Objective For prevention of obesity in Chinese population, it is necessary to definethe optimal range of healthy weight and the appropriate cut-off points of BMI and waistcircumference for Chinese adults. The Worki...Objective For prevention of obesity in Chinese population, it is necessary to definethe optimal range of healthy weight and the appropriate cut-off points of BMI and waistcircumference for Chinese adults. The Working Group on Obesity in China under the supportof International Life Sciences Institute Focal Point in China organized a meta-analysis on therelation between BMI, waist circumference and risk factors of related chronic diseases (e. g.,high diabetes, diabetes mellitus, and lipoprotein disorders). Methods 13 population studiesin all met the criteria for enrollment, with data of 239 972 adults (20-70 year) surveyed inthe 1990s. Data on waist circumference was available for 111411 persons and data on serumlipids and glucose were available for more than 80 000. The study populations located in21provinces, municipalities and autonomous regions in China's Mainland as well as inTaiwan. Each enrolled study provided data according to a common protocol and uniformformat. The Center for data management in Department of Epidemiology, Fu Wai Hospitalwas responsible for statistical analysis. Results and conclusion The prevalence ofhypertension, diabetes, dyslipidemia and clustering of risk factors all increased withincreasing levels of BMI or waist circumference. BMI at 24 with best sensitivity andspecificity for identification of the risk factors, was recommended as the cut-off point foroverweight, BMI at 28 which may identify the risk factors with specificity around 90 % wasrecommended as the cut-off point for obesity. Waist circumference beyond 85 cm for menand beyond 80 cm for women were recommended as the cut-off points for central obesity.Analysis of population attributable risk percent illustrated that reducing BMI to normalrange (<24) could prevent 45%-50% clustering of risk factors. Treatment of obese persons(BMI≥28)with drugs could prevent 15%-17% clustering of risk factors. The waistcircumference controlled under 85 cm for men and under 80 cm for women, could prevent47%-58% clustering of risk fact展开更多
Background： Atopic dermatitis （AD） is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several ...Background： Atopic dermatitis （AD） is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczemaJAD and to propose Chinese diagnostic criteria for adult/adolescent AD. Methods： A hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients （12 years and over） with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and-investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software. Results： A total of 2662 valid questionnaires were collected （1369 male and 1293 female）. Of all 2662 patients, 2062 （77.5%） patients had the disease after 12 years old, while only 600 （22.5%） patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine （80.4%） patients had the disease for more than 6 months. One thousand one hundred and forty-four （43.0%） patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight （58.2%） patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients. Conclusion： Late-onset of eczema or AD is common. Th展开更多
Objective To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015.Methods Data were collected from three nationally representative cross-sectional surveys.Fasting venous blo...Objective To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015.Methods Data were collected from three nationally representative cross-sectional surveys.Fasting venous blood samples were collected and serum lipids were tested by biochemical analysis and enzymatic determination.Lipid levels and the prevalence of dyslipidemia among adults were analyzed with complex sampling weighting adjustment for age and gender.Results The weighted means of TC, TG, and LDL-c significantly increased linearly from 3.93, 1.12, and 2.12 mmol/L in 2002 to 4.59, 1.41, and 2.78 mmol/L in 2010 and then to 4.63, 1.47, and 2.87 mmol/L in 2015, respectively;by contrast, HDL-c levels decreased significantly from 1.30 mmol/L to 1.26 mmol/L over the same period.Similar trends in mean non-HDL-c and lipid-related ratios were observed.The weighted dyslipidemia prevalence linearly increased;in particular, hypercholesterolemia increased from 1.6% to 5.6% and then to 5.8%, hypertriglyceridemia increased from 5.7% to 13.6% and then to 15.0%, low HDL-c increased from 18.8% to 35.5% and then to 24.9%, and high LDL-c increased from 1.3% to 5.6% and then to 7.2%(P for trend <0.001).Conclusion Dyslipidemia increased among Chinese adults from 2002 to 2015.Development of a comprehensive strategy to decrease lipid levels in this population is urgently required.展开更多
AIM:To systematically evaluate and update evidence on the efficacy and safety of probiotic supplementation for the treatment of constipation. METHODS:The MEDLINE,EMBASE,CINAHL,and Cochrane Library databases were searc...AIM:To systematically evaluate and update evidence on the efficacy and safety of probiotic supplementation for the treatment of constipation. METHODS:The MEDLINE,EMBASE,CINAHL,and Cochrane Library databases were searched in May 2009 for randomised controlled trials(RCTs)performed in paediatric or adult populations related to the study aim. RESULTS:We included five RCTs with a total of 377 subjects(194 in the experimental group and 183 in the control group).The participants were adults (three RCTs,n=266)and children(two RCTs,n= 111)with constipation.In adults,data suggests a favourable effect of treatment with Bifidobacterium lactis DN-173 010,Lactobacillus casei Shirota,and Escherichia coli Nissle 1917 on defecation frequency and stool consistency.In children,L.casei rhamnosusLcr35,but not L.rhamnosus GG,showed a beneficial effect. CONCLUSION:Until more data are available,we believe the use of probiotics for the treatment of constipation condition should be considered investigational.展开更多
目的系统评价中国大陆成人(≥14岁)哮喘的患病率。方法计算机检索PubMed、Web of Science、CENTRAL、CINAHL、WanFang Data、CBM、CNKI和VIP数据库,搜集有关中国成人哮喘患病率的横断面研究,检索时限均为2000年1月至2019年12月。由2名...目的系统评价中国大陆成人(≥14岁)哮喘的患病率。方法计算机检索PubMed、Web of Science、CENTRAL、CINAHL、WanFang Data、CBM、CNKI和VIP数据库,搜集有关中国成人哮喘患病率的横断面研究,检索时限均为2000年1月至2019年12月。由2名研究者独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Stata 15.0软件进行Meta分析。结果共纳入67个横断面研究,包括1381673例研究对象,19871例成年哮喘患者。Meta分析结果显示,中国成人哮喘患病率为1.81%[95%CI(1.59%,2.01%)]。亚组分析结果显示,中国男、女性哮喘患病率分别为1.87%和1.76%;东北、中部、东部、西部地区哮喘患病率分别为2.16%、1.34%、1.63%、2.23%;15~40岁、41~60岁、>60岁的哮喘患病率分别为0.73%、1.53%、2.81%;文盲、小学、初中、高中、大专及以上哮喘患病率分别为3.07%、1.69%、1.46%、1.01%、0.98%;农林牧业人员、工人、公职人员、商业与服务业人员、军人和其他职业哮喘患病率分别为2.23%、2.10%、1.17%、1.45%、1.09%、1.41%;汉族和其他民族哮喘患病率分别为1.41%、1.59%;城市、农村哮喘患病率分别为2.03%、1.99%;2000~2005年、2006~2010年、2011~2015年、2016~2019年哮喘患病率分别为1.22%、2.07%、2.25%、2.62%。结论中国大陆成人哮喘患病率较高,且研究报道的哮喘患病率有逐年升高的趋势。受年龄、性别、地区、学历和职业的影响,哮喘患病率存在差异。展开更多
Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired...Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired linear growth.Nutrition has an important role in the management of IBD.In adults with CD,enteral nutrition(EN) is effective in inducing clinical remission of IBD,although it is less efficient than corticosteroids.Exclusive EN is an established primary therapy for pediatric CD.Limited data suggests that EN is as efficient as corticosteroids for induction of remission.Additional advantages of nutritional therapy are control of inflammation,mucosal healing,positive benefits to growth and overall nutritional status with minimal adverse effects.The available evidence suggests that supplementary EN may be effective also for maintenance of remission in CD.More studies are needed to confirm these findings.However,EN supplementation could be considered as an alternative or as an adjunct to maintenance drug therapy in CD.EN does not have a primary therapeutic role in ulcerative colitis.Specific compositions of enteral dietselemental diets or diets containing specific components-were not shown to have any advantage over standard polymeric diets and their place in the treatment of CD or UC need further evaluation.Recent theories suggest that diet may be implicated in the etiology of IBD,however there are no proven dietary approaches to reduce the risk of developing IBD.展开更多
Antibiotic-associated diarrhea(AAD) and Clostridum difficile infections(CDI) have been well studied for adult cases, but not as well in the pediatric population. Whether the disease process or response to treatments d...Antibiotic-associated diarrhea(AAD) and Clostridum difficile infections(CDI) have been well studied for adult cases, but not as well in the pediatric population. Whether the disease process or response to treatments differs between pediatric and adult patients is an important clinical concern when following global guidelines based largely on adult patients. A systematic review of the literature using databases Pub Med(June 3, 1978-2015) was conducted to compare AAD and CDI in pediatric and adult populations and determine significant differences and similarities that might impact clinical decisions. In general, pediatric AAD and CDI have a more rapid onset of symptoms, a shorter duration of disease and fewer CDI complications(required surgeries and extended hospitalizations) than in adults. Children experience more community-associated CDI and are associated with smaller outbreaks than adult cases of CDI. The ribotype NAP1/027/BI is more common in adults than children. Children and adults share some similar risk factors, but adults have more complex risk factor profiles associated with more co-morbidities, types of disruptive factors and a wider range of exposures to C. difficile in the healthcare environment. The treatment of pediatric and adult AAD is similar(discontinuing or switching the inciting antibiotic), but other treatment strategies for AAD have not been established. Pediatric CDI responds better to metronidazole, while adult CDI responds better to vancomycin. Recurrent CDI is not commonly reported for children. Prevention for both pediatric and adult AAD and CDI relies upon integrated infection control programs, antibiotic stewardship and may include the use of adjunctive probiotics. Clinical presentation of pediatric AAD and CDI are different than adult AAD and CDI symptoms. These differences should be taken into account when rating severity of disease and prescribing antibiotics.展开更多
文摘Objective For prevention of obesity in Chinese population, it is necessary to definethe optimal range of healthy weight and the appropriate cut-off points of BMI and waistcircumference for Chinese adults. The Working Group on Obesity in China under the supportof International Life Sciences Institute Focal Point in China organized a meta-analysis on therelation between BMI, waist circumference and risk factors of related chronic diseases (e. g.,high diabetes, diabetes mellitus, and lipoprotein disorders). Methods 13 population studiesin all met the criteria for enrollment, with data of 239 972 adults (20-70 year) surveyed inthe 1990s. Data on waist circumference was available for 111411 persons and data on serumlipids and glucose were available for more than 80 000. The study populations located in21provinces, municipalities and autonomous regions in China's Mainland as well as inTaiwan. Each enrolled study provided data according to a common protocol and uniformformat. The Center for data management in Department of Epidemiology, Fu Wai Hospitalwas responsible for statistical analysis. Results and conclusion The prevalence ofhypertension, diabetes, dyslipidemia and clustering of risk factors all increased withincreasing levels of BMI or waist circumference. BMI at 24 with best sensitivity andspecificity for identification of the risk factors, was recommended as the cut-off point foroverweight, BMI at 28 which may identify the risk factors with specificity around 90 % wasrecommended as the cut-off point for obesity. Waist circumference beyond 85 cm for menand beyond 80 cm for women were recommended as the cut-off points for central obesity.Analysis of population attributable risk percent illustrated that reducing BMI to normalrange (<24) could prevent 45%-50% clustering of risk factors. Treatment of obese persons(BMI≥28)with drugs could prevent 15%-17% clustering of risk factors. The waistcircumference controlled under 85 cm for men and under 80 cm for women, could prevent47%-58% clustering of risk fact
文摘Background： Atopic dermatitis （AD） is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczemaJAD and to propose Chinese diagnostic criteria for adult/adolescent AD. Methods： A hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients （12 years and over） with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and-investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software. Results： A total of 2662 valid questionnaires were collected （1369 male and 1293 female）. Of all 2662 patients, 2062 （77.5%） patients had the disease after 12 years old, while only 600 （22.5%） patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine （80.4%） patients had the disease for more than 6 months. One thousand one hundred and forty-four （43.0%） patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight （58.2%） patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients. Conclusion： Late-onset of eczema or AD is common. Th
基金supported by the National Health and Family Planning Commission(formerly the Ministry of Health of the People’s Republic of China)Medical Reform Major Program:China Nutrition and Health Surveillance(2010-2012)and Chinese Adults Chronic Diseases and Nutrition Surveillance(2015)
文摘Objective To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015.Methods Data were collected from three nationally representative cross-sectional surveys.Fasting venous blood samples were collected and serum lipids were tested by biochemical analysis and enzymatic determination.Lipid levels and the prevalence of dyslipidemia among adults were analyzed with complex sampling weighting adjustment for age and gender.Results The weighted means of TC, TG, and LDL-c significantly increased linearly from 3.93, 1.12, and 2.12 mmol/L in 2002 to 4.59, 1.41, and 2.78 mmol/L in 2010 and then to 4.63, 1.47, and 2.87 mmol/L in 2015, respectively;by contrast, HDL-c levels decreased significantly from 1.30 mmol/L to 1.26 mmol/L over the same period.Similar trends in mean non-HDL-c and lipid-related ratios were observed.The weighted dyslipidemia prevalence linearly increased;in particular, hypercholesterolemia increased from 1.6% to 5.6% and then to 5.8%, hypertriglyceridemia increased from 5.7% to 13.6% and then to 15.0%, low HDL-c increased from 18.8% to 35.5% and then to 24.9%, and high LDL-c increased from 1.3% to 5.6% and then to 7.2%(P for trend <0.001).Conclusion Dyslipidemia increased among Chinese adults from 2002 to 2015.Development of a comprehensive strategy to decrease lipid levels in this population is urgently required.
基金Supported by The Medical University of Warsaw,Poland
文摘AIM:To systematically evaluate and update evidence on the efficacy and safety of probiotic supplementation for the treatment of constipation. METHODS:The MEDLINE,EMBASE,CINAHL,and Cochrane Library databases were searched in May 2009 for randomised controlled trials(RCTs)performed in paediatric or adult populations related to the study aim. RESULTS:We included five RCTs with a total of 377 subjects(194 in the experimental group and 183 in the control group).The participants were adults (three RCTs,n=266)and children(two RCTs,n= 111)with constipation.In adults,data suggests a favourable effect of treatment with Bifidobacterium lactis DN-173 010,Lactobacillus casei Shirota,and Escherichia coli Nissle 1917 on defecation frequency and stool consistency.In children,L.casei rhamnosusLcr35,but not L.rhamnosus GG,showed a beneficial effect. CONCLUSION:Until more data are available,we believe the use of probiotics for the treatment of constipation condition should be considered investigational.
文摘目的系统评价中国大陆成人(≥14岁)哮喘的患病率。方法计算机检索PubMed、Web of Science、CENTRAL、CINAHL、WanFang Data、CBM、CNKI和VIP数据库,搜集有关中国成人哮喘患病率的横断面研究,检索时限均为2000年1月至2019年12月。由2名研究者独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Stata 15.0软件进行Meta分析。结果共纳入67个横断面研究,包括1381673例研究对象,19871例成年哮喘患者。Meta分析结果显示,中国成人哮喘患病率为1.81%[95%CI(1.59%,2.01%)]。亚组分析结果显示,中国男、女性哮喘患病率分别为1.87%和1.76%;东北、中部、东部、西部地区哮喘患病率分别为2.16%、1.34%、1.63%、2.23%;15~40岁、41~60岁、>60岁的哮喘患病率分别为0.73%、1.53%、2.81%;文盲、小学、初中、高中、大专及以上哮喘患病率分别为3.07%、1.69%、1.46%、1.01%、0.98%;农林牧业人员、工人、公职人员、商业与服务业人员、军人和其他职业哮喘患病率分别为2.23%、2.10%、1.17%、1.45%、1.09%、1.41%;汉族和其他民族哮喘患病率分别为1.41%、1.59%;城市、农村哮喘患病率分别为2.03%、1.99%;2000~2005年、2006~2010年、2011~2015年、2016~2019年哮喘患病率分别为1.22%、2.07%、2.25%、2.62%。结论中国大陆成人哮喘患病率较高,且研究报道的哮喘患病率有逐年升高的趋势。受年龄、性别、地区、学历和职业的影响,哮喘患病率存在差异。
文摘Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired linear growth.Nutrition has an important role in the management of IBD.In adults with CD,enteral nutrition(EN) is effective in inducing clinical remission of IBD,although it is less efficient than corticosteroids.Exclusive EN is an established primary therapy for pediatric CD.Limited data suggests that EN is as efficient as corticosteroids for induction of remission.Additional advantages of nutritional therapy are control of inflammation,mucosal healing,positive benefits to growth and overall nutritional status with minimal adverse effects.The available evidence suggests that supplementary EN may be effective also for maintenance of remission in CD.More studies are needed to confirm these findings.However,EN supplementation could be considered as an alternative or as an adjunct to maintenance drug therapy in CD.EN does not have a primary therapeutic role in ulcerative colitis.Specific compositions of enteral dietselemental diets or diets containing specific components-were not shown to have any advantage over standard polymeric diets and their place in the treatment of CD or UC need further evaluation.Recent theories suggest that diet may be implicated in the etiology of IBD,however there are no proven dietary approaches to reduce the risk of developing IBD.
文摘Antibiotic-associated diarrhea(AAD) and Clostridum difficile infections(CDI) have been well studied for adult cases, but not as well in the pediatric population. Whether the disease process or response to treatments differs between pediatric and adult patients is an important clinical concern when following global guidelines based largely on adult patients. A systematic review of the literature using databases Pub Med(June 3, 1978-2015) was conducted to compare AAD and CDI in pediatric and adult populations and determine significant differences and similarities that might impact clinical decisions. In general, pediatric AAD and CDI have a more rapid onset of symptoms, a shorter duration of disease and fewer CDI complications(required surgeries and extended hospitalizations) than in adults. Children experience more community-associated CDI and are associated with smaller outbreaks than adult cases of CDI. The ribotype NAP1/027/BI is more common in adults than children. Children and adults share some similar risk factors, but adults have more complex risk factor profiles associated with more co-morbidities, types of disruptive factors and a wider range of exposures to C. difficile in the healthcare environment. The treatment of pediatric and adult AAD is similar(discontinuing or switching the inciting antibiotic), but other treatment strategies for AAD have not been established. Pediatric CDI responds better to metronidazole, while adult CDI responds better to vancomycin. Recurrent CDI is not commonly reported for children. Prevention for both pediatric and adult AAD and CDI relies upon integrated infection control programs, antibiotic stewardship and may include the use of adjunctive probiotics. Clinical presentation of pediatric AAD and CDI are different than adult AAD and CDI symptoms. These differences should be taken into account when rating severity of disease and prescribing antibiotics.
