secondary and tertiary hospitals,direct standardization was adopted to compare the rates of ICU quality indicators among provinces/regions.Multivariate analysis was performed to identify potential factors for in-hospital mortality and factors related to ventilator-associated pneumonia(VAP),catheter-related bloodstream infections(CRBSIs),and catheter-associated urinary tract infections(CAUTIs).Results:From the survey,the proportions of structural indicators were 1.83%for the number of ICU inpatients relative to the total number of inpatients,1.44%for ICU bed occupancy relative to the total inpatient bed occupancy,and 51.08%for inpatients with Acute Physiology and Chronic Health Evaluation II scores≥15.The proportions of procedural indicators were 74.37%and 76.60%for 3-hour and 6-hour surviving sepsis campaign bundle compliance,respectively,62.93%for microbiology detection,58.24%for deep vein thrombosis prophylaxis,1.49%for unplanned endotracheal extubations,1.99%for extubated inpatients reintubated within 48 hours,6.38%for unplanned transfer to the ICU,and 1.20%for 48-hour ICU readmission.The proportions of outcome indicators were 1.28‰for VAP,3.06‰for CRBSI,3.65‰for CAUTI,and 10.19%for in-hospital mortality.Although the indicators varied greatly across provinces and regions,the treatment level of ICUs in China has been stable and improved based on various quality control indicators in the past 5 years.The overall mortality rate has dropped from 10.19%to approximately 8%.Conclusions:The quality indicators of medical care in China’s ICUs are heterogeneous,which is reflected in geographic disparities and grades of hospitals.This study is of great significance for improving the homogeneity of ICUs in China.展开更多
Background:At present,a large number of chronic obstructive pulmonary disease(COPD)patients are undiagnosed in China.Thus,this study aimed to develop a simple prediction model as a screening tool to identify patients ...Background:At present,a large number of chronic obstructive pulmonary disease(COPD)patients are undiagnosed in China.Thus,this study aimed to develop a simple prediction model as a screening tool to identify patients at risk for COPD.Methods:The study was based on the data of 22,943 subjects aged 30 to 79 years and enrolled in the second resurvey of China Kadoorie Biobank during 2012 and 2013 in China.We stepwisely selected the predictors using logistic regression model.Then we tested the model validity through P-P graph,area under the receiver operating characteristic curve(AUROC),ten-fold cross validation and an external validation in a sample of 3492 individuals from the Enjoying Breathing Program in China.Results:The final prediction model involved 14 independent variables,including age,sex,location(urban/rural),region,educational background,smoking status,smoking amount(pack-years),years of exposure to air pollution by cooking fuel,family history of COPD,history of tuberculosis,body mass index,shortness of breath,sputum and wheeze.The model showed an area under curve(AUC)of 0.72(95%confidence interval[CI]:0.72-0.73)for detecting undiagnosed COPD patients,with the cutoff of predicted probability of COPD=0.22,presenting a sensitivity of 70.13%and a specificity of 62.25%.The AUROC value for screening undiagnosed patients with clinically significant COPD was 0.68(95%CI:0.66-0.69).Moreover,the ten-fold cross validation reported an AUC of 0.72(95%CI:0.71-0.73),and the external validation presented an AUC of 0.69(95%CI:0.68-0.71).Conclusion:This prediction model can serve as a first-stage screening tool for undiagnosed COPD patients in primary care settings.展开更多
Background:Influenza and pneumococcal vaccination are a priority in patients with chronic obstructive pulmonary disease(COPD).However,limited information is available on vaccination coverage among patients with acute ...Background:Influenza and pneumococcal vaccination are a priority in patients with chronic obstructive pulmonary disease(COPD).However,limited information is available on vaccination coverage among patients with acute exacerbations of COPD(AECOPD)in China.This study aimed to determine the rates and associated factors of influenza and pneumococcal vaccination in patients hospitalized with AECOPD.Methods:Baseline data from a national,multicenter,hospital-based study that included adult inpatients with AECOPD between 2017 and 2021 were analyzed.The outcomes of interest were the influenza vaccination in the past year and the pneumococcal vaccination in the past 5 years.To ensure national representativeness,rates were weighted according to the distribution of hospital levels and types enrolled in this study.Multivariable Poisson regression based on mixed-effects models were used to determine the associated factors.The independent variables included the region and hospital features where the participants were located,sociodemographic characteristics(age,sex,rural/urban residence,education,etc.),and clinical indicators(COPD disease history,lung function parameters,comorbidities,etc.).The treatment profiles of the vaccinated and unvaccinated participants were compared.Results:Of 6949 eligible participants,the weighted rates of influenza/pneumococcal,influenza,and pneumococcal vaccination were 2.72%(95%confidence interval[CI]:2.34%-3.10%),2.09%(95%CI:1.76%-2.43%),and 1.25%(95%CI:0.99%-1.51%),respectively.In multivariable models,age≥60 years(60-69 years,odds ratio[OR]:1.90,95%CI:1.11-3.25;≥80 years,OR:2.00,95%CI:1.06-3.78),geographical regions(Northern China relative to Eastern China,OR:5.09,95%CI:1.96-13.21),urban residence(OR:1.69,95%CI:1.07-2.66),a higher education level(junior high school,OR:1.77,95%CI:1.21-2.58;senior high school or above,OR:2.61,95%CI:1.69-4.03),former smoking(OR:1.79,95%CI:1.15-2.79),and regular inhaled medication treatment(OR:3.28,95%CI:2.29-4.70)were positively associated with vaccination.Patients who had experienced severe exacerbations in the past year were less likely to be vaccinated(OR:0.65,95%CI:0.45-0.96).Compared with unvaccinated participants,vaccinated participants adhered better to pharmacological and non-pharmacological treatment.Conclusions:Influenza and pneumococcal vaccination coverage are extremely low.Urgent measures are necessary to increase vaccination coverage among inpatients with AECOPD in China.展开更多
基金The National Key Technology Support Program during“12th Five-Year Plan”Period of China,No.2014BAI08B00the Leapforward Development Program for Beijing Biopharmaceutical Industry(G20),No.Z171100001717008.
文摘BACKGROUND Previous studies have demonstrated that dietary factors are involved in irritable bowel syndrome(IBS),but the role of diet was evaluated mostly based on food frequency questionnaire.Whether food categories,quantity per time,and intake frequency are different between IBS patients and non-IBS individuals has not been clearly clarified.AIM To explore differences in dietary habits of people with vs without IBS and their correlation with symptom and psychological status.METHODS A total of 220 questionnaires were administered in a community population and the Rome IV criteria was applied to diagnose IBS.The dietary questionnaire used in this study was multidimensional from food categories,quantity per time,and intake frequency,in contrast to“yes or no”classification used in previous studies.Questionnaires including IBS symptom severity scale(IBS-SSS),IBS quality of life,visceral sensitivity index,hospital anxiety and depression score(HADS),and gastrointestinal symptom rating scale were used to assess the participants.Rank sum test was used to compare the quantity per time and intake frequency between IBS patients and non-IBS participants.The correlation between psychological factors and diet was evaluated by Spearman correlation analysis.Logistic regression analysis was used to assess the possible dietary risk factors for IBS.RESULTS In total,203 valid questionnaires were collected(response rate 92.3%).Twentyfive participants met the Rome IV criteria for IBS,including 15(60.0%)women and 10(40.0%)men.Compared with the non-IBS group,the quantity per time and intake frequency of soybean and its products,spicy food,and dry-fried nuts were statistically significant in IBS participants(P<0.05).They were positively associated with IBS-SSS and HADS anxiety and depression scores(P<0.05).Besides,seafood,soft drinks,vegetables,and fruits differed only in quantity per time.The intake frequencies of egg,barbecue,and coarse grain were statistically significant in IBS patients(P<0.05).We also found that the frequency of soybean and its products(≥7 times/week,odds ratio=11.613,95%confidence interval:2.145-62.855,P=0.004)was an independent risk factor for IBS.CONCLUSION Both quantity per time and intake frequency,especially soybean,differ between IBS patients and non-IBS participants.Dietary habits might play potential roles in the pathophysiology of IBS.
基金This work was funded by the National Natural Science Foundation of China-Project of Karst Science Research Center of Guizhou Provincial People’s Government(U1812401)the Science and Technology Foundation of Guizhou Province(QianKeHeJiChu[2020]1Y095)+3 种基金Guizhou provincial department of education youth science and technology talent growth project(Qianjiaohe KY Zi[2018]128)the National Natural Science Foundation of China(31701494,31760419)the Initial Fund for Doctor Research in Guizhou Normal University(11904/0516026)the Earmarked Fund for construction of the Key Laboratory for Conservation and Innovation of Buckwheat Germplasm in Guizhou(QianJiaoHe KY Zi[2017]002).
文摘Common buckwheat(Fagopyrum esculentum),a specialty crop in southwest China,is not only used as a supplement to primary grain crops but also to produce beverages,such as tea and wine.To fully exploit the products made from common buckwheat flower,ultra-performance liquid chromatography–electrospray ionization–tandem mass spectrometry(UPLC–ESI–MS/MS)was conducted to analyze the metabolites in red-(‘Guihong 2’)and white-flowered(‘Fengtian 1’)buckwheat cultivars.A total of 784 metabolites were identified of which flavonoids were the largest group with 191 components,followed by organic acids and derivatives(126),and amino acids and derivatives(95).Besides,dozens of phenylpropanoids,nucleotides and derivates,lipids,alkaloids as well as several kinds of indole derivatives and sterides were detected.Among these rich varieties of metabolites,24 metabolites were only detected in the red flower that mainly included 8 anthocyanins and 6 flavones,while 22 metabolites were only detected in the white flower,which mainly contained 5 lipids,5 flavonoids,and 5 organic acids and derivatives.Our results enrich the metabolites’information of buckwheat and may be helpful for the exploitation of products from common buckwheat flowers.
基金Supported by the National Key Research and Development Program of China,No.2018YFC1313902。
文摘BACKGROUND Prediabetes risk assessment models derived from large sample sizes are scarce.AIM To establish a robust assessment model for prediabetes and to validate the model in different populations.METHODS The China National Diabetes and Metabolic Disorders Study(CNDMDS)collected information from 47325 participants aged at least 20 years across China from 2007 to 2008.The Thyroid Disorders,Iodine Status and Diabetes Epidemiological Survey(TIDE)study collected data from 66108 participants aged at least 18 years across China from 2015 to 2017.A logistic model with stepwise selection was performed to identify significant risk factors for prediabetes and was internally validated by bootstrapping in the CNDMDS.External validations were performed in diverse populations,including populations of Hispanic(Mexican American,other Hispanic)and non-Hispanic(White,Black and Asian)participants in the National Health and Nutrition Examination Survey(NHANES)in the United States and 66108 participants in the TIDE study in China.C statistics and calibration plots were adopted to evaluate the model’s discrimination and calibration performance.RESULTS A set of easily measured indicators(age,education,family history of diabetes,waist circumference,body mass index,and systolic blood pressure)were selected as significant risk factors.A risk assessment model was established for prediabetes with a C statistic of 0.6998(95%CI:0.6933 to 0.7063)and a calibration slope of 1.0002.When externally validated in the NHANES and TIDE studies,the model showed increased C statistics in Mexican American,other Hispanic,Non-Hispanic Black,Asian and Chinese populations but a slightly decreased C statistic in non-Hispanic White individuals.Applying the risk assessment model to the TIDE population,we obtained a C statistic of 0.7308(95%CI:0.7260 to 0.7357)and a calibration slope of 1.1137.A risk score was derived to assess prediabetes.Individuals with scores≥7 points were at high risk of prediabetes,with a sensitivity of 60.19%and specificity of 67.59%.CONCLUSION An easy-to-use assessment model for prediabetes was established and was internally and externally validated in different populations.The model had a satisfactory performance and could screen individuals with a high risk of prediabetes.
基金National Key R&D Program of China(No.2020YFC0861000)the CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2020-I2M-CoV19-001)+2 种基金the China International Medical Exchange Foundation Special Fund for Young and Middle-Aged Medical Research(No.Z-2018-35-1902)the 2020 CMB Open Competition Program(No.20-381)the Chinese Medical Information and Big Data Association(CHMIA)Special Fund for Emergency Project and Beijing Municipal Natural Science Foundation(M21019)。
文摘Background:It is crucial to improve the quality of care provided to ICU patient,therefore a national survey of the medical quality of intensive care units(ICUs)was conducted to analyze adherence to quality metrics and outcomes among critically ill patients in China from 2015 to 2019.Methods:This was an ICU-level study based on a 15-indicator online survey conducted in China.Considering that ICU care quality may vary between secondary and tertiary hospitals,direct standardization was adopted to compare the rates of ICU quality indicators among provinces/regions.Multivariate analysis was performed to identify potential factors for in-hospital mortality and factors related to ventilator-associated pneumonia(VAP),catheter-related bloodstream infections(CRBSIs),and catheter-associated urinary tract infections(CAUTIs).Results:From the survey,the proportions of structural indicators were 1.83%for the number of ICU inpatients relative to the total number of inpatients,1.44%for ICU bed occupancy relative to the total inpatient bed occupancy,and 51.08%for inpatients with Acute Physiology and Chronic Health Evaluation II scores≥15.The proportions of procedural indicators were 74.37%and 76.60%for 3-hour and 6-hour surviving sepsis campaign bundle compliance,respectively,62.93%for microbiology detection,58.24%for deep vein thrombosis prophylaxis,1.49%for unplanned endotracheal extubations,1.99%for extubated inpatients reintubated within 48 hours,6.38%for unplanned transfer to the ICU,and 1.20%for 48-hour ICU readmission.The proportions of outcome indicators were 1.28‰for VAP,3.06‰for CRBSI,3.65‰for CAUTI,and 10.19%for in-hospital mortality.Although the indicators varied greatly across provinces and regions,the treatment level of ICUs in China has been stable and improved based on various quality control indicators in the past 5 years.The overall mortality rate has dropped from 10.19%to approximately 8%.Conclusions:The quality indicators of medical care in China’s ICUs are heterogeneous,which is reflected in geographic disparities and grades of hospitals.This study is of great significance for improving the homogeneity of ICUs in China.
基金supported by the National Key Research&Development Program of China(Nos.2016YFC1303904 and 2016YFC0900500)National Natural Science Foundation of China(Nos.81941018,91846303,and 91843302)
文摘Background:At present,a large number of chronic obstructive pulmonary disease(COPD)patients are undiagnosed in China.Thus,this study aimed to develop a simple prediction model as a screening tool to identify patients at risk for COPD.Methods:The study was based on the data of 22,943 subjects aged 30 to 79 years and enrolled in the second resurvey of China Kadoorie Biobank during 2012 and 2013 in China.We stepwisely selected the predictors using logistic regression model.Then we tested the model validity through P-P graph,area under the receiver operating characteristic curve(AUROC),ten-fold cross validation and an external validation in a sample of 3492 individuals from the Enjoying Breathing Program in China.Results:The final prediction model involved 14 independent variables,including age,sex,location(urban/rural),region,educational background,smoking status,smoking amount(pack-years),years of exposure to air pollution by cooking fuel,family history of COPD,history of tuberculosis,body mass index,shortness of breath,sputum and wheeze.The model showed an area under curve(AUC)of 0.72(95%confidence interval[CI]:0.72-0.73)for detecting undiagnosed COPD patients,with the cutoff of predicted probability of COPD=0.22,presenting a sensitivity of 70.13%and a specificity of 62.25%.The AUROC value for screening undiagnosed patients with clinically significant COPD was 0.68(95%CI:0.66-0.69).Moreover,the ten-fold cross validation reported an AUC of 0.72(95%CI:0.71-0.73),and the external validation presented an AUC of 0.69(95%CI:0.68-0.71).Conclusion:This prediction model can serve as a first-stage screening tool for undiagnosed COPD patients in primary care settings.
基金CAMS Innovation Fund for Medical Sciences(No.2021-I2M-1-049)
文摘Background:Influenza and pneumococcal vaccination are a priority in patients with chronic obstructive pulmonary disease(COPD).However,limited information is available on vaccination coverage among patients with acute exacerbations of COPD(AECOPD)in China.This study aimed to determine the rates and associated factors of influenza and pneumococcal vaccination in patients hospitalized with AECOPD.Methods:Baseline data from a national,multicenter,hospital-based study that included adult inpatients with AECOPD between 2017 and 2021 were analyzed.The outcomes of interest were the influenza vaccination in the past year and the pneumococcal vaccination in the past 5 years.To ensure national representativeness,rates were weighted according to the distribution of hospital levels and types enrolled in this study.Multivariable Poisson regression based on mixed-effects models were used to determine the associated factors.The independent variables included the region and hospital features where the participants were located,sociodemographic characteristics(age,sex,rural/urban residence,education,etc.),and clinical indicators(COPD disease history,lung function parameters,comorbidities,etc.).The treatment profiles of the vaccinated and unvaccinated participants were compared.Results:Of 6949 eligible participants,the weighted rates of influenza/pneumococcal,influenza,and pneumococcal vaccination were 2.72%(95%confidence interval[CI]:2.34%-3.10%),2.09%(95%CI:1.76%-2.43%),and 1.25%(95%CI:0.99%-1.51%),respectively.In multivariable models,age≥60 years(60-69 years,odds ratio[OR]:1.90,95%CI:1.11-3.25;≥80 years,OR:2.00,95%CI:1.06-3.78),geographical regions(Northern China relative to Eastern China,OR:5.09,95%CI:1.96-13.21),urban residence(OR:1.69,95%CI:1.07-2.66),a higher education level(junior high school,OR:1.77,95%CI:1.21-2.58;senior high school or above,OR:2.61,95%CI:1.69-4.03),former smoking(OR:1.79,95%CI:1.15-2.79),and regular inhaled medication treatment(OR:3.28,95%CI:2.29-4.70)were positively associated with vaccination.Patients who had experienced severe exacerbations in the past year were less likely to be vaccinated(OR:0.65,95%CI:0.45-0.96).Compared with unvaccinated participants,vaccinated participants adhered better to pharmacological and non-pharmacological treatment.Conclusions:Influenza and pneumococcal vaccination coverage are extremely low.Urgent measures are necessary to increase vaccination coverage among inpatients with AECOPD in China.
